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 DESCRIPTION
The cancer cervicouterino is a frequent type of cancer in women, and it consists of an illness in which (malignant) cancerous cells are in the textiles of the neck of the womb.
The womb is the hollow organ, an inverted pear, where the fetus develops. The neck or cérvix uterine is a gap that connects the womb with the vagina (channel of birth).
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The cancer cervicouterino starts by growing slowly. Before cancerous cells appear in the neck of the womb, the normal textiles of the neck of the womb happen for a well-known process as displasia, during which abnormal cells begin appearing. A cytology with Papanicolaou coloring generally will find these pre-malignant cells. Later, the cells cáncerosas begin to grow and are spread by major depth in the neck of the womb and in the surrounding areas.
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Since in general there are no symptoms associated with cancer cervicouterino, a series of tests is usually necessary to diagnose it:
Cytology with Papanicolaou coloring: It is carried out using a cotton piece, a brush or a spatula of small wood to scrape gently the exterior of the neck of the womb in order to gather cells. The patient can feel something of pressure, which will be accompanied in some cases of pain. Biopsy. If abnormal cells are, the doctor will have to extract a sample of textile of the neck of the womb and will observe it across the microscope to determine the presence of cancerous cells. To carry a biopsy out only a small textile quantity is needed and it can be done in the consultation of the doctor. Sometimes it is necessary to extract a biopsy sample in the shape of cone, more big (conización), for which perhaps it is necessary to go to the hospital.
The prognosis (possibilities of recovery) and selection of treatment depend on the stage in which the cancer is (if it is only in the neck of the womb or if it has been spread to other places) and the state of health in general.
STADIUMS OR ETÁPAS OF THE CANCER CERVICOUTERINO
The following stages are used in the classification of the cancer cervicouterino:
Stadium 0 or carcinoma in situ. The carcinoma in situ is a very early cancer. The abnormal cells are only in the first layer of cells that cover the neck of the womb, and do not invade the deepest textiles of the neck of the womb.
Stadium I. The cancer affects the neck of the womb, but it has not been spread to the surroundings.
The Ith - to: a very small cancer quantity, only visible for microscope, is already in the deepest textile of the neck of the womb.
I-b: a major cancer quantity is in the above mentioned textile.
Stadium II. The cancer has been spread to nearby areas, but it is still in the pelvic area.
The IIth - to: the cancer has been spread out of the neck of the womb to two top thirds of the vagina.
II-b: the cancer has been spread to the textile about the neck of the womb.
Stadium III. The cancer has been spread to the whole pelvic area. It can have been spread to the low part of the vagina, or infiltrate the uréteres (the pipes that connect the kidneys to the bladder).
Stadium IV. The cancer has been spread to other parts of the body.
The IVth - to: Dissemination to the bladder or to the rectum (organs close to the neck of the womb)
IV-b: Dissemination to organs they be distant like the lungs.
Appellant. Illness appellant (relapse) means that the cancer has returned after having being treated. It can happen in the proper cérvix or appear in another location.
TREATMENT OF THE CANCER CERVICOUTERINO
Treatments exist for all the patients with cancer cervicouterino. Three classes of treatment are used:
- Surgery (extraction of the cancer in an operation)
- Radiotherapy (radiations of high energy to eliminate the cancerous cells).
- Chemotherapy (medicines or "poisons" to eliminate the cells cáncerosas).
It is possible to extract the cancer using some of the following operations:
The criocirugía consists of the elimination of the cancer for freezing. The surgery with laser consists of the use of a bundle of intense light to eliminate cells cáncerosas. The conización consists of the extraction of a piece of textile in the shape of cone in the place where the abnormality is. It is used for biopsies, but also for the treatment of early cancers of the neck of the womb. The split electroquirúrgica (LEEP, initials in English) uses an electric current that happens for a hoop of thin wire, which serves like chopper. A hysterectomy is an operation in which the whole womb is extracted, including the whole neck of the womb, in addition to the cancer.
1. Vaginal hysterectomy. The womb is extracted across the vagina.
2. Abdominal hysterectomy. The womb is extracted by means of an incision in the abdomen. It can be necessary to extract also the ovaries and the horns of Falopio (bilateral Salpingooforectomia).
3. Radical hysterectomy is an operation in which there are extracted the neck of the womb, the womb and part of the vagina. Also the lymphatic ganglions of the area are extracted. (The lymphatic ganglions are small structures in the shape of string bean that are for the whole body and whose function is to produce and to store cells that fight the infections).
- Exenteración Si the cancer has been spread out of the neck of the womb or the feminine organs, it can be necessary to extract the low, straight colon or bladder (depending on the place to which the cancer has been spread) together with the neck of the womb, womb and vagina. The patient can need plastic surgery to form an artificial vagina (vaginoplastia) after this operation.
TREATMENT FOR STADIUMS
The treatments for cancer cervicouterino will depend on the stage in which there is the illness, the size of the tumor, the age and general state of health, and the desire to have children.
Stadium 0 (carcinoma in situ). The treatment can consist of:
1. Conización.
2. Surgery with laser.
3. Split procedure electroquirúrgica (LEEP).
4. Criocirugía.
5. Surgery to eliminate the cáncerosa area, neck of the womb and womb (abdominal whole or vaginal hysterectomy) for those women who cannot or want no to have children.
Stadium I. The treatment depends on the depth of invasion of the tumor:
The Ith - to: 1. Entire abdominal hysterectomy, with or without salpingooforectomia bilateral.
2. Conización.
3. Radical hysterectomy, with or without dissection of lymphatic ganglions).
4. Radiotherapy.
I-b: 1. Radiotherapy.
2. Radical hysterectomy extended with or without radiotherapy.
Stadium II. The treatment depends on the depth of invasion of the tumor:
The IIth - to: 1. Radiotherapy.
2. Entire abdominal hysterectomy, with or without salpingooforectomia bilateral.
II-b: 1. Radiotherapy.
2. Clinical essays of new forms of radiotherapy / chemotherapy.
Stadium III. The treatment might consist in:
The IIIth - to: Radiotherapy.
III-b: Clinical essays of new forms of radiotherapy / chemotherapy.
Stadium IV. The treatment might consist in:
The IVth - to: 1. Radiotherapy.
2. Clinical essays of new forms of radiotherapy / chemotherapy.
IV-b: 1. Radiotherapy to relieve the sintomás as the pain.
2. Chemotherapy.
RELAPSES. The treatment of the local relapse might consist in:
1. Surgery to extract the low colon, the rectum or bladder (depending on the place to which the cancer has been spread) together with the neck of the womb, womb and vagina (exenteración).
2. Radiotherapy and chemotherapy.
If the cancer has resorted out of the pelvis, it is possible to choose to a clinical test with systemic chemotherapy.
WHAT DOCTOR CAN TREAT ME?
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