Cancer of the labia. Malignant diseases of the female genital organs

Among diseases of the female genital organs, tumors occupy a significant place. Tumors develop in the body under certain conditions. At the heart of this disease is the property of the cells that make up the tissues, to acquire the ability to overgrow and spread.

Tumors are either benign or malignant. Benign tumors develop slowly, they are delimited from the surrounding tissues, do not grow into adjacent organs and blood vessels. Painful phenomena associated with the growth of a benign tumor arise due to the pressure of the tumor on the organs adjacent to it. Surgical removal of a benign tumor usually relieves the patient from the disease.

Malignant tumors that develop from the cells of the integumentary tissues (epithelium) are called cancer. Other malignant tumors - sarcomas develop from cells of the interstitial, connective tissue.

The causes of malignant tumors have not yet been clarified. It is only firmly established that the onset of cancer is often preceded by a number of changes in the body, in particular, chronic and long-term diseases. A malignant tumor almost always develops on a sick basis, on the basis of all kinds of painful changes. Cancer occurs most often in middle and old age (40-60 years). For example, cancer of the cervix and ovarian cancer occurs most often between the ages of 40 and 50, cancer of the body of the uterus - after 50 years, cancer of the external genital organs occurs mostly after 60 years. Sometimes a woman is affected by cancer even at a young age (25-35 years).

Inflammatory processes, which often precede cancer and create conditions for its occurrence and development, play an important role in the occurrence of cancer of the female genital area. Inflammatory diseases and ulcers of the cervix create fertile ground for the development of cancer. Erosion (ulcer) of the cervix is a defect in its mucous membrane. It is formed as a result of sloughing of the surface layers of the mucous membrane that covers the neck. Most often, erosion occurs in chronic inflammatory diseases accompanied by leucorrhoea.

Under the influence of the inflammatory process, the whiter surface layers of the integument of the cervix are exfoliated, the cervix is "exposed" and becomes loose. As a result, an ulcer is formed on the cervix. Thus, any disease of the genital organs, accompanied by leucorrhoea, can lead to the formation of cervical erosion. Erosion of the cervix is not an independent disease, but only a manifestation of one or another painful condition of the genital apparatus or the entire body of a woman.

A disease similar to erosion is the eversion of the mucous membrane of the cervix. Inversion of the mucous membrane (ectropion) occurs due to cervical tears occurring during childbirth. In this case, the mucous membrane of the cervical canal is exposed and it is easily exposed to adverse effects from the vagina and its secretions.

Cervical cancer can occur on the basis of the so-called "leukoplakia" (white plaque), which is the area of hardening of the lining of the cervix.

Sometimes the basis for the development of the cancerous process can be loose, lush growths of the mucous membrane of the cervical canal. These growths, called polyps, can be single or multiple, spreading beyond the cervix, into the depths of the uterine cavity. In these cases, we are no longer talking about polyps, but about noliposis. Excessive growth (hyperplasia) of the lining of the uterus, which sometimes occurs in old age, can also contribute to the development of cancer of the uterine body.

Malignant neoplasms of the ovaries also most often occur against the background of inflammatory and other female diseases.

Finally, it should be remembered that with a prolonged course, benign tumors can acquire the properties of malignant ones, and degenerate. Often there are cases of malignant degeneration of harmless ovarian cysts. About ten times more often than other women, cancer occurs in patients with uterine fibroids. The frequency of the coincidence of fibroids and cancer of the body of the uterus makes us take this disease very seriously.

Cancer arises on the basis of the above and other painful changes in a woman's reproductive apparatus, but by no means always, but only in the presence of certain, not yet completely clarified conditions. Therefore, these diseases, or, as they are called "precancer", do not necessarily and do not always lead to the development of cancer. However, the fact that cancer occurs more often with them than under other equal conditions should alert us and call for timely and radical treatment of these diseases.

What are the signs of developing genital cancer? At the onset of the disease, the signs of cancer are insignificant and do not bother the patient much. However, with a careful attitude to one's health, in most cases, disorders are detected that oblige the patient to consult a doctor. The most common initial symptom of the disease is leucorrhoea. Leucorrhoea in the early stages of the disease may be no different from leucorrhoea caused by other causes. It should only be emphasized once again that the appearance of brown leucorrhoea, whiter than the color of meat slops with an unpleasant putrefactive smell, most often indicates the development of a cancerous process, and sometimes already started. Leucorrhoea mixed with blood deserves special attention. Even small streaks of blood, observed outside of menstruation or at the age when menstruation has already stopped, should alert a woman and force her to immediately see a doctor. An important symptom of the disease is the appearance of bloody discharge from the vagina that is not associated with menstruation. The amount of blood secreted is insignificant.

Often, with uterine cancer, scanty spotting appears during sexual intercourse, after douching, after tiring and long walking, when lifting weights, straining, etc. All these types of spotting are observed in many female diseases and are especially characteristic of cervical erosion. At the same time, they often indicate a cancerous lesion of the female genital organs, primarily the uterus. In addition to leucorrhoea, spotting, or bleeding outside of menstruation, one of the signs is pain in the lower abdomen or lower back. However, pain appears much later than the other phenomena described above. It should be remembered that in case of pain in the lower abdomen and in the lower back, one should not, without a doctor's prescription, apply any treatment and resort to heat, heating pads, etc.

In some cases, a cancerous lesion of the genital area of a woman is initially manifested by a violation of urination or a disorder of the intestines. This should also be remembered.

Malignant tumors of the ovaries are less common than cancer of the uterus, but they are a relatively common disease of the female genital organs. It is believed that out of about 6-7 ovarian cysts, one is malignant. Ovarian cancer is often preceded by inflammatory diseases or benign cysts. Often this disease in the initial stages does not cause any painful sensations and is detected only during a medical examination. In some cases, the presence of an ovarian tumor is indicated by a feeling of pressure in the lower abdomen, pain, cessation of menstruation or bleeding, swelling of the skin on the pubis and lower abdomen, frequent or difficult urination, constipation or diarrhea.

In addition to the uterus and ovaries, cancer can also affect the external genitalia. True, this form of the disease is relatively rare. So, about 40 cancers of the uterus account for one cancer of the external genital organs, mainly in old age. Sometimes one of the early signs of genital cancer is some thickening in the skin. Cancer of the vulva is often preceded by a noncancerous disease called vulvar kraurosis. With this disease, whitish spots form on the external genital organs, the skin of the external genital organs wrinkles, and severe dryness appears. Subsequently, cracks appear, accompanied by unbearable itching. Fissured areas develop ulcers, which can be the basis for the development of cancer.

Treatment of malignant tumors of the female genital organs is performed by an operative (surgical) method, using X-rays or beams of radioactive substances that destroy cancer cells. Combined methods of treatment are also used: surgical removal of the tumor and tissue in its circumference, and then - treatment with rays. Currently, new methods of cancer treatment are being successfully developed, in particular, treatment with the help of special medicinal substances.

It is still widely believed among the population that cancer is incurable. However, this is not true: a large number of people who have been operated on for cancer live 10-15 years or more after the treatment. It is only necessary to remember that the earlier cancer treatment is started, the easier it is to cure it, the more often complete recovery occurs. It has been established that with an early visit to a doctor, a complete cure for cancer occurs in 75-80% of cases.

- a fairly common problem in gynecology. According to medical statistics, almost every fifth to eighth woman in the Russian Federation suffers from certain tumors of the vulva, vagina, cervix, uterus, ovaries.

For example, WHO data indicate that such a widespread benign tumor like uterine fibroids, every fifth woman in the world at the age of 30-35 years old, more than 25% of surgical interventions in gynecology are performed for ovarian cysts, etc. Due to the often asymptomatic course of tumor diseases, they are sometimes diagnosed accidentally during the next examination for some other problem.

Tumors of the female genital organs are pathological formations due to a violation of the mechanism of cell division. Experts distinguish between benign and malignant tumors of the genital organs.

Causes of tumors of the female genital organs

Nowadays the reasons emergence and development benign and malignant tumors are not fully understood. It is known that it is based on a defect in the genetic material of the cell (DNA), as a result of which the mechanism of growth and division of cells undergoes pathological changes, apoptosis develops (self-destruction of the cell as a result of programming for death). The factors predisposing to the onset of tumors are the following:

Genetic factors (hereditary predisposition is the leading factor)
Chemical factors (influence of aromatic substances on DNA)
Physical factors (ultraviolet radiation, other types of radiation)
Mechanical injury, overheating of the body
Biological factors (viruses and infections)
Decrease in the body's immune defenses, autoimmune processes
Endocrine system pathologies, hormonal imbalance

Some types of tumors may not give any symptoms at all, others - depending on the nature, size, location of the tumor - may show local or general symptoms. Local symptoms of tumors are enlarged regional lymph nodes, palpable swelling.

