Uterine cancer

It is the 2nd most common women's cancer in the world. Most often it is squamous cell carcinoma.
Uterine cancer can affect young women, but its development increases as they age. It is very often related to a virus infection.
Le principal facteur de risque: infection à HPV( papilloma virus).

• The age of discovery is exceptional before 25 years of age and then the incidence gradually increases with age.

• Multi-sex partners

• Early sexual debut

• Multiparity (>5 pregnancies)

• Tobacco

• Estrogen-progestogen pill

• Vitamin A deficiency
  Symptoms:

• Painless red blood bleeding outside the period often during sexual intercourse

• Purulent loss by associated infection

• Lower abdominal pain, urinary tract infection, upper abdominal pain

• Discovery during A consultation.

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• Examination by the doctor with speculum: normal if cancer is micro-invasive, most often: budding tumour, bleeding on contact
• Examination under general anaesthesia performed in the operating room: biopsies in suspected areas, examination completed by cystoscopy with biopsies. Evaluation of the tumor stage.
• Pelvic MRI: allows to measure the volume of the tumor and to visualize the extension
• Abdominal-Pelvic CT: search for lymph node metastasis.
• Pre-operative laparoscopic lymphadenectomy: allows the condition of the lymph nodes to be assessed with certainty
• Determination of tumor markers (SCC, ACE)

**SPECIAL CASE OF MICROINVASIVE CERVICAL CANCER (T1A): **
It is a cancer that is just beginning and easily treatable. It accounts for 7% of cancers and mainly affects women under 40 years of age.
Its diagnosis is made by anatomopathological examination after a vaginal rubbing performed by a gynaecologist.
Its treatment is called conservative when it is beginning: it is a conization. The cervix is surgically removed from the uterus.
This procedure is performed under general anesthesia.
If the cancer is more invasive (deep), the contribution alone is not sufficient, and the uterus and possibly the associated lymph nodes must be removed (total hysterectomy with or without lymphadenectomy).
TREATMENT OF INVASIVE CERVICAL CANCER(>B):
For all other much more invasive (deep) cancers, surgery alone is not enough.
Appointments with the surgeon, radiotherapist, anesthesiologist and oncologist are organized to determine after meeting all these specialists the most effective treatment.
Cancers are classified according to stages.
Depending on the stadium, can be carried out:
Uterovaginal brachytherapy followed by surgery: extended hysterectomy with bilateral adnexectomy and pelvic lymphadenectomy:
The uterus, ovaries, fallopian tubes and lymph nodes around these organs are removed.
The approach, i.e. the surgeon's path, varies according to the type of cancer:
The surgeon can either privilege:
• laparotomy or open belly surgery: which consists in opening the wall of the abdomen either vertically (from the navel to the pubic bone) or horizontally (in the pubic hair).
• laparoscopy or closed belly surgery. The surgeon inserts an optical system into the abdomen from 4 small incisions. This technique is increasingly preferred, reducing complications, hospitalization time and cosmetic scarring disorders.
Post-operative external radiotherapy will then be performed according to the results of the anatomopathology examination of the tumour (analysis of the part operated on under the microscope)
Sometimes, if the stage is more advanced, preoperative radiochemotherapy is organized. The deeper lymph nodes are also often removed during the operation.
It is often necessary to temporarily place a urinary catheter to facilitate the evacuation of urine.
Drains are also placed at the level of the scars to prevent the accumulation of lymph and haematomas.
The anesthesia is general.

SPECIAL CASE OF MICROINVASIVE CERVICAL CANCER (T1A):
After the treatment:
You stay in the recovery room for about 2 hours. The anesthesiologist adjusts an oral or venous pain treatment. Monitoring for spontaneous urination recovery is necessary.
La durée de votre hospitalisation est brève entre 24 et 48h.
A blood test and a control ultrasound are performed before discharge.
A one-week check-up with the gynaecologist is necessary.
TREATMENT OF INVASIVE CERVICAL CANCER(>B):
After the treatment:
You stay in the recovery room for about 2 hours. The anaesthetist initiates a morphine-based treatment for pain by venous injection.
Regular monitoring is carried out in your room (blood pressure, urine, resumption of transit, nutrition and pain).
You are quickly urged to walk to avoid phlebitis although an injection of anticoagulant and compression stockings are prescribed.
The drains and urinary catheter are removed at the surgeon's request between the 2nd and 4th day.
A supportive psychologist is at your disposal and a diet adapted to the treatment is established.
The average length of hospitalization is 5 days but may vary from one patient to another.

About Uterine cancer

Since July 2007, the cervical cancer vaccine (Gardasil by Sanofi) has been available for girls from the age of 14.
The vaccine protects against 4 strains of Papillomavirus: 16 and 18, responsible for more than 7 out of 10 cervical cancers, and 6 and 11, responsible for genital warts. Its objective is to vaccinate 70% to 80% of girls aged 14 years before their first sexual intercourse to reduce the risk of cervical cancer by 70% and to reduce the risk of acuminate condylomas by 90%.
The vaccine does not offer protection against all carcinogenic HPVs or existing infections.
The smear remains essential: Maintaining screening for women aged 25 to 65 is essential in parallel with vaccination because the vaccine is not intended to replace the smear.
The HPV viral test detects the risk of cervical dysplasia or cancer if the HPV virus is permanently present. The risk seems to be ruled out for the 5 or 10 years if the test is negative. This test must be repeated every 5 years.
MEDICAIM is looking for the best specialists for you and we will offer you several renowned doctors.
MEDICAIM organizes your entire stay for you: post-operative nursing care, biological follow-up, therapeutic, nutritional and psychological support.
Any additional questions? Ask your doctor about it: careteam@medicaim.com