HPV and cervical cancer: methods of diagnosis and treatment of the disease

Oncological diseases of the uterus are in second place in frequency after breast cancer in women. The disease can be treated in its early stages; the main thing is that women undergo a routine examination by a gynecologist. Oncology can be detected in time and eliminated using one of the methods - conservative or surgical.

Cancer does not occur spontaneously. Its development requires time and predisposing factors. The tumor can occur at a young age, when the girl has not yet given birth or been sexually active. This complicates the treatment process, since it is necessary to give the patient a chance to have a child, but at the same time, to save her from a terrible disease.

This is possible if cervical cancer is detected at an early stage, before symptoms manifest themselves and irreversible changes occur in the tissues.

Causes of cervical cancer

One of the frequently asked questions is whether there can be cervical cancer if there is no HPV? Maybe, since there are many reasons for the occurrence of malignant tumors. Human papillomavirus is one of them. You can live with HPV if the immune system keeps the virus under control and does not allow it to multiply and release toxic toxins, which are a kind of carcinogen.

To the question whether there can be cervical cancer if there is no uterus, the answer can be: maybe. The cervix has a complex structure and all 4 groups of tissues:

• connecting;
• muscular;
• epithelial;
• nervous.

Cancer can develop when one type of cell undergoes malignant transformation. In addition, if the ovaries, which provide the necessary level of hormones in the body, are removed, then the general condition of the immune system worsens. Replacement therapy is required to restore hormonal levels and immunity.

Risk factors for malignant degeneration of cervix cells are:

• the presence of immunodeficiency conditions - AIDS, genetic diseases, chronic diseases, lack of normal nutrition;
• if HPV is detected in the husband, then the wife may have it, so a diagnosis needs to be made;
• erosion;
• use of an IUD - intrauterine device;
• presence of endometriosis;
• severe stages of dysplasia;
• leukoplakia;
• long-term use of hormonal contraception;
• benign tumors – fibroma, fibroids, polyps;
• promiscuity and lack of personal hygiene;
• early sexual activity or childbirth before age 16;
• deviations in health during previous examinations, chronic pelvic inflammatory processes.

Additional factors are unbalanced nutrition - lack of vitamins, protein, microelements in the diet. Smoking and drinking alcohol also weakens the body. In old age and if you are overweight, the prognosis is worse.

Dysplasia and leukoplakia are considered precancerous conditions.

CMM dysplasia

Epithelial cells with dysplasia change their structure. The danger of this condition is that it does not manifest itself. A woman may feel unwell, may be bothered by changes in her cycle, or spotting after sexual intercourse. It is necessary to conduct tests and visual examination if dysplasia is suspected.

Leukoplakia CMM

A violation of keratinization of the cervical epithelium in the form of a white spot that cannot be removed in the usual way. When the process is started, mild symptoms appear - bleeding, discomfort during sexual intercourse. Itching and leucorrhoea are the initial signs of leukoplakia, but they are characteristic of other, less dangerous diseases, so most often they are not paid attention to.

Types of CC

Cervical cancer is characterized by two types of cancer: squamous cell and adenocarcinoma. The first case is more common and can be found in young virgin girls who do not have sexual intercourse. Signs of a malignant tumor can appear at any age, although carcinoma, for example, is considered a very rare type of cancer. However, cases of the disease have been described.

A symptom of any type of cancer is bleeding and vaginal discharge. Bleeding weakens the body and leads to anemia, which complicates the course of the disease and its outcome. At later stages, signs of intoxication appear, which cause vomiting, fever, and chills. When spreading to the lymph nodes, an increased level of leukocytes and swelling are observed.

If the diagnosis is confirmed during pregnancy, a supporting uterine ring - a pessary - is prescribed, and treatment is postponed until the postpartum period.

Squamous cell carcinoma

It does not manifest itself in the initial stage, which makes diagnosis difficult. Changes in the squamous epithelium of the cervix are possible if a woman has had her uterus removed for adenocarcinoma or fibroids, but metastases remain. Postoperative therapy did not produce results, the process returned and recurrent cancer occurred. Squamous cell carcinoma has the appearance of a necrotic or ulcerative lesion.

Adenocarcinoma of the uterus

Carcinoma does not occur often. Affects the endometrium. Develops in women after 50 years. The reasons for the appearance have not been precisely established. Possible factors that cause uterine tumors are excess weight, smoking. Women who have not given birth have a higher risk of developing a tumor. The genetic theory of the disease is being studied.

