The uterus is the main female reproduction organ, for it is here that the entire pregnancy will take place. However, this organ can be affected by cancerous tumors; the two distinct types are cervical cancer and endometrial cancer, another name for the uterine lining.
Cervical cancer can affect young women, but its occurrence drastically increases with aging. It is often associated with a viral infection, by the human papillomavirus, or HPV, which can be responsible for precancerous lesions. The development of the use of Pap smears in women tends to decrease the numbers of cervical cancer of the uterus.
Cancer of the cervix is often asymptomatic, that is to say, it does not generate any identifiable clinical signs, hence the importance of screening. Sometimes, however, suggestive but non-specific signs are possible:
- bleeding occurring outside of the menstrual period;
- genital discharge.
Following a sign evoked at a clinical exam or at a screening, some tests are commonly prescribed. Firstly, an examination with a speculum, a plastic tool used to visualize the cervix, will be used to identify a possible injury. If a lesion is present, samples will be taken. These biopsies are usually taken under general anesthesia and are sent out for analysis to identify their nature. In addition, an MRI or an intravaginal ultrasound may also complete the diagnosis. If there is indeed cancer proved, staging is necessary, i.e. the research by various examinations of other sites of cancer cell migration.
Depending on the classification of the tumor as determined by the doctor (based on the results of sampling and staging), different treatment options are possible. If the lesion is not advanced, a simple cone incision will be made. Otherwise, an ablation assembly of the uterus, known as total hysterectomy, may be necessary accompanied by radiotherapy, chemotherapy or a technique called brachytherapy, the using a radioactive source near the tumor. Surgery may even be extended to the ovaries and fallopian tubes (called total hysterectomy with oophorectomy), and nearby lymph nodes can be "cleaned".
Cancer of the cervix can be prevented. Screening for precancerous lesions is assured by Pap smears, starting in the months following the onset of sexual activity, and repeated every three years until age 65. This does not prevent the appearance of these precancerous lesions, but allows them to be diagnosed and managed as early as possible. Prevention can also be assured through vaccination, which protects girls, before the onset of sexual activity, from most carriers of precancerous HPV, including HPV 16 and 18.