Cancer of the female organs: symptoms, stages and treatment features. Diagnosis of cancer of the female genital organs The first signs of cancer in women

At the initial stage, the signs of a painful condition do not remind of themselves. At later stages, the following symptoms of cancer of the female genital organs are noted:

• discharge with blood during the intermenstrual period and in women with menopause;
• pain in the lower abdomen;
• pain and discomfort during sexual intercourse.

Signs of the disease state vary depending on the type of disease and stages of development.

Features of malignant formation of the external genitalia

Malignant neoplasms mainly affect elderly women and are nodules of a dense structure, papillary growth, infiltrates, and sometimes ulcerative formations with hard edges may appear.

The precancerous stage of the disease are diseases such as vulvar kraurosis and leukoplakia. A cancerous tumor of a dense structure can grow over the surface of the vulva, as well as deep into tissue joints; regional lymph nodes are also affected.

Symptoms, course and treatment methods for cancer of the external genitalia

The initial symptom of this disease is itching, a burning sensation in the vagina and on the surface of the vulva. Next, painful sensations are observed, and when the tumor begins to disintegrate, bloody discharge with purulent particles is released from the vagina, and a foul odor is noted.

At the first and second stages of the disease, a combined course of treatment is prescribed, in most cases this includes surgery and radiation therapy. At the third and fourth stages of cancer, only radiation therapy is used.

Features of vaginal cancer

As an independent disease, vaginal cancer is extremely rare. Women during menopause and menopause are more susceptible to this pathology. The disease develops against the background of the appearance of infiltrates of a dense structure or ulcerative neoplasms on the vaginal walls with a rapid process of ulceration.

Symptoms, course and treatment methods for vaginal cancer

Symptoms of vaginal cancer:

• leucorrhoea of ​​purulent-bloody consistency;
• pain in the second stage of the disease;
• sensations of squeezing of the vaginal space;
• disturbance of the urination process;
• general signs of intoxication of the body.

In most cases, the treatment of this pathology is radiation therapy, since metastases are characterized by characteristic mobility and spread to the lymph nodes. Also, neoplasms in the vagina are removed by excision during surgery.

Features of cervical cancer

A malignant tumor of the cervix is ​​the most common type of oncology among all malignant forms of pathology of the female organs.

There are different stages of cervical cancer:

• initial stage;
• the first stage, which is characterized by damage only to the cervix;
• the second stage, which is characterized by the spread of the neoplasm throughout the entire space of the vagina, uterus, and parametrically shaped tissue;
• the third stage, which is characterized by the spread of tumor cells over a larger space than in the second stage;
• the fourth stage, which is characterized by tumor growth in the area of ​​the bladder and rectum, metastasis spreads to all organs: bones, lungs, etc.

Symptoms, course and methods of treatment of cervical cancer

The initial stage of this disease does not show any symptoms. At the first stage, leucorrhoea of ​​a serous or bloody-serous consistency may be released, which intensifies during the examination of the vaginal space, as well as after sexual intercourse, defecation, and contact bleeding may be observed. At the second and third stages of the disease, bloody leucorrhoea with characteristic purulent components, which are distinguished by a fetid odor, is released. The following symptoms are also observed:

• pain in the lumbar region and abdominal cavity;
• general physical condition is impaired;
• intoxication;
• bladder dysfunction;
• rapid weight loss.

Treatment methods depend on the stage of the disease. At the initial or first stage of cervical cancer, both surgical intervention and combined treatment are performed - radiation therapy and surgical excision of the tumor. At the second and third stages, radiation therapy of a combination form is carried out. At the fourth stage, symptomatic treatment is carried out.

Prevention of cervical cancer involves the timely detection of pathology in the cervical area, which can subsequently trigger the development of cancer: various forms of cervical erosion, scar changes, endocervicitis.

Features of uterine cancer

Cancer of the uterine body develops with the formation of diffuse lesions of the inner uterine lining (endometrium) or the growth of a polypous form. In the process of germination into the tissue connections of the uterus, tumor cells can spread to the abdominal cavity and appendages. Metastasis is observed at later stages.

Symptoms, course and methods of treatment of uterine cancer

The disease progresses gradually. The following symptoms are characteristic of this pathology:

• discharge of leucorrhoea of ​​serous-bloody or bloody-purulent consistency with an unpleasant odor;
• acyclic bleeding in elderly women;
• bleeding during menopause.

The above symptoms require curettage from the uterine cavity with further histology of the material taken.

Treatment methods for uterine cancer:

• combined treatment (radiation therapy, surgery);
• complex treatment (radiation therapy, surgery, hormonal therapy).

Features of ovarian cancer

At the initial stage of the disease, no symptoms are observed. Further signs of ovarian cancer appear:

• increase in abdominal size;
• palpation of a tumor neoplasm;
• the appearance of ascites, during which fluid accumulates in the abdominal cavity.

In more advanced cases, pain, signs of intoxication appear, the functioning of the bladder and intestines is disrupted, sudden weight loss and exhaustion.

For ovarian cancer, combination treatment is prescribed. First, radiation therapy, chemical and hormonal therapy are used.

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

• fibroma;
• myoma;
• fibroids;
• cystoma;
• polyp.