Cervical cancer with uterus removed

Primary adenocarcinoma of the uterine body may appear after removal of the organ. In the case of adenocarcinoma, doctors recommend surgery and removal of the entire uterus and cervix.

If metastases are visible on MRI, then lymph nodes, ovaries and tubes are also removed. After surgery, they undergo radiation therapy and chemotherapy prophylaxis.

If the disease cannot be cured in this way, the prognosis for the future is unfavorable. Doctors give me a maximum of a year to live.

If the cervical tumor has not been removed and metastases remain, carcinoma can arise, deepening into the cervical canal.

Erosion, HPV, CC

Erosion is a consequence of mechanical damage to the tissue:

In young girls, erosion occurs due to hormonal deficiency, which spontaneously heals with the onset of sexual activity and after the birth of children. Erosion does not necessarily occur under the influence of human papillomavirus. In the presence of HPV, there is not always visible damage to the cervical mucosa.

If erosion is not treated, and the state of the immune system will deteriorate, then cell mutation and the occurrence of severe dysplasia are quite possible, which over time can lead to a malignant process.

Many infections can occur against the background of erosion, which is an indicator of hormonal imbalance, therefore, protection is reduced, and pathogenic bacteria are able to multiply uncontrollably.

In reverse order: prolonged inflammation and sluggish infections provoke changes in the mucous membrane of the cervix, which leads to ulceration. Before starting treatment, you should take all tests and determine the type of infection.

After the course of treatment, take tests again to make sure there are no infectious agents. After a 2-3 month break, it is worth checking again.

If the appearance of the cervix has improved and the erosion has disappeared, then surgery will not be required.

There is no need to undergo surgery, even the simplest one, unless necessary.

You can treat erosion with folk remedies that support the immune system, restore hormonal levels, and improve your general condition.

Cases of erosion degeneration into cancer are rare, so it is worth considering treatment without surgery.

Erosion is diagnosed visually. There is redness on the cervix, which can occupy the entire vaginal area of ​​the cervix. Confirms the presence of erosion of leukocytes in the smear, which indicate an inflammatory process.

Rshm in nulliparous women

Theoretically, an oncological process can occur against the background of a lack of sexual activity. Many experts consider this a myth, but if you look at it, the lack of sexual satisfaction provokes pelvic inflammatory processes. Venous outflow is disrupted, and with it the metabolism in the organs. Stagnation causes swelling and accumulation of toxic substances in tissues.

Under unfavorable circumstances - a decrease in immunity, the occurrence of concomitant diseases or hormonal imbalance can lead to a change in the structure of epithelial cells and their degeneration into cancer.

Is it possible to do without surgery for cervical cancer?

At the first stage of the process, conservative treatment helps in most cases. But to do this, you need to establish the type of cancer in time - conduct histology tests and begin treatment. The solution could be:

• radiation therapy;
• chemotherapy;
• antitumor drugs;
• The NIERT method - low-intensity electromagnetic resonance therapy - is one of the newest methods that allows for cure in 75% of cases; a NIERT treatment center has opened in Germany.

Using modern radiation therapy equipment, the method is completely painless. The prognosis after treatment of cancer in the early stages is positive.

As a preventive measure for cervical cancer, Elena Malysheva’s program discussed vaccination issues, although the fact that this vaccination works has not been proven. Doubts have been raised about the ability of vaccinated women to have children.

Relapses of cervical cancer

Relapses of cervical cancer occur due to incomplete treatment process. If rehabilitation therapy has not been carried out after surgical or conservative treatment:

• drugs that prevent tumor growth were not taken for the prescribed time;
• the diet was not followed;
• products that enhance immunity were not used;
• physical activity exceeded the permissible limits;
• intimate hygiene was not maintained.

Consequently, the body was unable to restore strength and defeat the causes that caused the growth of a malignant tumor. After the first victory over the tumor, you should lead a healthy lifestyle, eat right and maintain water balance in your own body.

According to progressive scientists, some people have a genetic predisposition to cancer. Why, in the same situation with lifestyle and bad habits, does the disease not develop in some people, while it kills others?

But probability is not a death sentence if you reconsider your habits in time and quickly take a number of measures to restore your own health.

Video: oncogenic HPV

Video: HPV, cervical cancer and dysplasia are treated

Video: Human papillomavirus and cervical cancer

Video: why is human papillomavirus dangerous?

