Radiation exposure in cervical cancer. Violation of the function of the bladder and intestines. The nature of the treatment depending on the radiation doses

Content

Cervical cancer is considered a serious pathology that has dangerous consequences. The disease is more often detected in women from thirty to fifty years old and progresses asymptomatically for a significant part of the time, which can lead to undesirable consequences.

Cervical cancer develops with the formation and progression of a malignant tumor. Pathological process can be observed both in the vaginal area of the cervix, and in the cervical canal. Quite often, malignant changes are found in the so-called transformation zone.

Structural features

The cervix is not considered by specialists as separate body. In reality it is Bottom part uterus, its narrowest section, performing a series of necessary functions. The cervix protects the uterus from harmful flora, being a kind of barrier. Through the neck, the rejected endometrium is removed during menstruation. In addition, the cervix is directly involved in childbirth and conception.

The cervix can be either conical or cylindrical. The appearance of the uterus depends on the realization of the woman's reproductive function. The neck resembles a narrow muscular tube, which has an insignificant length.

In the structure of the cervix, two sections are distinguished.

supravaginal. This is the largest department, which, nevertheless, is not visualized during examination.
Vaginal. This is the area that is adjacent to the vagina and is examined during gynecological examination.

The vaginal part of the cervix has the following characteristics:

pale pink color;
smooth flat surface;
homogeneity of the epithelium in color and texture.

Any deviation from the norm can talk about pathology and have serious consequences.

The cervix is lined with the following types of epithelium:

flat layered(vaginal part);
cylindrical single layer(cervical canal).

The vaginal part of the cervix is lined with an epithelium consisting of multilayer flat cells. Cellular elements are located in three main layers and differ varying degrees maturity.

The basal layer contains immature rounded cells with one large nucleus inside.
Intermediate layer includes maturing flattened cells with one reduced nucleus.
Surface layer consists of mature flat cellular elements with one small nucleus.

The cervical canal is located inside the uterus. The entrance to the canal in women giving birth is slit-like. Surface cervical canal formed by cylindrical single-layer cells. The glands that produce protective mucus also function in the cervical canal. The narrowness of the canal and mucus prevent infection from entering the uterine cavity.

The surface of the mucous membrane of the cervical canal has a reddish tint and a velvety texture. Top end the canal is opened into the uterine cavity, which forms the internal os. The lower edge of the cervical canal opens into the vagina, thus forming the external os. In its depth there is a transition zone called the transformation area.

According to statistics, a significant number of malignant tumors formed in the transformation zone.

Classification

The consequences of cervical cancer depend on its type. Gynecologists distinguish many forms of cervical cancer, some are quite rare. The classification of cervical cancer includes varieties that are distinguished based on different criteria.

Depending on the tissue that forms a malignant tumor, there are:

squamous a form of cancer
glandular type of cancer.

Squamous cell carcinoma is diagnosed in 90% of cases, while glandular oncology or adenocarcinoma occurs no more than 10% of cases.

According to the degree of invasion, cervical cancer is distinguished:

pre-invasive, meaning stage zero;
microinvasive, including stage 1A;
invasive, meaning stages 1B - 4.

According to the degree of cellular differentiation, cervical cancer is:

highly differentiated;
moderately differentiated;
poorly differentiated.

Highly differentiated tumors, unlike poorly differentiated or undifferentiated ones, have a good prognosis, are not aggressive, and rarely metastasize. However, moderately differentiated neoplasms are diagnosed in the vast majority of cases.

stages

The consequences of cervical cancer depend on the diagnosed stage. Stages or stages indicate the severity of the course.

There are four stages in the progression of cervical cancer.

Neck injury. A1 - invasion up to 0.3 cm. A2 - invasion up to 0.5 cm. B1 - germination up to 4 cm. B2 - germination over 4 cm.
Involvement of the uterus. A - no defeat serous membrane. B - germination in the serous membrane.
Spread to pelvic wall and vagina. A - involvement of the lower third of the vagina. B - involvement of the pelvic wall.
Formation of distant metastases, damage to organs outside the small pelvis. A - germination in the bladder and intestines. B - spread of the tumor to distant organs, the formation of metastases.

The severity of the consequences depends on the stage.

