{"id":4011,"date":"2015-04-06T18:12:15","date_gmt":"2015-04-06T18:12:15","guid":{"rendered":"https:\/\/jurmed.ro\/medici\/?p=4011"},"modified":"2015-04-06T18:12:15","modified_gmt":"2015-04-06T18:12:15","slug":"cancerul-de-col-uterin","status":"publish","type":"post","link":"https:\/\/jurmed.ro\/medici\/cancerul-de-col-uterin\/","title":{"rendered":"Cancerul de col uterin"},"content":{"rendered":"

\n\"Amethyst\"<\/a>\u00a0\u00a0 La inceput cancerul de col uterin este asimptomatic. Primele semne si simptome care alarmeaza pacienta apar de obicei cand leziunea progreseaza local. \u00a0 \u00a0Manifestarile initiale constau in sangerare dupa contact sexual, durere la contact, secretii vaginale mai abundente, uneori cu miros neplacut, cu striuri sangvino \u00a0lente.\u00a0 Pe masura ce boala progreseaza poate aparea durerea la nivelul pelvisului, aceasta poate iradia catre membrele inferioare sau posterior, dificultati la urinat, \u00a0contipatie. In stadiile avansate se pot produce comunicari cu vezica urinara si rectul iar prin vagin se pot exterioriza urina si materii fecale.<\/p>\n

\u00a0In ultima perioada a fost stabilit ca principal factor ce duce la aparitia celor mai multe cazuri de cancer al colului uter in infectia cu virusul HPV. Exista anumite \u00a0tulpini ce prezinta un risc crescut pentru transformare maligna a epiteliului cervical dintre acestea cele mai importante sunt tulpinile 16 si 18. Nu toate pacientele ce \u00a0vor avea aceste tulpini vor dezvolta cancer al colului uterin.<\/p>\n

Alti factori ce se asociaza frecvent cu cancerul de col uterin sunt: promiscuitatea, femeile cu multi parteneri, femeile ai caror parteneri au multe partene, fumatul, o igiena deficitara.<\/p>\n

Pentru depistarea precoce a cancerului de col uterin orice femeie trebuie sa consulte periodic un medic ginecolog. Examenul Babes Papanicolau trebuie efectuat anual insa trebuie stiut faptul ca un examen Babes Papanicolau normal nu exclude cancerul de col uterin. In cazul in care apar sangerari in perioada dintre menstruatii, secretii vaginale modificate, sangerare sau durere la contact sexual\u00a0 trebuie consultat medicul ginecolog.<\/p>\n

Exista un marker tumoral SCC ce poate fi crescut in cancerul de col uterin dar acesta nu este specific cancerului de col uterin si nu prezinta o sensibilitate crescuta deci nu poate fi utilizat ca metoda de scrinning asa cum se dozeaza PSA-ul pentru cancerul de prostata.<\/p>\n

Pentru cancerul de col uterin nu este dovedita existenta unei mutatii genetice transmisibile astfel ca existenta in familie a cazurilor de cancer de col sau cu alte localizari nu predispune catre aceasta boala.<\/p>\n

Atunci cand la examenul ginecologic se ridica suspiciunea unui cancer de col uterin trebuie efectuata o biopsie de la nivelul formatiunii tumorala care sa confirme suspiciunea si care sa ne aduca informatii despre tipul celulelor tumorale.\u00a0 Dupa stabilirea diagnosticului este necesara o evaluare a extensiei locale si la distanta ale bolii. Pentru aceasta medical va recomand sa se efectueze un examen RMN de pelvis cu substanta de contrast si un examen CT de torace si abdomen cu substanta de contrast. Daca exista suspiciuni de afectare a vezicii urinare si rectului se recomanda cistoscopie si rectoscopie.<\/p>\n