Source: https://sheika-matka.ru/rak/mozhet-byt-rak-shejki-matki-esli-net-vpch/

Cervical cancer: a preventable disease

Cervical cancer is merciless. More than 500,000 new cases of cervical cancer are registered annually around the world, and about 53% of women die. In our country, this cancer kills 21 women every day. We know a lot about this disease, because the cervix is ​​an organ that is quite accessible to examination. Why are we still diagnosing things too late?

Cervical cancer

A disease with a well-studied and proven cause. In 2008, Harald zur Hausen won the Nobel Prize for proving the connection between HPV infection (human papillomavirus) and the development of cervical cancer.

Back in 1983, he managed to discover the most aggressive type of virus - HPV-16.

Over 34 years of research, which involved more than 10,000 patients, it was proven that 95% of cervical cancer cases are associated with one of the types - HPV-16 or HPV-18.

As always, a new idea captured hearts and minds. Thousands of doctors then rushed to look for HPV in millions of women, followed by monstrous attempts to get rid of the pathogen at any cost. In my memory, dozens of drugs came onto the market with the promise of “cure HPV forever.” Enthusiastic reviews gave way to bewilderment and disappointment.

Each subsequent medicine became more expensive than the previous one, each was accompanied by evidence of effectiveness in the form of studies of varying degrees of homegrown. I can safely say that we have definitely achieved only one effect - we have created HPV hysteria in the space around us.

“HPV cure” has become so popular that I am no longer surprised by claims that someone was cured of HPV with cow pats or Allokin-alpha.

Time for the big scare

Now it is obvious to most specialists: HPV is highly contagious; most sexually active women with more than one partner encounter HPV at least once in their lives. HPV is an epitheliotropic virus.

It lives in the thickness of the epithelial layer on the cervix, vaginal walls or on the skin of the external genitalia.

Moreover, we often see the place of its “registration” through a colposcope, and the results of vital activity in the form of atypical cells end up in cytological smears.

In most cases, HPV infection does not require any treatment at all, because the virus is spontaneously eliminated - it leaves the body on its own without any treatment along with the exfoliating cells of the stratified squamous epithelium.

If the HPV test is positive, but there are no colposcopic and cytological signs of damage, no treatment is required.

The senseless and merciless use of immunotherapy drugs for the latent form of HPV infection causes damage not only to the wallet, but also, possibly, to the body.

Admittedly, our actions in relation to the immune system are suspiciously reminiscent of the pirouettes of a bull in a china shop.

We can’t even proudly boast: “I cured Ivanova’s latent form of HPV!” Because it is impossible to prove why the virus left the body. Either he did it voluntarily, or he somehow got bored with our medicinal shamanism.

The younger the woman, the higher the likelihood of spontaneous elimination. Most experts consider it inappropriate to routinely test sexually active women under 25 years of age for HPV.

However, these patients with latent forms of HPV require careful monitoring. We will have to repeat the examination once or twice a year to make sure that HPV has left the body.

The average time for self-elimination of the virus is 1.5 years.

If the same type of HPV was detected three times over the course of 1.5–2 years, we can talk about persistence. Persistence can also be suspected if the viral load is high in women over 30 years of age. This in no way means that the patient has cervical cancer or its prestages, but, of course, indicates a significant risk and requires the same thing - careful monitoring.

Persistence of HPV without colposcopic and cytological signs of damage is not a reason for treatment.

And then, like Khoja Nasreddin: either the donkey dies or the sultan dies. Either HPV will leave the body, or we will still “catch” changes in cytology or colposcopy.

Why get tested?

Firstly, in order to identify a favorable group - women without HPV. They can be invited for screening less often (provided they have a monogamous sexual relationship); the risk of developing cervical cancer in this group is minimal.

Already in 2009, it was possible to prove that HPV-negative CIN (pre-stage cervical cancer) is impossible. If the results of a cytological examination indicate a precancerous condition of the cervix, and tests for HPV are negative, then someone is mistaken.

I often offer the mantra to my patients: “No HPV, no cervical cancer.” However, it must be remembered that the human factor has not been canceled.

Everything should be assessed in combination with cytology and colposcopy.

Who really needs HPV testing:

• patients with unclear results of cytological smears;
• after surgical treatment of precancerous diseases of the cervix - CIN;
• as a regular screening for patients over 25 years of age;
• with questionable results of colposcopy.

