Symptoms of uterine cancer in postmenopause. Uterine cancer: symptoms at an early stage. What diagnostic procedures are necessary to undergo if uterine cancer is suspected?

Content

After 45 years of age, women are at risk of getting uterine cancer due to hormonal changes, so you should be aware of the first signs and symptoms of the disease in order to prevent it. The initial stages of the disease are asymptomatic, but the development of oncology can be suspected during regular examination by a gynecologist. The sooner a pathology is detected, the sooner it can be treated in order to avoid serious consequences.

What is uterine cancer

In medical terminology, uterine carcinoma is the development of a malignant tumor in the female genital organ. It is the main one for bearing a child and is responsible for a woman’s reproduction. In appearance, the uterus resembles a hollow, flattened sac with an angle, consisting of a body and a cervix. Inside, it is lined with endometrium, which is shed and released out with each menstruation. Oncology of this organ is extremely dangerous and can lead to death.

Causes

Doctors have identified a number of reasons that influence the occurrence of cancer inside the uterine cavity and cause the rapid growth of cancer cells:

• absence of childbirth;
• obesity;
• diabetes;
• taking hormonal medications due to hormonal imbalance, but not birth control pills;
• infertility, menstrual irregularities;
• early menstruation and late menopause;
• polycystic ovaries, their tumors;
• breast cancer due to lack of breastfeeding;
• hereditary colon cancer without polyps:
• past endometrial dysfunction;
• age over 45 years;
• difficult pregnancies, miscarriages, abortions.

Classification

According to oncological data, there are several types of classifications of malignant neoplasms:

1. According to the morphological form - adenocarcinoma, sarcoma, clear cell (mesonephroid) adenocarcinoma, squamous cell carcinoma, glandular squamous cell oncology, serous, mucinous, undifferentiated cancer.
2. According to the form of growth - with predominantly exo- or endophytic, mixed autonomous growth.
3. By localization - in the area of ​​the bottom, body, lower segment.
4. According to the degree of differentiation (the lower, the worse) – highly differentiated, moderately differentiated, poorly differentiated cancer.
5. According to the ICD code, according to the FIGO classification - its own types with digital and letter codes.

Forecast

In 90% of cases, cervical and ovarian cancer is completely cured through surgery and subsequent radiotherapy. If cancer is detected in time, it is possible to prevent the development of metastases and improve the survival prognosis. Depending on the stage, the prognosis will be as follows:

• in the first – 78% of patients survive the first five years;
• on the second – 57%;
• thirds – 31%;
• fourth - 7.8%.

Stages of uterine cancer

Oncology develops gradually, starting from stage zero, when only the first rudiments of cancer cells can be detected. The main stages of development are considered:

• first – the tumor affects the endometrium or grows into the muscle layer (myometrium);
• the second is the development of a tumor on the neck (collus uterus);
• third – the cancer goes beyond the uterus, spreads to the vagina, pelvic or lumbar lymph nodes;
• fourth - germination into the bladder, rectum;
• metastasis – the appearance of metastases in the liver, lungs, and inguinal lymph nodes.

Endometrial cancer

A malignant tumor of the mucous membrane lining the cavity from the inside is the initial cancer of the endometrium of the uterus. It occurs after menopause, 72% of detection occurs in the first stage. The cause of development is estrogenization - due to an excess of the female sex hormone, endometrial hyperplasia begins. Types of endometrial oncology:

• simple hyperplasia without atypia;
• complex adenomatous without atypia;
• simple atypical – precancerous condition of a malignant neoplasm (MN);
• complex atypical – degenerates into cancer with a probability of 80%.

Cancer of the uterus

The next stage after damage to the endometrium is considered to be a tumor of the uterine body. Oncology of the uterus develops from the tissues of the mucous membrane (adenocarcinoma) or muscular tissue (leiomyosarcoma). The growth of a malignant tumor occurs in the fundus, isthmus, and uterine cavity. Cells metastasize to adjacent tissues, to the cervix, fallopian tubes, ovaries, lymph nodes, and blood vessels.

Cervical cancer

A malignant tumor often found in women is cervical cancer. 85% of its cases are due to the emergence of neoplasms from flat epithelial cells, the remaining 15% are adenocarcinoma, arising from cells that produce mucus. There are exo- and endophytic forms that affect the vagina or uterine body. The papillary type is characterized by the growth of small papillae (looks like cauliflower), and the crater-shaped type is characterized by the covering of the tumor with ulcers and a gray coating. The cause of tumor growth is often the human papillomavirus (HPV).