Fibroids typically appear on parts such as the ovaries, labia, or inside the cervix. Formed from fibrous connective tissue. Cancer manifests itself in female signs of pain in the pelvis and difficulty during bowel movements.

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

Fibroids form in the uterus and can reach significant sizes. As the tumor develops, pressure occurs 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 the appearance of pain, spasms and discomfort during intimacy is characteristic.

Polyps are soft, red-pink growths. Arranged in clusters. With them, bleeding appears after sexual intercourse and discharge increases during menstruation.

General 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 yourself experiencing symptoms, you should immediately consult a doctor in order to prevent the development and exacerbation of oncology in advance:

• Bloating.

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

• Stomach ache.

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

• Lower back pain.

You can even get used to monotonous pain of a constant nature and not pay attention to it, but this is a symptom of oncology.

• Fever.

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

• Heavy bleeding.

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

• Stomach upsets.

Diarrhea, constipation, flatulence and irregular stool, sometimes with the presence of blood, are reasons to consult a doctor. These are signs not only of genital cancer, but such manifestations indicate possible rectal cancer.

• Changes in the genital organs.

Changes uncharacteristic of the vulva or vagina (skin color, discharge, blisters, wounds) can serve as a signal of the development of cancer, so a visit to the doctor is required. Regular examination by a gynecologist is the basis for preventing cancer.

• Weight loss

Losing more than five kilograms per month without stress and effort is unnatural. Weight fluctuations are possible, but rapid weight loss is not a positive fact.

• Fatigue

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

• Breast changes

Any lumps, wounds, swelling or redness found on the mammary glands during examination is not a good sign, so you should immediately consult a doctor.

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

Uterine cancer and its causes

The causes of cancer in women may include promiscuity, early onset of sexual activity, viral diseases and cervical injuries. Cancer often develops due to herpes (papillomas), so it is recommended to get tested in order to detect pathology in time.

At 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 the pathology can be diagnosed during an examination by a gynecologist.

With cancer of the uterine body, polypous growths form. A malignant tumor, when germinating, affects the appendages and abdominal cavity, which is why an unpleasant-smelling discharge is formed, consisting of a mixture of pus and blood.

Ovarian cancer

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

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

Vaginal cancer

The first sign can be purulent-bloody leucorrhoea. 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 menopause.

Labia cancer

This type develops during menopause and consists of ulcerative nodules with dense edges. As the tumor grows, it penetrates deeper, affecting the lymph nodes. Initial signs are burning, itching and pain. During exacerbation, purulent-bloody discharge occurs.

Prevention of labia cancer

Regular gynecological examinations help prevent the development of labia cancer, which not everyone can avoid. It is also advisable to follow the recommendations of oncologists to reduce the risk of getting sick. Increased immune status protects well from cancer, for which it is recommended to lead a healthy lifestyle, which includes:

• moderate physical activity, hardening;
• absence of bad habits (alcohol consumption, smoking, drug addiction should be excluded);
• diet and proper diet with foods rich in vitamins, microelements, and plant fiber;
• proper sleep and rest (it is better to avoid stressful situations and overwork, which, according to psychosomatics, provoke cancer);
• genital hygiene;
• maintaining normal weight;
• absence of promiscuity.

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Evaluation of treatment effectiveness

The criterion for the effectiveness of chemotherapy is the complete disappearance or significant reduction in tumor size, which allows radical surgery to be performed.

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Diagnosis of cancer of the external genitalia in women

Due to the similarity of the early symptoms and clinical picture of cancer and precancerous lesions, the onset of cancer often goes unnoticed. Recognition of cancer can be helped by a cytological examination of a fingerprint smear from the surface of an ulceration or a smear prepared from a scraping from a suspicious area of ​​the mucosa. The final diagnosis of cancer of the external genitalia in women is made using a biopsy. To diagnose metastases in superficial lymph nodes, they are punctured to obtain punctate for cytological examination.

Cancer of the external genitalia in women should be differentiated from the following diseases. Papilloma is a single lobular formation of a round shape, soft consistency, has a thin stalk, and does not infiltrate the underlying tissue.

Genital condylomas have the appearance of multiple soft thin papillae. They are found in young women and are located at the entrance to the vagina and on its mucous membrane around the anus.

A chronic ulcer is small in size, located in the area of ​​the anterior and posterior commissures, and is characterized by severe pain and inflammatory infiltration of surrounding tissues.

A tuberculous ulcer has the character of a superficial ulceration with a granular, greasy bottom and undermined edges.

Complications

With the development of labia cancer, there is a high probability of metastases spreading not only to nearby but also to distant organs. Chemotherapy treatment is often accompanied by side effects such as swelling of the lower extremities, inflammation, rupture of sutures, which leads to the accumulation of fluid in the wound.

The role of tumor markers in the diagnosis of ovarian cancer

In addition, after chemotherapy there may be the following consequences:

• decline immune systems;
• volume reduction vagina;
• apathetic state;
• discomfort during urination;
• general weakness;
• feeling anxiety;
• increased nervous state.

After taking painkillers, patients experience nausea, dizziness, decreased blood pressure, and dry mouth.

Diagnosis

Due to the localization of the pathology on the skin, there are no problems with diagnosis. This type of cancer is easier to diagnose than any other. First you need to contact a gynecologist.