The reasons

Cervical cancer develops as a result of dysplastic changes. In fact, dysplasia implies a precancerous condition.

Under the dysplastic process, they mean changes in the structure of cells related to the violation of their maturation and differentiation. Normal cells are known to be arranged in three layers squamous epithelium. With dysplasia, there are consequences in the form of a change in the shape and structure of cells, the disappearance of division into layers.

The precancerous process has several degrees of flow:

defeat of 1/3 of the epithelium (CIN I);
involvement of half of the thickness epithelial tissue(CINII);
detection of atypical cells in the entire epithelial layer (CIN III).

Consequences of dysplasia:

rounded cells become shapeless;
the number of cores increases;
layering disappears.

If atypical cells acquire the ability to intensively multiply and grow into surrounding tissues, a consequence develops in the form of cancer.

The main cause of dysplastic changes is HPV infection. More than a hundred strains of the virus are known to science, however, only a few are distinguished by a high degree of oncogenicity and the ability to cause cancer. For example, strains 16 or 18 usually cause cervical cancer. Some strains do not have a transforming, but a productive effect, which is expressed in the formation of papillomas, condylomas.

However, in the presence of dangerous strains, cancer develops if the patient has a history of comorbidities. A healthy immune system removes the virus from the body within a few months.

The consequences in the form of cancer develop with the following adverse factors:

sexual infections, especially complex ones, such as HPV and herpes;
ignoring the condom during casual sexual intercourse;
having multiple sexual partners;
early intimate relationship that increase the risk of contracting sexually transmitted infections, trauma to the cervix;
chronic inflammatory processes in the small pelvis;
the role of heredity;
damage to the epithelium of the cervix;
smoking;
adverse environmental conditions;
carcinogenic effect of male smegma is not the cervix.

Women with HPV should have regular check-ups preventive examinations in order to prevent the consequences in the form of cervical cancer.

Symptoms and methods of diagnosis

Cervical cancer is known to cause severe consequences and long recovery after treatment. Often, the progression of cancer to serious consequences is due to the latent course and the irregular nature of the examination.

Usually, the consequences in the form of symptoms appear in the third or fourth stage, when there is a violation of the functioning of organs and multiple metastases. Gynecologists identify the following signs that may indicate the development of consequences in cervical cancer:

bleeding from fetid odor, on appearance reminiscent of meat slops;
bleeding;
contact discharge that appears during a gynecological examination, sexual intercourse;
leucorrhea with damage to the lymphatic capillaries;
edema as a result of the involvement of regional lymph nodes;
signs of compression Bladder, intestines, which is manifested by blood in the urine and feces, constipation, painful frequent urination;
pain in the pelvic region;
weakness;
nausea;
dizziness;
anemia;
temperature rise.

The consequences of cervical cancer can be similar to the symptoms of many diseases. That is why, when a characteristic clinical picture a survey should be carried out, including the following methods.

Gynecological examination in cervical cancer is informative in the later stages. On the early stages it is necessary to perform laboratory and instrumental studies.
Colposcopy involves examining the cervix with a colposcope. During a simple procedure, the doctor examines the epithelium under a microscope. An extended procedure is required when abnormalities are found. After solution treatment acetic acid white areas indicate the defeat of the papillomavirus. If unpainted areas remain after applying Lugol, atypia is possible.
A biopsy is performed only after identifying atypical areas. The sampling of material for histological examination is carried out different ways. After the diagnosis, it is necessary to follow the recommendations of the doctor during the recovery period.
smear for oncocytology held every six months for all women. Cytological examination shows the presence of abnormal cells and inflammation.
Curettage of the cervical canal required for suspected adenocarcinoma. The procedure and the first days of the recovery period take place in a hospital.

Examination in order to exclude the consequences in the form of metastases involves the use of MRI, CT, X-ray and other studies.

Radiation therapy method

Radiation therapy is considered one of the most effective treatments malignant diseases, including cervical cancer. Radiation therapy has been successfully used in many countries around the world. With the help of radiation therapy, it is possible to destroy malignant cells and prolong the life of cancer patients in the later stages of the disease. However, the method of radiation therapy has features of implementation and recovery after treatment.

