Cervical cancer: origin, diagnosis, treatment

The cervix is ​​the low, narrow part of the uterus. Cervical cancer is a disease that develops on the lining of the cervix, that is, on the tissue that covers it. 

More precisely, it originates in the first layer of the mucous membrane which is called the epithelium.

Cervical cancer is the 12th leading cause of cancer in women. The number of new cases in France is estimated at 2,800 in 2011.

What its origin?

The main cause of cervical cancer is a persistent infection with a virus that is sexually transmitted, human papillomavirus (HPV)

When this virus settles permanently in the cervix, it can cause changes in the epithelium, we speak of precancerous lesions. 

In rare cases, these lesions can progress to cancer. This progression is slow since cancer usually appears 10 to 15 years after persistent infection with the virus.

Diagnosis

Cervical cancer is suspected if an abnormality is found during a  screening exam (cervico-uterine test)  or if  symptoms have appeared.

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To establish the diagnosis, samples (biopsies or conization) are taken from the lesions. 

It is the pathological examination of these samples which confirms the diagnosis of cervical cancer. The extent of the disease is then determined by imaging examinations and in particular by MRI of the pelvis.

All of the diagnostic examinations make it possible to precisely characterize each cancer and to define in particular the type of cells involved (histological type), the depth of the tumor in the mucosa, its possible extension to neighboring organs or to nearby lymph nodes and its extension. possible to distant organs (metastases).

How is the choice of treatment made?

The choice of treatments is adapted to your situation, that is to say to the characteristics specific to the cancer from which you are suffering. 

Several doctors from different specialties meet to discuss the best possible treatments in your situation (multidisciplinary consultation meeting). 

They are based for this on recommendations of good practice. They may also suggest that you participate in a clinical trial.

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The possible treatments ?

The treatment of cervical cancer, depending on the extent of the disease, involves surgery, external beam radiation therapy, brachytherapy and chemotherapy, used alone or in combination.

Surgery is mainly used to treat tumors confined to the cervix, smaller than 4 centimeters. It most often involves removing the uterus, certain nearby tissues and organs, and lymph nodes.

Concomitant radiochemotherapy which combines external radiotherapy, brachytherapy and chemotherapy is the standard treatment for tumors larger than 4 centimeters and tumors that have spread beyond the cervix into the pelvis.

In the case of tumors that have reached distant organs (metastases), treatment is based on chemotherapy and / or radiotherapy (most often external).

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