The uterus, also known as the womb, is one of the strongest organs in the female body. Many layers of muscle tissue arranged in different directions surround the uterus. During childbirth, it is ready to exert tremendous pressure to push the baby out, and this pressure is far greater than anything any other organ in the body can produce. The part of the uterus that is specialized for handling this pressure and carrying a pregnancy, among other functions, is called the cervix.

Cervical Dysplasia (Cellular Abnormalities) Cervical dysplasia refers to the abnormal growth of cells on the cervix, which can be considered as precancerous lesions. It is often associated with human papillomavirus (HPV) infection and is typically detected through routine Pap smear tests.

Dysplasia is categorized into mild, moderate, and severe degrees:

• Mild dysplasia (CIN 1): Shows slight abnormalities in the cells and often resolves on its own.
• Moderate dysplasia (CIN 2): Displays more obvious cellular abnormalities and may require treatment.
• Severe dysplasia (CIN 3): Refers to serious cellular abnormalities with a high risk of progressing to cervical cancer, previously known as cancer in situ.

Treatment options depend on the severity of the dysplasia and typically involve removing the abnormal cells. Prevention methods include regular screenings, HPV vaccination, and a healthy lifestyle.

Treatment options for cervical dysplasia vary according to its degree. Observation is common for mild dysplasia (CIN 1), as it often resolves on its own, and doctors typically prefer to monitor the situation with follow-up tests in a few months.

Cryotherapy (freezing treatment): Abnormal cells are frozen and destroyed using liquid nitrogen. This method is generally suitable for mild and moderate dysplasia (CIN 2).

Loop Electrosurgical Excision Procedure (LEEP): In this procedure, abnormal cells are cut and removed using a small electrical current passed through a wire loop. It is effective for both moderate and severe dysplasia (CIN 2 and CIN 3).

Cone biopsy (conization): This surgical procedure removes a cone-shaped tissue sample from the cervix, used both for diagnosis and treatment, especially for more severe dysplasia cases (CIN 2 and CIN 3).

The HPV vaccine is an important preventive method for protecting against the types of HPV that cause cervical cancer. The vaccine is most effective in individuals who have not yet been infected with HPV, but may also be recommended for those who have been infected in some cases.

The treatment plan is personalized and depends on factors such as a woman’s age, general health, fertility plans, and the severity of the dysplasia.

Cervical Cancer

Cervical cancer develops in the lower part of the uterus that connects to the vagina. It is a gynecological cancer type that occurs due to cellular changes, which may be contributed by HPV (human papillomavirus). It primarily affects women between the ages of 30 and 50, especially those who are sexually active. Despite being treatable with early detection and diagnostic methods, cervical cancer remains one of the deadliest types of cancer in the world.

Cervical cancer is a relatively common cancer in women but is preventable through vaccination. The key to effective treatment is early detection, as recovery rates can reach up to 90% in the early stages. Therefore, it is recommended that women between the ages of 30 and 65 undergo a Pap smear and HPV-DNA test every five years, even in the absence of symptoms. Regular and systematic check-ups are crucial for early diagnosis.

If treatment is delayed, cervical cancer can affect deeper layers of tissue or spread to other organs, causing damage. The more advanced the disease, the lower the chances of recovery. This highlights the importance of frequent routine examinations. Cervical cancer generally does not have any precancerous symptoms. Once symptoms of cervical cancer appear, cancer cells have usually already spread.

Common symptoms of cervical cancer include abnormal vaginal bleeding, unexpected vaginal discharge, pelvic pain, and pain or spotting during intercourse.

Stages of Cervical Cancer

Cervical cancers are classified into stages based on their progression and extent. The first stage of cervical cancer is localized only to the cervix. This is known as an early stage and is typically the most suitable stage for cervical cancer surgery, except in special cases. Stage IA cervical cancer is microscopic and can only be detected through screenings. In Stage IB, the cancer is visible but smaller than 4 cm and has not spread beyond the cervix’s anatomical structure. Early detection and treatment in this stage are crucial as recovery rates are very high.

In the second stage of cervical cancer, while it is still considered an early stage, it is no longer classified as "very early." In this stage, surgery is an option for only a small number of patients. The primary treatment for this stage is concurrent radiotherapy and chemotherapy. It is essential for both the patient and their loved ones to understand this stage, and for healthcare providers to distinguish it using the most optimal examination and imaging methods. This phase requires dedication and patience.

In stage IIA, the cancer has grown larger than 4 cm but has not spread to surrounding tissues. Surgery may be performed on selected patients in this group at this stage. In stage IIB, the tumor has spread beyond the anatomical structure of the cervix into the parametrium, which consists of fat and connective tissue. This stage is critical, as surgery is no longer an option once the cancer reaches this point.

In stage III cervical cancer, the tumor has extended beyond the cervix, reaching the lower part of the vagina and, in some cases, blocking the kidney tubes, leading to swelling of the kidneys. Additionally, lymph nodes in the lower abdomen may also show metastasis. The recommended treatment for this stage is concurrent radiotherapy and chemotherapy, as surgery is not suitable.

In the final and most severe stage, stage IV, it is generally not possible to completely cure or eliminate the disease. The primary treatment goal is to shrink the cancer and control the disease. This stage is further divided into two subgroups. In stage IVA, the disease has not spread to distant organs but has involved neighboring organs such as the bladder and intestines, indicating regional spread. In selected patients, if extensive tests show that the tumor has not spread beyond the lower abdomen, concurrent radiotherapy and chemotherapy may be appropriate. In stage IVB, the cancer has spread to distant organs such as the liver, lungs, bones, brain, or upper abdomen, and chemotherapy along with targeted therapy (smart drugs) is considered the most suitable option.

Cervical Cancer Treatment

Generally, surgical intervention is the primary treatment for cervical cancer. The surgery involves the removal of the uterus and cervix (total hysterectomy) along with the fallopian tubes and ovaries. Various other treatment methods are available and may be used in combination depending on the patient's condition and the stage of the disease, as evaluated by the doctor.

For instance, radiation therapy is commonly used as an adjunct treatment after surgery to prevent recurrence of the disease. This type of treatment is known as adjuvant therapy. If surgery is not possible due to the patient's general health or other medical conditions, radiation therapy may be used as the primary treatment.

Another treatment option is hormone therapy. Some types of uterine cancer grow in response to estrogen or progesterone. These are known as hormone-dependent or hormone-sensitive cancers and can sometimes be treated with hormone therapy. For recurring or metastatic cervical cancer, hormone therapy may be recommended as an initial treatment if surgery is not an option. Chemotherapy is a widely known treatment method that involves using drugs to destroy cancer cells, prevent their spread, or slow their growth. The primary goal of chemotherapy is to eliminate cancer cells while minimizing damage to healthy cells.

If ovaries are removed during treatment, patients will no longer have menstrual cycles. Menopause, which typically occurs between the ages of 45 and 55, can be a natural process for women. However, if ovaries are removed before this natural process, it may be more painful, especially in terms of menopausal symptoms. Additionally, if a hysterectomy is performed, the ability to conceive is lost. Post-surgical complications can also include issues like urinary incontinence, which some women may experience after the procedure. It is important to discuss all possible outcomes and treatment options with your doctor to make an informed decision.

For more detailed questions or support regarding cervical problems, feel free to contact our clinic.