Tratamentul cancerului de col uterin este combinat, multidisciplinar si include: chirurgie, radioterapie si chimioterapie. Pentru pacientele la care boala este limitata la nivelul colului, tratamentul poate consta doar in interventie chirurgicala sau radioterapie si chimioterapie concomitenta. Uneori dupa interventia chirurgicala poate fi recomandata radioterapia ca tratament adjuvant daca examenul histopatologic deceleaza factori de risc crescut pentru o recidiva locala. Pentru pacientele la care boala depaseste colul uterin dar nu este foarte avansata local se poate efectua radioterapie si chimioterapie pentru micsorarea volumului tumoral, urmate apoi de interventie chirurgicala. Aceste paciente ca si cele cu boala avansata local pot efectua radioterapie cu o doza mai mare, in acest caz nu se mai intervine chirurgical iar controlul local poate fi destul de bun. Pentru pacientele la care boala a diseminat la distanta tratamentul consta in chimioterapie.<\/p>\n

Tendinta pacientelor este de a schimba radical stilul de viata si in special regimul alimentar. Nu exista dovezi ca renuntarea la proteinele din carne, un regim fara glucide, renuntarea la produsele din lapte ar imbunatatii rezultatele tratamentului. Terapia fiind una solicitanta pentru pacienta este important ca aceastasa sa nu se infometeze si sa aiba un regim alimentar variat si sanatos.\u00a0 In timpul radioterapiei insa exista tendinta catre accelerare a tranzitului intestinal si aparitia meteorismului abdominal si scaunelor diarei motiv pentru care trebuie evitate alimentele ce fermenteaza sau acele care regleaza tranzitul ( legume, fructe, mancare de fasole, mazare etc). De asemenea consumul excesiv de antioxidanti (legume si fructe proaspete, preparate naturiste, fresh-uri) in timpul radioterapiei ar putea interfera in mod negativ cu efectul radioterapiei .<\/p>\n

In ceea ce priveste preventia cancerului de col uterin probabil ca cea mai eficienta metoda ar fi vaccinarea impotriva virusului HPV a fetitelor inaintea inceperii vietii sexuale. Ca metoda de depistare precoce,\u00a0 efectuarea periodica a consultului ginecologic si a examenului Babes Papanicolauar duce la diagnosticarea in stadi localizate a cancerului de col uterin ceea ce ar presupune tratamente mai putin agresive si\u00a0 o rata de vindecare mai mare pentru aceste paciente. Trebuie avut in vedere faptul ca aceasta boala \u201cnu doare\u201d decat atunci cand evolutia locala este avansata, din acest motiv femeile nu ar trebui sa intarzie prezentarea la ginecolog daca observa modificari ale secretiei vaginale sau sangerare vaginala anormala. Un examen Babes Papanicolau normal nu exclude cancerul de col uterin. Diagnosticul de certitudine il pune biopsia de la nivelul leziunilor suspecte ale colului uterin.<\/p>\n

 <\/p>\n

\"3d5a93f59687347d668c5a94e3bf5cb4\"<\/a> Dr. Gabriel Ricu, medic specialist radioterapie Amethyst Radiotherapy \u00a0\"logo-300px\"<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

\u00a0\u00a0 La inceput cancerul de col uterin este asimptomatic. Primele semne si simptome care alarmeaza pacienta apar de obicei cand leziunea progreseaza local. \u00a0 \u00a0Manifestarile initiale constau in sangerare dupa […]<\/p>\n","protected":false},"author":5,"featured_media":4014,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"categories":[33,168],"tags":[170,171,169,105],"class_list":["post-4011","post","type-post","status-publish","format-standard","has-post-thumbnail","category-articole","category-oncologie","tag-amethyst","tag-babes-papanicolau","tag-cancer-col-uterin","tag-oncologie"],"yoast_head":"\nCancerul de col uterin - Jurmed - Medici<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/jurmed.ro\/medici\/cancerul-de-col-uterin\/\" \/>\n<meta property=\"og:locale\" content=\"ro_RO\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Cancerul de col uterin - Jurmed - Medici\" \/>\n<meta property=\"og:description\" content=\"\u00a0\u00a0 La inceput cancerul de col uterin este asimptomatic. 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