One of the most serious health problems threatening women's health is gynecological cancers originating from the reproductive organs of the woman. The most common gynecological cancers are cervical cancer, popularly known as cervical cancer, cervical cancer arising from the inner layer of the uterus and ovarian cancer. In addition, very rare vulva-vaginal cancer and trophoblastic tumors are among the gynecological cancers.
The incidence of gynecological cancers is increasing among all cancers. The most common type of cancer in women after breast cancer is cervical cancer. This year, 500 thousand new cervical cancer cases are expected to be diagnosed all over the world. Especially in cervical cancer, the welfare and development level of the countries is extremely important. Cervical cancer is less common in women in developed countries, but women in developing countries have a higher incidence and mortality. The reason for this is the early diagnosis and treatment of cervical cancer with cervical swabs taken during regular gynecological examinations in modern societies.
Uterine and Cervical Cancer
The chief culprit in cervical cancer is identified as HPV called Human Papilloma Virus, Anadolu Medical Center Gynecology and Obstetrics Department Assoc. Dr. Fatih Güçer, cervical cancer alone for the formation of this virus is not enough stresses. In addition to HPV infection, poor nutrition from vitamins, smoking and obesity also have important effects on cervical cancer formation. Asserting that some types of HPV, which are very different types, cause cancer. Dr. Er Being infected with several types of HPV will accelerate the course of cancer. In addition, unprotected sexual intercourse, polygamy life, early onset of sexual life, lack of vitamins A and C and suppression of the immune system are the reasons for cervical cancer.
Cervical cancer is not a specific symptom of Assoc. Dr. Güçer, however, described as' unusual discharge 'and sometimes in the style of bloody broth, sometimes after sexual intercourse discharge or blood coming from the cervical cancer requires suspicion, saying,' Depending on the spread of the disease, pubic pain, leg swelling, urine Hemorrhage or bleeding during constipation, a smelly continuous vaginal discharge are symptoms suggestive of cervical cancer. However, these are the symptoms after cervical cancer reaches a certain size. These symptoms occur during the stage of the tumor we call 'stage 1b'. However, our goal is to diagnose tumors before they reach 4 cm in diameter from stage 1b and start treatment. Konuşuy
Menopause period or immediately after the increase in the frequency of uterine cancer, Assoc. Dr. Güçer, especially in overweight women, diabetes and hypertension in women with uterine cancer is seen more, said: “Taking animal food here is considered as one of the most important reasons. Because in the body of overweight women, the conversion of androgen hormone to estrogen is much more. This leads to an excess of estrogen, one of the most important causes of uterine cancer. In 2007, the number of newly diagnosed uterine cancer cases in the US is expected to be around 47,000. Amsal
Although uterine cancer poses a risk for women after menopause and after menopause, Assoc. Dr. Fatih Güçer, amalı It should be noted that 5 percent of all uterine cancers seem to be under 40 years. For this reason, women under the age of 40 should also be careful. The symptom that leads to uterine cancer patients comes to us is that they begin to bleed when they are not expecting irregular menstruation during menopause or no menstrual bleeding after menopause. 70-80 percent of patients present with irregular bleeding. Apart from this, some patients speak of a secret discharge when entering menopause or in the postmenopausal period. This is because the tumor continues to grow inside the uterus, adding an infection to the event causing the discharge. This is one of the symptoms of uterine cancer. Uterine cancer first metastasizes to the lung. For this reason, it is very rare that a chest X-ray can be used to diagnose a mass.
Ovarian cancer is the most insidious of gynecological cancers and the treatment success is lower due to the patient's referral to the physician at advanced stage. Although ovarian cancer often appears after menopause, it can also develop in younger women. 70 percent of the 'stage three' begins to show symptoms in the period called. This makes surgical and postoperative treatments more difficult; therefore, the patient's remaining life is slightly reduced.
Assoc. Dr. Güçer, “Generally abdominal swelling, menstrual irregularity in menstruation, pain, constipation and enlargement around the abdomen can be counted as symptoms of ovarian cancer. These symptoms appear in the third stage. Because during this period, there is an accumulation of fluid in the stomach of the patients. This accumulation of fluid causes the patient's abdominal circumference to expand and the patient cannot wear the clothes he had previously worn. The patient often goes to the doctor with swelling and indigestion problem in his abdomen, and the diagnosis of cancer is made as a result of the investigation of common fluid in his abdomen.
SUITABLE TREATMENT FOR INTERNATIONAL GUIDELINES IN ASM
Asserting that the treatment guidelines of the American Cancer Society and American Gynecology and Obstetrics Association are being treated while planning the gynecological oncology treatment at Anadolu Medical Center, Assoc. Dr. Fatih Güçer, therefore, a cancer patient coming to ASM in the United States John Hopkins, Mayo Clinic or MD Anderson'dan not see a different treatment, stating that a road map before starting treatment, he says.
In particular, the most common in America but in third place in terms of incidence in Turkey in the treatment of cervical cancer among gynecologic cancers considered extremely face PBUH said Prof. received satisfactory results. Dr. Gucer said, “When we catch the disease at a very early stage when it has not started to spread to the uterine wall, there is no need to undergo extensive surgery. Only by taking the uterus and ovaries we are able to treat this patient. ”
Güçer, all cancer cases before and during treatment were discussed at the ASM Tumor Board and treatment plan gynecological oncologist, radiation oncologist, medical oncologist, pathologist and radiologist said that a meeting was drawn together.