The specialist will collect anamnesis, identify complaints, and then conduct an examination using mirrors.

During the examination, the patient will find a node or ulcer on the labia, and the diameter of the growth or tissue lesion will be recorded. To accurately examine the ulceration, use a magnifying glass or use a colposcope. Using palpation, the density and consistency of the tumor, the extent of the oncological process, the adhesion of the tumor to other tissues and mobility are determined.

The patient undergoes a biopsy: the skin area is sent for histological examination. This helps to perform differential diagnosis with other pathological conditions.

The following manipulations are also indicated for diagnosis:

• vulvoscopy;
• fluorescence microscopy of the vulva;
• radiological examinations using radioisotopes of phosphorus;
• cytology of smears from the surface of the tumor;
• lymphography is an important study for assessing the condition of the lymph nodes;
• sigmoidoscopy - for visual assessment of the rectum;
• cystoscopy - if there is a suspicion of tumor formations in the bladder or urethra.

Women suspected of having this type of cancer also undergo a chest x-ray, since metastases affect lung tissue. The condition of the small pelvis is also examined, because these organs are located closest to the lesion.

Endometriosis:

Endometriosis- this is the growth of tissue similar to the mucous membrane of the uterus in its muscular layer in the area of ​​the cervix, vagina, fallopian tubes, ovaries, etc. The tissue retains hormonal dependence and undergoes transformations according to the menstrual cycle. The disease most often occurs in women of working age, has a long-term course, and is prone to relapses. The disease is characterized by severe pain in the premenstrual period and during menstruation, heavy prolonged menstruation, intermenstrual bleeding, and frequent disturbances of reproductive function.
In some cases, pain may occur during sexual intercourse. Treatment of the disease is long-term, medicinal and surgical. Endometriosis can be caused by uterine fibroids, fibrocystic mastopathy, cholecystitis, and gastritis.
Normal pregnancy and childbirth and breastfeeding the child slow down the growth of the tumor and can contribute to its disappearance.

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Vulvar cancer stage IV

Therapy

After diagnosis, the woman is referred to an oncologist. He will develop competent treatment tactics. Most often, treatment begins with surgery.

The operation is performed without general anesthesia. Local anesthesia is well tolerated by the body even in old age.

After surgery, a course of radiation therapy is indicated. The method is prescribed to prevent relapses.

If, according to indications, surgery cannot be performed, they are treated only with radiation therapy, but a larger dosage of drugs is prescribed. This technique is not as effective as the surgical one.

At the initial stage, cancer can be removed using vulvectomy: the patient’s labia majora, labia minora, and clitoris are excised.

The extent of surgical intervention depends on the stage of the pathology:

1. The first is radical vulvectomy, removal of regional lymph nodes.
2. The second is that surgery is combined with radiation therapy and fast electrons are used.
3. The third is, in addition to the previous methods, the elimination of inguinal lymph nodes and blood vessels.
4. Fourth, therapy is symptomatic in nature, since other methods will not bring the desired result. The patient is prescribed painkillers, anti-inflammatory nonsteroids, and narcotic analgesics. Sometimes blood transfusions, anti-itch ointments, and antihistamines are recommended.

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Forecast

When diagnosing the disease at stages 1-2, the outcome is favorable. Life expectancy without recurrence for three years is observed in 50-70 percent of patients.

With metastasis, the prognosis will not be so good, since the likelihood of death increases significantly. Success in treatment can only be achieved in 7-10 percent.

Clinical signs and symptoms

Symptoms of vulvar cancer at the onset of the disease are scanty (burning, itching, leucorrhoea, dysuria are possible).
Later, pain, bloody, purulent discharge, and difficulty urinating appear. A tumor of the vulva is most often localized on the labia majora, less often on the labia minora, in the clitoral area and on the posterior commissure of the lips; macroscopically it can be exophytic (nodular or papillary) or endophytic (ulcerative or infiltrative).

Complications and side effects of treatment

The use of platinum drugs causes nausea, vomiting, nephritis, leukopenia, thrombocytopenia, hearing loss, polyneuritis, and dermatitis.
The use of fluorouracil can cause side effects such as stomatitis, diarrhea, leukopenia, thrombocytopenia, and anemia.

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Classification

Experts identify several of the most common areas of cancer localization.

Uterus

In most cases, the pathological process is called endometrial carcinoma. This is explained by the fact that the initial formation of the tumor occurs in the mucous membrane of the uterine body. This condition is considered one of the most frequently diagnosed among all malignant processes of the female reproductive system.

The onset of pathology occurs in the postmenopausal period and occurs in the female half of the population aged 50-60 years. Tumor cells have a predisposition to metastasize not only to nearby, but also to distant organs and systems.

Fallopian tubes, lymph nodes and blood vessels may be affected. After entering the blood system, metastases spread throughout the body.

Cervix of the uterine body

This is the lower part of the uterus, which passes into the vagina. In medicine, the disease is also called carvical carcinoma.

The disease ranks second among the total number of malignant neoplasms affecting the female genital organs. A tumor can form in any woman, regardless of age. Most often, however, it is diagnosed between the ages of 35 and 55 years.

In most cases, the onset of the disease is preceded by infection with the human papillomavirus, the route of transmission of which is unprotected sexual contact.