General symptoms of tumors of the female genital organs otherwise called "small signs" of tumors. Tumors of certain organs can have individual symptoms, for example, with uterine cancer, women may complain of uterine bleeding outside the cycle, ovarian dysfunction, etc. With a long-standing tumor of large sizes, pain in the lower abdomen with irradiation to the lower back, perineum, rectum and other organs may be noted.

Common symptoms of cancerous tumors are fast fatigue, rapid progressive weight loss, impaired appetite, decreased performance and mood, low-grade fever.

Types of benign and malignant neoplastic diseases of the female genital organs

Uterine fibroids, uterine fibroids- one of the most common tumors of the female genital organs in gynecological practice. In most cases, it may not have pronounced clinical symptoms and be determined by chance during a bimanual examination.

The diagnosis is established on the basis of transvaginal ultrasound, hysteroscopy, colposcopy, laparoscopy, biopsy, cytological or histological examination.

In GUTA-CLINIC, all types of effective surgical treatment of uterine fibroids are carried out using laparoscopic and hysteroscopic myomectomy - non-invasive surgical treatment of fibroids without incisions, as well as laparotomy with myomectomy, hysterectomy if indicated.

Conservative therapy can be used in young patients with small sizes of slowly growing fibroids and the absence of contraindications to the prescribed drugs. Fibroids require mandatory surgical treatment due to the possibility of transition to sarcoma - a malignant tumor.

Ovarian cyst is a cavity filled with liquid (the exact nature of the contents is established directly during a detailed examination). Most often, an ovarian cyst is found in young women of reproductive age, in the elderly it is extremely rare.

Distinguish between endometrioid, paraovarial, mucinous, serous, dermoid, follicular cysts, corpus luteum cysts, etc.

An ovarian cyst may not bother a woman and may be detected by chance when examined by a gynecologist. In some cases, an ovarian cyst may be accompanied by menstrual irregularities, profuse and prolonged menstruation, lower abdominal pain, anovulation, infertility, etc.

Currently, the "gold standard" treatment for ovarian cysts is laparoscopy, which allows the patient to recover faster and fully preserve her reproductive function. Ovarian cysts are subject to mandatory surgical treatment, because can become malignant, lead to the development of serious complications (the development of peritonitis, suppuration of the cyst, etc.)

Cervical cyst, mistakenly called by patients "cyst of the uterus" - a frequent complication of pseudo-erosion, which, in turn, is a frequent complication of true erosion. The dimensions of the cervical cyst are most often several millimeters, the cyst itself looks like a round formation of a yellowish-white color.

With regard to the cysts of the cervix, the tactics of observation are chosen: if the cysts are small and do not affect the health of the cervix, they are left untreated, if the cysts are multiple, deform the cervix, treatment with the radio wave method with the Surgitron apparatus is recommended - this method can be recommended even to nulliparous girls due to its atraumaticity.

Vulvar cancer- a malignant epithelial tumor, which is quite rare. It is characterized by the formation of nodules with further damage to the inguinal lymph nodes, metastasis. Vulvar cancer is more common in menopausal women. In the absence of treatment, death is inevitable due to cachexia, urosepsis, bleeding, pelvic vein thrombophlebitis and other complications.

Vaginal cancer- a malignant epithelial tumor, in appearance resembles papillomatous growths. It develops more often in women over 40 who have undergone many births. It is manifested by bloody discharge and leucorrhoea with an admixture of pus. Treatment is surgical with X-ray therapy and other methods.

Cervical cancer- the most common malignant tumor of the female genital organs. The reasons may be some types of HPV (human papillomavirus, untreated erosion, etc.). Previously, it was believed that cervical cancer affects mainly women who have given birth over 40 years of age, but recently the tendency for the spread of the disease among young, even nulliparous girls has increased significantly, which is explained by the widespread spread of human papillomavirus infection.

Cervical cancer may be asymptomatic, and early signs may be leucorrhoea and spotting, sometimes with an unpleasant odor. In the absence of treatment for cervical cancer, death occurs from peritonitis, sepsis, cachexia, bleeding, etc.

Cancer of the body of the uterus- less common than cervical cancer, the cause is hormonal disorders in the body, it can be combined with uterine myoma, ovarian tumors, endometrial hyperplasia, diabetes mellitus, obesity and other metabolic disorders. It mainly develops in women over 45-50 years old, often asymptomatic, women complain of weakness and rapid fatigue.

Diagnostics and treatment of tumors of the female genital organs

In most cases diagnosis of benign and malignant tumors female genital organs are carried out using the following methods:

Gynecological examination
Bimanual vaginal examination
Transvaginal ultrasound (ultrasound of the pelvic organs)
Computed tomography (CT) of the pelvic organs
Magnetic resonance imaging (MRI) of the pelvic organs
Endoscopic examination of the pelvic organs
Hysteroscopy, therapeutic and diagnostic laparoscopy
Colposcopy
Biopsy followed by histological or cytological examination

Depending on the identified disease, its form, stage, nature, characteristics of the course, individual indications of the patient, surgical or conservative treatment is prescribed. As a rule, prompt treatment of tumors of the female genital organs carried out with heavy bleeding, rapid tumor growth or large size of the detected tumor, etc.

The scope of surgical treatment is different - it can be organ-preserving laparoscopy (for cysts and ovarian cystomas) or radical amputation (extirpation) of the uterus - for large fibroids or uterine cancer without metastases. As a rule, preference is given to the first - minimally invasive - method of treating tumors of the female genital organs.

In parallel with surgical treatment, according to indications, antiviral or antibacterial therapy, immunomodulating and biostimulating drugs are prescribed.

GUTA-CLINIC specialists remind patients that in the absence of treatment, even some benign types of tumors are able to turn into cancer, leading in some cases to a fairly rapid death due to developing complications and the spread of metastases.

That is why they are subject to compulsory treatment, in some cases - observation (passive uterine myoma). Considering that the development of most types of tumors is characterized by unexpressed, erased clinical symptoms, gynecologists at GUTA-CLINIC recommend that you regularly undergo preventive examinations by specialists, even if the woman is not worried about anything.

Tumors of the female genital organs are benign and malignant.

Benign tumors of the female genital organs

Benign tumors develop slowly, they are delimited from the surrounding tissues, do not grow into adjacent organs and blood vessels. Painful phenomena associated with the growth of a benign tumor arise due to the pressure of the tumor on the organs adjacent to it. Surgical removal of a benign tumor usually relieves the patient from the disease.

Of the benign tumors of the genital organs, women are most often found ovarian cysts and fibroids (fibroids, fibroids) of the uterus.

Ovarian cysts are called formations, which are cavities of various shapes and sizes, formed in the ovary. Most often they have a rounded shape, and their wall (shell) is made up of stretched ovarian tissue. The content of ovarian cysts can be of various types: completely transparent liquid, jelly-like mass, fat and hair, chocolate-colored liquid, blood, etc.

The most common signs of a cyst are discomfort in the lower abdomen, a feeling of heaviness, fullness and pressure on the lower abdomen. Cysts can lead to menstrual irregularities, bleeding, and infertility. Often, the presence of a cyst pressing on the bladder and rectum leads to impaired urination (frequent urge) and disrupts bowel activity. If the cyst reaches a large size, the woman notes an increase in the abdomen. Sometimes patients themselves feel the edge of a spherical tumor or the entire tumor, if it is sufficiently mobile. Ovarian cysts are subject to surgical removal. Surgical removal of the cyst relieves the patient of the disease. Otherwise, the tumor leads to a breakdown in the activity of nearby organs, disrupts the normal conditions of blood circulation in the pelvis. With mobile cysts ("cysts on legs"), there is a real danger of twisting and necrosis. In these cases, there is a threat to the patient's life and only an urgent operation saves the patient. Sometimes the contents of the cyst become infected, pus forms in its cavity and the tumor turns into an abscess, limited by the capsule of the cyst. In other cases, a purulent-inflammatory disease of the tubes and ovaries is limited to scar tissue and, as a result, a cavity is filled with pus and resembles a cyst. Both in the first and in the second case, only the surgical removal of the purulent tumor relieves the patient from the disease.