Uterine and ovarian cancer

After damage to the cervix and in the absence of treatment, oncology reaches the ovaries, which serve to produce hormones. The disease is asymptomatic, but can manifest itself in pain, constipation, and compression of the bladder. Types of ovarian oncology:

• mucinous;
• serous;
• endometrioid;
• Brener's tumor;
• clear cell;
• mixed epithelial;
• carcinoma;
• sex cord stroma;
• lipoid cell;
• soft tissue lesions;
• germinal;
• secondary;
• gonadoblastoma;
• cysts.

An ovarian tumor develops in one organ, quickly spreads to the second, and affects one of them completely. The formation affects the fallopian tubes, body, and abdominal cavity. The third stage is manifested by infection of the lymph nodes, inguinal, and ends with metastases in the liver and lungs. 80% of patients at the first stage can be successfully cured of cancer; at later stages this figure is only 10%.

Metastasis

Metastases are understood as secondary foci of growth of malignant tumors. Endometrial tumor manifests itself in three types of metastasis:

• implantation - a path of decay involving the visceral peritoneum;
• lymphogenous – damage to the pelvic lymph nodes;
• hematogenous - damage to the lymph nodes and infection of the bones, liver, lungs.

Symptoms of uterine cancer

The first stages of uterine cancer are asymptomatic; only in postmenopause can one notice acyclic uterine bleeding or heavy, prolonged menstruation. Signs of uterine cancer in the early stages are watery vaginal discharge streaked with blood. A less common symptom is pain in the pelvis and abdomen, accompanied by short duration. Older women may experience stenosis (fusion) and accumulation of pus in the uterine cavity.

First signs

Doctors identify the following first signs of uterine cancer, which characterize the disease, and if present, you should immediately consult a doctor:

• bleeding from the genitals, reminiscent of menstruation, but occurring suddenly;
• pain.

Discharge

Depending on the stage of tumor development, the type, format and volume of discharge differs, both during menstruation and pathological:

• with oncology of the uterine body - serous leucorrhoea, pain, bleeding without reference to the cycle;
• at the first stage - light one-time uterine bleeding, watery discharge, odorless mucous membranes;
• in the last stages - foul-smelling discharge, blood-stained, pus, fever.

Diagnosis and treatment of uterine cancer

If symptoms of oncology are detected, you should urgently contact a gynecologist for examination and diagnosis. The doctor examines, palpates the uterus, and scrapes the cervix. The smear is examined for the presence of cancer cells; if the result is positive, the inner layer of the uterus is cleaned out under general anesthesia and a sample of the mucous membrane is performed. To confirm a cervical tumor, a CT scan is done to determine exactly where the tumor is located. Biopsy, hysteroscopy, immunohistochemical study, cytological method, MRI help to establish the etiology.

Oncology treatment is carried out in several ways, depending on the stage of development and severity of the disease:

1. The operation is the complete removal of the uterus and ovaries, if the tumor has affected them too. The fallopian tubes are removed. The surgical method leads to early menopause and deals a blow to the woman’s psyche.
2. Radiation therapy is prescribed for signs of disease after removal of the uterus. The procedure reduces the risk of cervical lesions and metastases. Radiotherapy can be carried out remotely (irradiation of all pelvic organs in several series) or internally (introduction of radioactive emitters at the site of pathology).
3. Hormone therapy – to exclude recurrence of cancer. Progesterone, hormonal drugs that reduce estrogen production, is prescribed.
4. Chemotherapy – to reduce tumor volume and in severe advanced cases.

Prevention of uterine cancer

To reduce the risk of cancer, elimination of hyperestrogenism and hormonal therapy are used. In addition, prevention includes:

• regular examination by a gynecologist, smear tests;
• performing ultrasound;
• taking combined oral contraceptives;
• excess weight loss;
• vaccination against HPV in the absence of contraindications.

