How long does it take for cervical erosion to develop into dysplasia and cancer? Who is at risk for cancer: can cervical erosion develop into cancer? Erosive cancer

Know the enemy by sight

Cervical erosion is a disease in which there is a violation of the integrity or a pathological change in the epithelium, the mucous membrane lining its surface.

But, you must admit, partial absence(disturbance) of the mucous membrane and an atypical change in its tissues are two completely different things. To be more precise, two different conditions and two different approaches to treatment. Only an experienced gynecologist can diagnose and prescribe adequate therapy.

The inflammatory process occurring in the cervix, an acidic environment, damage to the cervix - all this provokes increased secretion of the mucous membrane, which is manifested by the formation of specific secretions that “corrode” the mucous membrane.

This is how the cervical epithelium is forced to defend itself. But this leads to a violation of the integrity of the epithelium and subsequent changes, the appearance of neoplasms.

Types of treatment for erosion

If a slight erosion is detected, the gynecologist prescribes electrocoagulation, laser cauterization or cryocoagulation. If there is discharge accompanying the disease, anti-infective medications are additionally prescribed.

Upon confirmation cancer cervical cancer use standard cancer treatments:

1. Surgical exposure. This method is considered the most acceptable in the presence of malignant tumors. If the damage is minor, then only the layer of modified epithelium is removed. If the tumor has expanded significantly, the uterus or its cervix is ​​amputated.
2. Chemical therapy. The patient is prescribed special toxic drugs that destroy cancer cells. The method is unsafe for health, since toxic substances also affect healthy cells. But for the treatment of cancer, especially in the early stages, chemotherapy is most effective.
3. Radiation therapy. This procedure is performed using a significant dose ionizing radiation. Irradiation allows you to destroy mutated cells without destroying anatomical structure uterus.

Often used in cancer treatment combined methods which include surgery, radiation and chemotherapy.

papilloma virus
, which is one of the causes of erosion, also greatly affects the likelihood of cancer formation, increasing it approximately a hundred times.

When the norm of the vaginal flora changes, processes also occur that affect the development of erosion. In addition, such changes can lead to the degeneration of cells into a malignant tumor.

To prevent the precancerous condition of cervical erosion, it is necessary to be observed by a gynecologist every six months.

Treatment with Surgitron is rightfully considered the most effective at the moment. It has such advantages as the absence of postoperative pain and scars, etc. Additional information about the method is disclosed in the article
"Treatment of erosion with surgitron"
.

Like
radio wave treatment
, this method does not leave scars and does not disrupt the elasticity of the uterus, which is extremely important for those planning a pregnancy. You also don’t have to worry about bleeding during surgery, because cryodestruction involves the use of ultra-low temperatures.

Minus this method One can highlight a small probability of scar formation when getting rid of large erosions.

The procedure uses special drugs (Solkovagin and Vagotil). To get rid of erosion, they are applied to the affected area.

The direct connection between the development of cervical diseases (especially cancer) and the presence in the body of viruses such as herpes type 2 (or so-called genital herpes) and human papillomavirus (HPV) has been reliably proven.

Cervical erosion can provoke both benign and malignant degeneration of epithelial tissue, especially if it persists for a long time.

Lack of timely, competent assistance means a really high risk of developing cervical cancer!

In order to treat effectively, firstly, you need to carefully diagnose and eliminate the cause of the disease - the inflammatory process. Secondly, remove the changed cervical tissue. Thirdly, stimulate recovery processes.

The choice of treatment method depends on the duration, form and nature of the disease and whether the woman is planning a pregnancy.

What is erosion? This disease is a proliferation of epithelium, which leads to deterioration of the cervix.

Malignant erosion of the cervix appears only when the patient completely ignores the symptoms of the disease - if the treatment is completed on time, and the woman does not refuse to comply with complex therapy, it will be possible to get rid of the erosion quickly and effectively. Today, many women are sure that the disease is considered life-threatening - indeed, the disease is dangerous.

Therapy benign process must be carried out by a woman before the disease becomes aggressive.

Today the disease is treated using modern procedures, such as:

1. Laser. As the tumor develops, doctors often prescribe laser treatment to women. After all, its radiation is the safest and most effective for the patient’s health, since the power of the device helps to heal even the deep layers of the epithelium. The doctor directs the laser only at the diseased cells, causing them to evaporate.
2. Radio waves

In the absence of proper treatment, doctors often prescribe radio wave therapy. Its principle is this: damaged areas of the cervix are treated with radio waves using various devices, for example, Surgiton. After the procedure, no scars remain on the surface of the epithelium.

1. Cryodestruction. Depending on the cause of the disease, doctors prescribe this method treatment. When performing it, the affected areas are treated liquid nitrogen, which, as it freezes, destroys harmful cells due to its low temperature. This treatment option also does not cause scarring.

In addition to such procedures, the patient is also prescribed drug treatment. Thanks to medications, damaged cells are quickly replaced by healthy ones.

It is important to take medications after they are prescribed by a doctor - this is the only way to achieve full recovery and not cause other diseases of the reproductive system.

Can cervical erosion turn into cancer?

To detect the development of erosion, a cytological examination can be performed in any hospital. This must be done, since without diagnostics the doctor has no right to prescribe treatment.

Over a long period of time, as the disease develops, changes occur in the body that negatively affect health. Can erosion develop into cancer if left untreated? Many modern scientists believe that when the epithelial layer grows, new and healthy cells begin to be produced in the female body.

This leads to the covering of the damaged surface of the uterus, as a result of which the cells over time can degenerate into malignant and dangerous to health. As a result, long-term treatment that does not bring health benefits, or a complete lack of therapy, can cause the formation of malignant cells on the surface of the genital organs.

However, modern medicine has proven that epithelial cells are not cancerous, since their structure does not contain malignant components that can begin to grow at any time. To summarize, it can be noted that if a woman has erosion on the surface of the genital organs, the possibility of its degeneration into a cancerous tumor will depend on a number of factors.

• genetic predisposition sick;
• state of the immune system;
• the presence of more dangerous diseases occurring in the body;
• incorrect treatment erosion, as a result of which different drugs are used.

After cauterization, cervical erosion does not cause cancer. This is facilitated by the action of the laser on the body, which destroys all affected cells.

Even the chronic form of the disease cannot cause cancer if a woman begins to fight it in time and strictly follows the doctor’s recommendations. A negligent attitude to health, and the presence of certain factors, lead to the formation of a tumor, not every of which can be completely cured.

Symptoms and diagnosis of cervical erosion

Erosion is a benign cavity formation, during the development of which a woman can immediately notice the development of the disease. However, sometimes patients, on the contrary, do not notice the appearance of pathology, justifying their own condition with fatigue.

Dysplasia of the epithelial layer and others modern methods diagnostics will help to correctly diagnose even at the initial stage of the development of the disease, when a woman is attacked only by dubious signs of the appearance of erosion.

• pain during intimacy, moving from the lower line of the abdomen to the cervix;
• clear discharge;
• bleeding with blood clots;
• pain when going to the toilet;
• discomfort in the lower abdomen;
• pain when lifting weights.

Usually subject to availability favorable factors erosion (even with its recent appearance) is detected by a gynecologist in a chair, where, with the help of mirrors, it is possible to examine all the features of the course of the disease. It is often possible to identify pathology through a detailed examination of the cervix - this diagnostic method is called colposcopy.

It is required if the doctor cannot make the correct diagnosis and careful identification of the affected organs is required if erosion is suspected.

Why can erosion cause cancer? A malignant neoplasm can attack the female body due to the combination of two epithelia (the walls of the cervix and the border of erosion). Therefore, you should not start the course of the pathology, otherwise it can lead to long and difficult therapy.

In addition to the examination on the chair, the doctor will also prescribe a sick series diagnostic procedures:

• taking a smear for microflora;
• PAP test;
• sowing the microflora of the vaginal cavity;
• PCR tests, making it possible to identify an infection occurring latently in the body.

