cervixIt is the small part of the uterus that extends into the vagina (vagina). Cancers originating from this section can show early symptoms and can be diagnosed early with annual gynecological check-ups.
cervical cancer It has been the most common female genital tract cancer in the world for many years. However, with the widespread use of screening methods such as smear in this disease, the incidence of the disease has decreased significantly. cervical cancer sexually transmitted It is thought to act like a disease. The reason for this is that a researcher observed in 1842 that this disease did not occur in nuns. A study conducted in 1953 found that the incidence was higher in prostitutes than in normal people, which strengthened this idea. It can be seen in all women between the ages of 20 and 80.
Risk Factors
However, the increase in the disease in those who migrate from these societies to developed countries brings the impact of environmental factors to the agenda. Risk factors include starting sexual life before the age of 20, having more than 2 partners, low socioeconomic level, having sexual contact with more than one partner, and HSV and HPV type viruses. Smoking also appears as an important risk factor. It is suggested that having multiple births and being uncircumcised also increases the risk. However, these ideas are losing popularity. Today, it is known that more than 90% of cervical cancer occurs due to HPV (Human Papilloma Virus).
Symptoms
Cervical cancer that is not detected in the early stages (at the CIN stage) begins to progress and presents with clinical findings. The most common complaint is abnormal vaginal bleeding. Since the vascularity in the cancerous tissue increases, bleeding begins in situations such as touching, sexual intercourse, or examination. A foul-smelling discharge may occur due to the tissue losing its vitality. In advanced cases, unstoppable bleeding occurs. As the disease spreads, kidney failure occurs and is the most common cause of death. Classically, painless bleeding and broth-like discharge should suggest cervical cancer.
staging
For an optimal treatment, the stage of the disease must be determined precisely and accurately. In the staging accepted today, 5 stages are used. The earliest stage is Stage 0 and the most advanced stage is Stage 4. Here metastasis (spread) to distant organs occurs. Each stage is divided into sub-stages (such as Stage 1a1, Stage 2a). Staging is done clinically, that is, by evaluating the results of examination, cystoscopy (observation of the bladder), rectoscopy, medicated renal film (IVP), radiography and computed tomography together. The role of ultrasonography in staging is limited. According to some authors, it is necessary to evaluate the patient surgically for appropriate staging. However, this idea has few supporters.
treatment
In principle, the prevailing idea in treatment is not to perform surgery on patients with Stage 2b and above. Recommended treatments according to stages are:
Stage 0: Conization or simple hysterectomy (uterus removal)
Stage 1a1: Conization or simple hysterectomy if there is no lymphatic or vascular spread
Stage 1a2- Stage 2a: Extensive and radical hysterectomy
Stage 2b and above: Radiotherapy
Applied today radical hysterectomy It is a pretty major surgery. The aim is to remove the cancer beyond its borders by passing through healthy tissues along with the vessels and lymphatic pathways. If this is not successful, radiotherapy Application gives better results than surgery. According to some authors, regardless of the stage of the disease, patients over 50 years of age should be treated with radiotherapy instead of surgery, but the advocates of this idea are gradually decreasing. The reason for this decrease is developments in the field of anesthesia. Another method commonly used in treatment is radiotherapy in addition to surgery. Radiotherapy can be used at all stages of cervical cancer. The aim here is to destroy cancerous cells that cannot be reached by surgery. In recent years, chemotherapy has also been tried in cervical cancer, but its benefits are still controversial.
Disease course and survival
The prognosis of cervical cancer, that is, the course of the disease, depends on many factors. These are factors such as the stage of the disease, lymph node involvement, tumor size, vascular involvement, cell type, and DNA content of the cell. The 5-year survival rates according to the stage of the disease are as follows.
Stage 1: 85%
Stage 2: 66%
Stage 3: 39%
Stage 4: 11%
If relapse occurs during follow-up of the disease, the prognosis is very poor and 80% of patients die. Relapses generally occur within the first 2-3 years. It is extremely rare after 5 years. Although cervical cancer is a fatal and difficult to treat disease, it is one of the rare cancers that can be detected very early thanks to regular check-ups and can be easily treated, often without even the need for surgery.
Even if you have no complaints, do not forget to visit your gynecologist regularly every year and have your smear test done!