Radiotherapy or radiation therapy is carried out by means of ionizing radiation, which affects the tissues affected by cancer. Under the influence of radiation therapy, it is possible to suppress the growth, spread cancer cells in the body. To create a beam of elementary particles, medical accelerators are used.

It is noteworthy that radiation therapy does not cause the breakdown of cancer-affected tissue, however, it leads to changes in DNA. Thus, the growth and division of cancer cells stops or slows down. Radiation therapy leads to rupture of molecular bonds of atypical structures. Radiation therapy has a greater effect on cancer cellular elements. Healthy tissue is virtually unaffected, making recovery easier.

The doctor can change the direction of radiation during radiation therapy. This is necessary to ensure maximum dose radiation in damaged tissues.

In general, radiation therapy is successfully used as an independent method of treatment. However, radiation therapy can also be used in combination with surgical treatment. special value radiation therapy has in the presence of multiple metastases that cannot be removed surgically. The recovery period after radiation therapy is easier than after chemotherapy.

It is known that in order to achieve maximum efficiency and to facilitate the recovery period, doctors can use both internal and external radiation exposure. Usually, specialists use two methods of using radiation therapy in combination. The use of only internal or external influence performed quite rarely.

outer shape

External or external beam radiation therapy is recommended for five to six weeks. Radiation therapy is carried out in outpatient settings. Before a course of radiation therapy, a woman undergoes an examination. Of particular importance is the determination of the exact location of the tumor.

Before the application of radiation therapy, special markers are placed on the skin for the exact direction of exposure. Radiation therapy is carried out 5 times a week daily. The duration of the radiotherapy procedure depends on the following factors:

the size of a malignant neoplasm of the cervix;
general state woman's body.

A radiation therapy session usually lasts about two to three minutes. During a radiotherapy procedure pain do not arise. An important condition is to keep the body still.

If the patient missed one of the radiation therapy sessions, the procedure can be carried out twice a day, observing an interval of six to eight hours.

inner form

Intracavitary irradiation is carried out as part of inpatient or outpatient treatment. In order to obtain the maximum result, special applicators are placed in the cervical area for radiation therapy. Anesthesia is performed prior to the procedure. To prevent displacement of the tube, a swab is inserted into the vagina. The correct position of the applicator is assessed using CT.

After a session of radiation therapy, pain medications are prescribed. The duration of the radiation therapy session is determined by the attending physician. Usually, intracavitary radiation therapy is carried out either in a long course or in short sessions.

Internal radiotherapy can be given with the following radiation doses:

high;
medium;
low.

Usually high doses of radiation therapy are used. Moreover, radiotherapy sessions are used for ten minutes for every two to three days. Between procedures, a special tube is removed from the uterine cavity or cervix.

If low-dose irradiation is used, it is advisable to use it once. The duration of the session ranges from one day to several days. In order to prevent displacement of the tube, the patient is in a supine position.

Sometimes specialists use pulsed radiation, which resembles a low-dose technique. However, within the framework of this technique, there is an effect not of constant, but of periodic irradiation.

Efficiency

Radiation therapy cannot guarantee a complete cure for cervical cancer. However, using the method has high efficiency. Radiation therapy can prevent the appearance of new metastases. It is known that after surgery, a relapse is possible after 20 years.

Radiation therapy has the following positive effects:

reduction of pain syndrome;
reduced risk of metastasis to surrounding tissues;
destruction malignant cells after operation;
the possibility of complete recovery in the early stages of the oncological process.

Radiation therapy for cervical cancer is the main treatment. In the first stage of cancer, radiotherapy is used as an adjunct to surgical method. However, in the second - third stage, radiation therapy is considered as the only effective method of treatment. In cervical cancer of the last stage, radiation therapy is palliative in nature, that is, it is prescribed to alleviate the condition of the cancer patient.

Recovery after radiotherapy

Usually, radiation therapy is well tolerated by patients, and recovery is uneventful. However, side effects may occur during the recovery period. In such cases, you should consult a doctor.

Side effects

One of the most frequent consequences during the recovery period, the occurrence of bleeding is considered.

Side effects during recovery from radiation therapy include the following manifestations.