1. HPV test. Carried out after detection in the patient bleeding that do not coincide with the onset of the menstrual cycle. In this case, the doctor conducts an analysis to confirm the expected diagnosis, as well as to identify the condition of the cervical mucosa, which, in the presence of unfavorable factors, often turns into cancer.
2. Cervical biopsy. A cancerous tumor can begin to grow at any time, so if signs of disease are detected, the doctor must perform a biopsy. This diagnostic method involves the use of a small element of the cervix, which is carefully examined under a microscope for the presence of malignant cells.

Groups and risk factors

Erosion itself is not an oncological disease. But there are a number of factors that contribute to the possibility of development cancer formation:

• frequent change of sexual partners;
• stressful situations;
• early sexual relationships;
• HPV infection;
• hereditary predisposition to cancer;
• weakened immune system;
• poor nutrition, malnutrition;
• frequent consumption of alcoholic beverages, smoking.

Constant fatigue and lack of sleep or hypothermia reduce the level of the body's defenses, thereby increasing the risk of developing cancer.

Can cervical erosion turn into cancer? If the cervix is ​​left untreated, certain factors can accelerate the growth of a malignant tumor.

1. Infection female body papillomavirus. In the early stages of the disease, papillomavirus infection is considered the most important factor in the development of cervical cancer. The papilloma virus is capable of infecting a large number of cells in the body, which include cells in the mouth, genitals, pharynx, skin, anus, and so on. If it enters the cavity of the reproductive organ, especially if a woman suffers from erosion, PVI can cause cancer, forming small papillomas.
2. Smoking. Various diagnostic methods make it clear that smoking greatly increases the risk of cervical cancer. In patients who smoke, small amounts of tobacco combustion products are present in the cervical mucus. These harmful components disrupt the DNA structure of the cells that make up the mucous membrane, which becomes serious factor the appearance of a malignant tumor.
3. Impaired immune system functions. HIV greatly aggravates the immune system, so if a woman has AIDS, her risk of developing a tumor is too high.
4. Taking contraceptives. Long reception birth control also causes the growth of cancer cells.
5. Nutrition. A lack of vitamins in a woman’s diet can lead to the appearance of a malignant tumor. The risk increases significantly if the patient has sexually transmitted diseases.

It is important to pay attention to these factors, which can greatly worsen your health.

Preventive actions

Symptoms such as the release of blood clots and pain in the lower abdomen should definitely alert a woman. If the patient has just completed a course of treatment for cervical erosion, she should definitely follow preventive measures, helping to avoid re-development diseases.

• mandatory personal hygiene (and this should be done not only by the woman, but also by her sexual partner);
• itching, burning and discomfort in the genital area should be a mandatory reason to visit a doctor - remember that the earlier the disease is detected, the faster it can be cured;
• the use of contraceptives during intimacy, especially if a woman enters into a relationship with a person unfamiliar to her;
• refusal to frequently change partners, as this causes a strong change in the vaginal microflora, which can lead to various infections;
• regular examinations by a gynecologist, which will help identify the disease at the initial stage of its development, and will also prevent the disease from starting.

Malignant erosion is one of the types of early stage cervical cancer.

Despite modern advances achieved in the treatment of uterine cancer, thanks to the development of surgical techniques and techniques, despite the spread and improvement of radiation therapy methods for uterine cancer, the diagnosis of the disease and the fate of the patient primarily depend on how early the diagnosis was made. It can be argued that almost every case of uterine cancer is curable if it is subjected to radical treatment at the onset of the disease. And if, nevertheless, a large percentage of patients with uterine cancer die today in all countries of the world, this is due to the fact that patients often turn to specialists already in an advanced stage of the disease.

Early recognition of uterine cancer is complicated primarily by the fact that in the very initial stage of the disease, an accurate diagnosis cannot be made using conventional gynecological examination methods - examination and palpation. But if there are symptoms that will be discussed below, the doctor should think about the possibility of cancer in this patient.

What are the symptoms caused by uterine cancer and especially cervical cancer?

Signs and recognition. Symptoms of incipient cancer are bleeding and leucorrhoea. Pain in cervical cancer appears only in the late stages of the disease, when cure is hardly possible.

In the initial stage, cervical cancer does not cause pain, so the presence of pain in a doubtful case may speak more against cancer than for it.

Bleeding in cervical cancer may have the character of increased or prolonged menstruation, as well as bleeding that appears in the intermenstrual period or regardless of menstruation, especially in menopause. The amount of blood released varies. Heavy bleeding is usually observed in the later stages of the disease, while at the beginning the bleeding is moderate or insignificant, but is characterized by its continuity and frequent recurrence. The appearance of bleeding or spotting after a minor injury is of especially great diagnostic importance: sexual intercourse, gynecological examination, vaginal douching, passage of solids. feces through the adjacent rectum, etc. (“contact” bleeding). This kind of bleeding should raise suspicion of cancer, especially when a woman is at menopausal age.

At the beginning of the disease, leucorrhoea does not have the fetid character that it acquires in the later stages of uterine cancer. In the early stage of the disease, leucorrhoea is often odorless, light, serous or serous-bloody. This is how they differ from secretions that arise on the soil. inflammatory diseases and having a mucopurulent character in endocervicitis and a cloudy serous-purulent character in colpitis. Although not a reliable symptom of incipient cancer, leucorrhoea that appears suddenly in old age for no apparent reason should be noticed Special attention. Occasionally, there are cases of cancer in which in the early stages of the disease there is no bleeding or leucorrhoea.

Due to the fact that cancer occurs more often in the menopausal and premenopausal periods, some authors require that antenatal clinics, in order to systematically combat uterine cancer, involve all women in their area who are at a specified age in periodic gynecological examinations. IN Lately this demand meets with full support. Other age groups of women are also included in the survey. It is necessary that doctors antenatal clinics, gynecological clinics, rural medical centers in the fight for early detection initial forms uterine cancer, the greatest attention was paid to those symptoms that could cause the slightest suspicion of cancer. The second unconditional requirement is that in each case the doctor, after performing a thorough gynecological examination, mandatory examined the cervix in the speculum. True, such a study makes it possible to confidently diagnose cervical cancer only in advanced cases. At the initial stage of the process, the examination allows the doctor to make only a presumptive diagnosis or raises a suspicion of cancer. Therefore, in such cases, in addition to a gynecological examination, one should resort to additional research methods. Appointment of any therapeutic measure against bleeding or leucorrhoea without a thorough gynecological examination is a gross omission on the part of the doctor, which could expose the woman who turned to him for advice to mortal danger.

What are the objective changes detected on the cervix during gynecological examinations that may raise suspicion of incipient cancer?

In the initial stage of development of cervical cancer that has arisen inside the cervical canal, a gynecological examination may not provide any information at all. objective signs; in other cases, suspicion of cancer may be caused by the presence of some thickening and hardening of the cervix, especially if the examination is accompanied by the appearance of blood from the cervical canal.

In rare cases of cancer that does not arise from the mucous membrane of the cervical canal, but in the thickness of the cervix, in the initial stage of the disease (before the tumor breaks through into the cervical canal or onto the surface of the vaginal part of the uterus), there will be no symptom of bleeding, so in such cases it is usually recognized very late .

Cancer of the vaginal part of the uterus can be detected during a gynecological examination much earlier than cancer that occurs in the cervical canal, since its location is accessible to inspection in the speculum. In these cases, cancer can be detected in the form of a small papillary growth or hardening located on the anterior or posterior lip of the pharynx, which slightly rises above the adjacent area and bleeds when touched, but more often there is an ulcer, initially somewhat reminiscent of inflammatory erosion. Inflammatory erosion has a bright red color with a bluish tint, velvety in appearance, and bleeds slightly when touched. The eroded area evenly rises above the mucosa and gradually turns into healthy tissue. Inflammatory erosion is often accompanied by the presence of testicles, tissue swelling, and copious mucopurulent discharge from the cervix.

A cancer ulcer has a slightly different appearance: its surface is uneven and lumpy; The color of the ulcer is darker than the color of the surrounding healthy tissue. In some places hemorrhagic and necrotic areas are observed. When palpated, the ulcer tissue is denser than the surrounding tissue and is extremely fragile; at the slightest mechanical damage, heavy bleeding begins; during examination, the probe easily penetrates the tissue.

