In the initial stages of the disease surgical treatment. This applies to patients in stage I and IIA. Methods of treatment of these stages are aimed at preventing relapse and the use of organ interventions. Are used:
Conization of the cervix (cone-shaped electroscission). The advantages of the method include radical tumor removal (by electroscission). This method allows for a thorough histological examination of the remote site. The advantages also include a small number of complications, keeping all physiological functions, including fertility. Also electroscission sometimes used methods such as cryosurgery, laser photocoagulation, and cervical conization, electrocoagulation. These methods do not allow histological examination during the operation, and therefore less likely to apply in the case when there is confidence in the form of microinvasive cervical cancer and require more careful monitoring of the patient, because give more chances for relapse. Given that the initial forms of cervical cancer can be identified in most cases, the effectiveness of treatment for this type of surgery is 97%.
Amputation of the cervix. This method of surgical treatment is applied in the presence of severe deformities of the cervix (eg, tears of the cervix during labor, the defeat of the cervical canal). Normally held: classical conical amputation of the cervix, laser ablation of the cervix, cervical cryosurgery, ultrasound cervical amputation, amputation of radiosurgery. The operation is carried out using vnutrevennoy anesthesia. Extirpation of the uterus (hysterectomy). Indications:
Age older than 50 years.
The location of the tumor in the cervical canal.
Poor cone biopsy (eg, detection of preinvasive cancer sites).
No possibility of elektrokonizatsii.
The combination of preinvasive cancer of the uterus or uterine tumors of the appendages
In stages I b - II Wertheim operation is conducted, or its equivalents - removal of the cervix, uterus and appendages. If in the future we plan to radiotherapy, it is desirable during surgery perform ovarian transposition. In this case, they do not fall under irradiation, and therefore will not develop menopausal symptoms.
If the investigation reveals the para-aortic lymph node metastasis, it is assigned radiotherapy, which is usually performed in combination with surgery and sometimes chemotherapy methods, and has its own characteristics. Thus, when radiation therapy for cervical cancer is extremely important to determine the optimum conditions of irradiation. This is a minimal exposure of adjacent organs against the maximum exposure of the tumor and the zone of regional metastasis. To this end, a pre-medical imaging using ultrasound, x-ray computed tomography, magnetic resonance imaging.
To carry out a radical irradiation combined radiotherapy is used:
exposure to external sources of gamma rays and beta particles. A single dose of about 2 Gray and the total radiation exposure of about 50 Gray;
intracavitary radiation therapy with a single dose of about 5 Gy, and total - 50 Gy. Usually preceded by intracavitary therapy of surgery and external irradiation is carried out in the postoperative period. External radiation dose of 2 Gy is conducted per session (20-30 sessions).
Chemotherapy is used as a comprehensive treatment, or isolation. As the only method of chemotherapy is used only at stage IV cervical cancer. Various schemes of chemotherapy using the following drugs: cisplatin, fluorouracil, Navelbin, interferon, bleomycin, adriamycin, cyclophosphamide, cyclophosphamide.
Prediction of treatment. Five-year survival rate of patients with cervical cancer are: in Stage I - 95-97%; in stage II - 70-75%, in stage III - 40-45%.
As you can see, early detection and treatment gives excellent results, which once again confirms the need for periodic examinations by a gynecologist.