About 85 percent of cases are squamous cell carcinoma of the cervix, when the tumor is formed from squamous epithelial cells, which are similar in structure to skin cells.

The first symptoms of cervical canal cancer

Other types of cancer are formed from columnar glandular epithelium (adenocarcinoma). Also, both types of cells can participate in tumor development.

Pathological cells can also give metastases to both nearby and distant systems and organs.

Ovaries

The development of ovarian carcinoma occurs between the ages of 50-70 years. According to statistics, it occurs in one woman out of seventy. This type of genital cancer is the third most common.

It is also worth noting that ovarian cancer is considered the most dangerous disease. It accounts for more deaths than any other malignant tumor of the reproductive system.

Since the structure of the ovaries is made up of various tissues, a neoplasm can form from one of them or several at the same time.

Cancer cells can spread to nearby tissues as well as to other organs through the lymphatic system. In addition, pathogenic cells enter the circulatory system.

As a result, metastasis will be diagnosed in distant organs. As a rule, the lungs and liver are affected.

Vagina

In this area, the formation of approximately one percent of all malignant processes is noted. The disease is more often diagnosed in women when they reach 45-65 years of age. In approximately 95% of cases, the cancer has a squamous cell form and is morphologically similar to cancer of the vulva or cervix.

The cause of the development of squamous cell type neoplasms is papillomavirus.

Experts also identify diethylstilbesterol-dependent vaginal carcinoma, which is a relatively rare disease. It is detected in women whose mothers consumed diethylstilbesterol during pregnancy.

Vulva

It is a system of external female genital organs. Vulvar carcinoma accounts for about four percent of all female genital cancers. In most cases it develops after menopause.

Usually the disease is characterized by tissue damage near the entrance to the vagina. Cancer is formed from the same cells as a malignant skin tumor.

90 percent are squamous cell carcinoma, about 4% are basal cell carcinoma. The remaining six percent account for melanoma, Bartholin gland tumor, Paget's disease and others.

The development of the oncological process begins on the surface. Then it spreads to nearby tissues without affecting other organs. Despite the aggressiveness of some types of ovarian malignancies, their peculiarity lies in their rather slow progression.

If left untreated for a long time, the cells begin to spread to the vagina, anus, or urethra. They can also penetrate the lymph nodes of the reproductive system.

Preinvasive vulvar carcinoma

Until recently, it was generally accepted that the use of chemotherapy in patients with vulvar cancer was inappropriate due to the low sensitivity of squamous cell carcinoma cells to their effects. However, clinical practice indicates the possibility of using chemotherapy to treat this pathology.
Thus, for pre-invasive vulvar carcinoma, the use of fluorouracil ointment can lead to a cure: Fluorouracil, 5% ointment, apply 5 g to the affected area at night, 5 days, repeated courses every 6-12 weeks.

Differential diagnosis

It is necessary to carry out a differential diagnosis of vulvar cancer with papillomas (exophytic form), ulcers with chancroid, tuberculosis and syphilis (endophytic form).

Diagnosis of vulvar cancer is based on data from:■ gynecological examination;■ vulvoscopy using a colposcope;■ cytological examination of fingerprint smears or scrapings from the surface of a suspicious area;■ histological examination of a biopsy specimen.
To determine the condition of the inguinal and femoral lymph nodes, palpation, ultrasound and puncture biopsy are used. According to their structure, they are found:■ predominantly squamous cell forms of cancer (keratinizing and non-keratinizing);■ less often - glandular;■ extremely rarely - basal cell.

Etiology and pathogenesis

The etiology and pathogenesis of vulvar cancer have not been sufficiently studied.
The mechanism of development of various parts of vulvar cancer is often induced by hormonal changes that occur during menopause and postmenopause. This, to a certain extent, determines the fact that vulvar cancer occurs in relatively elderly women.
There are background and precancerous diseases of the vulva.
Background processes are characterized by a large number of clinical and pathomorphological manifestations, which are caused by dystrophic changes in the vulva. Their occurrence is associated with metabolic and neuroendocrine disorders during the aging process and, to a large extent, with viral infection. According to clinical manifestations, kraurosis (lichen sclerosus), leukoplakia (squamous hyperplasia) and vulvar condylomas are distinguished.

Possible complications

This cancer can lead to metastases. During treatment, including chemotherapy and radiation, side effects may occur: swelling of the legs, inflammatory processes, suture dehiscence. Liquid may accumulate in the seam area.

There is a risk of consequences after surgery if the nerve is damaged. The woman experiences tingling and numbness. The seam does not heal well - it must be lubricated with products prescribed by the doctor.

Complications of chemotherapy:

Taking painkillers can lead to the following effects:

• clouding of consciousness;
• feeling of nausea;
• dizziness;
• decreased blood pressure;
• feeling of dry mouth;
• constant desire to quench thirst.

Cervical cancer

The tumor itself grows from the epithelial cells of the soft tissues of the inner walls of the cervix and body of the uterus. The tumor is moderately aggressive and grows quite slowly compared to other tumors. Cervical cancer and uterine oncology are one of the most common diseases in women, and they rank second after breast tumors.

Causes

The main reason is that a change occurs at the chromosomal level, and cells begin to randomly divide, multiply and lose the ability to self-destruct or die.