A cancerous ulcer does not appear uniformly elevated, like a benign erosion, and at the border with healthy tissue it is sometimes separated from it as if by a groove. Catarrhal phenomena, which usually accompany benign cervical erosion, may be absent in the initial stage of cancer. This is how a cancerous ulcer differs mainly from benign erosion. These features clearly expressed, but in the initial stage of cancer, but only when the process has already gone quite far.

At the very beginning of the disease, in its clinical picture, cervical cancer is not much different from a benign ulcer.

Differential diagnosis between cancer and primary syphilitic or tuberculous ulcer of the cervix can also be very difficult. Thus, palpation and speculum examination data in many cases can only raise suspicion of cancer, but they cannot always bring complete clarity to the diagnosis. Meanwhile, the answer to the question whether there is cancer in this case or not, must be given immediately, since saving the patient’s life may largely depend on this.

Therefore, in order to accurately make a diagnosis in a case of suspected cervical cancer, it is necessary to resort to a biopsy.

Biopsy for suspected cervical cancer. A microscopic picture of a histological section with a correctly applied biopsy technique can detect cancerous degeneration at the very initial stage of its development. And if we consider that it is the initial cases of uterine cancer that provide, we repeat, the greatest opportunities for a favorable treatment outcome, then it is clear that the method of microscopic diagnosis in the fight against uterine cancer becomes especially important.

Unfortunately, microscopic examination of the biopsied area does not always allow one to come to an accurate and final decision. If histological examination does not reveal cancer, while the clinical picture is still highly suspicious, it is necessary to re-examine, since the biopsied piece may have been excised incorrectly (for example, taken not from a cancerous lesion, but from an adjacent area where there is inflammation only). Difficulties and errors may arise when interpreting microscopic picture. All this indicates that the data of histological examination, when they are in conflict with the clinical picture, should be treated with some caution. In such cases, the woman should be placed under special registration and systematically undergo repeated thorough gynecological and histological examination.

The II Congress of Obstetricians and Gynecologists noted in its resolution on the programmatic issue of uterine cancer: “ The Congress believes that a microscopic examination that denies a cancerous lesion in the presence of a suspicious picture should not serve as a basis for considering a patient beyond suspicion of cancer and as a reason to release such a patient from the doctor’s field of view».

The question often arises whether a biopsy should be performed in a local hospital or in an institution whose working conditions do not allow, in the event of receiving a response from a histologist confirming the presence of cancer, necessary treatment. Perhaps the local doctor would do better if he sent the patient straight to a medical institution, where a biopsy would be performed, and, if necessary, immediate surgery?

Of course, this line of behavior has certain advantages already because a biopsy performed long before surgery can lead to the introduction of an infection or neoplasm from a cancer focus to nearby or distant areas.

To avoid this danger, in our clinic, in cases where the type of ulcer (disintegration; caused a strong suspicion of a malignant neoplasm), we used the following method: a biopsy was performed half an hour to an hour before the intended operation. This time is enough to examine the biopsied piece using a freezing microtome tissue. If a histological examination revealed cancer, then a radical operation was performed immediately, and then there was no threat of infection and cancer cells spreading through the lymphatic tract from the cancerous ulcer. And if there was no cancer, then the radical operation was cancelled.

But if the biopsy was not carried out at all on the spot, then some women, not attaching much importance to, in their opinion, insignificant complaints, will not always go as intended, and then cases of initial cancer can turn into advanced and inoperable. Therefore, the requirement to perform a biopsy only in an institution where the patient can receive appropriate treatment should not, in our opinion, be categorical.

It goes without saying that performing a biopsy locally with sending an excised piece of tissue for microscopic examination to a pathology office located in the nearest center requires good organizational coordination in the work of local doctors, as well as the entire general treatment and preventive network with oncological service institutions, in the organizational center of which was and remains the oncology clinic.

If a gynecological examination causes the doctor to strongly suspect cancer, then it is better not to perform a biopsy at the site, but to immediately send the patient to one of the medical institutions in the district or region, where a biopsy and, if necessary, surgery can be performed. But in such a case, the local doctor should not limit himself to just the prescription, but must check whether the patient has fulfilled the prescription, and, if necessary, take all measures to ensure that the patient fulfills it without wasting time.

Biopsy technique. A biopsy, or test excision, i.e. cutting out a wedge-shaped piece of tissue from a suspicious area on the cervix for histological examination, is one of the minor gynecological operations. From a technical point of view, it can be accessible to every operating doctor. But despite its simplicity, the operation can sometimes be performed insufficiently carefully, and sometimes incorrectly, resulting in a diagnostic error. So. for example, it may happen that extensive bleeding papillary erosion on the cervix in one place begins to turn into cancer. It is sometimes difficult for an inexperienced doctor to correctly select exactly the area on the eroded neck where cancer is most likely to be detected. As a result, a test piece can be cut out from an area on the cervix where there is no cancer yet, although it is already present in another area of ​​erosion.

In order to choose the right place for a biopsy, you can perform a test, which at one time was proposed to recognize the initial stage of cancer of the vaginal part of the uterus, as an independent diagnostic method. This test consists of lubricating the vaginal part of the uterus exposed by the speculum with Lugol's solution (instead of lubricating, you can make a bath of Lugol's solution). The flat epithelium covering the healthy surface of the vaginal part of the uterus, containing glycogen in its protoplasm, under the influence of Lugol's solution is stained in dark brown color, while cancer cells stain weakly or not at all. As a result, the area of ​​the vaginal part of the uterus affected by the cancerous tumor, after the action of the Lugol solution on it, stands out among the healthy tissue as a lighter spot. This method still did not fully live up to the hopes placed on it. It turned out that the test was specific only for the brown coloration of normal surface epithelium and that areas that did not accept the dye were not necessarily affected by cancer. For example, the surface on which there is hyperkeratosis or benign (inflammatory) erosion with a detached surface layer of the epithelium is weakly stained. However, it is still impossible to completely deny the diagnostic value of this method, and it seems to us that for a doctor with little experience in these matters, this test can help in choosing a site on the vaginal part of the uterus for a biopsy.

In cases where suspicious erosion has widely affected the lips of the uterine pharynx, test pieces must be cut out from both the anterior and posterior lips.

The biopsy can also be performed incorrectly from a purely technical point of view. The most common mistake is to cut out too small a piece, so that the area where there is incipient cancer may not be included in the study drug. In another case, cancer can be suspected when the examined piece contains strands and nests of squamous epithelium, and since the cut piece is too small and thin, it is impossible to determine whether the squamous epithelium grows into the depths and into the adjacent tissue, which is so characteristic of cancer. Of course, microscopic examination reveals, in addition to this, other more or less character traits, but still the overall picture of a large section, allowing one to trace the relative position of the epithelium and stroma over a sufficient distance, is usually of decisive importance. In addition, a too small piece cut from the surface in the form of a plate presents great difficulties for its correct positioning when gluing it to the block; in the removed plate it is impossible to decide by eye where the underlying tissue is located and where the integumentary epithelium is; if the preparation on the block is positioned incorrectly, then in the first sections you can remove the integumentary epithelium and in the next sections have only the stroma. It is, of course, impossible to give a definite answer in such cases.

A piece taken from the surface of a tumor or ulcer is even less suitable for research, since this surface layer can, with existing cancer, give a picture of only necrosis. A wedge-shaped piece cut out from the cervix for microscopic examination must necessarily contain not only the suspicious tissue, but also the adjacent and underlying tissue. Therefore, the cut piece should extend 1 cm beyond the border of the ulcer onto a healthy (to the eye) mucosal surface. In the same way, the cut piece should go so deep that its edge contains a layer of tissue lying under the suspicious area of ​​​​the mucosa.

Usually, no anesthesia is used during the trial cutting. If the biopsy is performed on an outpatient basis, then V. S. Gruzdev recommends using a special instrument. It is a windowed forceps with triangular holes with sharp edges; With these forceps, a piece is bitten out from the anterior or posterior lip of the vaginal part of the uterus.

We do not have personal experience in using such instruments, but we believe that it is unlikely that a biopsy performed with these instruments will often meet all the methodological requirements that were outlined above.