At present, it has been proven with certainty that completely benign cysts, with a long course, can degenerate into malignant ones. Therefore, women who are offered an operation for an ovarian cyst, even in the absence of painful phenomena, must agree to the surgical removal of the tumor.

Fibroids of the uterus Is a benign tumor that develops from the muscle tissue of the uterus. Discomfort, a feeling of heaviness and pressure in the lower abdomen are also signs of this tumor. Just like ovarian cysts, fibroids often lead to disorders of urination and bowel activity. Fibroids can reach large sizes, sometimes they consist of separate nodes, which in non-obese women can be felt through the abdominal wall. In some cases, the fibromatous node grows towards the uterine cavity and is connected to its wall only by a thin leg. Such a node can be "born" through the vagina.

One of the characteristic signs of fibroids is bleeding that coincides in time with menstruation. With fibroids that grow into the uterine cavity, menstruation that comes on time lasts a long time, and the amount of blood lost increases. The more the tumor develops, the longer and more profuse menstrual bleeding becomes. In these cases, only the removal of the tumor leads to a cure. Surgical removal of fibroids is also performed when the tumor is large, with its rapid growth, multiple nodes, with pain, disorder of the activity of nearby organs. With small fibroids that do not increase for a long time, do not manifest themselves in anything, the operation is not always mandatory.

It should be borne in mind that with the extinction of the function of the ovaries, after the cessation of menstruation, often there is a reverse development, a decrease (atrophy) of fibroids. Therefore, in some cases, in the treatment of fibroids, it is permissible to be limited to conservative measures: hormonal treatment, X-ray irradiation of women in old age, etc. However, when fibroids are detected, a woman should be under constant systematic supervision of a doctor. Only a doctor who monitors a woman for a long period can decide the choice of the method of treatment in each individual case.

Malignant tumors of the female genital organs

Malignant tumors, unlike benign ones, develop and grow rapidly. They grow relatively quickly into adjacent tissues and organs, and destroy the walls of blood vessels. Separate small parts of malignant tumors are carried to nearby or distant tissues and organs by the flow of interstitial fluid (lymph) or blood. Small particles of the tumor brought in new places also grow and spread rapidly. Consequently, one of the features of malignant tumors is their ability to create multiple foci of development and spread in the body, that is, to give so-called metastases. Malignant tumors sometimes develop even after treatment, that is, they give relapses of the disease.

Malignant tumors that develop from the cells of the integumentary tissues (epithelium) are called cancer. Other malignant tumors - sarcomas develop from cells of the interstitial, connective tissue.

The causes of malignant tumors have not yet been clarified. It is only firmly established that the onset of cancer is often preceded by a number of changes in the body, in particular, chronic and long-term diseases. A malignant tumor almost always develops on a sick basis, on the basis of all kinds of painful changes. Cancer diseases occur most often in middle and old age (40-60 years). For example, cancer of the cervix and ovarian cancer occurs most often between the ages of 40 and 50, cancer of the body of the uterus - after 50 years, cancer of the external genital organs occurs mostly after 60 years. Sometimes a woman is affected by cancer even at a young age (25-35 years).

Inflammatory processes, which often precede cancer and create conditions for its occurrence and development, play an important role in the occurrence of cancer of the female genital area. A fertile ground for the development of cancer is created inflammatory diseases and cervical ulcers... Erosion (ulcer) of the cervix is a defect in its mucous membrane. It is formed as a result of sloughing of the surface layers of the mucous membrane that covers the neck. Most often, erosion occurs in chronic inflammatory diseases accompanied by leucorrhoea.

A disease similar to erosion is eversion of the cervical mucosa... Inversion of the mucous membrane (ectropion) occurs due to cervical tears occurring during childbirth. In this case, the mucous membrane of the cervical canal is exposed and it is easily exposed to adverse effects from the vagina and its secretions.

Cervical cancer can occur on the basis of the so-called "leukoplakia" (white plaque), which is the area of hardening of the lining of the cervix.

Sometimes the basis for the development of the cancerous process can be loose, lush growths of the mucous membrane of the cervical canal. These growths, called polyps, can be single or multiple, spreading beyond the cervix, deep into the uterine cavity. In these cases, we are no longer talking about polyps, but about polyposis. Excessive growth (hyperplasia) of the lining of the uterus, which sometimes occurs in old age, can also contribute to the development of cancer of the uterine body.

Malignant neoplasms of the ovaries also most often occur against the background of inflammatory and other female diseases.

What are the signs of the development of cancer of the female genital organs? At the onset of the disease, the signs of cancer are insignificant and do not bother the patient much. However, with a careful attitude to one's health, in most cases, disorders are detected that oblige the patient to consult a doctor. The most common initial symptom of the disease is leucorrhoea. Leucorrhoea in the early stages of the disease may be no different from leucorrhoea caused by other causes. It should only be emphasized once again that the appearance of brown leucorrhoea, whiter than the color of meat slops with an unpleasant putrefactive smell, most often indicates the development of a cancerous process, and sometimes already started. Leucorrhoea mixed with blood deserves special attention. Even small streaks of blood, observed outside of menstruation or at the age when menstruation has already stopped, should alert a woman and force her to immediately see a doctor. An important symptom of the disease is the appearance of bloody discharge from the vagina that is not associated with menstruation. The amount of blood secreted is insignificant.

In some cases, a cancerous lesion of the genital area of a woman is initially manifested by a violation of urination or a disorder of the intestines. This should also be remembered.

Malignant tumors of the ovaries are less common than cancer of the uterus, but they are a relatively common disease of the female genital organs. It is believed that about 6-7 ovarian cysts, one is malignant. Ovarian cancer is often preceded by inflammatory diseases or benign cysts. Often this disease in the initial stages does not cause any painful sensations and is detected only during a medical examination. In some cases, the presence of an ovarian tumor is indicated by a feeling of pressure in the lower abdomen, pain, cessation of menstruation or bleeding, swelling of the skin on the pubis and lower abdomen, frequent or difficult urination, constipation or diarrhea.

Malignant lesions of the genital organs in women is a rather rare disease, but very dangerous. In the overwhelming majority of clinical cases, cancer of the labia majora (as well as cancer of the labia minora) is diagnosed in elderly patients.

The main contingent of patients with this disease are women over 70 years old: this fact gives doctors reason to consider age-related changes in the mucous membranes as one of the main risk factors for cancer of the external genital organs.

The age factor also contributes to the late detection of the disease in question. Women who practically do not visit a gynecologist due to their advanced age, as a rule, show signs of cancer at its later stages, which complicates the treatment process.

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Doctors advise women who have left the reproductive period to continue to visit a gynecologist at least once a year or six months. This will make it possible to diagnose oncological pathologies at an early stage and to carry out successful treatment. Consider the causes, signs, and methods for detecting and treating cancer of the external genital organs.

The reasons

Medical practice shows that women from poor strata of the population who cannot properly and fully observe personal hygiene, eat healthy foods and regularly visit a doctor often get sick with labia cancer. Genital tumors are most commonly reported in countries with a low standard of living.

Other factors that can affect the development of this disease are:

the presence of human papillomavirus (this microorganism affects cell mutations in various areas of the body - including in the labia);
skin diseases - kraurosis, warts, leukoplakia, lichen;
overweight;
high blood pressure (hypertension);
diabetes mellitus and other metabolic disorders;
smoking;
promiscuity of sex life;
the presence of infections of the genital organs and inadequate therapy for sexually transmitted diseases;
genetic predisposition to cancer;
alcoholism;
poor nutrition;
prolonged exposure to the sun;
exposure to toxins in hazardous production;
the use of low quality intimate hygiene products with carcinogenic substances in the composition;
the presence of cancerous foci on the skin in the past and in the present.

The development of the disease is often preceded by local inflammatory and dystrophic processes that cause itching and lead to changes in the histological structure of the cells of the external genital organs.

Signs and symptoms of labia cancer

It is quite simple to suspect and identify a disease at the initial stage - you just need to monitor the state of the reproductive organs and note all the changes that occur. However, elderly patients are often ashamed of going to a gynecologist.

This is a fundamentally wrong approach to your health, since delay in malignant pathologies threatens the transition of the tumor to the stage of spreading and metastasis, and it is much more difficult to treat such cancer. It is much easier to carry out timely removal of a localized tumor at the first stage. It is extremely rare that malignant lesions of the labia appear out of the blue - without preliminary changes in the tissues.

