Squamous cervical cancer prognosis and methods of treatment

Under such medical terms as cervical cancer means a malignant neoplasm that arises in the cervix.

According to the data of histology, to distinguish between two main types of malignant tumors:

• Adenocarcinoma;
• Squamous cell carcinoma.

Information about the etiology and pathogenesis

Today, there are a number of factors that can impact on improving the development of malignant process in the cervix, for example:

• HPV;
• Early initiation of sexual activity (under 16 years);
• Smoking;
• Frequent change of sexual partners (more than 2-3 per year).

In most cases, the main precipitating factor is HPV (16 and 18-th serotype). The viruses of these serotypes are the causes of malignant tumors in 65 — 75 % of cases.

Route of infection the virus predominantly sexual as a barrier contraceptive methods are not sufficiently effective against HPV infection.

Squamous cervical cancer is one of the most common malignant tumors formed from cells of the squamous epithelium, which have a different degree of atypia. The disease occurs in women, whose age is 17 to 90 years.

According to the data of microscopic investigations to distinguish between:

• Keratinizing;
• Neorogovevayuschy;
• Verrucous;
• Condylomatosis etc.

For highly differentiated squamous (keratinizing) of cancer characterized by the presence of a huge number of keratin and the formation of cancer pearls in the center of the tumor. The tumor cells have large hyperchromatic nuclei and eosinophilic cytoplasm. Stroma tissue of squamous cell carcinoma is characterized by a pronounced inflammatory infiltration with the presence of plasma cells and multinucleated cells.

Neorogovevayuschy cancer is the most frequent variant of squamous cell carcinoma. For neorogovevayuschy squamous cancer of the cervix (nizkotemperaturnogo) is characterized by:

• the presence of cells with oval nuclei;
• poorly visible cytoplasm;
• many mitoses;
• polymorphism and ill-defined boundaries;
• areas of necrosis of tumor tissue;
• different size of the nuclei;
• the absence of cancer pearls.

In some cases, there is verminophobia type of cell that is similar to sarcoma. To make a clear differentiation helps to conduct immunohistochemical studies.

Squamous cell carcinoma can spread to adjacent organs, characterized by metastases in the paracervical and hypogastruridae lymph nodes and nodes in the iliac region.

Clinical manifestations

In the early stages of clinical manifestations may be absent or occur under the guise of a hard-to-define discomfort. In the later stages of the cancer there are the following clinical manifestations:

• The presence of abnormal vaginal bleeding;
• Bleeding after douching, sexual intercourse, vaginal examination, specialist gynecologist;
• Change the duration and nature of menstruation;
• Bloody discharge from the vagina after menopause;
• Pain during sexual intercourse;
• The feeling of pain in the pelvic area.

All of the above symptoms are non-specific.

The occurrence of this condition is accompanied by a number of systemic manifestations:

• Anemia;
• Rapid weight loss;
• weakness;
• The presence of long-lasting subfebrile temperature of 37.5° C;
• The increase in the level of ESR.

The absence of clinical manifestations and the absence of complaints at the initial stages of the disease complicates early diagnosis.

Diagnosis

inspection">due To the fact that the complaints and clinical manifestations of this malignancy are absent, the most effective method of diagnosis is considered to be a gynecological examination, which should be held regularly (every 6 months).

In the early stages of the disease can be identified by the method of screening by Cytology.

The main method of diagnosis can be called colposcopy, which as necessary can be expanded with various additional manipulations. If there is suspicion for the presence of atypical cells is prescribed a colposcopy with biopsy.

It is important to know that a precancerous condition does not always entail the development of malignant pathologies, but their presence is a poor prognostic sign in relation to the increased risk of malignancy.

Methods of dealing with cancer

The treatment of patients with squamous cell carcinoma is complex, it often combines radiotherapy, chemotherapy and surgical treatment. Combination therapy treatment is indicated in all cases, the presence of regional metastasis.

Surgical treatment:

• In the presence of common invasive cancers shows an enhanced histerectomia method of Wertheim—Meigs (one-stage excision of the pelvic tissue with the lymph nodes, the removal of at least one-third of the vaginal tube of the uterus with appendages).

The purpose of radiation therapy:

• Radiation therapy is a leading method of treating cancer in combination with chemotherapy. Assign remote gamma-therapy. Single dose which is given on impact area - 2 gray.
• The effect is a combination of: radiation therapy + antineoplastics the drug GA-40(inducers of apoptosis - binding lectin Solomon's seal).

Chemotherapy:

• In combination with radiation therapy administered combination chemotherapy with several cytotoxic drugs.

On the one hand, this therapy has a positive effect:

• Reduced chances of education radioimmunoassay of the tumor.
• Increases the effectiveness of radiation therapy;
• Reduced radiation dose.

On the other hand, radiation and chemotherapy rather poorly tolerated by patients and leads to increased side effects.

Some experts are of the opinion that the appointment of a course of chemotherapy in combination with radiation therapy is ineffective and even dangerous.

However, a large number of experts came to the conclusion that the use of regional intra-arterial chemotherapy with cytotoxic agents during radiation therapy has a positive effect, for example: survival of patients in this case increases.

The effectiveness of the introduction of platinum agents (cisplatin) on the radiation therapy clinically proven.

The purpose of immunotherapy

Today the issue of preserving the immune system during radiation and chemotherapy is being studied intensively, it is necessary in order to enable the body to engage its antitumor mechanism.

Relatively effective is the introduction of interferons, questions dosage of these drugs in the scientific community are actively discussed, but to a common consensus to date has not come yet.

Preventive measures

A huge role regarding cancer prevention it is necessary to give timely irradical of the female body women HPV. For this purpose the vaccine Gardasil or Cervarix, her girls are vaccinated at age 13-15 years, in some cases, vaccinations are and boys are prepubertal, in order to reduce the circulation of HPV.

Forecast

Forecast therapy of squamous cell carcinoma of the cervix is considered a conditionally favorable and primarily depends on the stage wherewas diagnosed with cancer. In the Russian Federation in the early stages relative five-year survival rate is approximately 92 %. If we talk about overall survival, which includes the late stage of cancer is about 72 %. Information are provided purely for reference, for more accurate answers, we recommend to contact a qualified technician.