A piece should be cut out especially deeply in cases where the patient is suspected of having one of the rare and most insidious forms of cancer - central, intramural cervical cancer. In such a case, until the cancerous tumor reaches the surface of the mucous membrane of the neck, it is not visible, and only the swelling of the neck and its dense consistency may arouse suspicion and require a trial cutting. Thus, a biopsy will detect cancer only if the cut wedge penetrates deep enough into the muscle.

A deep defect in the cervix, formed during a trial cutting, must be closed with one or two ligatures to avoid bleeding. With a less deep notch and where there is no bleeding, you can limit yourself to vaginal tamponation.
It goes without saying that both the operation and the preparation for it must be carried out according to all the rules applied for any vaginal operation.

If the doctor cannot accurately determine which area of ​​erosion is most suspicious of cancerous degeneration, then the excised piece should have a larger surface.

If a cancerous tumor has arisen in the upper part of the cervical canal, then microscopic diagnosis can only be made by examining a scraping.

At the end of the biopsy operation, the cut piece of tissue is washed from the blood, then placed in a jar with a 5-10% formaldehyde solution or 96% alcohol. To avoid possible errors the jar with the drug must be equipped with a label indicating the last name, first name and age of the patient, the date of the biopsy, as well as the place from which the piece was cut out.

Recognition of cervical cancer arising from the mucous membrane of the cervical canal. Cervical cancer can develop both from stratified squamous epithelium covering the mucous membrane of the vaginal part of the uterus, and from columnar epithelium of the mucous membrane of the cervical canal.

From here, of course, it does not follow that cancer of the vaginal part of the uterus will always be squamous cell, and cancer of the cervical canal will always be columnar cell. Regardless of the morphological form of cancer, cancer of the vaginal part of the uterus in the initial stage of its development can be detected earlier than the beginning cancer of the mucous membrane of the cervical canal. This is quite understandable, since the vaginal part can be subjected not only to palpation, but also to direct inspection, and the mucous membrane of the cervical canal remains inaccessible to the eye. Therefore, when palpation and examination with mirrors reveal an area on the vaginal part that is suspicious for cancer, a test cutting (biopsy) is performed to establish a diagnosis.

But what to do in the case when the anamnesis and clinical phenomena (bleeding and bloody issues in menopause or in old age, contact bleeding, etc.) raise suspicions of cancer, but examination in the speculum does not reveal anything suspicious on the mucous membrane of the vaginal part of the uterus? It's a big mistake to wait further development events. Suspicion must be, as this must be repeated tirelessly, in the shortest possible time either confirmed or rejected.

If the suspicion is based, in addition to the indicated symptoms, on the presence of a small limited hardening on the anterior or posterior lip of the uterine pharynx, then a deep notch can still detect incipient cancer of the cervical canal, which comes close to the vaginal part, but has not yet grown onto its surface. If cervical canal cancer in the early stages of its development is located higher towards the internal os, then in the presence of clinically suspicious symptoms, examination of the vaginal part of the uterus may not reveal anything, and the diagnosis can only be made by microscopic examination of a scraping taken from the cervical canal.

Microscopic diagnosis of cervical cancer can be simple and easy for every pathologist.

In the initial stages of the disease differential diagnosis between a cancerous (and precancerous) neoplasm and various forms of inflammatory processes of the cervix can present great difficulties even with a microscopic examination of an excised piece of tissue. In such a case, consultation with a more experienced specialist may be necessary.

Microscopic diagnosis of cervical cancer by examining native, unstained preparations - smears taken from the affected area of ​​the cervix. Due to the fact that there may be contraindications for performing a biopsy (acute and subacute inflammatory processes of the female genital organs, the presence of pyometra, etc.), the aspirations of clinicians and pathologists were aimed at finding new research methods that could replace a biopsy.

A similar method could be of great interest in the dynamic monitoring of patients with cervical cancer during radiotherapy.

In this direction for last years favorable results have been achieved. As a number of reports by the authors show, in which the discharge taken from the affected area of ​​the cervix in a native, unstained preparation is examined, it gives the highest percentage of matches with the data of histological examination, while the study of stained vaginal smears using the Papanicolaou method not only has no advantages in comparison with the method of studying native drugs, but is also significantly inferior to it, being more complex and less reliable.

When it comes to cervical erosion, in most cases we talk about pseudo-erosion, in which there is no violation of the integrity of the mucous membrane. Fortunately, erosion is quite easy to treat. However, the insidiousness of this disease is that most often it is asymptomatic, and it can only be determined during a routine gynecological examination. It is important to know that neglected erosion can develop into cancer.

As soon as the patient finds out that she has been diagnosed with erosion, she should immediately begin treatment - for this you can use effective folk remedies(on our website there are special articles on this topic). This will help restore women's health and avoid severe consequences diseases.

What is erosion?

When erosion occurs, a disruption of the normal structure of the epithelium lining the cervix occurs. The uterus is connected to the vagina by its narrowest part. This place is called the neck. Normally, the vagina and cervix are lined with multilayered squamous epithelium, and the walls of this organ are lined with single-layer cylindrical epithelium. These two types of epithelial tissue differ in structure and properties. Flat epithelium is more elastic, while columnar epithelium is more rigid. The acidity of the cervix and uterine cavity also differs. Normally, the columnar epithelium secretes a secretion that creates an alkaline environment, while in the vagina and cervix the environment is acidic. This balance is critically important, as it is one of the factors protecting a woman’s genital organs from infection. With erosion, the normal squamous epithelium of the cervix is ​​replaced by columnar epithelium. This condition appears as a red spot surrounding the cervical canal.

Many people mistakenly believe that cervical erosion does not pose any danger. The disease most often does not manifest itself with any symptoms, but if left untreated it can lead to unpleasant and dangerous consequences, in particular, cancer may occur.

Why does erosion occur?

There are congenital and acquired erosion of the cervix.

Congenital occurs due to an imbalance in the normal balance of female sex hormones and most often goes away after the birth of the first child.

• early onset of sexual activity
• mechanical damage to the mucous membrane after gynecological procedures, late stage abortion;
• ruptures of the mucous membrane after childbirth;
• chronic infectious diseases of the mucous membrane;
• state of immunodeficiency;
• diseases of the endocrine system and hormonal imbalances;
• viral infections.

Types of cervical erosion

Currently, the following classification of erosions is used in medical practice.

1. True erosion. In this case, they talk about damage to the mucous membrane. Ulcerations form on its surface, which can bleed. True erosion is extremely rare.
2. Pseudo-erosion or ectopia. The columnar epithelium moves down and replaces the squamous epithelium that normally lines the cervix. This disease can be congenital or acquired. If ectopia is congenital, it most often goes away on its own after pregnancy and childbirth.
3. Ectropion. It is believed that this is a later stage of ectopia. In this case, the mucous membrane of the cervix turns outward into the vagina, which is accompanied by damage to the integrity of the mucous membrane. Often the disease occurs after childbirth.
4. Leukoplakia. With this type of disease, keratinization of the mucous membrane develops. This type of erosion may be associated with a viral infection.
5. Polyps and condylomas. With prolonged viral infection, a woman can develop benign neoplasms - polyps and condylomas of the cervix. These neoplasms can cause a number of unpleasant symptoms such as surface ulceration and minor bleeding, chronic infections, blockage cervical canal and infertility. Over time, such tumors can develop into cancer.

Is cervical erosion dangerous?

Cervical erosion is quite easy to treat. If the disease is identified in a timely manner and appropriate therapy is carried out, there will be no negative consequences will not arise. But the danger of the disease is that it is practically asymptomatic. Often, erosion can only be determined as a result of a routine gynecological examination. Without proper treatment, the disease progresses.

Late-stage cervical erosion can cause a number of other problems.

Infections

One of the biggest dangers of erosion is the likelihood of developing acute and chronic infection of the cervix and uterine cavity. This occurs because the mucous membrane affected by erosion is unable to perform its functions and no longer serves as a barrier against bacteria. The causative agent of the infection can be lactic acid bacteria, which normally populate the vaginal mucosa, or bacteria and fungi that enter the woman’s body from the external environment.

Infertility

Both the infectious process and the development of erosion itself can lead to infertility. In some cases, epithelial tissue grows. This tumor can block the entrance to the uterine cavity.