Cervical cancer develops very slowly. From the moment HPV enters the body to the development of cancer, years, and sometimes even decades, pass.

At first, the activity of the virus is almost invisible, but as soon as it is integrated into the genome of the cells, we will see characteristic changes in cytological smears.

Koilocytes ("empty" cells typical of HPV infection) and dikaryosis (various disorders in the cell nucleus, multinucleated cells) appear. This stage can last from 3 to 20 months.

Under unfavorable conditions, real cancer cells appear on the lower layers of the epithelial layer, where the most active cell division occurs. This is CIN I (mild dysplasia or grade 1 cervical intraepithelial neoplasia). As scary as it sounds, CIN I is not cancer; it develops many years before actual cancer.

In stage CIN I, the disease is reversible.

For young women and/or women planning pregnancy, we have the right to continue observation for 1.5 to 2 years. If the process is not going to regress, treatment is carried out.

Drug therapy is ineffective and can be used either as an auxiliary method or not at all.

And treatment is the complete removal of the lesion: excision (removal of the affected area) or conization (removal of a cone-shaped fragment of the cervix).

On average, CIN I turns into CIN II–III in 3–5 years (of course, the process will be much faster with concomitant HIV infection, chlamydia or gonorrhea). But there is still nothing irreparable at these stages. If we “caught” the patient at stages CIN II – CIN III, then wide excision of the affected areas is performed: excision or conization of the cervix.

A young woman with CIN I, having read horror stories on the Internet, sobs bitterly:

- Why are you crying so much? — I read that I will have cancer! I will die! - But you are already here. We would be worthless on a market day if we did not know how to identify and treat this stage.

After all, this is exactly why you came to the gynecologist - so that you don’t miss CIN. We didn't miss it. Now let’s carefully remove everything and continue to observe. - Will I be able to give birth? - Necessarily.

- When will it be possible to get pregnant?

- You can start 6 weeks after surgery.

Wide excision of the affected areas with a loop of a radio wave apparatus is a simple procedure. We mostly do this on an outpatient basis under local anesthesia. The entire removed area is sent for histological examination.

If it's so simple, why are women still dying?

This is a cruel and valid question. Cervical cancer is always someone's fault. Although, of course, if a woman did not go to the gynecologist’s office for 10 years, only doing an ultrasound from time to time, anything could be grown.

Olga was 44 years old. I leafed through her outpatient card: gynecologist, gynecologist, gynecologist... Over the past 10 years, she gave birth to three children and had 4 abortions. There is not a single cytological smear in the card. In the mirrors - advanced cervical cancer, symptomatic treatment.

Elena, 32 years old. She gave birth to 2 children with an interval of 2 years, came for an appointment 4 months after the second birth. Cytological smears were taken twice during pregnancies, but probably very gently for fear of spotting. In the mirrors - cervical cancer, stage IIb - we will be treated.

Marina, 38 years old, cook. He undergoes regular medical examinations and shows his health certificate. In the mirrors - advanced cervical cancer, stage III, we will be treated, but the prognosis is very doubtful. I doubt she was examined in mirrors at all. Perhaps they took smears for gonorrhea and trichomoniasis without looking. The most annoying thing is that Olga was sure that everything was fine with her, since she was regularly examined.

Cervical cancer is a disease of the young. The peak incidence in our country occurs at the age of 30–35 years. The cervix is ​​an easily accessible object for research, which makes each case of advanced cancer even worse. The disease is easily preventable by catching it at the CIN stage. And the woman will get married, and give birth to a child or three, and live a long and colorful life.

My youngest patient with invasive cervical cancer was 23 years old. A young man brought her by the hand to be examined for infection. The young man was bothered by the unpleasant smell of his beloved’s discharge. Wertheim's operation, radiation therapy, then relapse, chemotherapy. She died 2 years after diagnosis.

The human factor cannot be ignored...

There are many reasons for late diagnosis. It takes years from the introduction of HPV into the genome of epithelial cells to the onset of cancer, but invasive cancer grows and progresses very quickly.

Today, a new cervical screening strategy is being implemented everywhere in the Russian Federation - the use of liquid cytology with HPV testing. This significantly increases the chances of early diagnosis of cancer. It is this problem that gynecologists should deal with, and not “cauterizing erosions” and a merciless battle with HPV.

Let's set goals correctly. We strive to catch cancer in its pre-stages and neutralize it. “Cauterizing” everything that turns red does not help the diagnosis; on the contrary, it creates serious difficulties, masking a slowly smoldering process.