Chair disorders. This is a fairly common consequence that occurs during recovery after radiation therapy. During the recovery process, doctors recommend consuming at least two liters of water to prevent dehydration.
Nausea. Usually this manifestation accompanied by vomiting and loss of appetite. In such cases, a woman is recommended high-calorie drinks.
Weakness. Fast fatiguability often occurs on the background of radiation therapy. In order to reduce backfire, the patient should be given Special attention rest.
Narrowing of the vagina. This condition can make it difficult to conduct a gynecological examination and the introduction of special applicators. To maintain the required diameter of the vagina, gynecologists recommend the introduction of tubes. Moreover, the risk of injury proper treatment minimal.

Sometimes, against the background of minor side effects, serious consequences are observed, for example, premature menopause. With the complex use of radiotherapy and surgery, lymphedema may appear during the recovery period. At this consequence there is swelling of the lower extremities.

Often side effects and complications are not treatable. That is why a woman should be attentive to her well-being during the recovery period.

Radiation therapy technique constantly optimized, which reduces the risk of consequences during the recovery period and increases the effectiveness of treatment.

Events

It is essential during recovery after radiation therapy that the correct good nutrition. Diet helps prevent such consequences as upset stools and nausea. Doctors recommend eating small meals. The diet during the recovery period should be varied, include the necessary vitamins.

During recovery, in order to prevent consequences for the body, it is advisable to abandon the following products:

canned;
fatty;
smoked.

Recovery after radiation therapy includes:

recreation and outdoor activities;
refusal of hot baths;
restriction in the use of cosmetics.

Cervical cancer is successfully treated with radiation therapy. Consequences after the procedure occur in a small number of cases. The duration and number of procedures is determined by the doctor depending on the stage of the disease and the size of the neoplasm. The duration of recovery depends on the amount of radiation therapy, the age of the patient, and the nature of the spread of the malignant process.

Cervical cancer has no known hereditary factors, and is caused by human papillomavirus infection, more precisely, its oncogenic subtypes 1 and 18. In Russia maximum amount 22.3% of cases are under 39 years old. One of the treatments is radiation therapy for cervical cancer.

General principles

The method is based on the fact that ionizing radiation has a much stronger effect on cells that are actively dividing and growing. It is from these cells that malignant tumor. Therefore, the dose of radiation that is detrimental to such tissue has a much smaller effect on healthy tissues and organs.

Radiation therapy for cervical cancer is rarely done in isolation. How independent method its treatment is used only relatively; starting from IA2 - when the depth of tumor growth is more than 3 mm but does not exceed 5, and the spread is up to 7 mm in width, and ending with stage IIA1 - when the tumor is less than 4 cm. Even at these stages, surgery is given priority, and radiation is connected when surgery is contraindicated due to comorbidities of the patient.

In all other cases, radiotherapy acts as an adjuvant - additional to surgery - method of treatment. We have to remember that the combination of radiation therapy and surgical treatment increases the likelihood of complications after surgery.

In the later stages, when the operation is no longer effective, chemoradiotherapy becomes the main method of treatment, as the name implies, this is a combination of cytostatic agents and radiation.

Radiation Therapy Options

Radiation therapy for cervical cancer can be external and intracavitary.

With external radiation therapy for cervical cancer, the radiation source is a special device. The location of the radiation source is carefully calculated - traditionally used x-ray of the pelvis in 2 projections, now CT is considered more accurate. The radiation covers not only the location of the tumor, but the area of the uterine ligaments, lymph nodes, tissue around the uterus inner surface pelvis. This allows you to capture areas of possible metastasis of cancer cells, including microscopic metastases that cannot be detected by any methods. The procedure itself is completely painless.

External radiation therapy for cervical cancer is often combined with intracavitary therapy, in which a special applicator - a radiation source is applied directly to the tumor. Before applying radiation, the location of the applicator must be checked using MRI. As a rule, intracavitary irradiation for cervical cancer is performed under anesthesia or spinal anesthesia. The main site of its impact is directly the primary tumor, the areas of possible metastases are captured less frequently. That is why both methods are necessarily used in combination.

Duration of radiation therapy for cancer clinical standards treatment should not exceed 6-7 weeks. This reduces the likelihood of complications.