Epithelial layer dysplasia

With long-term erosion, normal epithelial cells are replaced by atypical ones, and a disease such as dysplasia occurs. Dysplasia is a benign neoplasm, but if not properly treated, dysplasia can develop into cancer.

Cervical cancer

A direct connection has been proven between erosion at a late stage and the occurrence of malignant neoplasm in the cervix. In most cases, cervical cancer is caused by a viral infection, namely the human papillomavirus. At the beginning of the infectious process, this virus causes erosion, which then degenerates into a malignant tumor.

Human papillomavirus (HPV) and cancer

The connection between viral infection and the development of cancer has been proven. According to the latest data, the risk of malignant neoplasms in women infected with HPV increases a hundred times. However, a viral infection is often asymptomatic and can only be detected as a result of a targeted examination.

The human papillomavirus is quite widespread. You can only become infected with it through contact. Most often, infection occurs during unprotected sex.

Currently, more than a hundred types of HPV are known, but most of them do not lead to the development of the disease. Basically, the body copes with the virus on its own, and the pathogen is destroyed within several months after infection. However, some types of the virus are highly oncogenic and lead to the development of cancer of the cervix, vulva or anus.

Cervical cancer can take 5–20 years to develop from HPV infection. The speed of this process depends on the woman’s immunity.

Other types of HPV do not cause cancer, but they cause the development of benign tumors, which, although not fatal, can cause a number of unpleasant symptoms or lead to infertility.

Like other cancers, cervical cancer can only be successfully treated if it is diagnosed in the early stages. In this case, up to 90% of patients completely get rid of the tumor, without losing the ability to give birth to a child.

The danger of this disease is that signs of cancer appear only at a late stage of the disease. These signs include:

1. Bleeding after non-menstrual sexual intercourse. Bleeding may be regular or occur periodically.
2. Atypical vaginal discharge, which often has an unpleasant odor.
3. Pain in the lower abdomen, lower back, legs.
4. Decreased appetite, weight loss, chronic fatigue.
5. Thus, cervical erosion may indicate the presence of HPV infection and the risk of cancer.

Do erosions need to be treated?

There are conflicting opinions about whether cervical erosion should be treated.

If the disease is congenital in nature, it is believed that it cannot lead to oncological diseases, since in this case we are not talking about viral nature diseases. Congenital pseudoerosion is most often not treated until the birth of the first child. After this, the young woman’s body often undergoes restructuring and changes. hormonal background, and the disease goes away on its own.

If erosion is acquired, then the need for treatment is determined by a number of factors. The disease needs to be treated if:

• erosion is accompanied by chronic inflammation of the cervix or uterine cavity.
• lesions occupy a large area;
• the disease is at a late stage, the appearance of atypical cells or dysplasia of the epithelial layer is observed;
• erosion is accompanied by HPV viral infection.

Traditional medicine suggests treating erosion with cauterization. However, it is important to remember that moxibustion is not recommended for girls before the birth of their first child, as this can lead to infertility, early interruption pregnancy or difficult childbirth with multiple ruptures.

In addition, cauterizing erosion is very dangerous if the patient has already developed cancer. Cauterization of a malignant neoplasm, even at an early stage, can lead to a faster spread of the disease. Also in this case, any injuries to the mucous membrane that damage its integrity are dangerous. This leads to cancer cells entering the blood and lymph and spreading throughout the body; metastases occur.

But even if there are no contraindications to cauterization of erosion, this treatment is still very traumatic. After this, scars form on the mucous membrane of the cervix; it is not able to fully perform its functions. This increases the risk of infectious processes. In addition, when a child is born, the opening of the uterus becomes difficult, and ruptures and bleeding may occur.

A more gentle method of treatment is therapy with folk remedies. Traditional therapy includes douching with herbal decoctions, using tampons with medicinal agents and taking drugs internally. This treatment has a complex beneficial effect on the body, restores integrity and normal functioning epithelial layer and does not lead to dangerous side effects.

Write in the comments about your experience in treating diseases, help other readers of the site!

Questions

Question: Can cervical erosion cause cancer?

Can cervical erosion cause cancer?

No, cervical erosion itself cannot cause cancer. Unfortunately, in recent years, gynecologists very often scare women with the fact that erosion can “grow” into cervical cancer over time. However, such a statement is fundamentally incorrect and, moreover, completely absurd. Let's take a closer look at what the relationship may actually be between erosion and cervical cancer.

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Erosion, HPV and cervical cancer: What to do?

So, if you have read the article up to this part, you have probably learned a lot useful information, and most importantly - truthful and modern, about the human papillomavirus, precancerous and cancerous conditions of the cervix and the notorious vaccine against cervical cancer. Let's summarize the above to move on to practical recommendations, which can be used by both women and doctors who want to increase their level of knowledge on these issues.

Cervical erosion is not a precancerous condition and does not develop into cervical cancer. This term is not used in modern gynecology.

The precancerous condition of the cervix includes only one type of condition - severe dysplasia.

The term "dysplasia" is obsolete and has been replaced by the term "intraepithelial lesion".

The diagnosis of this precancerous condition is a laboratory diagnosis - it cannot be made by eye, but only by examining the tissue of the cervix - cytologically and/or histologically.

Neither ectopia, nor polyp, nor leukoplakia, nor mild dysplasia are precancerous conditions of the cervix, and therefore do not require urgent treatment, much less surgical treatment.

Of the 40 types of HPV that affect the human anogenital area, HPV 16 and HPV 18 are most often involved in the occurrence of cervical cancer, and HPV 6 and HPV 11 are most often involved in the occurrence of genital warts.

Genital warts do not develop into cancer and are a benign process.

Natural life cycle The HPV virus is harmless to the human body. HPV infection is found in 70-80% of young people living sex life.

90% of women with HPV infection get rid of the HPV virus without negative consequences for their body.

In the 10% of women with persistent HPV infection, cancer is extremely rare, although there may be abnormalities in cytological smears.

There is no cure for HPV infection.

Overall, 99.9% of women will never get cervical cancer, whether they have ever been infected with HPV or not.

Cervical cancer is a rare disease.

It takes at least a year for cancer to develop from a state of severe dysplasia, so there should be no rush in diagnosis and treatment when HPV or minor abnormalities in cytology are detected.

HPV infection in itself is not an indicator for surgical treatment of the cervix (cauterization, freezing, laser, radio wave therapy), unless the woman has severe dysplasia.

There are two vaccines - HPV4 (Gardasil) and HPV2 (Cervirax) for the prevention of HPV infection and cervical cancer.

The effectiveness of HPV vaccines is not observed after 3-4 years.

Longer periods (up to 10 years) of vaccine effectiveness have not been proven.

HPV vaccines are medicines, therefore, their appointment must take into account strict contraindications. Women and men should be warned about side effects vaccinations.

The use of the vaccine during pregnancy or during pregnancy planning is contraindicated.

Vaccination effectiveness cannot be achieved unless all three doses of the vaccine are administered. Only a small number of women receive the full vaccination (three doses).

Of course, other conclusions can be drawn, and each reader will likely draw his own conclusions.

We come to the question of how, against the background of these numerous contradictory facts, this panic fear before cancer, the commercial influence of pharmaceutical tycoons on modern scientists, doctors and many other people, find the optimal plan-strategy for detecting cervical cancer? I offer you an algorithm for examining and monitoring women, which is supported by many progressive doctors. These recommendations may be completely different from those your doctors follow. However, they are based on a strong rational approach, taking into account the available scientific evidence on HPV infection and cervical cancer. It is your personal business to be guided by these recommendations or use the old ones, because your health is in your hands.

To vaccinate or not to vaccinate against HPV infection?

My personal opinion, which coincides with the opinion of many doctors, is that the age of 9-12 years is not rational, i.e. optimal for vaccination. The desire of the teenager himself to be vaccinated should also be taken into account without manipulating his decision through intimidation that if the child is not vaccinated, he will definitely develop cancer. It is the responsibility of every parent to build healthy relationships with their children and teach them healthy lifestyles, including sexual relations and sexual hygiene.

For women under 30 years of age who have sexual relations with one regular partner and who do not have HPV, vaccination is not mandatory and the choice should always remain with the woman. Manipulating the decision using the argument that a woman's partner may cheat on her and subsequently infect her with HPV is unethical.