The onset of neoplasms is almost always preceded by precancerous pathologies - in particular, condylomas or krauroses.

Warts are warty growths on the external female organs that appear at a young and middle age and over time (if you do not take medical measures) can develop into cancer. Kraurosis is not really a disease, but a syndrome that accompanies age-related processes in tissues.

excessive dryness of the genitals;
the appearance of wrinkles on the skin of the labia;
itching in the perineum.

Another precancerous pathology is leukoplakia, which looks like whitish spots on the mucous membrane of the genitals. In most cases, these spots contain abnormal cells that can develop into cancer.

In the presence of these diseases, it is very important to carry out additional diagnostic procedures that will identify cancer at stage zero. In this case, the treatment will be fast and effective.

Symptoms and signs of cancer of the labia at the initial stage are as follows:

itching and burning in the perineum;
the appearance of warts and genital warts;
the presence of a painless nodule or induration with well-defined edges;
the presence of non-healing ulcerations on the skin of the labia;
a sharp deterioration in health - weakness, drowsiness;
weight loss;
subfebrile temperature.

Over time, the symptoms worsen - the neoplasm increases in size, the edges become uneven, the ulcers begin to bleed: a necrotic focus appears at the bottom of the ulceration. Painful sensations depend on the location of the cancer and its histological type. In one clinical case, pain may appear at the earliest stage, in another, it may arise only at the stage of the spread of the malignant process to other organs.

The tumor can be of the exophytic type, endophytic and diffuse. All three varieties quickly grow into the surrounding tissue and spread to the urethra, vagina and perineum.

The abundance of lymphatic and blood vessels in this area contributes to rapid metastasis. When a malignant process occurs in them, the lymph nodes thicken and become painful. In the future, the pain intensifies so much that it does not allow patients to exercise natural skills and even move.

What cancer of the labia looks like should be known to all women at risk for this disease.

Diagnostics

The primary diagnosis of cancer is an external gynecological examination, which is performed using a magnifying glass. During the examination, palpation is also carried out, which determines the consistency of the tumor and the degree of its spread to the surrounding tissues. A gynecological examination using mirrors allows an assessment of the condition of the vagina and cervix. Sometimes a rectovaginal digital examination is also necessary.

Of importance is a cytological examination of smears from suspicious areas of the mucous membrane of the genital organs. A biopsy allows you to clarify the diagnosis - taking a sample of tumor tissue and examining it in a laboratory under a microscope.

Additional diagnostic procedures for labia cancer and suspected metastases are:

cystoscopy;
excretory urography;
sigmoidoscopy;
chest x-ray;
analysis of menstrual function (at reproductive age);
lymphography - examination of lymph nodes for the presence of cancer cells;
diagnostic laparoscopy;
CT, ultrasound and MRI of internal organs.

This article describes the main characteristics of early lip cancer.

Treatment

The choice of therapeutic methods for any oncological diseases (including cancer of the genital organs) depends on many concomitant circumstances:

age;
the state of internal organs and the presence of their pathologies;
state of immunity.

The main method of treatment is surgery. Ancillary and alternative methods are radiation therapy and chemotherapy.

If the patient's state of health (mainly the state of the cardiovascular system) allows for the operation, resection of the labia and nearby nodes of the lymphatic system is performed. After removal of the primary malignant focus, radiation and drug treatment are prescribed.

Sometimes radiation is given before surgery: in general, genital tumors respond well to radiotherapy. If the primary tumor resolves, the operation is not prescribed, but the patient should be under constant dynamic observation. In the presence of a residual focus, oncologists prescribe a vulvectomy. Total vulvectomy is the extirpation of all external genital organs, as well as adipose tissue.

Chemotherapy is usually prescribed as an adjuvant treatment after surgery: cytostatics are used - substances that prevent cell mitosis (division). Drug treatment is often combined with radiation therapy if surgery is contraindicated.

Forecast

Patient survival prognosis is relatively favorable at stages 1 and 2 of the disease. Success, which is determined by a relapse-free life span of 3 years, can be counted on by 50-70% of patients. The survival rate for cancer of the labia is reduced due to the advanced age of the majority of patients, who, as a rule, already have other concomitant diseases at the time of diagnosis of tumors.

Treatment at stages 3 and 4, when metastases have already spread throughout the body, has a less favorable prognosis: the probability of death is quite high. Successful treatment is possible only in 7-10% of all clinical cases.

The main causes of lip cancer are described in this section.

Lip cancer treatment should be as competent as possible, this will allow for effective therapy and save the life of a person who is faced with this insidious disease. You can learn more about the methods of treatment here.

Prevention

Measures to prevent malignant tumors of the labia include quitting smoking, maintaining a healthy lifestyle and eating well.

It is also necessary to regularly undergo examination by a gynecologist and treat precancerous pathologies. Strengthening the immune system in adulthood and old age also has a beneficial effect. Throughout their lives, women need to provide adequate care for their genitals and maintain sexual hygiene. All infectious and venereal diseases must be treated promptly and fully.

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Do not self-medicate. Please consult your healthcare professional.

Cancer of the female genital organs

Cancer of the external genital organs (vulva) is a malignant tumor that appears more often during menopause in the form of dense nodes, infiltrates, or papillary growths, often ulcers with dense edges are formed. A precancerous condition is vulvar kraurosis, leukoplakia. A cancerous dense tumor grows along the surface and in depth, the inguinal lymph nodes are quickly involved in the process. Depending on the distribution, 1, 2, 3 and 4 stages are distinguished.

The initial signs are itching, burning in the vulva, then pains join, and when the tumor decays, purulent-bloody discharge.

At stages 1 and 2 - combined (surgical and radiation), at stages 3 and 4 - radiation.

Vaginal cancer is rare as an independent disease. More often women fall ill in menopause and menopause. The process proceeds in the form of a dense infiltrate or ulcer on the walls of the vagina with rapid ulceration.

Purulent bloody leucorrhoea, pain does not appear earlier than stage 2 of the process; further - signs of compression of the vagina, impaired urination, general intoxication.

Beam. Moving metastases in regional lymph nodes are surgically removed.

Cervical cancer is the most common malignant tumor of the female genital organs.

0 stage (initial;)
Stage 1 (the process is limited only to the cervix);
Stage 2 (further spread of the tumor to the vagina, uterus and parametric tissue);
3 stage (the same as in 2, but the process covers more space);
Stage 4 (germination into the bladder, rectum, metastases to distant organs - bones, lungs, liver, etc.).

Subjectively, the initial stage (0) is not manifested in anything, 1 tbsp. accompanied by the release of serous or serous-bloody leucorrhoea, aggravated by vaginal examination, after sexual intercourse, an act of defecation (contact bleeding). Later, at 2 and 3 tbsp. there are purulent bloody leucorrhoea with a putrid odor, pain in the lower abdomen, lumbar region, violation of the general condition: intoxication, dysfunction of the bladder and rectum, sharp weight loss.

In the initial stages (0 and 1), surgical and combined (surgical and radiation) treatment is possible. With 2 and 3 tbsp. - Conducting combined radiation therapy. At 4 tbsp. - symptomatic treatment. Prevention consists in identifying pathological conditions of the cervix that contribute to the development of cancer: erosions of the cervix, its cicatricial changes, endocervicitis and their timely treatment.

Cancer of the body of the uterus occurs in the form of a diffuse lesion of the inner lining of the uterus (endometrium) or individual polypous growths. Growing into the layers of the uterus, the cancer spreads to the appendages and peritoneum. Distant metastases appear late.

It progresses slowly, characterized by serous-bloody or purulent-bloody fetid leucorrhoea or acyclic bleeding in older women or bleeding during menopause. When these symptoms appear, it is necessary to scrap the uterine cavity with a histological examination of the scraping.

Combined (surgical and radiation) or complex (surgery, radiation, hormone therapy).

Ovarian cancer in the initial stages is asymptomatic. Subsequently, the abdomen enlarges, the tumor is palpable, and ascites (fluid in the abdominal cavity) appears. In advanced cases, pain, intoxication, dysfunction of the bladder and intestines, cachexia (exhaustion) occur.

Combined: surgical followed by radiation therapy, chemotherapy and hormone therapy.

Signs of genital cancer

Pretumor diseases of the external genital organs are kraurosis and leukoplakia, which are characterized by dryness and wrinkling of the skin of the labia majora, itching, ulceration and scarring, and multiple whitish spots. They can remain unchanged over the years.