1. Papillomavirus.
2. Herpis.
3. Viral diseases that damage the soft tissue of the uterus.
4. Often appears in older women.
5. The risk group includes nulliparous women.
6. Rare sexual relations.
7. Diabetes.
8. Alcohol and cigarettes.
9. Excess weight.
10. Genetics.
11. Hormonal changes in the female body, drugs that affect them.

Stages

• Stage 1- the tumor is small in size and spreads only within one tissue.
• Stage 2- the cancer process affects nearby tissues. Back pain and fever may already appear.
• Stage 3- is large in size and begins to swell. The cancer affects and damages nearby lymph nodes.
• Stage 4- metastases go to the nearest organs: intestines, bladder, kidneys and liver. Headaches and pain in bones and muscles appear against the background of general intoxication of the body.

The most important thing to remember is that cancer in the early stages of development has a high survival rate, since metastases do not affect organs. At stage 3, the lymph nodes are already damaged, which is why surgeons at this stage usually remove the uterus along with the nearest lymphatic system.

NOTE! First of all, the patient needs to pay attention to pain, temperature and bleeding from the vagina and immediately contact a gynecologist for an examination.

Surgical, combined and radiation treatment methods are generally accepted. Chemotherapy is not used often.
For systemic chemotherapy of vulvar cancer, all recommendations for mono- and polychemotherapy for cervical cancer can be used.
In the treatment of patients with vulvar cancer, the leading treatment method is surgery.
The combined method is used in 2 options:■ surgery followed by radiation therapy;■ preoperative radiation followed by surgery.
For patients in whom vulvectomy is not possible due to comorbidities or tumor spread, radiation therapy may be the only treatment that improves survival.

Recurrence of vulvar cancer

When vulvar cancer recurs, a combined treatment is also sometimes used, including chemotherapy (Scheme 3), radiation, and surgery, although the effectiveness of treatment is insignificant.

Precancerous diseases of the vulva

represented by epithelial dysplasias. Depending on the degree of damage to the epithelial layer, mild, moderate and severe epithelial dysplasia are distinguished. The diagnosis is made on the basis of histological examination of biopsy specimens.
Currently, the accepted classification of premalignant changes in the vulva is in the form of vulvar intraepithelial neoplasia (VIN). VIN I corresponds to mild dysplasia, VIN II to moderate dysplasia, VIN III to severe dysplasia and preinvasive carcinoma.
If we take into account the average age of patients with non-tumor dystrophic diseases (56 years), it is clear that in order to identify early forms of vulvar tumors, special attention should be paid to the age group of 60 years and older.
The anatomical and topographical features of the external genitalia, abundant blood supply and extremely developed lymphatic network contribute to the rapid spread of vulvar cancer and metastasis.
The predominant route of metastasis for vulvar cancer is lymphogenous; hematogenous spread is very rare. Regional lymph nodes of the first order are superficial and deep inguinal-femoral lymph nodes, and second order are deep pelvic ones. A retrograde route of metastasis is possible.

Vulvar cancer stage III

The following combinations of drugs are used as neoadjuvant chemotherapy for stage III vulvar cancer. Regimen 1: Bleomycin IM 10 mg/m2 2 times/week, 2-3 weeks + Methotrexate orally 10 mg/m2 2 times/week, 2-3 weeks. The courses are repeated after 3 weeks, 4 courses are carried out.
Scheme 2: Mitomycin IV drip 10 mg/m2 on the 1st day + Fluorouracil IV as a 24-hour infusion, 30 minutes after the administration of mitomycin, 1 g/m2, 3 days.
Systemic chemotherapy with platinum derivatives or fluorouracil improves treatment outcomes for patients with stage III vulvar cancer in combination with surgery and radiation.
Scheme 3: Cisplatin IV drip 100 mg/m2 on the 1st day + Fluorouracil IV as a 24-hour infusion of 1 g/m2, 5 days.
The course is repeated after 3 weeks. The number of courses depends on the effectiveness of the therapy.
This combination chemotherapy causes complete tumor regression in 53-89% of initially inoperable patients.

As a rule, when we get sick, we rush to find “bad” symptoms in our body and think about the worst. How common is cancer and at what age? Symptoms of cancer are extremely important in the process of detecting pathology. Common symptoms of cancer include sudden weight loss, high fever, weakness and fatigue, pain and changes in the quality of the skin. Of course, it should be borne in mind that the presence of any of the listed symptoms does not mean 100% that a person suffers from cancer. However, the detection of any of the listed manifestations should prompt a thorough medical examination. Women over twenty-five years of age are recommended to regularly examine the cervix for cancer, and those over fifty years of age - the mammary glands. Breast cancer ranks first among all malignant diseases in women.