The HPV vaccine is not recommended for women over 30 years of age.

In women diagnosed with HPV 16 and/or HPV 18, vaccination will not be effective in protecting against precancerous and cancerous conditions of the cervix. The protective effect can only be against HPV 6 and HPV 11, if they are not infected with them. If other types of HPV are present, the vaccine is also not effective.

Due to the lack of reliable data on the duration of the protective effect HPV vaccines, women and men should know that the clinical effect of the vaccine is observed only for 3-4 years. Is additional revaccination necessary? There is no convincing data on this issue.

How and when to screen for cancer?

Cytological examination of women should begin at the age of 21, regardless of the age at which the woman began sexual activity.

HPV testing is additional method screening and in combination with cytological examination allows to identify from 88 to 95% of severe dysplasias. However, the presence of HPV is not an indication for additional examination and treatment if cytology results are normal.

Now let's look at a possible combination of test results:

Repeated cytological examination can be performed after 3 years.

Cytological examination is normal

Repeated cytological examination can be performed after 1-2 years.

Conduct a microbiological examination, exclude other vaginal infections or treat if present. Repeated cytological smear – after 6-12 months.

Cytological examination - atypical cells

Conduct a microbiological examination, exclude other vaginal infections or treat if present. Repeated cytological smear – after 3-6 months.

Repeated cytological examination after 6-12 months.

Cytological examination – mild dysplasia

Colposcopy can be performed, but is not necessary. Repeated cytological examination after 3-6 months. Biopsy for mild dysplasia is not indicated.

Cytological examination – moderate dysplasia

A colposcopy is necessary. If severe dysplasia is suspected, a biopsy is recommended. Repeat the cytological examination after 3-6 months.

Cytological examination – severe dysplasia

HPV – negative or positive

Colposcopy and biopsy are recommended. When the diagnosis is confirmed colposcopically and histologically, surgical treatment of the cervix is ​​performed using one of the available methods (cauterization, freezing, laser, radio wave therapy, less commonly, conization). If severe dysplasia is not confirmed histologically, repeat cytological examination and colposcopy are performed after 3 months.

If cancer is detected, a woman should be referred to an oncology clinic immediately.

A small addition about colposcopy: using this method, without additional examinations, it is possible to detect moderate and severe dysplasia of the cervical epithelium in only 2/3 of cases. It is believed that in order for a doctor to begin an independent colposcopic examination of cervical cancer, he must conduct at least 200 colposcopies under the supervision of a highly qualified colposcopist and maintain his professional level by conducting at least 25 colposcopies per year.

A biopsy with histological examination of the biopsy specimen has strict indications and contraindications - it is an invasive method of examination, and therefore is carried out only after obtaining the patient’s written or verbal consent. After a biopsy, a woman should avoid coitus for 7-10 days to prevent infection and additional trauma to the biopsy area.

If a woman is vaccinated against HPV, the doctor's priority should always be the results of the cytological smear, and not the presence or absence of HPV infection. Therefore, vaccinating a woman against HPV infection does not eliminate the need for such women to undergo cytological examination regularly.

Women aged or older with a 10-year history (3 cytological smears every 3 years) of normal cytological results can stop screening for precancerous and cancerous diseases of the cervix. The exception is women who are sexually active and have multiple sexual partners.

Thus, of all conditions of the cervix, only severe dysplasia and cancer require surgical treatment. In situ cancer (stage 0) is not considered an invasive form of cancer, so most often it is treated with preservation of the uterus.

When doctors rush with cauterizations and other things surgical interventions When intimidating about the possible development of cancer, I always advise such women to take off the glasses of fear and turn on the safety system for their own body in their consciousness-thinking. First, an examination is necessary (if it is really necessary, because it is enough to simply retake a cytological smear in a few months), and only then - “cutting” the cervix into pieces, but not vice versa. If you do not have severe dysplasia, and the doctor persistently puts pressure on your psyche with surgical treatment, try to forget the way to such a doctor.

Also, few doctors explain to young, frightened patients that surgical treatment of the cervix has many complications. What are these complications?

Infertility due to stenosis of the cervical canal, decreased production of cervical mucus, functional inferiority of the cervix and secondary tubal dysfunction due to ascending infection;

Formation of cervical scars and its deformation;

The occurrence of carcinoma due to incomplete or inaccurate examination;

Menstrual dysfunction;

Exacerbation of inflammatory diseases of the genitourinary system;

Premature birth and premature rupture of membranes (a significant risk of this complication is observed after DEC and cryodestruction, so the doctor must take the choice of treatment seriously in women of reproductive age, especially nulliparous women, in whom surgical treatment may be delayed for a certain period of time).

If you have undergone surgical treatment (with or without indications), it is important to understand that recovery cover epithelium cervix needs time. During the entire recovery period (at least 4 weeks), a woman should not lift weights, use tampons, douche, or be sexually active, as all this provokes trauma with subsequent bleeding and infectious processes of the cervix. The normal histological picture of the cervical epithelium is restored in 60% of women 6 weeks after treatment, and in 90% after 10 weeks. Cytological smear must be repeated no earlier than 3-4 months after treatment. The healing process of cervical cancer after surgical treatment sometimes lasts up to 6 months, so early colposcopic or cytological examination sometimes leads to false positive results and unfounded suspicion of the presence of residual effects of cervical intraepithelial neoplasia.

In conclusion, I would like to focus your attention on the issues of preventing cervical cancer. Some of you will be surprised: isn’t the entire article dedicated to this and isn’t this what vaccines were created for? The trouble is that almost the entire world community, especially the medical community, is fixated on HPV vaccinations. Do you know why? Because behind this lies the generation of income. What about other prevention methods? Are they not there or are they ineffective? They exist, but they will not lead to the creation of income for commercially-minded doctors and pharmaceutical companies. They can save their owners a lot of money, but for many people it is easier to put a pill in their mouth or get an injection than to start and lead a permanently healthy lifestyle. Therefore, people themselves become enemies of their own body.

What other types of prevention are these if we are not talking about vaccines? I have already mentioned risk factors for the development of precancerous and cancerous conditions of the cervix. If the influence of these factors is eliminated or reduced, the chance of cancer will also decrease. Let's look at these risk factors again, but through the prism of cervical cancer prevention. What can we change, where can serious work be done?

Large number of births - the number of births in many countries is decreasing because modern women do not want to give birth to more than 1-2 children, but it is important to reduce the number of abortions, because they can also be accompanied by trauma to the cervix. In addition, proper management of childbirth will protect many women from cervical ruptures - this entirely depends on the qualifications of doctors and midwives.

Deficiency of vitamins A, C and β-carotene in the diet of women – balanced diet will help prevent not only cervical cancer, but also many other diseases;

Long-term (more than 5 years) use hormonal contraceptives– proliferative effect of the estrogenic component of COCs – many doctors still prescribe old forms of contraceptives with high content hormones. Increasing the level of education and experience of doctors and women in issues modern contraception will help reduce Negative influence hormonal contraception on a woman’s body;

Women whose partners have been diagnosed with cancer of the glans penis, which in some cases can be caused by oncogenic types of HPV - cancer of the glans penis is more common in those men who have had or are leading a promiscuous sex life with frequent changes of partners. Women are not to blame for this that their health largely depends on the responsibility of their spouses as sexual partners, and teaching men rationality and caution in sexual life or preventing adultery is not easy, but regular cytological screening remains in women whose partners have or have had cancer of the glans penis;

Immunodeficiency conditions, including AIDS, as well as the use of medications that suppress the immune system (organ transplants, treatment of cancer, etc.) - when treatment is necessary, there is nowhere to go, but excessive use of steroid drugs, antibiotics, biostimulants does not lead to good, Monitoring the use of drugs , which can reduce the body’s defenses - this is an important task for both doctors and people who use these drugs;

Individual genetic predisposition to gynecological malignant processes– is rare, but it is important to pay attention to the history of cervical cancer in close relatives;

Sexually transmitted infections, which can often suppress defense mechanisms integumentary epithelium of the cervix - prevention depends entirely on the person engaging in sexual relations, and his level of knowledge, concern about how to protect himself from sexually transmitted infections; Educational work will not hurt here;

Human papillomavirus (HPV) - most often transmitted through sex, it all depends on the person himself - how much he understands the importance and necessity protective measures from various types of sexually transmitted infections;

Number of sexual partners (more than three) - the number is never reflected best quality, and the philosophical law is reflected at the level of sexual relations: what is important is not the number of sexual partners from whom one can become infected with many diseases, but stable, high-quality sexual relations with one partner.

