Cervical cancer T1N0M0

Cervical carcinoma is a malignant epithelial tumor that develops from squamous epithelium or glandular epithelium of cervix and cervical canal. The absolute major of cause of cervical carcinoma is HPV 16,18, 31,33, 35,52. HPV can reproduce for a long time in epithelial cells. Visual external examination of mucosal membrane of uterus shows no changes, papilloma virus is revealed in scraping in PCR analysis. Early or later the virus infiltrates into cellular DNA. This results in cell transformation, which leads to neoplasia (cervical dysplasia).  That is pre-cancer, increase of malignant transformations is classified as cervical dysplasia of grade 2 or 3. Cervical dysplasia, grade 3 or CIN3 eventually develops into intraepithelial cancer (carcinoma in situ). That is a non-invasive cervical carcinoma, which has no metastases yet. Later on it infiltrates basal membrane and becomes early invasive cervical carcinoma. The deeper develops invasion, the higher grows the risk of metastases. Still, in case of grade 3 dysplasia and non-invasive carcinoma, hysterectomy with appendages removal is performed. 

Patients and their relatives should know that dysplasia, non-invasive and even early invasive carcinoma may be cured while not involving any crippling surgery. Such opportunity is achieved by photodynamic therapy. Only one PDT session is quite sufficient for complete cure of dysplasia, non-invasive and early invasive carcinoma. A photosensitizer – fotoditazin or photolon – is infused intra-venously, the photosensitizer re-distributes within 2 – 3 hours so that its concentration in the affected pathological site becomes several times higher than that in the normal mucosa. An optical fiber of a special shape is introduced in the cervical canal to provide an even laser irradiation of 660-670 nm wavelength. After the PDT session all displasive and tumor cells die.   The mucosal membrane of the treated area heals within 8 weeks. The cervical anatomy and reproductive function are completely preserved.

Displasia and early cervical carcinoma can be found by extended colposcopy and fluorescent diagnostics. During extended colposcopy the cervix is examined with multiplication, it is treated by 5% acetic acid and Lugol’s iodine solution. The sites of acetic white epithelium and iodine-negative areas show unhealthy mucosa. Tissue samples for histological analysis are taken out from suspected sites. During fluorescent diagnostics the examiner can observe luminescence of porphyrins in the mucosa. Porphyrins accumulate mainly in the pathologically affected lesions. Measurement of the fluorescent signal can present qualitative evaluation of the lesion. Such as chronic inflammation, dysplasia, carcinoma.  

The results of treatment of 2 and 3 grade cervical dysplasia and early cervical cancer by photodynamic therapy are directly connected with doctor’s professional skills in this therapy method. The absolute leader in this field is Pavel Borisovich Popov. The methodology that he established is so highly effective that in terms of radical cure it may be successfully compared with extended hysterectomy. But unlike extended hysterectomy, PDT preserves the uterus and its reproductive function.

Infiltrative squamous cell low differentiated cervical carcinoma. Colposcopic picture, the whole cervical surface is covered by tumor tissue, which is bleeding severely at mechanical contact.