Radiation therapy is contraindicated in:

severe concomitant pathology (cardiovascular, renal, hepatic insufficiency);
a decrease in the number of blood cells - anemia (erythrocytes), leukopenia (leukocytes), thrombocytopenia (platelets);
prolonged rise in temperature;
collapse of the tumor.

Consequences of radiotherapy

Radiation therapy is huge pressure on the body. Therefore, normal fatigue and weakness. To reduce these phenomena, shortly before the start of the course of irradiation, it is recommended to switch to a nutritious high-calorie food, and be sure to drink plenty of water.

As already mentioned, radiation has the strongest effect on rapidly dividing cells. In addition to tumor cells, epithelial cells, including cells of the intestinal mucosa and bladder, have such properties. The consequences of irradiation - the mucous membrane becomes thinner and easily injured, which is manifested by the admixture of blood in the urine and feces.

Other possible consequences radiotherapy for cervical cancer:

diarrhea;
bleeding from the vagina; "daub" should not last more than 5-7 days in a row, otherwise you need to see a doctor;
loss of appetite, nausea, vomiting;
dryness and narrowing of the vagina, cicatricial changes may occur;
premature onset of menopause - due to radiation, the ovaries cease to perform their function;
lymphostasis and swelling in the legs;
violation of hematopoiesis - part of the red bone marrow, which creates blood cells, is located in pelvic bones and lumbar vertebrae.

Recovery after radiation therapy for cancer

No matter how trite it sounds, but the basis of recovery should be proper nutrition and healthy lifestyle life. Nutrition must necessarily contain easily digestible protein, it is better from fish and dairy products, it is better to limit meat. Vegetables and fruits will provide the body with fiber that normalizes intestinal motility. Be sure to drink at least 2 liters of water per day (if there is no kidney pathology).

Return to usual physical activity better from walks, first short, then longer and longer. As the general condition improves, you can increase the pace of walking. In no case should you “overcome” yourself, the load should be comfortable.

It is imperative to monitor the condition of the blood - at least once every three months you need to do general analysis If there are deviations from the norm, you need to see a doctor.

Intimate life after radiation therapy is possible if the attraction is preserved (depending on how the ovaries remained after radiotherapy) and the vagina is not deformed by cicatricial narrowing. Otherwise, you may need intimate plastic. In any case, the resumption of sexual intercourse is possible only after the cessation of bleeding (if it occurred during exposure) and with the permission of the doctor.

In spite of possible complications- Radiation therapy, especially in combination with chemotherapy, is quite effective method treatment. Cervical cancer recurs after combined radiation therapy no more than 6.7%, and the appearance of distant metastases - 5.8%. Most sensitive to radiotherapy, worst prognosis for undifferentiated cancer.

Radiation therapy of the uterus (radiotherapy) for cancer of the cervix and body of the uterus is the most effective, and therefore a popular method of treating this disease.

This type of therapy is prescribed by the attending physician, depending on the patient's condition.

Kinds

Types of radiation therapy are distinguished depending on the area of the lesion:

external (remote). General irradiation is carried out through healthy tissues. Such radiation therapy for uterine cancer is used if the affected area is hidden deep behind other layers of tissues. The disadvantage of this method is that healthy tissues are also damaged.
internal (brachytherapy or contact). A catheter with a radiation source is inserted into the vagina. In this case, less harm is done to healthy tissues. However, this method is not always possible.
combined (external and internal together). At severe forms diseases.

Procedure

Radiation therapy for uterine cancer is done within minutes. The patient is taken to a room specially adapted for this, laid on a couch, radiation sources are directed directly to the affected area, the rest of the body is covered with a special cloth that protects from radiation. The rays affect the tumor and destroy it.

The doctor observes the course of the procedure through a window from a room that is protected from exposure to rays.

Radiation therapy for cancer of the body and cervix can be carried out in several stages, depending on the recommendation of the doctor.

Training

Preparation for radiation therapy requires very thorough. After all necessary research for accurate identification area of the affected area, the radiologist calculates the amount of radiation needed, as well as the angle at which the rays will be injected. Only at the end of all these procedures does the session itself begin.

Be sure to follow the doctor's instructions and remember that during the procedure you can not move so that the rays fall only on the planned areas.