Video

Attention! The information presented in the article is for informational purposes only. The materials in the article do not encourage self-treatment. Only a qualified doctor can make a diagnosis and give treatment recommendations based on the individual characteristics of a particular patient.

is a disease that occurs in many places. In addition, in terms of prevalence, this disease ranks fourth after breast, skin, and gastrointestinal cancer. It is necessary to note the age when maximum risks appear: from forty to sixty years.

Diabetes, the immunodeficiency virus, early intimate contacts, the onset of menopause at a late age, menstruation disorders, infertility, early first birth, various sexually transmitted diseases, prolonged and frequent use of protective drugs against pregnancy, and frequent changes of sexual partners lead to an increased risk.

Conditions that are dangerous for the female body and most often, in the absence of timely and adequate action, become causes of cancer, deserve special attention. Such conditions are erosions, scars after childbirth, ulcers, epithelial growths in the form of polyps and condylomas, chronic inflammation.

What symptoms may there be

The consistency of leucorrhoea can be mucous or watery, may include blood clots, and may have an unpleasant odor. When the disease is advanced, blood appears in significant quantities. Delayed discharge and the development of infection lead to purulent leucorrhoea, which manifests itself with an odor. In the last two stages, the situation with discharge worsens, as rottenness appears.

Bleeding may occur once or become regular, which suggests frequent recurrence. The volume of discharge also varies significantly: insignificant or significant. For cervical cancer, the most common bleeding is bleeding, which occurs during intimate contact, examination, lifting heavy objects, and douching. During menopause, spotting is most often an indicator of a malignant neoplasm.

Pain syndrome manifests itself only in the later stages, when the cancer involves the lymph nodes, as well as pelvic tissue with infiltrates.

General symptoms of uterine cancer, including sudden weight loss, appear only in advanced stages.

Signs of cancer

Heavy bleeding may occur during menstruation. This occurs in the presence of menstruation and cancer. Menstruation becomes irregular.

After menopause, a complete absence of menstruation is expected, and the first signs are bloody, purulent discharge, which allows one to immediately identify cancer. The discharge may be abundant or scanty.

At the first suspicion of a disease, you should contact an experienced physician. You must remember that treatment of advanced stages is difficult.

Only if the symptoms are recognized in a timely manner does the treatment promise a high level of effectiveness.

Stages of the disease

1. The first stage of cancer is a tumor that forms on the surface of the uterus. At this time, destruction of lymphatic vessels occurs. As a result, a woman may experience discharge, which is an alarming sign. In this case, pain is completely absent. If you are diagnosed with early stage uterine cancer, your chances of a full recovery are greatest.
2. The second stage of the uterus involves serious damage to cancer cells of the uterus. Cancer spreads from the body to the cervix. At this stage, bloody discharge appears, which is usually contact. This is due to the fact that the tumor leads to the destruction of blood vessels. As a result, the symptoms of the disease become more pronounced. At the second stage, a woman may face serious disorders of the reproductive system. Treatment remains possible and reproductive functions can be preserved.
3. At the third stage, cancer develops outside the uterus, and there are two options for the course of the disease. The oncological process can affect the vagina or parametric tissues of the peritoneum. In some cases, the lesions occur simultaneously. Unfortunately, the disease can go beyond certain boundaries. Now life is at serious risk.
4. The fourth stage leads to damage to neighboring organs. Metastases can appear in the liver, lungs, and spine. The infestation is large and serious, so the chances of success are minimal.

Features of surgical treatment

Many patients must undergo removal of not only the uterus, but also its appendages. In some cases, lymph nodes located in the pelvis are also removed. In some cases, combined treatment is required, including surgery with radiation performed remotely and intracavitary gamma therapy. Radiation irradiation of the affected organs can be carried out before surgery, which is recommended in the third stage. Radiation therapy can be an independent technique, which is used only in cases of local spread of the oncological process and contraindications to surgery.

Therapeutic agents intended to effectively fight a tumor are usually prescribed for the third and fourth stages of the disease, as well as for neoplasms that differ in differentiation.

Most often, two types of treatment are successful: combined radiation therapy and extirpation of the uterus and appendages.

