Cervical cancer (squamous cell carcinoma) is often associated with human papillomavirus 16 or 18. It is detected by a gynecologist by chance during a routine examination or a screening examination (cervical uterine analysis), or when symptoms appear (bleeding outside the menstrual period).
A smear test for cervical cancer is performed every three years for women aged 25 to 65 years. Preventive vaccination reduces the risk of cervical cancer. This vaccine allows a woman to be immunized against certain types of HPV and can be administered from 11 years old.
Diagnosis is set by biopsy or conization. Extensive diagnostics is performed using a thoraco-abdominal pelvic scanner and an MRI of the pelvic area. All these studies allow you to find out the histological type of squamous cell carcinoma or adenocarcinoma, as well as the size and depth of the tumor, its spread to the lymph nodes and the possible involvement of other organs.
The operation is used to treat tumors limited to the cervix, and which have a volume of less than 4 centimeters. It includes the removal of the uterus and lymph nodes. Concomitant radio-chemotherapy combines external radiotherapy, brachytherapy, and chemotherapy to treat tumors larger than 4 cm or tumors that have spread beyond the cervix to the pelvis.
The used dose in radiotherapy delivered to the area of the tumor and pelvic lymph nodes (with possible affecting the lumbar-aortic lymph nodes) is 45 Gy in 25 sessions of 1.8 Gy per procedure. One session per day, five sessions per week. Cisplatin-type weekly chemotherapy may be suggested in the absence of contraindications. An additional dose of Gy is proposed for pathological lymph nodes by radiation therapy with a total dose of up to 60 Gy. Then brachytherapy is performed in the area where the tumor was as an additional treatment.