Indications

Radiation therapy for cervical cancer and cancer of the body of the uterus is carried out at all stages of the treatment of the disease and at all stages.

Radiation therapy after removal of the uterus can also be carried out if the tumor has spread to other tissues and organs.

Whether this method is effective and acceptable for you - the doctor decides. You also need to know about all its pros and possible cons in order to be fully prepared.

Contraindications

Radiation therapy of the uterus also has contraindications:

radiation sickness
feverish conditions
a large degree of damage, multiple metastases, tumor decay, which is accompanied by
heavy accompanying illnesses(e.g. heart attack, tuberculosis, diabetes, heart and kidney failure etc.)
thrombocytopenia, leukopenia, anemia

Other contraindications are discussed individually with your doctor.

Effects

The consequences of radiation therapy for cervical cancer and cancer of the body of the uterus can be very different.

Adverse reactions depend on the dose of radiation and the individual characteristics of the organism. The most frequent of them:

nausea and vomiting
stool disorder
redness and peeling of the skin
hair loss in the pubic area
weakness
burning and dryness in the vulva
narrowing of the vagina (in some cases)

within 3 hours after the procedure, rest is necessary, the patient needs to rest for at least 3 hours
as a prophylaxis of burns, a variety of lotions are prescribed (rosehip oil, sea buckthorn, dimexide solution). In addition, burns can be treated with a variety of ointments: dermozolon, levosin, prednisone.
During the period of radiation therapy for cervical cancer, you can not use various creams and other perfumes, so as not to cause irritation and allergies once again.
All are contraindicated thermal treatments(for example, warming up). If you take a shower, then the water should be moderately warm, not hot.
Spend as much time as possible outdoors, if you are indoors, it should be well ventilated.
Food should be rich in vitamins, greens. Minimize fatty meals and non-natural products. Useful food rich in protein.
Widely used means traditional medicine and drugs that help the body recover, strengthen the immune system.

Be healthy and happy!

Cervical cancer is a malignant neoplasm that develops in the cervical area of a woman. This disease in last years very progressing, according to statistics, the disease ranks first in reducing the number of years of life, and second in frequency of occurrence after breast cancer. It is known that it can shorten a woman's life by 25-30 years. This is enough high rate, which makes you think about how to be much more attentive to your health. It is known that this disease appears against the background of precancerous pathologies, so it can be easily predicted and even prevented. For this, it is necessary to systematically visit a gynecologist, at least twice a year.

Scientists say that the disease can be provoked various factors, the main ones include: entry into early sexual activity (14-16 years), frequent change sexual partners, the presence of the papilloma virus and herpes, taking hormonal oral contraceptives, smoking, and so on. Concerning symptomatic manifestations cancer, then they are very long on early stages may be missing.

Often a woman or girl learns about an existing pathology only at a gynecologist’s appointment, and it’s good if this is only the initial stage of the development of a cancerous process that responds well to treatment and in 90% of cases leads to a complete recovery.

So, to the main clinical manifestations diseases include:

foamy discharge from the vagina with an admixture of blood between menstruation, the discharge before and after menstruation is especially intensified;
discharge occurs during or after intercourse, the process may be accompanied by pain;
at a later date, the above symptoms may be joined pain syndrome, which is localized in the abdomen and sacrum;
in advanced cases pathological changes in the work of the kidneys and intestines begin to appear.

Treatment of the disease with radiation exposure

Radiation therapy for cervical cancer involves exposing atypical cells to very high doses of X-rays, which have a destructive effect on them and lead to death.

This type of treatment for CMM cancer pathology can be of two types, namely: external and internal. As a rule, the doctor selects any one type for treatment, but often these days, specialists have begun to combine these two types. If we talk about the duration of RT treatment, then it can vary from 5 to 8 weeks, everything will depend on the patient and the stage of the disease. Often this method of treatment of cervical cancer is used on initial stages, but also its effectiveness has been proven in the fight against large tumors that have gone beyond the boundaries of the cervix.

Radiation exposure for cervical cancer is also used after surgery, during which a malignant tumor was removed and there is a risk of recurrence. In this case, radiation will be combined with chemotherapy, which will only double the effectiveness of the treatment.

