carcinoma cervix is preventable cancer in women. Pap smear screening has reduced the percentage of new cases of carcinoma cervix. In developing countries the most common cancer in women is breast cancer, cancer cervix and the third most common cancer is ovarian cancer. cancer cervix is not common in women and young adults who are sexually not active.
The squamous cell carcinoma is the most common histological type in carcinoma cervix. The most common spread is through lymphatic, blood and direct implantation during a surgical operation. There are four stages of carcinoma cervix. The stages are classified with the FIGO staging through examination like the colposcopy, lymph node examination, biopsy and hysteroscopy.
stage I - confined to the cervix
stage Ia - deep invasion<5mm
stage Ib - cancer limited to the cervix uteri.
stage 2 - invades beyond the uterus and not to the pelvic wall
stage 2a - no parametrial invasion
stage 2b - with parametrial invasion
stage 3 - extends to the pelvic wall and to the lower third of the vagina
stage 4 - extends beyond the pelvic wall and to the bladder and rectum
stage 4a - spreads to the adjacent structures
stage 4b - distant metastasis to other organs
Complications of carcinoma cervix:
- vaginal bleeding
- pus collection in the endometrium
- vesicovaginal fistula and rectovaginal fistula.
Management of carcinoma cervix:
PREVENTIVE MEASURES:
- Maintain good hygiene
- avoid multiple sex partners and early sexual intercourse before the age of 16 years.
- use of condoms
- in high-risk person removal of the cervix during a hysterectomy
Surgical management:
radical hysterectomy is the prefered choice.
Chemotherapy is needed in old age and persons who are unfit for operation. In addition with surgical management, the chemotherapy is necessary to prevent metastasis.
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