Treatment of changes in the cervix

Cervical cancer occurs when abnormal cervical cells grow out of control. The cervix is the lower part of the uterus that has the aperture in the vagina and forms a lower third of the uterus. Cervical cancer can often be successfully treated if detected in early stage. In early stage it can be detected by a regular annual PAPA test.

Causes of changes in cervix cells
Most of the cervical cancers are caused by Human Papillomavirus (HPV). Human Papillomavirus is sexually transmitted by a person who is already infected. There are several types of HPV viruses and they are divided according to the frequency of causing malignant changes to highly malignant and non-malignant types. Some types cause condyloma, while some do not cause any symptoms.
You can have Human Papillomavirus for years, without even knowing it. The virus can remain in your body in latent form and only after years of staying in the body lead to the development of cervical cancer. It is therefore important that you regularly do PAPA tests. The PAPA test can identify changes in the cervix before they turn into cancer. If you treat these changes with adequate therapy, known as “wounds” of the cervix, you can prevent cervical cancer.

Symptoms of Cervical Cancer
Abnormal cervical cells rarely cause symptoms. However, you can have symptoms if abnormal cells lead to a change in the quality and appearance of the cervical tissue.
Symptoms include:
Vaginal bleeding that is unusual or changes in your menstrual cycle that you cannot explain,
Bleeding when the cervix gets in contact with something, such as contact during sexual intercourse or when you are putting diaphragm,
Pain during sexual intercourse,
Bloody vaginal discharge,
Changes in vaginal portion of cervix visible under speculum.

Prevention
PAPA test is the best way to detect changes in cervical cells that can lead to cancer, and this test almost always, if done once a year, shows changes before they turn into cancer. It is important that you follow all the instructions given to you by a gynecologist, if a change in the cervix is detected in purpose to prevent cancer.
A Human Papillomavirus that causes cervical cancer is transmitted sexually. The best way to avoid getting a sexually transmitted infection is to practice safe sex, using a condom or mechanical barrier method of contraception.

Since HPV infection is a group of sexually transmitted infections, but at the same time one of the rare ones whose transmission is not always protected by condoms, primary care is the vaccination of adolescents.

How are the changes in the cervical cells diagnosed?
The PAPA test is an integral part of the annual gynecological examination. During the PAPA test, a gynecologist scrubs a small sample of cells from the surface of the cervix that are sent for analysis. If the PAPA test shows abnormal changes, your gynecologist will probably do additional tests:

Colposcopy, that is coating of the cervix for the purpose of coloring modified cells and their more detailed analysis,
Punch biopsy of the cervix, that is taking a small sample of tissue with special pincers from a part of the cervix on which there is a change that is then sent to a pathohistological analysis,
LOOP or RF cutting of the cervical change to healthy tissue in the purpose of its removal and microscopic examination of the edges of change towards surrounding healthy tissue (at the same time diagnosis, and also the cure for changes that do not reach the inner confluence).

Healing
Treatment of initial changes in the cervix, that is erythroplasia or “wound” is successfully administered by cryotherapy, LOOP or RF excision of change, and after its coloring for differentiation from surrounding healthy tissue. This method of treatment enables the preservation of the reproductive function.
The basic precondition is early identification and prompt response before the abnormal precancerous cervical sputum spreads into the deeper layers of the cervix and uterus, which naturally requires a more extensive operative procedure for cure.

Treatment of advanced stages of cervical cancer involves:

Conization ,
An operation, such as hysterectomy and the removal of the pelvic lymph nodes with or without the removal of both ovaries and both oviducts,
Chemotherapy,
Radiation therapy.

Depending on how much the cancer has grown, one or more procedures have to be done, and sometimes there is a combination of these procedures. If you have had a hysterectomy, you will not be able to have children, but this procedure is not always necessary, especially if the cancer is detected at its earliest stage.

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Darko Jović

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Doc. PhD. Darko Jović

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