Hunting for CIN

The implementation of a simple algorithm guarantees timely diagnosis of changes in the cervix.

1. Smears for oncocytology must be done for all women who are sexually active. You can do it annually, but not less than every 3–5 years. Women over 25 years of age should undergo HPV testing along with cytology.
2. A “bad” cytology smear and/or detected HPV requires mandatory colposcopy. An unclear red spot on the cervix, even with “good” cytological smears and the absence of HPV, requires mandatory colposcopy.
3. Abnormal colposcopy results require taking a biopsy from all suspicious areas, or, which is more correct and cheaper, performing a wide biopsy of the cervix.

After treatment for CIN, continued follow-up for at least 5 years is strongly recommended. Anything can happen—the disease can recur. If you don't lose sight of it for a couple of years, you can notice a relapse in time and prevent the development of invasive cancer.

Oksana Bogdashevskaya

Photos 1- thinkstockphotos.com, 2-5 - provided by the author

Source: https://apteka.ru/info/articles/zhenskoe-zdorove/rak-sheyki-matki-bolezn-predotvratima/

Human papillomavirus and cervical cancer

Human papillomavirus is the most common viral infection of the genital tract. This means that most sexually active women and men will acquire the infection at some point in their lives, and some may become reinfected.

Types of human papillomaviruses:

Types of human papillomavirus are designated by numbers. Thus, viruses of low oncogenic risk include types 6, 11, 42, 43, 44 and 73. Viruses of types 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, 68 are classified as dangerous species.

Such viruses are capable, under certain conditions, of causing a malignant process. Of these, the most unfavorable types are HPV types 16 and 18.

They are responsible for the development of squamous cell carcinoma of the cervix and adenocarcinoma, respectively.

https://www.youtube.com/watch?v=Jo99Qm6fQ8Y

The peak period for acquiring infection for both women and men begins immediately after they become sexually active.

How is human papillomavirus transmitted?

The human papillomavirus is quite easily transmitted. Therefore, its prevalence among people is very high. Most people are infected with HPV and infect others. For example, a third of women of reproductive age undergoing routine examination have external manifestations of this infection. And these are genital warts.

This virus lives and manifests itself on the skin and mucous membranes and is transmitted from these areas by contact - by touching an infected object.

Thus, human papillomavirus infection is not a disease transmitted exclusively through sexual contact . First of all, if a human papillomavirus is detected, there is no need to accuse your partner of cheating.

Yes, of course , sexual intercourse is also a way to transmit the virus, but not the only one: it could be transmitted to you through everyday means - by touching, using the same toilet and hygiene items, or kissing.

Non-sexual HPV infection has not yet been sufficiently studied, since only in rare cases can the exact time of infection be determined - after all, most often carriage is asymptomatic: the incubation period can last up to several years.

Signs and symptoms of HPV

The human papillomavirus can live in the body for a long time, even from birth. He does not detect any signs of his presence. Or it may appear for the first time in mid-life due to decreased immunity.

In most cases, a person is diagnosed only because symptoms led him to see a doctor or the virus was detected during a random examination. So it is not always correct to associate the first manifestation of the virus with a recent infection. Since it could have happened quite a long time ago, and you may not have known about it.

Many types of HPV do not cause problems.

Human papillomavirus types 16 and 18

The most dangerous for humans are HPV types 16 and 18, because they most often cause neoplasia, including cervical cancer.

Today, cervical cancer is the most common disease associated with HPV types 16 and 18.

Although data on anogenital cancers other than cervical cancer are limited, growing evidence links HPV to cancers of the anus, vulva, vagina and penis.

Although these cancers are less common than cervical cancer, their association with HPV makes them potentially preventable by using the same primary prevention strategies as for cervical cancer.

Genital warts are widespread and highly infectious.

Most HPV infections do not cause symptoms or illness and go away on their own. However, persistent infection with certain types of HPV (most often types 16 and 18) can lead to the development of precancerous conditions.

Without treatment, these conditions can develop into cervical cancer , but this process usually takes many years.

In women with a normal immune system, cervical cancer develops within 15-20 years. In women with weakened immune systems, such as those with untreated HIV infection, it may take only 5-10 years to develop.

Interestingly, men who infect women themselves rarely suffer from HPV types 16 or 18, as they are transient carriers. Therefore, it is not surprising that when examining a married couple, papillomaviruses will be found only in the spouse.