I would like to talk separately about the consequences after radiation therapy for cervical cancer. It is known that this radiation has an extremely negative effect on the ovaries and for women. reproductive age it may speak of complete cessation their performance, that is, practically it leads to infertility. In addition, all this contributes to the development early menopause, as a rule, it occurs two, sometimes three months after the start of therapy. If the patient still wants to be able to give birth to a baby, then she must definitely discuss all these nuances with the doctor. Today there are special means and procedures to stop the menopause process and increase the duration of reproductive function.

Recovery period

Recovery after radiation therapy for cervical cancer is very important point for female patients. The body of a woman after undergoing a course of RT is very weakened and it needs time to recover. To do this, you need to breathe as often as possible. fresh air, do not refuse walks, or at least ventilate the ward as often as possible. Proper nutrition is of great importance, for a start, doctors recommend eating food without great content lactose and fiber, gradually introduce rice, potatoes, cheese into the diet. In addition, experts advise giving up milk, smoked meats, fried foods, and caffeine for the duration of rehabilitation.

Radiation therapy for cervical cancer can be used as the main and as ancillary treatment. As a result of a course of procedures, it is possible to cure cancer, as the process of tumor spread at the cellular level stops. The radiation dose and the number of sessions are determined by the attending physician based on the results. comprehensive examination female patients.

Modern medicine has the ability to conduct both external and internal irradiation of the focus pathological education. In most cases, these methods are combined for maximum results. Despite a number of side effects, this method of therapy can be recommended, since it can be used to fight the oncological process on different stages and save the lives of patients.

The essence of the method

Radiological exposure as an independent method is effective at the second and first stages oncological process. In the third stage, especially in the presence of metastases, such treatment is combined with chemotherapy.

The method is based on the interaction of radio rays with cells cancerous tumor. Radioactive radiation stops the reproduction of the tumor, since the processes of division of pathological cells stop, while healthy tissues retain this ability.

The mechanism of action of ionizing radiation is as follows:

There is a transformation of water molecules into peroxide radicals that damage the cell.
Active cells are damaged the most (cancer cells are most active). Radiation renders negative impact on DNA.
The tumor loses its ability to grow, as the division processes stop. Healthy tissues retain regenerative properties and therefore can fully restore their functionality.
In addition to stopping the division processes, in malignant neoplasm many mutations occur, which causes the death of pathological cells.

Treatment of cervical cancer (cervical cancer) with radiation therapy is possible with large tumor sizes and in the case of the spread of the oncological process. This method is also used after surgery, especially when high risk recurrence of the disease, and combined with chemotherapy. Irradiation sessions are carried out for 5-8 weeks with interruptions.

Types of exposure

There is a possibility to use various kinds radiation for therapeutic purposes. The applied models of equipment affect the tumor with the help of neutrons, electrons, photons and protons. The proton method is recognized as the most gentle, but also less accessible due to its high cost.

Not so long ago in medical practice began to apply latest equipment called "Neutron Knife". The special value of this installation lies in the possibility of treating cancer on final stages with minimal side effects. Such treatment is applicable for debilitated patients for whom intracavitary surgery is too dangerous and ineffective.

There are such ways of influencing the tumor with the help of radiotherapy:

external exposure. A special installation is used for remote influence on the focus of the oncological process.
internal exposure. A special capsule with a radioactive substance is introduced into the uterine cavity. A targeted effect on pathological cells is achieved, which contributes to speedy recovery after treatment.

In most cases, doctors use both of these methods in combination to achieve maximum results. Besides, radiation can be used in preparatory purposes before surgery to reduce the size of the neoplasm. After surgery, radiotherapy is used to permanently eliminate cancer cells to prevent recurrence.

External radiation therapy does not require hospitalization and is performed on an outpatient basis. The course consists of short procedures during which the area with the neoplasm is precisely irradiated using a linear catalyst. Previously, the patient undergoes computed tomography, which allows to obtain a three-dimensional image of the tumor. Then special markers are applied to the skin to limit the area of influence. The session lasts several minutes, and the procedure itself does not cause discomfort.

Internal radiation therapy is performed more often after external radiation. The course of treatment is carried out in stationary conditions, since the radiation source is placed in applicators (tubes), which are located in close proximity to the tumor. If the patient has not undergone hysterectomy, then the applicators are placed in her cavity and vagina.