General symptoms of oncology (cancer) in women and men

• a symptom of “unsuccessful treatment” (ulcerative lesions of the stomach and duodenum, inflammation of the stomach, pharynx, bladder, pneumonia), when the patient tries to cure the disease for a long time, but there is no improvement;
• “small signs” syndrome (increased fatigue, decreased performance, decreased or loss of interest in the outside world, discomfort, strong and short-term changes in body weight), unclear discharge (blood, mucus, etc.), persistent dysfunction of any organ, paraneoplastic syndromes.
• the “plus tissue” symptom, that is, the growth of a space-occupying formation. The “plus tissue” symptom is detected upon examination and palpation. It is possible to detect asymmetry and deformation of a part of the body, palpate the tumor and evaluate its size, consistency, mobility, relationship with surrounding tissues, and pain. Particular attention should be paid to the lymph nodes. They definitely need to be examined and felt. When affected, they are enlarged in size, round in shape, sometimes lumpy, dense, fused to the surrounding tissues, and have limited mobility.

Symptom of cancer - sudden weight loss

Most people suffering from any type of cancer begin to lose weight sharply in the early stages of the disease. The first symptom of cancer can be weight loss of more than five kilograms in a short time.

Symptom of cancer - high body temperature and feverish state

High body temperature can be observed with cancer that is already quite widespread. A febrile state overtakes cancer patients during anticancer therapy, which affects the body's immune forces, increasing susceptibility to the disease.

Symptoms of cancer: weakness and fatigue

Weakness and fatigue can be considered one of the most important symptoms of cancer. Fatigue can occur in the early stages of cancer development, when the progression of the disease is accompanied by blood loss, for example, with colon cancer.

Symptom of cancer - pain

Soreness can serve as an early manifestation of malignant neoplasms, for example, bone tissue.

A symptom of cancer is a change in the color and quality of the skin.

Tumors of the skin and certain types of oncology of internal organs can cause the development of dermatological signs of cancer, for example, darkening of the skin, yellowing of the skin, redness and scabies.

In addition to the general ones, there are also specific symptoms of cancer that are characteristic of a particular type of cancer. Again, this does not mean at all that if you detect any specific symptom from those listed, you should immediately think about cancer. All symptoms that arise should be reported to the doctor.

Stool disorders and bladder dysfunction

Stool disorders can manifest themselves in constant constipation or, on the contrary, in diarrhea. In addition, the amount of feces and their quality characteristics may change. When defecating, stool may contain blood. There may be pain when emptying the bladder, and urination may become more frequent or less frequent. The doctor must know all these changes to build a correct clinical picture.

Bleeding or unusual discharge

Unreasonable bleeding can occur both in the early stages of cancer development and in advanced cases. Blood impurities in sputum when coughing may indicate oncology of the lung tissue. Blood in the stool may indicate cancer of the large intestine or rectum. Oncology of the uterus or its cervix can lead to vaginal bleeding. Bladder cancer can result in blood in the urine.

Digestive disorders and difficulty swallowing

These symptoms can be observed in various non-oncological pathologies, but their combination may indicate oncology of the esophagus, pharynx or gastrointestinal tract.

Symptoms of oncological diseases (cancer) in women

Signs oncology at women. If a woman sees a doctor early, a cure for cancer is quite possible - modern medicine has proven this more than once. However, our women are afraid or embarrassed to go to the doctor with seemingly trivial complaints and make a serious mistake, wasting precious time. We will talk about the main symptoms of cancer in the weaker half of humanity. All women know about the existence of various cancer diseases. Unfortunately, in our time, such diseases occupy one of the main places in the structure of mortality.

1. Bleeding

One of the most alarming symptoms for women should be bleeding after menopause- that is, a year after the cessation of menstruation. Menstruation cannot return if it has already stopped. Do not think that this is normal - consult a doctor to clarify the circumstances.

Another serious symptom should be spotting after intercourse, intermenstrual bleeding or too heavy menstruation for 10-12 days, the appearance of pain during menstruation - this may be a sign of hormonal changes or cancer of the cervix or appendages.

The initial stages of cervical cancer are not difficult to diagnose; a smear from the cervical canal is taken to study special cells (cytology) and cancer markers.

To determine ovarian cancer, the volume of research is greater; ultrasound and blood testing for special markers specific to ovarian cancer are necessary.

2. Discharge

One of the signs of some types of endometrial cancer (the inner wall of the uterus), along with bleeding, is the appearance of unusual watery discharge with or without ichor from the genital tract. This symptom needs to be given special attention - sometimes, starting as a sign of infection, chronic inflammation passes into the oncogenic stage.

If diagnosed early, this type of cancer can be treated surgically and the disease can be completely cured.

3. Changes in the breast

Breast cancer is currently the number one most oncological diseases at women, which is the cause of their death. Every woman from 25-30 years old needs to know about self-examination of the breasts. This is a completely painless procedure that is recommended to be performed once a month at home in front of a mirror. By regularly performing this procedure on the same day of the cycle, you will thoroughly examine the gland tissue, which will allow you to notice changes in the breast or nipple in time. Most breast diseases in women can only be diagnosed in the laboratory (blood test for tumor markers).

Signs of concern should be any external differences compared to previous examinations:

• the appearance of a network of blood vessels on the skin, age spots or areas of "orange peel"
• change in the shape of the breast or nipple,
• the appearance of lumps in the breast that are not painful.
• change in color of the nipple areola (if you are not pregnant or nursing) and its peeling,
• discharge from the nipple, in the absence of lactation, especially if it is bloody or whitish.
• the appearance of dimples on the skin,
• increased temperature of the chest or a separate area thereof.