Risk factors for cervical cancer

• first sexual intercourse at an early age;
• multiple sexual partners;
• tobacco use;
• immune suppression (for example, people living with HIV are at increased risk of HPV infection and are infected with a wider range of HPV types).

More than half a million women develop cervical cancer every year as a result of HPV infection. At the initial stage there are no symptoms of human papillomavirus infection ; they appear later, sometimes many years after the moment of infection.

As a rule, there are no obvious clinical symptoms. The presence of HPV is confirmed by cytological examination and positive results of HPV tests, as well as the detection of papillomaviruses in a biopsy of cervical tissue.

This is why it is so important for every woman to undergo cervical screening annually to determine the condition of the cervix and possible HPV infection.

Detection of oncogenic HPV types 16 and 18 is not a death sentence. Modern medicine knows ways to restore women to the health and joy of motherhood.

In our medical center, in the department of gynecology and urology, an accurate diagnosis of HPV . If infection with dangerous papilloma viruses is confirmed, our doctors will offer you an effective way to solve the problem.

Source: https://medi-art.kz/disease/virus-papillomy-cheloveka-vpch-16-18-tipy-i-rak-shejki-matki/

Cervical cancer and human papillomavirus

In 2008, the viral nature of cervical cancer was proven. HPV, or human papillomavirus , is the same virus whose presence is associated with an increased risk of developing genitourinary cancer in both women and men.

In total, there are about 190 types of HPV, but about 30 live in the urinary tract. Of these, according to their degree of oncogenicity (i.e., the ability to cause cancer), all types are divided into 2 groups :

1. Low-oncogenic (types 6, 11, 42, 43, 44),

2. Highly oncogenic (types 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59).

Identification of a low-oncogenic type does not mean anything. Identification of a highly oncogenic type indicates a significantly higher risk of developing genitourinary cancer than in the general population. types 16 and 18 that primarily influence the development of cervical cancer .

Moreover, the more oncogenic types you have identified, the greater the risk.

The main route of transmission of the virus is sexual .

• Currently, there are 2 ways to prevent cervical cancer :
• 1. Early detection and treatment of precancerous diseases
• 2. Vaccination against HPV

The presence of any precancerous diseases increases the risk of developing cancer significantly in the presence of infection with the human papillomavirus, which often serves as a trigger for its development! vaccination is considered one of the most effective methods of preventing cervical cancer .

Here now I will make a lyrical digression and tell you about the story that Israeli doctors . Then I was at a medical conference, where we were attended by practicing oncologists from Israel. So, they told us simply stunning news! In Israel, cervical cancer has already been defeated !!!

And the whole point is that in this country, vaccination against HPV has become almost a state program, according to which all girls under the age of 14 receive this vaccination. And according to their data, the incidence of this cancer in women who received this vaccination in childhood is 0!!!

, the World Health Organization has long recommended including routine vaccination against HPV in national immunization programs , which is not yet the case in our country. Well, okay, now back to the official information)))

1. In our country, 2 types of vaccines (there are 3 in total):
2. • divalent (Cervarix);
3. • tetravalent (Gardasil).
4. These vaccines contain artificially created virus-like particles , which contribute to the development of the body's immunity in response to them and, accordingly, to the HPV itself, but by themselves cannot cause infection, infection and disease in humans due to the fact that they do not contain live microparticles of this virus .
5. Age for vaccination.
6. The bivalent vaccine is recommended for women aged 15 to 45 years ; Adolescent girls: from 9 to 14 years inclusive .

Vaccination with a quadrivalent vaccine is carried out for women aged 14 to 45 years . Men aged 14 to 26 years . Teenagers (boys and girls) aged 9 to 13 years .

Based on the experience of most gynecologists and the same Israeli doctors, I can add on my own that HPV infection through sexual contact occurs in 80% of cases. Therefore, getting vaccinated from the moment you become sexually active is essentially useless! Most likely, HPV infection has already occurred, and the fact that each of us, to one degree or another, is a carrier of certain types of this virus is a fact.

Therefore, this vaccination is recommended for under the age of 14 , inclusive, who are not yet sexually active . In this case, it will be most effective!

If you have to choose which vaccine to choose, the effectiveness and safety of quadrivalent vaccines throughout the world is recognized more for adolescents. For vaccination of repeated HPV infections in people over 26 years of age, the bivalent vaccine is more effective!