The applicators are installed under general anesthesia in a surgical way.

To prevent displacement of radiation sources, a gauze or cotton swab is placed in the genital canal. To reduce pain The patient is prescribed pain medication. If the patient's uterus has been removed, then only one large applicator is installed. In this case, there is no need for anesthesia.

With help computed tomography or x-ray control the placement of the applicators. According to the degree of impact on the tumor during internal radiation therapy, there are:

Indications for appointment

Radiation therapy is used as the main treatment for first-degree cervical cancer. In the second degree of the disease, this method can be considered as an auxiliary one, and the main one is surgical intervention. Indications for treatment with radioactive irradiation are:

tumor metastasis to nearby organs;
high risk for surgical intervention due to various diseases;
carcinoma or other poorly differentiated tumor that metastasizes at different stages;
the last stage of the cancer process, when surgical treatment is dangerous and impractical.

Radiotherapy is an integral part of treatment for all stages of cervical cancer. At the first stage of the oncological process, this may be the only method therapy, and in the second and third stages used as part of combined treatment. In most cases, cervical cancer is diagnosed at stages 2 and 3, when the patient begins to experience discomfort.

Due to the fact that radiological treatment negatively affects reproductive function and often causes infertility, they try not to prescribe this type of therapy to young patients capable of bearing children.

The use of radiation in such a case can be justified in critical cases with great care. Women may be asked to move their ovaries higher to move them out of the area of radiation or reduce it. Negative influence. The displacement is performed surgically.

Preparation for the procedure

Before conducting a course of radiological treatment, the oncologist performs the following actions:

calculates the radiation dose in accordance with the individual characteristics of the patient;
determines the size of the tumor and its exact localization;
applies markers to the skin of the patient according to the projection of the contours of the neoplasm.

Preparation for radiation exposure is carried out a week before the start of therapy and is as follows:

After starting the procedure, you must follow these recommendations:

do not wear woolen and synthetic clothing;
it is unacceptable to thermally affect the irradiation site (cool, warm);
the irradiation area should not be rubbed, applied to it cosmetics, deodorants and soap solutions.

Side effects

Due to radiotherapy, the general condition of the patient may worsen. The following post-radiation complications are observed:

At severe violations digestion is prescribed intake of high-calorie drinks instead of food. From general weakness helps only a long rest and absence stressful situations. During treatment, tissue changes occur, which causes shortening and dryness of the genital canal, in some areas it forms scar tissue, which complicates the examination and negatively affects the intimate life of the patient.

rehabilitation period

After radio irradiation with an oncological neoplasm of the cervix, recovery lasts for a long time. In order not to aggravate side effects and minimize their manifestation, it is recommended to adhere to the following rules:

provide moderate physical activity;
reduce the use of coffee and tea, if it is impossible to completely abandon the use of these drinks;
regularly walk in the fresh air;
ensure a complete healthy;
give up bad habits(they enhance the negative effect of radiation).

The diet during radiation therapy and after it provides for the inclusion in the diet a large number vegetables and fruits, as well as fermented milk products. The proportion of meat in the diet should be reduced and consumed in boiled or stewed form. From daily menu it is necessary to exclude flour, fatty, sweet and smoked dishes.

Effects

One of the most annoying and dangerous complications radiological treatment are bleeding, which may be accompanied by pain. In this case, you should immediately contact your doctor for further treatment and prevention of deterioration.

One of the consequences of a radiation burn is the formation of adhesions in the vagina, which makes it impossible intimate life and requires surgical treatment. The narrowing of the genital canal or its shortening also interfere with sexual intercourse and negatively affect the feelings of partners. To remedy the situation, the doctor may prescribe topical application of hormonal creams and the installation of a dilator (a plastic expander in the form of a tube) in the vagina.

Infertility as a result of exposure to radioactive rays on the ovaries of a woman is a frequent and in most cases an unrecoverable consequence of such treatment. Radiation therapy in the first and second stages of cancer allows to achieve a high survival rate of patients (97% and 75%, respectively). In the third stage, this figure drops to 60%, and in the fourth - to 10%. To prevent the recurrence of the disease, it is recommended to be examined by the attending physician every 3 months.