Sarcoma of the uterus
Among gynecological diseasessarcoma of the uterusit takes about 3-7% of cases. In 47% it develops from the myometrium, in 27% from the endometrium and in 25% from the fibromatous node.
What is dangerous for the uterine sarcoma?
By origin is a malignant neoplasm, formed from undifferentiated elements of the uterine layers.
The danger of malignant foci in the uterus is a high rate of its increase, because of what is observed:
- rapid surrounding and distant metastasis (lungs - 17%, liver - 9%, lymph nodes - 8%, ovaries - 7%, bones - 5%);
- defeat of the intestine, bladder and peri-endopathy;
- pronounced pain syndrome in the late stages, which requires the introduction of narcotic analgesics;
It is also worth noting that oncogenesis rapidly disintegrates, which leads to cancer intoxication and increased symptom severity.
To name the true reasons while it is not possible. Allocate only provoking factors that increase the risk of sarcoma. These include:
- trauma of the pelvic organs;
- malignancy of uterine fibroids;
- birth trauma;
- traumatization with abortion and other gynecological manipulations;
- inflammatory and infectious diseases of reproductive organs;
- polyps of the endometrium;
- hormonal disorders;
- bad habits, wrong nutrition.
At the initial stage, the sarcoma does not cause any symptoms, only periodic pain in the lower abdomen, acyclic menstruation and the appearance of abundant leucorrhoea are possible. Already at this stage it is necessary to see a doctor for examination and diagnosis to prevent disease progression and metastasis.
Clinical signs become more noticeable with the growth of oncogenesis. In addition, the symptoms depend on the localization of the malignant focus (the most symptomatic complex is with endometrial cancer and submucous nodes).
Against the background of pain syndrome and menstrual dysfunction, a woman notes an increase in body temperature to 3, degrees, weight loss, general weakness, dizziness and pale skin. The latter symptoms indicate the development of anemia due to frequent profuse menstruation and intermittent clotting.
When cancer cells spread through the blood and lymphatic vessels, metastases (mts) are formed, affecting distant organs. As a result, coughing, dyspnea (mts in the lungs, pleura), jaundice (mts in the liver), pain and disturbances of sensory and motor functions (metastases to the spine and spinal cord) are possible.
When should I see a doctor?
A visit to the doctor should be caused by the appearance of pain in the lower abdomen from one or both sides. Also, it is worth paying attention to the change in menstrual function (the volume of excretions, the presence of cyclicity and the appearance of intermenstrual blood loss).
A woman can also be bothered by abundant leucorrhoeas with an unpleasant odor, possibly with the appearance of purulent discharge.
Diagnosis of the disease begins with an analysis of the patient's complaints and gynecological examination. On examination, the blue shade of the cervix, its puffiness, hypertrophy and the presence of sarcomatous formation are noted.
Bimanual examination establishes the size, localization, consistency of the uterus, nodes, their mobility, assesses the condition of the appendages and lymph nodes.
From instrumental techniques, ultrasound of the small pelvis, computed tomography is used to detect neoplasm, its diameter, heterogeneity and visualization of blood flow.
With the help of cytological examination of aspirate from the uterine cavity and swabs, atypical cells are detected. For diagnostic purposes, hysteroscopy, diagnostic scraping with histological analysis, angiography and laparoscopy are also performed.
To assess the prevalence of the oncology, chest X-ray, urography, irrigoscopy and ultrasound of the abdominal cavity, retroperitoneal space and small pelvis are performed.
Modern treatment of uterine sarcoma
The therapeutic tactics for sarcoma of the uterus is based on a combined approach, which includes the operation and chemotherapy courses. The volume of the operation is often: removal of the uterus, appendages, a large omentum and nearby lymph nodes.
Chemotherapy is used to suppress the spread of sarcoma and the destruction of the remaining atypical cells after surgery. In addition, the use of chemotherapeutic agents is recommended for inoperable cancer, when the tumor conglomerate can not be completely removed.
How to live further if the uterus is to be removed?
Many women are worried about the question of how their life will change after removal of the uterus? Everything depends on the amount of surgical intervention:
- if the uterus with appendages and a large omentum is removed, then a decrease in libido due to removal of the ovaries is possible. They are a hormone-producing organ, on the basis of which sexual activity depends. In this case, hormonal drugs are prescribed as replacement therapy, the hormonal level is normalized and the libido is restored.
- when not only the uterus with appendages is removed, but also the external genitalia, then, in addition to hormone therapy, intimate plastic surgery is performed and the sex life will be resumed.
As for pregnancy, it is impossible with malignant damage to the uterus and appendages.
Probability of relapse
The probability of re-development of malignant process exists, especially in the presence of metastases or incomplete removal of tumor conglomerate. The duration of the disease-free period depends on the stage of cancer, the size of the operation and the number of courses of chemotherapy.
In the case when histologically confirmedsarcoma of the uterus, the forecast is unfavorable. Survival in the next 5 years at stage 1 is about 40%, with the second - does not exceed 20%, and in the latter stages the life expectancy does not exceed 2-5%..