SIGNS OF FEMALE GENITAL CANCER

The most common malignant tumors of the female genital organs are cervical cancer (in 83%). It mainly occurs in women between 40 and 60 years of age.

Liquid, corrosive, sometimes odorless leucorrhoea should be considered early signs of cervical cancer. In the process of tumor growth, as well as when it is damaged, leucorrhoea turns into bloody. Often, the first symptom of the disease is minor spotting that appears between menstruation. Most often, these bloody or bloody discharge occurs as a result of minor trauma to the tumor during heavy lifting, prolonged physical work, after douching or intercourse.

In unmarried women, the first sign of cervical cancer may be profuse bleeding or bleeding as a result of tumor breakdown.

Pain is not an early sign of the disease; it occurs much later.

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One should not think that leucorrhoea, spotting and bleeding necessarily indicate cancer of the genital organs. They can be signs and inflammatory diseases of the cervix, as well as age-related hyperplasia (proliferation) of the mucous membrane of the body of the uterus, single or multiple polyps. However, if bleeding occurs in older women several years after the cessation of menstruation, it is always suspicious.

Unlike malignant tumors of the cervix, which are more common in women of relatively young age, cancer of the uterine body in most cases [develops in the older (50-70 years), when the vast majority of women are already in menopause.

The first sign of cancer of the body of the uterus is most often spotting or bleeding, which appears several months or years after the cessation of menstruation.

With cancer of the body "- uterus pain occurs more often than with cancer of the cervix. This is explained by the fact that mucus and blood accumulate in the uterine cavity, which put pressure on the walls of the uterus. When the uterus is emptied of its contents, the pains cease (therefore, they are unstable).

Only a doctor can decide the nature of the disease. Therefore, it is very important that a woman immediately see a doctor when these symptoms appear.

During a routine examination, it is very difficult for a doctor to decide what causes these symptoms. To clarify the diagnosis of the disease, it is necessary to take the contents from the patient's uterus cavity for examination under a microscope, and also make a diagnostic scraping of the uterine cavity.

The clinical manifestation of ovarian tumors is very diverse. Sometimes benign cysts exist for many years, women know about them, but they do not go to doctors, since they do not bother them. However, an increase in the ovarian tumor, its induration may be signs of malignant transformation.

Relatively early signs of ovarian cancer include constant dull, aching pain and a feeling of heaviness in the lower abdomen, general malaise, loss of previous performance, apathy, and less often weight loss. In cases where the tumor reaches a significant size and puts pressure on the bladder, there are frequent urges to urinate, incomplete emptying of the bladder and, as a consequence, persistent inflammation of the bladder mucosa - cystitis. With the pressure of the tumor on the rectum, pain occurs in it, frequent urge to stool and pain during emptying, sometimes constipation.

Signs of cancer of the external genital organs will be: the appearance on dry and flabby skin of the labia majora, on the mucous membrane of the vestibule of the vagina of seals that rise above the surrounding surface of the skin, or the appearance on them of a small sore with dense edges.

MODERN METHODS FOR TREATMENT OF MALIGNANT TUMORS OF FEMALE GENITAL ORGANS

Currently, various methods are used to treat malignant tumors of the female genital organs: operational (when the affected organ is removed), radiation (when X-rays and radium or radioactive cobalt are used) and combined. In most cases, combined treatment is carried out, when radiation is carried out before or after the operation. Specialists involved in the treatment of malignant tumors have been convinced from their own experience that with this method of treatment it is possible to achieve the best results.

Combined radiation therapy (X-rays and radioactive drugs) is widely used to treat cancer of the body and cervix, in which in most cases it is possible to achieve a stable cure.

A doctor who treats tumors is well aware of the sensitivity of various tumors to radiation, the doses to be used for treatment, and the devices on which the patient should be irradiated.

People still have great faith in the “power of the knife,” which cuts through everything that is painful. But not all tumors can be treated surgically. In some patients, diseases of the heart or lungs, liver or kidneys interfere with giving anesthesia and performing surgery. In such cases, radiation treatment is the most acceptable and no less reliable. Therefore, the choice of the method of treatment must be left to the specialist doctor.

As for cervical cancer, the choice of treatment method depends on the patient's age and the extent of the tumor spread. For young women with small tumors, it is more expedient to apply surgical treatment followed by preventive radiation, and it is safer for older women to undergo radiation treatment, which will be just as successful.

For tumors of the body of the uterus, it is preferable to do! surgery followed by prophylactic radiation. However, surgery is always risky for older women with underlying cardiovascular disease. Therefore, the choice of a treatment method in such patients is decided after a thorough examination and joint discussion of the data obtained by several doctors.

As we have already said, without removing the ovarian tumor, examining it, and in some cases even without examining it under a microscope, it is impossible to say with certainty whether it is benign or malignant. Therefore, each ovarian tumor must be removed. If the ovarian tumor turns out to be malignant, surgery alone is not enough. The operation, as a rule, is supplemented by radiation and the appointment of antineoplastic and hormonal drugs. Treatment in this case will be complex and individual.

In ovarian cancer, anticancer drugs are used as an adjunct to surgery, before or after it. Sometimes they are just one link in the complex treatment of ovarian cancer. For example, first, a course of treatment with anticancer drugs is carried out, then an operation is performed, and after the operation, radiation is performed.

How female cancer appears, its first signs

Genital cancers in women can be divided into two types: benign and malignant.

Considering the first signs of cancer, this includes neoplasms that do not spread tumor cells throughout the body, but which need to be paid attention to in order to prevent their degeneration.

Benign tumors

Benign tumors grow in width, but are unable to spread to other organs. But they are also oncological neoplasms, and if they are not treated in time, then complications are likely. There are such types of these neoplasms:

Fibroids are characterized by manifestations on parts such as the ovaries, labia, or inside the cervix. Formed from fibrous connective tissue. Cancer manifests itself in women with signs of pelvic pain and difficulty in defecating.

Fibroids are characterized by heavy bleeding during menstruation and pain in the lower abdomen. With complications, the pain becomes worse, chills and fever appear. It represents the formation of nodules and seals.

Fibroids are formed in the uterus, and can reach significant sizes. In the process of tumor development, pressure arises in the pelvis, and the amount of discharge during menstruation increases.

Cystoma. Formed from a cyst. The first signs are irregularities in the menstrual cycle, discomfort and bloating. Sometimes pain, cramps and discomfort during intimacy are characteristic.

Polyps are soft, reddish-pink growths. They are arranged in bunches. With them, after intercourse, bleeding appears and the discharge increases during menstruation.

Common Symptoms

Often, cancer of the female genital organs does not have specific symptoms, and is similar to other diseases or disorders and abnormalities in work. There are a number of general signs that you should pay attention to, and if you find symptoms in yourself, you should immediately consult a doctor in order to prevent the development and exacerbation of oncology in advance:

This symptom is significantly common in ovarian cancer and is most often neglected. This is one of the main symptoms, so if you cannot button your skirt or pants, pay attention to this.

Pressure and constant aching pains in the area below the navel, not associated with menstruation, often indicate the development of cancer in the female genital organs.

You can even get used to monotonous pains of a constant nature and not pay attention to them, however, this is a symptom of oncology.

If you have a high fever all day for an extended period, you should see a doctor. This is a dangerous sign not only of ovarian cancer, but also disorders in the body or diseases.

Profuse bleeding.

Unnatural bleeding from the genitals is a common sign of oncology. Excessive bleeding during menstruation, unnatural in the stages between them and during sexual intercourse, are symptoms of cancer in women.

Diarrhea, constipation, flatulence and irregular feces, sometimes with the presence of blood, are a reason to see a doctor. These are signs not only of genital cancer, but similar manifestations indicate possible rectal cancer.

Changes that are unusual for the vulva or vagina (skin color, discharge, blisters, wounds) can signal the development of cancer, so a visit to the doctor is mandatory. Regular examination by a gynecologist is the basis for the prevention of cancer.

Losing more than five kilograms a month without exertion and effort is unnatural. Fluctuations in weight are possible, but rapid weight loss is not a positive fact.

Chronic lethargy is one of the main signs of cancer in any part of the body. Exhaustion and fatigue, even from small loads, are characteristic of the latter stages, but sometimes they appear at the initial stage.

