CERVICAL (CERVIX) CANCER
It is the most common female genital cancer worldwide. Its incidence is related to the development level of the country. Since cervical cancer screening test (smear) is widely applied in developed countries and precancerous lesions are detected more frequently, cervical cancer comes after uterus cancer in terms of incidence. However, since the smear test is not widely applied in underdeveloped countries, cervical cancer is the most common female organ cancer. This shows that cervical cancer in women is a cancer that can be significantly prevented or detected early by having smear tests done regularly, because the period of transformation from precancerous lesions to cancer takes about 8-12 years. Although the average age of onset of the disease is 52, it increases between the ages of 35-39 and 60-64.
What are the risk factors?
- The woman having had a Human Papilloma Virus (HPV) infection: Infections with especially high carcinogenic types (type 16, 18, etc.) increase the risk.
- Smoking: The risk is increased in both active and passive smokers.
- The suppression of the immune system
What are the main complaints and findings?
- The most common complaint is abnormal bleeding and bloody discharge. Bloody discharge after intercourse requires attention. Sometimes it can be seen in the form of bleeding after menopause. Smelly, dirty bleeding discharge is observed in advanced cervical cancers.
- Anemia may develop in patients resulting from bleeding.
- Lower abdominal pain may be seen in advanced cases.
- In the majority of patients during examination, there is a visible lesion in the cervix. In a small part part of the patients (in cancers that develop in the cervical canal), no lesion is witnessed on examination.
- In the advanced stages of the disease, swelling of the kidneys (hydronephrosis) and kidney failure may develop as a result of obstruction of the lower urinary tract.
How is the diagnosis made?
Colposcopic examination and biopsy of suspicious areas should be performed in patients with defects in the smear test. In cases where the pathological diagnosis is incompatible with the smear test, the diagnosis can be made by removing a small part of the cervix for diagnosis.
In patients with visible lesions during the examination, direct biopsy is performed and sent to the pathology laboratory.
In patients with cancer as a result of biopsy, a detailed examination is performed to determine the stage of the disease. With this examination, the extent of the disease and its stage are determined (in the case of uterine and ovarian cancer, the extent of the disease can be determined during surgery).
How is the treatment done?
In the early stages of the disease, surgical treatment is possible. According to the stage of the disease and the woman’s desire to have children, part of the cervix or the whole uterus is removed. In this period, the patient has a very high chance of a long life. In non-menopausal women, the ovaries are not removed. If necessary, postoperative radiation therapy (radiotherapy) can be given.
For advanced stage of disease that have missed the chance of surgery, radiation therapy (radiotherapy) and drug therapy (chemotherapy) are applied. These patients have a lower chance of a long life than the previous group.