Smoking (active and passive) – smoking is associated with many serious diseases, so quit smoking if you still smoke and it will reduce your risk of developing cervical cancer if you are a woman significantly;

A history of cytological smears with deviations from the norm - the more often and the more such deviations, the greater the chance of developing cancer, therefore cytological examination is not only a diagnostic method, but also a method of preventing cervical cancer;

Low social level – poor hygiene, including sexual life, promiscuity, lack of timely and high-quality medical care – government programs it is necessary to develop and guide towards improving the lives of people with a low social level. Then there will be no increase in tuberculosis, sexually transmitted infections, crimes and many other social problems;

Pattern of sexual behavior - bisexuals, homosexuals, promiscuity - people choose their sexual orientation themselves, and they should not be punished for this, but learning to protect themselves from sexually transmitted infections and creating stable, long-term sexual relationships will help prevent those types of cancer that are caused by HPV;

First sexual intercourse at an early age (before 16 years of age) – sexual education of adolescents depends primarily on parents, their relationship with children and the presence of trust. More effective sexuality education programs must be introduced in schools. Facilities mass media should not promote the depraved life of the PR elite and all kinds of “stars”, but take part in the moral, spiritual and physical healing of the nation.

Your health is in your hands, and your knowledge is your strength, which will protect you throughout life from artificially created problems. Take care of yourself!

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dajana Ukraine, Makeevka

Dashito

Elyosha Ukraine, Berdyansk

alice96 USA, New York

Olesya Russia, Kirov (Kirov region)

Future doctor Russia, Saratov

Guest

Today I had an appointment with a gynecologist for a medical examination.

She suggested that I treat my ectopia with vaporization, first take a biopsy and undergo a bunch of tests, buy a bunch of drugs with unproven effectiveness

At the same time, I told her that I was planning a pregnancy!

Yes, she is a wealthy doctor, I understood from her statements, but I didn’t pull her tongue. But she also knew that I was a doctor.

Thank you very much!

Olya Ukraine, Odessa

Marusya Russia, Krasnodar

Camomile Ukraine, Kyiv

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What is cervical erosion and can it develop into cancer?

Uterine erosion is a pathological disorder of the mucous membrane associated with damage to certain areas of the inner lining of the organ.

During a gynecological examination, the doctor may detect a number of changes in the mucous membranes, which are called erosion.

Etiology

Several types of damage are identified; each type of change has its own pathogenesis of the disease:

• Pseudo-erosion or ectopia. This change in the condition of the mucous membrane may be associated with changes in hormonal levels in the body. In the case of ectopia, an increased level of estrogen is observed in the blood. Such changes are not considered prerequisites for the development of cervical cancer; disorders do not require treatment. IN exceptional cases the doctor may prescribe treatment for pseudo-erosion if a focus of inflammation is detected in its area.
• Ectropion. Characterized by inversion of the cervix under traumatic influence. Injuries include postpartum injuries, consequences of abortions or uterine curettages.
• Dysplasia. Can be diagnosed by a doctor based on tests and visual examination; pathology is the main cause of development cancerous lesions. Dysplasia develops as a result of exposure of mucosal tissue to the virus that causes human papillomatosis.
• True. Caused by inflammatory processes in the uterine cavity, the cause of which is the presence of an infectious process. Pathogens of urogenital infections enter the body through unprotected sexual contact. Treatment of true erosion begins with identifying the cause of the development of the inflammatory process and destroying the infection that caused it.

Risk group

All age categories of women are susceptible to the disease, but most often it is found:

• The girls in age category from 20 to 40 years.
• In female representatives who are sexually active. The disease is less commonly found in virgins.
• In women and girls who systematically take contraceptive medications.
• True and dysplasia lesions of the cervix are found in patients who do not have a permanent sexual partner and often change partners.

There are statistics where there is a tendency to increase the detection of erosive changes in the uterine mucosa in women who use alcohol and tobacco products.

Pathogenesis

The development of cervical erosion, and subsequently cancer, follows the following pattern:

1. The beginning of the pathological process. It is characterized by the development of inflammation in the uterine cavity of an infectious or non-infectious nature.
2. Formation of erosion. Erosion may manifest as bloody or serous discharge, but is often asymptomatic. Detection of erosive changes by a doctor during examination.
3. Expanding the scope of changes. This scenario may occur if the disease becomes chronic, if it is not detected in the early stages or if there is no treatment.
4. Education benign or malignant formation. Perhaps if dysplasia or true erosion occurs.

Consequences

If detected in the early stages, the disease can be treated quite easily, but detecting changes in the mucosa in a timely manner can be very problematic. Whether erosion can develop into cancer depends on the nature of the damage to the mucous membrane observed in the woman:

• Pseudo-erosion cannot cause negative consequences on the body.
• When true erosion is detected, there is a danger that the infectious process will spread to nearby organs. Infectious lesions of the uterus and its appendages can lead to female infertility.
• In the case of dysplasia there is real threat the occurrence of malignant neoplasms.

Advanced cervical erosion may not always cause the development of cancer; additional diagnostic tests must be performed to accurately determine the risk of its development.

Diagnostics

The discovery by a gynecologist during a visual examination of the uterine cavity of dark red foci against the background of a paler mucous membrane of the uterus is the basis for suspecting the development of pathological changes in the mucous membrane.

Patients are surprised by the diagnosis of uterine erosion; this is due to the absence of a clinical picture in most cases.

Detection of a lesion similar to erosive one cannot be the basis for a final diagnosis. To clarify, a number of additional studies are being carried out to identify erosive changes and the causes of their occurrence.

• Cytological studies. For this purpose, a smear of the uterine cavity is taken. The analysis allows you to determine the risk of developing cervical cancer pathologies. At the same time, a flora study is carried out to identify the presence of inflammation.
• Colposcopy. The study is prescribed when cytological studies reveal suspicious changes in the cellular structure. The test is necessary to detect changes in a cancerous or precancerous condition.
• Biopsy. A piece of tissue from the affected area of ​​the uterus is taken if colposcopic studies reveal the presence of a neoplasm developing.
• Polymerase chain reaction(PCR). A highly accurate study that allows you to determine the nature of the causative agent of the infectious process. Only an accurate determination of the type of pathogen will allow us to determine treatment tactics.
• Research on HPV detection. It is the papilloma virus that leads to changes in the cervix and the development of cancer, therefore, if erosion is suspected, the presence of the virus in the tissues and its danger to health are determined.

Prevention

The danger of cancerous changes resulting from cervical dysplasia requires timely detection and treatment of the disease in the early stages.

• Infectious processes leading to the formation of erosion are often asymptomatic, so it is necessary to undergo regular testing to detect urogenital infections.
• An annual examination of the health of a woman’s genital organs will ensure that the disease is detected in the early stages of development.
• To avoid the development of inflammatory processes in the uterine cavity, it is necessary to carry out regular hygiene procedures, and protect yourself against sexually transmitted infections.
• Even banal thrush can cause the development of erosion; to avoid this, you should lead a healthy lifestyle and maintain the condition of the immune system.
• If erosive changes are detected, it is necessary to immediately proceed to treatment, and not allow erosion to develop into a chronic disease.

The risk of cervical erosion exists in women of all ages; timely detection of the disease will prevent the formation of malignant tissue changes.

A specialist is able to make a preliminary diagnosis through a visual examination, and only after additional research is an accurate diagnosis determined.

You should not self-medicate, use the correct prescription therapeutic procedures can only be prescribed by a gynecologist after conducting additional studies to determine the nature of the disease and its causes.

Cervical erosion is a lesion of the mucous membrane, flat cells in the epithelial layer of the organ. Also, it is with pathological changes in epithelial cells that the oncological process develops. So can erosion turn into cancer, and what is the likelihood of such a course of the disease? How are erosion and cervical cancer related?

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Can cervical erosion turn into cancer?