Found seals, wounds, swelling or redness on the mammary glands during her examination - not good sign, therefore, you must immediately consult a doctor.

Before talking about cancer, you should know that it has four stages of development, and at the first stage, the symptoms are almost imperceptible.

Cancer of the uterus and its causes

The causes of cancer in women can lie in promiscuous sexual intercourse, early onset of sexual activity, viral diseases and cervical injuries. Often cancer develops due to herpes (papillomas), therefore it is recommended to take tests in order to detect pathology in time.

In the second and third stages of uterine cancer, specific signs are bloody discharge, the presence of blood in the urine, pain in the back and legs. It should be added that the first stage often has no symptoms, and it is possible to diagnose the pathology when examined by a gynecologist.

With cancer of the body of the uterus, polyposis growths are formed. A malignant tumor, germinating, affects the appendages and the abdominal cavity, therefore an unpleasant-smelling discharge is formed, consisting of a mixture of pus with blood.

Ovarian cancer

Ovarian cancer is slightly less common than uterine cancer, but it occurs often, and especially in older women who did not know the joys of motherhood. Sometimes this is influenced by genetic inheritance.

Nausea, vomiting, bloating, and constipation are characteristic features of this pathology. The early stages are asymptomatic, which is why they are dangerous, and the tumor itself changes the functioning of the intestines, causing the accumulation of fluid.

Vaginal cancer

As the first sign, purulent-bloody leucorrhoea can be distinguished. In this case, dense ulcers form on the walls of the vagina, which subsequently cause pain and lead to compression of the internal cavity. In this case, intoxication of the body occurs, and difficulties arise when urinating. It is observed more often in women during menopause and with menopause.

Cancer of the labia

This type develops during menopause, is ulcerative nodules with dense edges. Growing, the tumor penetrates deeper, affecting the lymph nodes. The initial signs are burning, itching, and pain. With an exacerbation, there is a discharge of purulent-bloody content.

Treatment methods

Malignant tumors of the female genital organs are removed by combined methods of treatment or by certain types of procedures.

This is determined by the doctor and depends on the location of the neoplasm, its type and stage.

Treatment includes surgery, radiation therapy, and for complications, systemic drugs (chemotherapy) and hormone therapy. A special method is symptomatic treatment applied at the last stage.

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Cancer of the labia is the rarest cancer of the female genital organs. Cases of its detection are less than 3%. In the vast majority of cases, it affects older women over 70 years old. This fact makes doctors think that the main reason for the occurrence of a malignant tumor is age-related changes in the structure of the mucous membrane. In general, old age is a very common factor in many cancers, but labia cancer is especially associated with it. Also, due to the advanced age of patients, the disease is often detected at fairly deep stages. While a young and sexually active woman can quickly detect disturbing changes and visit a gynecologist, older women usually do not visit this doctor at all. As a result, labia cancer is detected when the disease has already begun to cause not just discomfort, but torment. An elderly woman is often difficult to convince of the need to visit a gynecologist and monitor her health, so relatives should help them with this, make an appointment with a doctor and take them to him.

Causes of cancer of the labia

Doctors note that labia cancer is a common disease of women of low socioeconomic status who are unable to observe the rules of personal hygiene, eat well and visit medical institutions. Human papillomavirus infection, which is the cause of other women's health problems, often causes cancer of the labia. Also, this disease is at risk of getting those women who have already been diagnosed with cancer of other organs of the genitourinary system. Skin conditions such as squamous cell hyperplasia or lichen sclerosus can develop into labia cancer. Obesity, arterial hypertension and diabetes mellitus have a very detrimental effect on the health of every woman, in particular, they can become a provoking factor in malignant tumors of the external genital organs. A lifestyle that includes frequent changes in sexual partners and the presence of bad habits, especially smoking, are also factors that cause labia cancer. Previously diagnosed melanoma can also be an indirect cause of malignant tumors of the external genital organs.

Classification and stages of cancer of the labia

Depending on how the neoplasm looks and develops, there are three types of labia cancer. The exophytic form looks like a nodular formation that rises above the surface of the skin. Endophytic cancer of the labia looks the other way around, like a depression. It is an ulcer with hard, jagged edges. The diffuse form is an infiltrate, hard to the touch on palpation and bleeding in appearance. Any of the forms is dangerous, therefore, if there is anything like this, an urgent visit to the doctor is necessary.

Symptoms and signs of labia cancer

Cancer of the labia is one of those diseases that cannot be overlooked or started if a woman is attentive to her health. Very rarely, this disease appears out of the blue. Oncologists know that the onset of a malignant tumor is preceded by other diseases, which are called precancerous. These include, for example, genital warts. These are small warty outgrowths on the external genital organs that are most common in women at a young age and, over time, if not taken care of, can cause cancer of the labia. Kraurosis is not a disease, but a condition that is accompanied by tissue aging. Visually, it is expressed in dryness of the mucous membrane of the external genital organs, wrinkled skin, which looks like parchment. Kraurosis in many women of advanced age is expressed by itching in the perineum, intensifying at night. This condition can be detected by microscopic examination of the tissue. Often kraurosis in older women becomes the cause of the development of malignant neoplasms. Leukoplakia is a disease that can develop on the mucous membrane of many organs. Oncologists consider this disease an obligate precancer, that is, a condition that is most likely to turn into cancer if no action is taken. Leukoplakia is a whitish spot on the mucous membrane of the labia (or other organ). If you study these spots in detail, then in most cases atypical cells will be found. The most common mistake of gynecologists is that they try to treat kraurosis and leukoplakia symptomatically, without carrying out additional diagnostic measures. It often happens that, by the time the real cause of all symptoms is discovered, the cancer of the labia has already spread deeply enough.

Diagnostics of the cancer of the labia

Cancer of the labia can be suspected already on a routine gynecological examination. The gynecologist will be able to collect sufficiently comprehensive information and prescribe additional research methods. First, it is necessary to subject the affected tissue or neoplasm to a thorough examination through a magnifying glass. It can look like foci of warts or genital warts, an ulcer or a node, a bumpy bleeding infiltrate or a cushion with uneven edges - the appearance of the tumor can be different. Palpation of the tumor and surrounding tissues will determine its consistency, tissue mobility, the presence or absence of pain. A standard examination of the vagina with speculum is necessary to assess the condition of the vaginal mucosa and cervix. Smears-prints, as well as scrapings from the surface of the pathological tissue are sent for cytological examination. This method will show if there are atypical cells in the neoplasm. If the smears did not give unambiguous and comprehensive information, then the biopsy method is used. A biopsy is the most accurate cancer diagnosis method, which allows you to clearly determine if there is cancer, and if so, what type of it. Since labia cancer often affects the lymph nodes, it will not be superfluous to conduct lymphography to assess their condition.

Labia cancer treatment

Always, when choosing a treatment for any oncological disease, a doctor must take into account many factors. The age of the woman, the stage of cancer of the labia, the presence of concomitant pathologies, the general condition of the patient - all this must be taken into account when prescribing any therapy. General methods differ little from the treatment of other malignant tumors. Treatment for labia cancer usually includes surgery to remove the tumor, radiation, and chemotherapy.

Prevention of cancer of the labia

Treatment will not be needed if there were properly organized preventive measures - everyone knows this, even people without medical education. Only, unfortunately, this knowledge does not induce action. Despite the fact that cancers of the external genital organs are easy enough to suspect in the early stages, this happens very rarely. This is the fault of both the patients and their doctors. Patients make the big mistake of ignoring alarming symptoms and discomfort, and succumbing to shame and indecision. Doctors, in turn, are mistaken, not prescribing women an extensive examination, including a biopsy. For this reason, labia cancer is very often treated initially as a common infection or inflammation. This is a criminal delay that may cost a woman her life. While the woman takes antibiotics and undermines her immune system, the malignant tumor progresses and spreads.

Malignant tumors can occur in any organ of the female reproductive system - the vulva (external genital organs), vagina, cervix, uterus, fallopian tubes, or ovaries.

Uterine cancer

Although this cancer is commonly called uterine cancer, it is more accurately called endometrial carcinoma because the tumor initially occurs in the lining of the uterus (endometrium). In women, it is the fourth most common cancer and the most common malignant tumor of the female genital organs. Cancer of the uterus usually develops after menopause, usually in women between 50 and 60 years of age. Tumor cells can spread (metastasize) both to adjacent tissues and to many other organs - down to the cervix, from the uterus into the fallopian tubes and ovaries, into the tissues surrounding the uterus, into the lymphatic vessels that transport lymph to all organs, lymphatic nodes, into the blood, then through the bloodstream to distant organs.

