Synonyms in a broader sense

Synonyms in the broader sense: cancer of the uterine entrance, uterine cancer
English: cervical cancer / cervix cancer

Symptoms

Symptoms rarely occur at first. Sometimes a sweet smelling discharge and spotting (especially after Sexual contact) be the first signs of cervical cancer. In the advanced stage, the tumor spreads further into the wall of the cervix as well as into the vagina, pelvic wall, rectum (rectum), and the connective tissue holding apparatus of the uterus in the pelvis (the so-called parametria).
Settlements (metastases) of the tumor can initially spread via the lymphatic system, later also through ingrowth into blood vessels in the liver, brain, lungs and bones (so-called hematogenous metastasis, i.e. settlement on the bloodstream), resulting in severe pain.

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Read more about the main cause of cervical cancer here: Human papillomavirus (HPV)

Classification according to Papanicolaou

PAP I: Normal cell structure

  • The finding is normal, there are no abnormalities, check-up after one year as part of the cancer screening examination.

PAP II: Inflammatory and metaplastic changes

  • The cell changes are not suspect, mostly caused by bacteria or other germs, if necessary an examination after 3 months and a possible treatment of the inflammation

PAP III: Severe inflammatory or degenerative changes, an assessment of whether the changes are malignant is not possible with certainty

  • The finding is unclear; if necessary antibiotic or hormonal treatment, short-term control after approx. 2 weeks; if Pap III persists, a histological examination is important

PAP III D: Cells show slight to moderate atypical cell changes

  • The finding is unclear; this change is mostly related to the common HPV infection. A check-up after 3 months is sufficient; a histological investigation is only necessary if it occurs again

PAP IV a: Severe dysplasia or carcinoma cells in situ (precancerous)

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  • Histological examination with the help of a curettage (scraping) and a colonoscopy / hysteroscopy

PAP IV b: Cells of severe dysplasia or of carcinoma in situ (early stage of cancer), cells of malignant cancer cannot be excluded

  • Requires tissue (histological) clarification by means of conization (see below) or biopsy (obtaining a tissue sample), therapy depending on the findings and family planning of the patient

PAP V: Cells of a suspected malignant cancer (malignant tumor), tumor is clearly malignant

  • Require tissue-based (histological) clarification by means of conization (see below) or biopsy (obtaining a tissue sample).
    Therapy: removal of the uterus (hysterectomy)

Also read the article: The biopsy of the cervix.


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