Assoc. Dr. Dr. Güçer describes the planning of treatment for uterine cancer:
Uz We plan treatment based on criteria such as tumor type, stage of the disease, ability to mimic the tissue in which the tumor is located. In some tumor types, we decide to perform a much wider operation before the surgery, while in some tumor types we decide the extent of the surgery according to the criteria mentioned above.
In order to screen for uterine cancer or to better examine suspected groups, we first examine the patient and perform an ultrasound. If there is anything to suggest about cancer in these patients for us, we do a biopsy through the uterus. But sometimes biopsy alone is not enough. For this reason, we enter the uterus with an optic, observe the inside of the uterus with a method called hysteroscopy, take parts from suspicious places and send them to pathology. When pathology diagnoses uterine cancer, it actually gives us clues on how to treat the patient. According to the pathologist's results, we surgeons are planning the surgery. We're also looking at some tumor markers. Every gynecological cancer patient necessarily want a lung film. Because the most common spread of uterine cancer outside the abdomen is the lung. We draw a map of the patient's condition before the surgery and discuss this with the patient before the surgery. In the operation, the frozen examination of the patient's uterus and ovaries determines the type of tumor, its extent in the uterus and its ability to mimic the tissue from which it originates, and we learn what to do next. ”
FIRST SURGERY IS SO IMPORTANT
Ovarian cancer in cervical cancer surgery is very important defending Assoc. Dr. Güçer said, “If we consider the treatment stages as dominoes, our first step domino is surgery. Then comes chemotherapy, radiotherapy or combined therapy. If we did not drop the first domino properly, then all of the steps that follow are incomplete or wrong. This directly affects the patient's life. For this reason, our aim is to ensure that the first dominoes fall in the right direction and in a powerful way and to ensure that all the advantages of radical cancer surgery are experienced. Hast
LAPAROSCOPY FOR UTERAL CANCER
Anadolu Medical Center in the treatment of uterine cancer in appropriate cases, especially as an alternative to open surgery laparoscopic surgery is also applied Assoc. Dr. Fatih Güçer, apor Laparoscopic surgery is a method of surgical approach with a faster recovery period after surgery. When we compare laparoscopy and open surgery, our aim is to do the same with laparoscopy in open surgery. So we do this patient's surgery closed 70 percent of this surgery, let's do 30 percent of the approach we do not have the approach, "he says.
IMPORTANCE OF RADICAL SURGERY
Assuming that the tumor should be completely cleaned with radical surgery in the treatment of ovarian or uterine cancer, Assoc. Dr. Fatih Güçer gives the following information: ırsak If we take the ovary and uterus and close the patient in surgical treatment, we are performing incomplete surgery. Some types of tumors have very different possibilities and ways of spreading. They can spread directly to the structures around the main vessels, which we call lymph nodes. We do not show any findings, and when we do not take them during surgery, we close the patient with metastasis to the lymph node. Patient 6 months after surgery, 1 year after a place where he never expected, usually in the lymph node comes with a tumor again. When it comes with a new tumor, we fall back two to three steps in treatment. Therefore, the first surgery is of great importance. That's why we take a radical approach to cancer surgery. ASM is completing two years. In this process, we operated on more than 20 various gynecological tumors. Only one of them repeated.
Regardless of the extent of tumor spread in the uterus in serous-papillary and clear cell types of uterine cancer, we have to remove all lymph nodes and omentum from the patient's groin to the renal vessels. In addition, even if no tumor appears anywhere in this patient, biopsy should be taken from ten different sites. In the same type of endometroid cancer, if the spread does not pass through the uterine wall, there may be no need to remove any lymph nodes. ”
Underlining that radical surgery should be applied in ovarian cancer, Assoc. Dr. Güçer, radikal How much radical surgery in ovarian cancer, the patient closes without any tumor is best for the patient. Because ovarian cancers are insidious tumors, stage three, in the intestines within the abdomen, under the diaphragm, peritoneum or lymph nodes are encountered as a variety of metastases. The larger the mass left after surgery, the lower the chances of survival for that patient. When you remove the uterus, ovaries, omentum and all the lymph nodes without leaving any tumors, you do the best thing for the patient. ”
As an alternative to surgery for cervical cancer, radiotherapy and chemotherapy combination is used Assoc. Dr. Dr. Güçer patient's condition and age can be decided according to surgery, specifying cervical cancer surgery was decided, the cervix from the bone to the side walls and tissue called the parameterrium should be taken, he says. Dr. Güçer, how much of this tissue to be removed before surgery is determined by MRI, he says. Since there are no satisfactory results with surgery in patients with cervical cancer in stage 2b and above, we are directed to the treatment using combined radiotherapy and chemotherapy.
He said that patients who applied to ASM for the treatment of gynecological cancers received treatment at an international standard. Gucer said, “Both our elbow contact with John Hopkins in the USA and the fact that we have worked abroad for many years and our friendship there are still continuing, and that we are people who follow innovations and apply them, enable our patients to receive optimal treatment according to their modern and stage. This is one of the biggest advantages of being treated for gynecological cancers in ASM. On the other hand, we write all the details of the surgery in our report. We can add a photograph of the final operation of the operation area to this report. Thus, a health archive is created which the patient can show to other institutions ”.