Also, “dimples” may appear on the skin of the breast, which are symptoms of cancer. These symptoms are a reason to immediately consult a doctor.

4. Discomfort

One of the first symptoms of genital cancer in women is itching and discomfort in the labia area, irritation or skin change not associated with infections or allergies. These changes are usually long-term and progressive - therefore, at the slightest discomfort, go for an examination to a doctor.

Oncology of the female genital organs can be divided into two groups: benign and malignant. When studying the signs of oncology in women, it is necessary to keep in mind that this concept includes not only cancer, but also other neoplasms that are unable to spread throughout the body and form new tumors, however, also requiring timely diagnosis and treatment.

Benign tumors of the female genital organs

A tumor that is benign in nature grows slowly in breadth and does not have the ability to metastasize, that is, spread to other organs. Nevertheless, such neoplasms are also considered oncological and require treatment, without which complications may occur. Gynecology distinguishes the following types of benign neoplasms:

• myoma;
• fibroids;
• fibroma;
• ovarian cystomas.
• polyps of the body and cervix.

Myoma is a tumor of the muscular lining of the uterus (myometrium). The cause of fibroids is a hormonal imbalance, leading to increased estrogen levels, pathologically rapid growth of uterine tissue and the formation of nodes and lumps.

A myometrial tumor can be recognized by the following signs: heavy bleeding during menstruation, pain in the lower abdomen. If left untreated and complications occur, patients may experience severe pain in the uterus and suffer from chills or fever.

Fibroids are formed from smooth muscle and connective tissue in the external or internal genital organs, most often in the uterus. Fibroids occur as a result of hormonal imbalance and can reach very large sizes. As the tumor grows, unpleasant symptoms begin to appear: sensations of pressure in the pelvic area, an increase in the amount of menstrual flow.

Fibroids form inside the cervix or uterine wall from fibrous connective tissue. Sometimes fibroids appear on the labia, ovaries, or vagina. Signs of benign oncology in women in this case are pain in the pelvic area, difficulty urinating and defecating.

An ovarian cyst is a cavity in the glandular tissue, often formed from an existing cyst. Oncological studies of cystoma have shown that it is quite dangerous because it can develop into a cancerous tumor. The first signs of ovarian cystoma: bloating, menstrual irregularities, and a feeling of discomfort. In some cases, spasms and tugging pain are observed, and sexual intercourse becomes painful.

Polyps are soft, benign, red-pink neoplasms located on the mucous membrane in clusters. Polyps on the cervix can be seen using a speculum or recognized by touch. With polyps, there may be an increase in discharge during menstruation and bleeding after sexual intercourse.

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Cervical and uterine cancer

Among cancers of the female genital organs, the most common is cervical cancer.

Among the main causes of cancer in women are: viral diseases, promiscuity or early onset, cervical injuries, smoking. Often the cause is herpes and papillomavirus, so women of any age are recommended to undergo regular tests to exclude the presence of these viruses. There are several stages of cervical cancer:

With stage 2 and 3 cervical cancer, patients often complain of spotting between menstruation, blood in the urine, and pain in the legs and back. The first stages of the development of the disease can be asymptomatic; diagnosis is possible only during a gynecological examination.

Cancer of the uterine body is characterized by diffuse lesions of the endometrium or isolated polypous growth. Growing into the uterine tissue, the tumor can spread to the abdominal cavity and appendages. With uterine cancer, patients may experience purulent-bloody vaginal discharge with an unpleasant odor. During menopause, bleeding may be a sign of the disease.

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Signs of ovarian cancer

The second most frequently diagnosed cancer in gynecology after cervical cancer is ovarian cancer. The risk group includes older women, especially those who have not given birth. Statistics show that mothers with many children suffer from this disease much less often. In some cases, the appearance of malignant neoplasms on the ovaries may be due to a genetic predisposition.

Signs of advanced ovarian cancer: bloating, nausea and vomiting, constipation. The appearance of unpleasant symptoms is due to the fact that the tumor disrupts the functioning of the intestines and causes the accumulation of excess fluid in the abdominal cavity (ascites). In the early stages, ovarian cancer may be asymptomatic.

Uterine cancer is the most common cancer of the female genital organs, accounting for 50% of all cancers. It is divided into two main types of malignant tumors: endometrial cancer and uterine cancer.

Symptoms

• In 90% of cases, the first sign is irregular bleeding during the childbearing period, perimenopause, and bleeding after menopause.
• Pain, heaviness and swelling in the uterine area. This condition may be associated with a muscle type of cancer.

Diagnostics

• Histological examination of a fragment of the endometrial mucosa.
• Pelvic ultrasound, as well as CT or MRI - to identify a tumor and possible metastases.

Treatment

Surgically - that is, removal of the uterus, appendages, lymph nodes. The most gentle methods allow you to preserve the ability to become pregnant and bear children. In such cases, progesterone therapy is used in high dosages. The disadvantage of this method is that even if cured, the woman remains at high risk of the disease returning. There is also the option of egg freezing for women who want to preserve the possibility of having children in the future. In later stages - pelvic irradiation. Sometimes additional chemotherapy is required.