The question of whether or not to vaccinate your child with this vaccine is up to you to decide. I personally will just vaccinate mine. Yes, the issue price is about 5000 rubles. But what does this compare to the life of your child???

• That's all for today) Don't forget to give a "thumbs up" and subscribe to my channel so as not to miss out on the newest and most interesting)
• Perhaps the best ex-oncologist, always yours, Marina Syskova)
• ———————————————-
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Source: https://zen.yandex.ru/media/id/5ab42e098c8be3aefcebf43e/5ac75a2455876bf07f136dc1

Cervical cancer

Cervical cancer (CC) is one of the most common malignant tumors of the female genital organs. Every year, more than 500,000 women are diagnosed with cervical cancer worldwide. In Russia, the incidence of cervical cancer ranks 2nd among gynecological oncological diseases.

Exogenous factors play a leading role in the development of cervical cancer. There is no data confirming that cervical cancer is a hereditary pathology.

Risk factors for the occurrence of cervical cancer are: early onset of sexual activity, early first birth, frequent change of sexual partners, refusal of “barrier” type contraceptives (condoms), exclusion of preventive examinations. There is convincing evidence of an increased risk of cervical cancer in women who smoke (2 times), which is associated with the carcinogenic effect of substances that make up tobacco smoke.

Currently, genital papillomavirus infection is considered an indisputable pathogenetic risk factor for the development of dysplastic changes (precancer) and CC.

Currently, about 200 types of HPV have been identified, of which about 40 affect the anogenital area. It has been established that certain types of HPV can infect a strictly defined type of epithelium.

All studied virus strains are conditionally divided into high- and low-risk groups based on their ability to induce dysplasia or CC. Highly oncogenic HPV types 16, 18, 31, 33, 35, 39, 45, 51, 52, 56 and 58, low oncogenic - 6, 11, 42, 43 and 44.

HPV types 6 and 11 are the cause of genital warts, are often identified in mild to moderate dysplasias, and are rarely associated with cervical tumors. HPV types 16 and 18 prevail over other types of papillomaviruses in cervical cancer.

Papilloma viruses infect the basal (deep) layers of the epithelium. The most “vulnerable” area is the zone of transition of stratified squamous epithelium into columnar epithelium.

It is believed that infection with the human papillomavirus is not enough to induce tumor growth, and the role of cofactors in the implementation of viral carcinogenesis, such as cellular factors involved in the regulation of the cell cycle and cell differentiation, is noted.

That is, not all women infected with high-risk HPV develop CC. Moreover, in 85-90% of women infected with HPV, the virus disappears from the body within 1-2 years under the influence of the body's immune system.

And only 10-15% experience long-term persistence of HPV in the epithelial cells of the cervix.

To prevent HPV infection and the subsequent development of dysplasia and cervical cancer, vaccination is effective (primary prevention of cervical cancer). Currently, two vaccines are registered in Russia: bivalent (against HPV types 16 and 18) Cervarix and quadrivalent (against HPV types 6, 11, 16 and 18) Gardasil.

Vaccines are not able to protect against HPV and the development of dysplasia if at the time of vaccination this type of virus persists in the epithelium of the cervix.

Currently, population cytological screening (collecting smears from the cervix for cytological examination) represents an almost ideal model for secondary prevention of invasive cervical cancer.

Research worldwide shows that cancer screening reduces mortality by reducing morbidity.

A reduction in mortality from CC with the widespread implementation of population cytological screening is achieved due to the increasing detection of dysplasia and intraepithelial cancer, and, as a consequence, a decrease in the frequency of invasive forms of CC.

The main immediate task of cytological screening is the identification and treatment of precancerous diseases, mainly severe dysplasia and preinvasive cervical cancer. CC screening begins 3 years after the start of sexual activity.

Any woman who is sexually active should undergo a cytological examination of cervical smears at least once every 3 years if she has high-risk HPV and at least once every 5 years if she does not have high-risk HPV. Women 70 years of age and older who have 3 (or more) normal test results, and in the absence of pathological changes in smears for 10 years, as well as women who have undergone hysterectomy, may refuse to participate in cervical cancer screening.

According to the figurative expression of the outstanding domestic oncogynecologist prof. I'M IN. Bokhman, cervical cancer does not arise “right off the bat.” There is a long period of 10-15 years, during which dysplasia of the squamous epithelium of the cervix first appears, which gradually progresses, turns into pre-invasive, and then into invasive CC.