Can erosion cause cervical cancer? Some doctors are of the opinion that it can. However, there is little basis for such a position. At its core, erosion is a small defect in the epithelial layer. In its structure and structure, it is almost completely similar to a skin abrasion.

This “abrasion” does not go away, since it is constantly affected by external factors. But it cannot cause cancer either. How mechanical damage to the skin does not cause cancer.

However, there are multi-step, complex mechanisms through which cancer and erosion may be indirectly related. Cancer tumor– this is a focus of active division of atypical cells (that’s why the tumor grows so quickly). That is, to begin such a process, in essence, you only need one atypical cell that can actively divide. The process of formation of such a cell is complex and suppressed by the immune system. But given favorable conditions, it can happen quite quickly.

It is believed that one of the factors that significantly increases the likelihood of developing oncology is the presence of a long-term non-healing defect in a particular organ. This defect reduces immunity (general and local). And it becomes more difficult for the body to suppress pathological cell divisions. Erosion is precisely such a defect.

Thus, if erosion exists for a long time (at least 10 years), then it can become a significant risk factor for the development of a precancerous condition. But even a precancerous condition in this case is not very dangerous. In reality, only about 0.1% of these conditions progress to cancer.

The presence of erosion increases the likelihood of the addition of other viruses and infections. Including human papillomavirus. It causes dysplasia. And this disease can turn into cancer with a high degree of probability (30-50% of all cases without treatment).

Groups and risk factors

Although erosion and cervical cancer are not directly related, the following factors increase the likelihood of developing cancer:

• HPV infection;
• Early onset of sexual activity;
• A large number of sexual partners without using barrier methods protection from STDs;
• Weakened immunity;
• Malnutrition, unbalanced diet, strict diets and so on.;
• Smoking, drinking alcohol and other bad habits;
• Genetic predisposition to the occurrence of oncological processes;
• Hormonal imbalances, in particular, treatment for threatened miscarriage;
• Constant stress;
• Lack of sleep and chronic fatigue;
• Regular long-term hypothermia.

To reduce the likelihood of such a development of the disease, it is recommended to get vaccinated against HPV. It is important to use barrier contraception and carefully observe intimate hygiene.

Signs of oncology

This disease may cause some symptoms during the transition to oncology. Although it is believed that oncology does not cause symptoms, it can still be suspected based on the clinical picture.

In the early stages

At the very beginning of the disease, there are no symptoms at all. But the disease can be detected through cytological examination or biopsy. Over time and initially, symptoms may appear:

1. Bleeding not associated with the menstrual cycle, as well as developing after sexual intercourse (occurs in 40% of cases with cancer);
2. A large number of vaginal discharge, their change;
3. Rectal examination may also reveal erosive bleeding.

However, these symptoms can be caused by a number of more common conditions. Therefore, cancer is rarely diagnosed at this stage.

In later stages

In later stages, symptoms are more pronounced. It develops when the tumor size is significant.

1. Fatigue and weakness;
2. Dysuria;
3. Urinary retention and difficulty with it;
4. Hydronephrosis;
5. Dramatic weight loss;
6. Hematuria;
7. Pain in lower limbs and in the pelvic area;
8. Edema;
9. Intestinal dysfunction.

At the metastatic stage, hypercalcemia, joint pain, hepatitis, and liver pain are also detected.

Treatment of cancer stage

In the early stages of the disease, when there is no precancerous or cancerous process, it is quite easy to cure erosion. Cryotherapy and cauterization are used different ways, radio wave therapy and other low-traumatic methods. In the case of the oncological stage, everything is more complicated. In this case apply standard methods oncology treatment.

Around the world, cervical cancer is considered one of the most dangerous cancers with a high mortality rate. Incidence statistics have remained stable over the past 10 years and are significantly higher in developing countries. On average, it occurs in women aged 30-34 years.

Often, such a diagnosis is preceded by changes in the structure of the mucous membrane of the cervix. Although the relationship of the problem " uterine erosion – cancer“does not always reliably indicate such a serious disease; you still need to understand when to worry and distinguish erosion from cancer.

Causes of cervical erosion

Erosion occurs when the squamous epithelial cells of the cervix become inflamed, red and velvety on the appearance. Blurred and infected areas are also observed.

1. Cervical erosion, as well as, is associated with increased level estrogen hormone, so it often occurs in young girls and women taking oral contraceptives, as well as during pregnancy.
2. Injury from tampons or other objects.
3. Vaginal infections such as herpes or syphilis.
4. Another condition for the occurrence of erosion is damage or inflammation (cervicitis) of the surface covering of the cervix during childbirth or after a miscarriage. This situation may take many years to be diagnosed. In this case, cervicitis becomes chronic, forming small mucous cysts on the cervix.

However, cervical erosion can occur in any woman without obvious reasons or predisposition, but not always erosion develops into cancer.

Symptoms of cervical erosion turning into cancer

Uterine erosion is usually asymptomatic. Only a doctor can detect the disease through direct examination. However, you should pay attention to signs such as bleeding after intercourse and/or heavy discharge.

It is important to remember that situations where erosion and cancer are interconnected do occur in medical practice. Therefore, you need to make sure that there are no precancerous changes in the cervix. For this purpose, a cytological examination (smear collection for analysis) and colposcopy are carried out.

Etiology of cervical cancer

The development of cervical cancer is directly related to the sexually transmitted human papillomavirus (HPV), which interferes with tumor suppressor genes such as p35 and retinoblastoma to produce viral carcinogenesis.

95% of cases of cervical cancer are associated with types of HPV infection such as 16 and 18, less often caused by 31, 33, 34 and 45 strains.

Risk factors :

Erosion turns into cancer only under favorable circumstances:

• early sexual experience with frequent changes of partners and lack of barrier methods of contraception;
• weakened immunity and malnutrition;
• hormonal factors, especially drug effects on the body when there is a threat of miscarriage;
• smoking reduces cellular immunity and viral clearance;
• family history may be a risk factor due to similar image life.

Symptoms of cervical cancer

1. In the initial stages, oncology is asymptomatic. It can be detected by a doctor by taking a smear from the cervix.
2. Intermenstrual and postcoital bleeding. Happens in 40% of cases. Particular attention should be paid to heavy and constant bleeding.
3. An increase or change in vaginal discharge.
4. A rectal examination may reveal bleeding due to erosion.

Symptoms in later stages include:

• pain in the pelvis, legs and swelling;
• changes in bowel function;
• hematuria;
• dysuria;
• urination or urinary retention;
• ureteral obstructions leading to hydronephrosis;
• fatigue and weight loss.

Cervical erosion - cancer: symptoms of metastatic disease

Malignant tumors in the last stages of the disease may include the following symptoms:

• difficulty breathing and hemoptysis (lung damage);
• jaundice and abdominal pain (liver damage);
• bone pain and hypercalcemia.

Treatment

Cervical erosion without cancer includes minor surgery. These procedures are usually painless and performed on an outpatient basis:

1. Freezing (cryotherapy).
2. Cauterization (diathermy).
3. Treatment with radio waves.

In cases where erosion is cancer, therapy requires treatment methods acceptable for cancer lesions:

Surgery:

Provides for the destruction of abnormal ectocervical epithelium by cauterization, cryodestruction or laser therapy.

At an advanced stage, a radical method of therapy may be required, which involves complete removal cervix, upper third of the vagina and uterosacral ligaments.

Radiotherapy:

Typically, a combination of radiation therapy and brachytherapy is used. Radiation therapy affects the pelvic floor to the upper sacrum. Intraresonator brachytherapy is effective for tumors up to 2 cm in diameter.

Chemotherapy:

Significantly improves overall survival for high-risk patients in the early stages.

Pharmacotherapy:

Can be used simultaneously with radiation treatment during primary radiation treatment. It has been shown that this method reduces the risk of relapse and death by 30-50%. But the toxicity of the method is high and it is suitable only for those patients for whom surgery or radiation therapy cannot be applied.

Prevention

To answer the question negatively: “ Does erosion turn into cancer??”, you must, first of all, observe personal hygiene standards and get vaccinated against human papillomavirus. It has been scientifically proven that this will help prevent the occurrence of cancer in the cervix.