Treatment is determined by the stage of the disease:

1. At stage 1-A, which involves microinvasive oncology, it is necessary to extirpate the uterus, as well as its appendages.
2. At stage 1 (the process involves only the cervix), irradiation is necessary, either remote or intracavitary. Then it is necessary to remove the uterus and its appendages. The intervention promises to be expanded. In this case, surgical intervention may be performed first, and then gamma therapy.
3. At the second stage, when the disease develops in the upper part of the vagina and there is a risk of spreading to the body of the uterus, the main technique is radiation therapy. Surgery is performed extremely rarely.
4. At the third stage, radiation therapy is performed.
5. At the fourth stage, irradiation is necessary, but its purpose is palliative maintenance of the body.

What to do after treatment and in case of relapses

During the first twelve months you should visit a doctor once every three months, for five years - every six months, after five years - annually.

What is the best way to deal with relapses? If the oncological process is limited or localized, removal of the uterus is required. The amount of work is determined by the characteristics of the patient’s condition. Chemotherapy is required for distant metastases. Radiation therapy allows treatment for palliative purposes.

Consequences of cancer for women

In case of relapses, a quarter of sick women can be treated with radiation therapy, which is aimed at all pelvic organs.

With relapses with metastases, cure almost never occurs. The therapeutic effect depends on the characteristics of the body, but the result usually does not last long.

In stage four, the 5-year survival rate is only nine percent.

It should be noted that the result of treatment largely depends on how effectively it is carried out and how correct the treatment was selected.

Early diagnosis of cancer with subsequent prevention is possible only through regular examinations. At the same time, a certain regularity of prevention is assumed. For example, women who have already celebrated their 30th birthday should see an experienced physician at least twice a year. In any case, prevention is required after the start of intimate life.

Identification of dangerous conditions is facilitated by regular examinations, ultrasound tomography, and cytological studies. Treatment for uterine cancer can be avoided thanks to preventive measures.

Treatment of women's diseases is truly important. Only with this approach can the risk of developing cancer be reduced. This treatment must be carried out in a timely manner. Among the common signs of these diseases, one should note a chronic course, the presence of constant symptoms, and the lack of the desired effect of anti-inflammatory treatment. Only radical methods can be effective. Radical methods can reduce mortality by six times.

To successfully eliminate the disease, you should stop smoking and carry out full prevention of STDs.

Involving an examination of the cervix, it will allow you to find out and understand the true position of the woman and determine the optimal actions to eliminate unnecessary risks.

When diagnosed with uterine cancer, a woman does not always notice the first signs and symptoms. She feels painful sensations in the lower abdomen, observes blood discharge after douching or sexual intercourse.

The disease is very often asymptomatic and is determined by a gynecologist during a routine examination. As the disease progresses, bleeding appears between menstruation or after sexual intercourse or douching. Bloody discharge from the vagina indicates a pathology in the body, and consultation with a specialist is necessary.

Causes and signs of manifestation of a malignant tumor

The most common causes of malignant pathology are:

• Diabetes mellitus, hypertensive disorders.
• Infectious, sexually transmitted diseases – HIV, human papillomavirus.
• Cigarette abuse.
• Disorders of menstruation.
• Use of oral contraception.
• Numerous sexual partners.
• Early pregnancy, late menopause.
• Very early sexual intercourse.
• Decreased immune system.

Excess weight is also an important factor. A precancerous condition can develop into a malignant formation due to erosion, polyps, scars after childbirth, and chronic inflammation.

One of the main causes of the disease is considered to be hormonal disorders in the body, which leads to the growth of the uterine mucosa.

Genital endometriosis can lead to cancer. With this disease, neoplasms appear on the mucous membrane, growths on the genital organs - ovaries, bladder, fallopian tubes.

The first signs of uterine cancer are bloody discharge from the vagina. If there is blood after sexual intercourse or the menstrual cycle is disrupted, you should consult a gynecologist.

If a woman has not had a period for more than a year, and then there is a discharge with blood, she needs to undergo a full examination for uterine cancer. Only an experienced specialist can recognize uterine cancer after examination and a complete examination.

In the early stages, the disease may not manifest itself, but if the disease progresses, the following symptoms are observed:

• Menstruation is painful, it becomes heavy and lasts for a long time.
• Heavy or spotting discharge appears between menstrual cycles.
• Blood after sexual intercourse, douching, physical exertion.
• Pain in the lower abdomen during sexual intercourse.

These symptoms are also typical for other gynecological diseases. But in order to determine pathological changes in the body, it is necessary to undergo an examination by a gynecologist.