The latter can be detected by histological examination equally both on a visually unchanged cervix and accompanied by dysplasia or invasive cancer.

The earliest clinical manifestations of the disease are copious watery discharge and “contact” bloody discharge (after sexual intercourse) from the genital tract.

In women of the reproductive period of life, bleeding can be acyclic in nature; in postmenopausal women, it can appear periodically or occur constantly.

With significant local-regional spread of the tumor, patients complain of pain in the lower abdomen and lower back, urination problems and difficulty defecating. With a large tumor volume, its partial necrosis and infection, discharge from the genital tract is accompanied by an unpleasant odor.

In advanced cases, rectovaginal and vesicovaginal fistulas are formed. One of the symptoms of advanced cervical cancer may be persistent swelling of one or both lower extremities, caused by a block of lymphatic and/or venous vessels due to the spread of the malignant process to the pelvic wall.

The main route of cervical cancer metastasis is lymphogenous (to the pelvic lymph nodes).

The transition of a tumor from locally infiltrative growth to lymphoregional spread marks a new, prognostically more unfavorable quality of the disease.

According to various authors, the frequency of metastases in regional lymph nodes in stage IA1 cervical cancer is less than 1%, stage IA2 - about 5%, stage IB - 15-18%, stage II - 25-35%, and in stage III it reaches 50-60 %.

When visualizing any form of background non-oncological pathology of the cervix, colposcopy is added to the above examination, and, if necessary, a tissue biopsy from all areas of the cervix suspicious for tumor transformation.

Scraping from the cervical canal complements the list of diagnostic measures that allow timely diagnosis of dysplasia of varying degrees, in situ cancer and microinvasive cervical cancer.

The most complete morphological picture at the listed stages of cervical cancer development is provided by a histological study of serially-staged sections of postoperative preparations after an extended knife biopsy, cone-shaped excision or amputation of the cervix.

In case of invasive cervical cancer, after histological verification of the tumor structure, subsequent diagnostic measures are aimed at establishing the extent of the tumor and determining the stage of the disease.

For this purpose, patients undergo a physical examination, X-ray examination of the chest organs, ultrasound examination of the pelvic organs, abdominal cavity and retroperitoneal space, MRI of the pelvis with IV contrast, and a study of the level of SCC in the blood (for squamous cell carcinoma).

If necessary, ultrasound of peripheral lymph nodes, cystoscopy, sigmoidoscopy, intravenous urography, radioisotope study of kidney function, and radiography of skeletal bones are performed. According to indications, it is possible to perform a CT scan of the abdominal cavity and chest, PET or PET-CT.

It should be noted that information about the prevalence of the tumor process at the stage of choosing treatment tactics is the basis for achieving the highest possible therapeutic results thanks to the optimal choice of the sequence of various stages and the volume of surgical, radiation and drug treatment.

In case of severe dysplasia and cervical cancer in situ, conization of the cervix , followed by curettage of the remaining part of the cervical canal and, if indicated, the uterine cavity. In the absence of tumor in the resection margin and scraping from the remaining part of the cervical canal, this volume of surgical intervention is considered sufficient.

In early stages of invasive cervical cancer, surgical treatment is preferable. In some patients, according to the results of histological examination of the removed material, prophylactic radiation or chemoradiotherapy is required in the postoperative period.

However, according to international recommendations, it is advisable to avoid a combination of surgery and postoperative radiotherapy due to the increased incidence and severity of complications when combining these treatment methods. This is possible either by expanding the scope of surgical intervention and abandoning postoperative radiation therapy.

Or by refusing surgery and carrying out radiation or chemoradiotherapy according to a radical program as an independent method of treatment.

In young patients who wish to preserve reproductive function, organ-preserving treatment can be performed.

For locally advanced cervical cancer, radiation therapy or chemoradiotherapy according to a radical program is usually performed as an independent method of treatment. When carrying out chemoradiation treatment according to a radical program, chemotherapy is auxiliary in nature and is necessary to enhance the effect of radiation therapy.

Sometimes treatment begins with several courses of chemotherapy. If the tumor has shrunk after chemotherapy, surgery may be performed. Based on the results of a histological examination of the removed specimen, the issue of the need for postoperative radiation or chemoradiotherapy is decided.

After completion of treatment, the patient is under clinical observation for at least 5 years.

Source: https://www.ronc.ru/grown/treatment/diseases/rak-sheyki-matki/