Symptoms and Diagnosis

Abnormal uterine bleeding is the most common early symptom of uterine cancer. Bleeding can occur after menopause and be repeated, irregular, or profuse in women who continue to menstruate. One in every three women with uterine bleeding after menopause will have this form of cancer. In case of pathological uterine bleeding after menopause, you should immediately consult a doctor, as it may be caused by a malignant tumor.

Several methods are used to diagnose this malignant tumor. The Pap test can detect cervical cancer cells, but when performed, tumor cells are not detected in about one third of cases. Therefore, the doctor also performs an endometrial biopsy or fractional curettage (separate curettage of the cervical canal and the uterine cavity), in which the tissue of the uterine lining is removed for examination under a microscope.

If biopsy or fractional curettage results confirm the presence of a malignant tumor in the lining of the uterus, more testing is needed to determine if the cancer has spread outside the uterus. Ultrasound (ultrasound), computed tomography (CT), cystoscopy (examination of the bladder with a fiber optic system), intestinal x-ray using barium sulfate, x-ray of the chest, intravenous urography (x-ray of the kidneys and ureters), bone scan and liver, sigmoidoscopy (examination of the rectum with a flexible fiber-optic instrument) and lymphoangiography (x-ray examination of the lymphatic system) provide the necessary information and help in prescribing optimal treatment. In each case, only some of the studies listed above are carried out for specific indications.

Treatment

Extirpation, that is, the surgical removal of the uterus, is the mainstay of treatment for this type of malignant tumor. If the cancer has not metastasized outside the uterus, then extirpation of the uterus almost always leads to a cure. During the operation, the surgeon usually also removes the fallopian tubes, ovaries (that is, performs salpingo-oophorectomy) and nearby (regional) lymph nodes. They are examined by a morphologist to determine the stage of cancer development and to establish the need for postoperative radiation therapy.

Even when the cancer has not metastasized, the doctor may prescribe postoperative drug therapy (chemotherapy) in case some of the cancer cells go undetected. Usually hormones are used that suppress the growth of a malignant tumor. Progestins (progesterone, a female hormone that blocks the effects of estrogens) and similar hormonal drugs are often effective.

If the cancer has spread outside the uterus, higher doses of progestins are usually given. In 40% of women with metastases of a malignant tumor, it decreases in size and its growth is suppressed by progestins for 2-3 years. If the treatment is effective, it can continue indefinitely. Side effects of progestins include weight gain due to water retention and, in some cases, depression.

If the cancer is widespread, or if hormone therapy is not working, other chemotherapy drugs such as cyclophosphamide, doxorubicin, and cisplatin may be added. These drugs are much more toxic than progestins and cause many side effects. Before starting treatment, the risks and expected benefits of chemotherapy must be carefully weighed.

In general, almost two-thirds of women who have this type of cancer survive and do not have recurrence (reappearance) of the malignant tumor within 5 years after diagnosis, less than a third die from this disease and almost 10% survive, although the cancer does not healed. If this malignant tumor is detected at an early stage of development, almost 90% of women live at least 5 years and usually recover. The chances are better in younger women, women with cancer that has not metastasized outside the uterus, and women with a slow-growing type of cancer.

Factors that increase the likelihood of uterine cancer

Exposure to high doses of estrogens (the main female hormones) from hormone-producing tumors or when taking drugs containing high doses of estrogens, including estrogen replacement therapy without progesterone after menopause
Menopause after 52 years
Menstrual irregularities (eg, excessive bleeding, bleeding between periods, or long intervals between periods)
Obesity
Lack of childbirth
High blood pressure
Diabetes
Tamoxifen therapy

Cervical cancer

The cervix is the lower part of the uterus that goes into the vagina. Of the malignant tumors of the female genital organs, cervical cancer (cervical carcinoma) is the second most common tumor among women of all ages and the most common among younger ones. Cervical cancer is usually found in women between the ages of 35 and 55. The development of this malignant tumor may be associated with a virus (human papillomavirus), which can be transmitted during intercourse.

The lower the woman's age during the first intercourse, and the more sexual partners she has in the future, the greater the risk of cervical cancer.

In about 85% of cases, cervical cancer is squamous, that is, it develops from stratified squamous epithelial cells, resembling skin cells, that cover the outside of the cervix. Most other types of cervical cancer develop from the cells of the columnar epithelium of the glands in the cervical canal (adenocarcinoma) or both.

Cervical cancer cells can penetrate deep under the mucous membrane, enter the vast network of small blood and lymphatic vessels in the deeper layers of the cervix, and then enter other organs. In this way, a malignant tumor metastases both to distant organs and to tissues located near the cervix.

Symptoms and Diagnosis

Symptoms include bleeding between periods or after intercourse. The woman may not be in pain and other symptoms may not develop until the last stages of the disease, but routine Pap tests (Pap smears) detect cervical cancer early enough. This disease begins with slow changes in normal cells and often takes several years to develop. Changes are usually detected by examination under a microscope of the cells of the mucous membrane of the cervix, which are taken for a Pap smear. Physicians-morphologists have described these changes as stages ranging from normal (no pathology) to invasive cancer.

The Pap test is inexpensive and can accurately detect cervical cancer in 90% of cases, even before symptoms appear. As a result, with the introduction of this research method, the number of deaths from cervical cancer has decreased by more than 50%. Doctors usually recommend that the first Pap test be performed when a woman is sexually active or reaches the age of 18, and then this test should be carried out annually. If normal results have been obtained within 3 consecutive years, such a woman can then have a Pap smear only every 2 or 3 years until her lifestyle changes. If in all women this cytological study was carried out regularly, then mortality from cervical cancer could be reduced to zero. However, almost 40% of patients do not receive regular check-ups.

If, during a gynecological examination, a neoplasm, ulcer or other suspicious area is found on the cervix, as well as suspicious changes in relation to a malignant tumor when a Pap smear is detected, the doctor performs a biopsy (takes tissue of the cervix for examination under a microscope). A tissue sample for this examination is usually obtained during a colposcopy, for which the doctor uses a fiber optic system with a magnifying lens (colposcope) to carefully examine the cervix and select the most suspicious biopsy site. Two types of biopsy are used - targeted biopsy, in which a small piece of cervical tissue is taken under the control of a colposcope, and endocervical curettage, in which the mucous membrane of the cervical canal is scraped without visual control. Both biopsies are painful and bleeding. Both methods usually produce enough tissue for the morphologist to make a diagnosis. If the diagnosis is unclear, the doctor will do a tapered biopsy, which removes more tissue. Usually, this type of biopsy is performed using loop electrosurgical excision (excision) techniques on an outpatient basis.

If cervical cancer is detected, then the next step is to determine the exact size and location of the tumor; this process is called determining the stage of development of a malignant tumor. Determination of the stage begins with a general examination of the pelvic organs and several special types of studies (cystoscopy, x-ray examination of the chest organs, intravenous urography, sigmoidoscopy) to determine the extent of the spread of the cervical tumor to neighboring tissues or more distant organs. If necessary, additional tests such as computed tomography, intestinal x-rays using barium sulfate, and liver and bone scans may be done.

Treatment

Treatment depends on the stage of development of the cervical cancer. If the malignant tumor is limited to its superficial layers (carcinoma in situ), the doctor can remove such a tumor completely - a part of the cervix is removed with a surgical method or with the help of a loop electrosurgical excision (excision). After such treatment, the ability to have children is preserved. Nevertheless, the doctor recommends that the woman come for examinations and perform a Pap smear every 3 months during the first year and every 6 months thereafter, since the malignant tumor may recur. If a woman has carcinoma in situ and she does not plan to have children, then she is recommended to remove (extirpate) the uterus.

If the cancer has reached a later stage of development, extirpation of the uterus is necessary in combination with the removal of the surrounding tissue (radical extirpation of the uterus) and lymph nodes. At the same time, normally functioning ovaries in young women are not removed.

Radiation therapy is also highly effective for the treatment of advanced cervical cancer if the tumor has not spread beyond the pelvic organs. Although radiation therapy usually does not produce early side effects, it sometimes causes rectal and vaginal inflammation; later damage to the bladder and rectum may develop, and ovarian function usually ceases.

If the cancer has spread outside the pelvic area, chemotherapy is sometimes recommended. However, only 25-30% of patients receiving it can expect a positive effect, and this effect is usually temporary.