During the examination, the doctor collects anamnesis, listens to all the patient’s complaints, finds out all the symptoms and the woman’s genetic inheritance.

It is important not to ignore such conditions:

• Discharge between periods can alert a girl. They may be transparent, yellowish, or mixed with blood. An oncological tumor can cause contact discharge, which appears during fast walking, physical activity, after sexual intercourse, even constipation causes spotting from the vagina. At an advanced stage, an unpleasant odor appears. The blood may flow profusely or lightly.
• The pathology causes anemia, fatigue and weakness of the entire body. Body temperature rises to 38% for no particular reason. These symptoms indicate cancer.
• Pain occurs when other organs are affected. In the later stages, pain appears in the lower back, rectum, and thigh; it is long-lasting and often repeated.
• The functioning of the urinary system is impaired. In the early stages, the tumor does not affect the bladder, but advanced disease causes frequent urge to urinate. This leads to the development of cystitis, the growth of a malignant formation contributes to the appearance of urinary retention and uremia.
• The neglect of cancer leads to constant constipation, and fistulas form in the intestines.

It is difficult to diagnose cancer in the early stages on your own. Only an experienced specialist can determine cancer after proper examination of the patient. Timely treatment saves 90% of women from death.

Diagnosis and treatment of pathology

To determine a gynecological disease, the gynecologist listens to the patient’s complaints and conducts an examination on a gynecological chair with mirrors. The doctor determines the condition of the vagina, the wall of the cervix, and determines the cause of bleeding, which is the main symptom of uterine cancer.

If there are any changes in the organs, the doctor takes a smear for further examination and takes part of the tissue for a biopsy. After histological examination, an accurate diagnosis can be made.

If uterine cancer is diagnosed, the patient undergoes vaginal curettage, then additional examination is performed. A woman is recommended to undergo ultrasound, computed tomography and magnetic resonance imaging.

All diagnostic methods are very important for prescribing the correct combined or radiation treatment for the tumor. Treatment for malignant disease depends on the severity of the disease, age and general condition of the woman.

Reading time: 15 minutes

Fear of the unknown is something that can break any person. The format of this thesis also fits into a terrible diagnosis for women - uterine cancer. Treatment of a spiritually broken woman is difficult, often unsuccessful. That is why we decided to draw the attention of readers to this terrible disease and show that early stage uterine cancer is not a death sentence. Moreover, in many cases, modern medicine gives women a chance to find the happiness of motherhood, so it is important to know what the first signs and symptoms are characteristic of uterine cancer.

Organ structure

To make the process of pathology more understandable, let’s say a few words about the structure of the female reproductive organ. Visually, the uterus looks like an inverted pear (see photo). At the top there is a wide “pear-shaped” base - the fundus of the uterus, to the bottom (towards the vagina) there are:

• body;
• isthmus;
• Cervix.

The tissue that makes up the organ is formed by 3 layers:

• endometrium - a mucous layer facing inward (on top the endometrium is lined with epithelial cells);
• myometrium - muscle (middle) layer;
• perimetry - the outer shell.

Types of uterine cancer

According to the activity of the pathology, they are distinguished:

• aggressive;
• low-aggressive - affects the epithelium lining the cervix, does not affect other tissues;
• microinvasive - differs from the previous type only in that individual tumor cells grow beyond the epithelium.

Early stages of the disease

The early stages include the zero and first stages:

• 0 - preinvasive carcinoma (carcinoma in situ);
• I - tumor is limited to the body of the uterus;
• IA - limited to the endometrium;
• IB - extends to at least half the thickness of the myometrium.

Symptoms in the early stages

The first signs and symptoms are mild:

1. Vaginal discomfort is noted.
2. There is a slight discharge of blood after sexual intercourse and heavy lifting.
3. There is copious mucous discharge.
4. Disruptions in the menstrual cycle are recorded.

Among women diagnosed with cancer, many pointed to the absence of the first signs of uterine cancer at an early stage. It follows from this that the only way to detect pathology in the initial stages is to undergo timely medical examinations.

Diagnostics

The presence of atypical epithelial cells (dysplasia) in the cervix is ​​determined visually by the gynecologist and serves as the first sign of oncology.

To confirm or refute the suspected diagnosis, the doctor prescribes one or more studies indicated in the table.