Risk factors

Doctors distinguish two types of endometrial cancer: estrogen-dependent and estrogen-independent. The first type is more common in young women and has a better prognosis than the second. Causes of elevated estrogen levels:

• obesity;
• diabetes;
• polycystic ovary syndrome;
• absence of pregnancy;
• early onset of menstruation or late menopause;
• irregular periods, lack of ovulation;
• Women who undergo hormonal therapy with estrogen without taking progesterone drugs to prevent the development of endometrial hyperplasia are also at risk;
• breast cancer patients receiving treatment with tamoxifen;
• patients with a family history of uterine and colon cancer.

Preventive measures

• Examinations by a gynecologist - every six months; In addition, examination must also be carried out in case of irregular bleeding.
• If you have a family history of uterine or rectal cancer, it is advisable to attend a genetic consultation to determine your predisposition to malignant pathology. It is also necessary to undergo regular rectal examinations and follow-up with a gynecologist.

Cervical cancer

Cervical cancer is the third most common cancer in women after uterine and ovarian cancer. The most common cause of cancer is infection with papillomavirus, which is sexually transmitted. Most cervical cancers can be prevented through a cervical smear test program as well as through vaccination.

Symptoms

• Bleeding is the most common symptom of cervical cancer. Most often it occurs during or after sexual intercourse.
• In later stages - pain in the back, lower abdomen or pelvis.
• Sometimes the tumor blocks the ureter and can cause kidney failure.

Diagnostics

• Colposcopy is an examination of the cervix using a special microscope.
• Cervical biopsy. In case of precancerous changes, a more extensive biopsy using an electrical loop is indicated.
• With a positive biopsy - ultrasound, CT and MRI.

Treatment

Depends on the stage at which the disease is detected. In the early stages - radiation therapy or radical extirpation of the uterus or cervix. In the latter case, a suture is placed in the area where the cervix used to be. With this option, the opportunity to become pregnant and carry a child remains, but birth occurs only by caesarean section. In the later stages - chemotherapy and radiation. Before treatment, patients are usually advised about the possibility of preserving ovarian function through ovarian transplantation. A woman who wishes to subsequently become pregnant can have eggs removed in advance for artificial insemination, or ovarian tissue can be frozen for subsequent transplantation.

Risk factors:

• papilloma virus infection;
• smoking;
• a large number of sexual contacts, as well as early onset of sexual activity;
• frequent pregnancies;
• reduced immunity;
• neglect of barrier contraception.

Preventive measures:

• vaccination against papillomavirus infections;
• to avoid the risk of contracting sexually transmitted infections, avoid promiscuity and use condoms.

Ovarian cancer

This disease is considered one of the most insidious, since early diagnosis is very problematic. Typically, patients seek help in the later stages, and even if cured, the risk of the disease returning is very high.

Symptoms

The symptoms are not specific. In the early stages, irregular periods are possible. If the tumor fills the pelvis, frequent urination, pain, and constipation are possible. Abdominal bloating, weakness and sudden weight loss usually appear in later stages of the disease.

Diagnostics

• Palpation of the pelvis or abdominal cavity.
• Ultrasound of the pelvic area. It can be used to determine the size and characterize the type of tumor.
• Blood markers - CA 125 - a non-specific marker, can be elevated in other situations, but helps in diagnosis and monitoring treatment results.
• If a pathology is suspected, surgical intervention is necessary to clarify the stage of the disease.

Treatment

Depends on the stage. Sometimes only surgical removal of the uterus, appendages and omentum is sufficient. In most cases, additional chemotherapy is required.

Risk factors:

• infertility;
• low number of pregnancies and births;
• hereditary predisposition, in particular mutations of the BRCA1 and BRCA2 genes, Lynch syndrome (uterine, ovarian and colon cancer);
• The peak of the disease occurs at the age of 60 years.

Preventive measures:

• the presence of at least one pregnancy and childbirth;
• It has been found that when taking birth control pills for five years or more, the risk of getting sick is reduced by 50%. This method is especially recommended if the woman has had cases of ovarian cancer in the family;
• preventive removal of appendages (if there is a genetic predisposition);
• Pelvic ultrasound twice a year.

What to do if fibroids are detected

Often in our country, when fibroids are detected, in order to avoid its degeneration into a malignant tumor, doctors insist on partial or complete removal of the uterus. However, this recommendation is not always justified. It has been established that the risk of cancer cells appearing in it is extremely low. In addition, the decision to undertake any surgical intervention should be made only after careful weighing of all factors. Indications for surgical removal of fibroids are pain, heavy bleeding that cannot be treated, as well as extremely rapid growth and large size of the tumor. Along with this, the location of the fibroid is taken into account, as well as the woman’s desire to become pregnant in the future. The operation is justified if the myomatous node is large and is found in a place where it can harm a potential fetus. In all other cases, it is better to resort to drug therapy. The mechanism of action of modern drugs is based on blocking progesterone receptors in the fibroid, due to which it quickly decreases in volume.

It is worth noting that modern medicine has achieved considerable success in curing cancer. If the tumor is detected in the early stages, recovery is almost guaranteed. So the best way to protect yourself is to lead a healthy lifestyle, and regularly, at least once or twice a year, be examined by a gynecologist.

Cosmo thanks Madanes expert Lyudmila Ostrovskaya, an Israeli gynecologist specializing in female oncology, for her assistance in preparing the material.

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