Pap test results: cervical cancer stages

Absence of pathological changes
Minimal cervical dysplasia (early changes that are not yet cancerous)
Severe dysplasia (late changes that are not yet cancerous)
Carcinoma in situ(malignant tumor limited to the most superficial layer of the cervical mucosa)
Invasive cancer

Like other cancers of the skin, vulvar cancer begins on the surface and first spreads to nearby tissues without invading other organs. Although some tumors can be aggressive, most types of vulvar cancer grow relatively slowly. If treatment is not carried out, they are gradually introduced into the vagina, urethra or anus, penetration into the lymph nodes of this area.

Symptoms and Diagnosis

Vulvar cancer can be easily detected with unusual lumps or sores near the opening of the vagina. Sometimes there are areas with flaking or discoloration of the skin. The surrounding tissue may appear wrinkled. The discomfort is usually mild, but itching in the vagina worries. In the future, bleeding often develops or a watery discharge appears. The appearance of these symptoms requires immediate medical attention.

The doctor will take a biopsy to make a diagnosis. After anesthetizing the suspicious area with an anesthetic, a small area of the altered skin is removed. A biopsy is needed to determine if the skin changes are cancerous or associated with infectious inflammation or irritation. The biopsy also makes it possible to recognize the type of malignant tumor when it is detected and to determine the treatment strategy.

Treatment

A vulvectomy is an operation that removes a large area of tissue from the vulva near the opening of the vagina. Vulvectomy is necessary for all types of vulvar cancer, except for preinvasive carcinoma, to remove squamous cell malignancies of the vulva. Such extensive removal is carried out because this type of vulvar cancer can quickly invade nearby tissues and lymph nodes. Because vulvectomy can remove the clitoris as well, the doctor discusses the treatment with the woman who has vulvar cancer to develop a treatment plan that best suits her, taking into account her comorbidities, age, and sexuality. Sexual intercourse after vulvectomy is usually possible. Radiation therapy may be given postoperatively to treat cancer that is very late in its development, where complete cure is unlikely. If a malignant tumor is detected and removed early, then in 75% of cases there are no signs of its reappearance within the next 5 years; if cancer has invaded the lymph nodes, fewer than 50% of women survive.

Since basal cell carcinoma of the vulva does not tend to metastasize to distant organs, surgical removal is usually sufficient. If the malignant tumor is small, then removal of the entire vulva is not required.

Vaginal cancer

Only about 1% of all malignant tumors that arise in the female genital organs develop in the vagina. Cancer (carcinoma) of the vagina usually occurs in women between the ages of 45 and 65. In more than 95% of cases, vaginal cancer is squamous and morphologically similar to cancer of the cervix and vulva. Squamous cell carcinoma of the vagina can be caused by the human papillomavirus, the same virus that causes genital warts and cervical cancer. Diethylstilbesterol-dependent carcinoma is a rare type of vaginal cancer that occurs almost exclusively in women whose mothers have taken diethylstilbesterol during pregnancy.

Symptoms and Diagnosis

Vaginal cancer invades the lining of the vagina and ulcers, which can bleed and become infected. Watery discharge or bleeding and pain during intercourse appear. If the cancer becomes large enough, the function of the bladder and rectum may also be impaired, and there may be frequent urge to urinate and pain when urinating.

When vaginal cancer is suspected, the doctor performs a scraping of the vaginal mucosa to examine it under a microscope, and biopsies the growths, ulcers, and other suspicious areas seen during the pelvic exam. A biopsy is usually done during a colposcopy.

Treatment

Treatment for vaginal cancer depends on the location and size of the tumor. However, all types of vaginal cancer are treatable with radiation therapy.

If the tumor is located in the upper third of the vagina, removal (extirpation) of the uterus and pelvic lymph nodes and the upper part of the vagina is performed or radiation therapy is used. For cancer in the middle third of the vagina, radiation therapy is given, and for cancer in the lower third, surgery or radiation therapy.

After treatment for vaginal cancer, intercourse may be difficult or impossible, although sometimes a new vagina is formed with a skin graft or part of the intestine. Survival within 5 years is observed in approximately 30% of women.

Cancer of the fallopian tubes

A malignant tumor can also develop in the fallopian tubes. This is the most rare location of a malignant tumor of the female genital organs. Symptoms include vague abdominal discomfort, sometimes watery or bloody vaginal discharge. Usually, a nodular formation is found in the small pelvis, but the diagnosis is made only after removal and cytological examination of the tumor. Removal (extirpation) of the uterus, fallopian tubes, ovaries and omentum, followed by chemotherapy, is almost always necessary. The prognosis is about the same as for ovarian cancer.

Trophoblastic disease

Trophoblastic disease is a tumor-like growth of trophoblast tissue (an element of the tissue of the ovum); this definition denotes the pathology of the trophoblast, which is clinically manifested in the form of cystic drift and choriocarcinoma.

Trophoblastic disease can develop from the epithelial cells of the chorionic villi remaining after a spontaneous abortion or full-term pregnancy, but, as a rule, arises from a fertilized egg as an independent pathological process of the transformation of chorionic villi into uviform formations (cystic drift). In rare cases, the placenta is affected in a normal fetus. In more than 80% of cases, trophoblastic disease is non-malignant, that is, it is a cystic drift; however, in 20% of cases, there is a malignant tumor - choriocarcinoma. A non-metastatic (invasive) form of trophoblastic disease and a metastatic form are distinguished, in which the tumor spreads outside the uterus throughout the body (liver, lungs, brain).

The likelihood of developing trophoblastic disease is highest when pregnancy occurs between 35 and 45 years. This tumor occurs in about 1 in every 2,000 pregnant women in the United States, and for unknown reasons, it occurs almost 10 times more often among women in the Far East. In Russia, the frequency of gallbladder drift is 1 in 820-3000 deliveries, and the frequency of choriocarcinoma is 1 in 5000 deliveries.

Symptoms and Diagnosis

Blistering often occurs shortly after pregnancy. The woman feels pregnant, but her belly grows much faster than it does in a normal pregnancy, because the growth of the tumor causes the size of the uterus to grow very quickly. This is accompanied by severe nausea and vomiting, uterine bleeding may occur; such symptoms indicate the need for immediate medical attention. With cystic drift, such dangerous complications as infectious inflammation, bleeding and pregnancy toxicosis (preeclampsia) develop, usually occurring in the second trimester of pregnancy.

A woman with a cystic drift does not feel fetal movements, its heartbeats are not heard. When bleeding occurs, the release of many bubbles with a transparent content, resembling bunches, is observed. Examination of this material under a microscope can confirm the diagnosis.

Your doctor may order an ultrasound (ultrasound) scan to make sure there is a mole, the absence of the fetus and the amniotic sac (the membranes that contain the fetus and the fluid around it). Blood tests are done to determine the content of human chorionic gonadotropin (a hormone normally produced as pregnancy progresses). With cystic drift, the concentration of gonadotropin is sharply increased, since the tumor produces a significant amount of this hormone. This analysis is less convincing in the early stages of pregnancy, when the level of gonadotropin is also high.

Treatment

The bubble drift must be completely removed. It is usually removed by dilatation (dilation) of the cervix and vacuum aspiration by scraping the uterus. Only in rare cases is the removal (extirpation) of the uterus required.

After the operation, regular monitoring of the content of human chorionic gonadotropin in the blood is performed to exclude the occurrence of choriocarcinoma. With the complete removal of the cystic drift, the hormone content returns to normal, usually within 8 weeks and remains so thereafter. If a woman becomes pregnant after removal of the cystic drift, then the explanation for the increase in the concentration of human chorionic gonadotropin becomes difficult, since it can be associated with both pregnancy and with the part of the tumor that has not been removed. Therefore, after removal of the cystic drift, women are advised to protect themselves from pregnancy for a year using oral (taken by mouth) contraceptives.

In the benign form of trophoblastic disease, chemotherapy is not required, but in its malignant form (that is, when choriocarcinoma occurs), chemotherapy is always prescribed. Medicines used for treatment include methotrexate, dactylonomycin, or a combination of these drugs.

The cure rate reaches almost 100% in women with cystic moles and non-metastatic trophoblastic disease and approximately 85% in women with late detection of the disease. As a rule, a woman can have children after removal of a cystic mole. After a course of chemotherapy, pregnancy occurs in 50% of women interested in it.