Treatment of uterine cancer in the early stages

Depending on the degree of the disease, the following methods are used:

• laser surgery;
• cryosurgery;
• conization;
• trachelectomy.

Features of tumor treatment at stage 0:

In the first stage of oncology, surgical intervention is deeper. The doctor’s task at this stage is to make every effort to preserve the organ and carefully remove areas containing cancer cells.

If we are talking about childbearing age, everything possible is done to ensure that the woman does not lose her fertile function (she can subsequently conceive a child and give birth).

The main methods of treating stage 1 oncology:

In some cases, surgery is supported by immunotherapy. The doctor prescribes hormone therapy to the patient, including anti-estrogenic drugs, provided that the tumor has receptors for these hormones.

Under no circumstances wait until the first signs and initial symptoms of uterine cancer appear. They simply may not exist. An annual examination by a gynecologist is a procedure that will protect you from a terrible diagnosis.

The causative agent of the disease is human papillomavirus with high oncogenicity: 16.18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, 68, 73, 82 serotypes. Of these, the first three are the most dangerous.

Therefore, do not allow promiscuity and use barrier products. Another factor influencing the occurrence of cancer pathology is bad habits. Avoid to minimize risk.

If you observe at least one of the above signs and symptoms of uterine cancer, consult your doctor immediately!

What puts you at higher risk

Let's look at the factors that contribute to the development of uterine cancer:

• the presence of bad habits in women, in particular smoking and drug addiction;
• indiscriminate change of sexual partners (read about effective contraception here);
• early onset of sexual life;
• hormonal disorders (consultation with an endocrinologist will help correct them);
• obesity;
• impossibility of conceiving/giving birth to a child for various reasons before the age of 30;
• hypertension;
• ovarian pathologies (treated by a gynecologist);
• diabetes;
• abortions;
• acute liver diseases;
• weakening of the body's protective functions.

In addition, it has been proven that unprotected sex with a man whose last sexual partner suffered from uterine cancer can also cause the formation of uterine cancer.

Stages and lifespan

Doctors distinguish 4 stages of cancer pathology:

• 1 tbsp. - the tumor is localized in the body of the uterus, determined during the examination;
• 2 tbsp. - the lesion covers the cervix;
• 3 tbsp. - stage of metastasis in the vagina and damage to parametric structures;
• 4 tbsp. - metastases actively spread beyond the boundaries of the pelvis and into the abdominal cavity.

The life expectancy of patients, as well as the prognosis for recovery and preservation of life, depends on many related factors - the general condition of the woman, age, period of oncology diagnosis.

The 5-year survival rates are shown in the table:

In the first 2 - 3 years after remission, relapses occur in more than 50% of cases, so patients must constantly undergo routine examinations with a gynecologist, as well as follow preventive measures.

With correct treatment of stage 1-2 uterine cancer and following all medical recommendations, patients who have undergone surgery can have every chance of a long and fulfilling life. Late detection of problems in most cases causes death within the first 10 years of life after surgery.

How quickly does the disease develop?

It is impossible to establish the exact period of progression of uterine cancer and the spread of cancer. It is known that the disease rapidly changes from one stage to another, so the pathology is usually diagnosed at stages 2, 3 or 4.
The development of the disease and its rapid course are influenced by:

• presence/absence of other chronic or acute diseases in the patient;
• state of the immune system;
• stability of blood circulation at the site of the cancer focus;
• type and location of pathological cells.

The timing of the formation and development of uterine cancer depends on the combination of these factors.
Scientists have found that on average, a cancerous tumor forms within two years. Further progression and growth of the formation depends on the degree of differentiation of the affected cells.
With a poorly differentiated type of cancer, the tumor consists of a large number of abnormal cells that spread quickly (from several months to 1 - 2 years), and there is also a high risk of metastasis to nearby internal systems and the bloodstream.
With a highly differentiated type of pathology, healthy and affected tissues are almost identical, and the tumor can form within 2 to 5 years, the danger of spreading metastases is minimized. If a tumor is suspected, consultation with an oncologist is necessary.

The difference between pathology and fibroids

Myoma is a benign tumor, and this is its main difference from uterine cancer. But it is necessary to understand that the primary symptoms of these diseases are similar. In addition, if you do not consult a doctor in a timely manner and late detection of fibroids, it can develop into oncopathology (observed in 1.5 - 2% of all cases). More details