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Cancer du col utérin : Tout savoir sur les symptômes, les causes et le traitement
Chaque année, le cancer du col utérin touche des milliers de femmes dans le monde. Cette maladie, bien que grave, est l’une des plus prévisibles et des plus évitables grâce aux progrès de la médecine et à la prévention.
Le col de l’utérus est la partie inférieure de l’utérus qui s’ouvre dans le vagin. Lorsque des cellules de cette zone se multiplient de manière incontrôlée, un cancer peut s’y développer. En 2022, selon l’OMS, on a diagnostiqué plus de 660 000 nouveaux cas de cancer du col de l’utérus dans le monde. C’est le quatrième cancer le plus fréquent chez la femme.
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Le but de cet article est de vous informer sur cette maladie. Nous aborderons ses causes, ses symptômes, les méthodes de diagnostic, les traitements disponibles et surtout, les moyens de prévention. En comprenant mieux le cancer du col de l’utérus, vous serez en mesure de prendre les bonnes décisions pour votre santé.
Le cancer du col de l’utérus : qu’est-ce que c’est ? Le cancer du col de l’utérus prend naissance dans les cellules du col de l’utérus, la partie inférieure de l’utérus qui s’ouvre dans le vagin. Normalement, ces cellules se renouvellent de manière ordonnée.
Cependant, sous l’influence de certains facteurs, comme une infection persistante par le virus du papillome humain (VPH), ces cellules peuvent se multiplier de manière anarchique, formant ainsi une tumeur. Celle-ci peut envahir les tissus voisins et se propager à d’autres organes comme les ganglions lymphatiques , les poumons ou le foie.
Du reste, il existe différents types de cancer du col de l’utérus, mais les plus fréquents sont :
Le carcinome épidermoïde : Il se développe à partir des cellules plates qui recouvrent la surface du col de l’utérus.
L’adénocarcinome : Il prend naissance dans les glandes présentes dans le col de l’utérus. En outre, pour mieux comprendre où se situe le col de l’utérus et comment se développe le cancer, il est utile de consulter un schéma anatomique ci-dessous :
Causes et facteurs de risque Le principal responsable du cancer du col de l’utérus est le virus du papillome humain (VPH) . Ce virus se transmet principalement par voie sexuelle et infecte les cellules du col de l’utérus. Certaines souches du VPH peuvent entraîner des modifications génétiques de ces cellules, les poussant à se multiplier de manière incontrôlée et à former une tumeur.
Bien que le VPH constitue le facteur de risque le plus important, d’autres éléments augmentent le risque de développer un cancer du col de l’utérus :
Nombre de partenaires sexuels : Un nombre élevé de partenaires sexuels augmente les risques d’exposition au VPH.
Âge au premier rapport sexuel : Les jeunes femmes qui ont leurs premiers rapports sexuels à un âge précoce présentent un risque plus élevé.
Tabagisme : Le tabagisme affaiblit le système immunitaire et favorise le développement des lésions précancéreuses.
Système immunitaire affaibli : Les personnes dont le système immunitaire est affaibli, en raison d’une infection par le VIH par exemple, sont plus vulnérables.
Utilisation de contraceptifs oraux sur le long terme : Certaines études suggèrent un lien possible, mais les résultats ne sont pas encore totalement clairs.
Antécédents d’infections sexuellement transmissibles (IST) : Certaines IST, comme la chlamydia, peuvent augmenter le risque de développer ce cancer en association avec le VPH. Il est important de noter que la présence du VPH ne signifie pas forcément qu’une femme développera un cancer du col utérin. La plupart des infections à VPH se résorbent spontanément grâce au système immunitaire. Cependant, une infection persistante par certaines souches à haut risque peut conduire à la survenance d’un cancer.
Symptômes du cancer du col utérin : les signes à surveiller Malheureusement, le cancer du col de l’utérus n’entraîne souvent aucun symptôme, surtout à ses débuts. C’est pourquoi le dépistage régulier par frottis de Pap est essentiel pour détecter d’éventuelles anomalies cellulaires avant qu’elles ne dégénèrent en cancer.
Cependant, lorsque le cancer progresse, il peut provoquer certains symptômes, notamment :
Des saignements vaginaux anormaux : Ceux-ci peuvent survenir entre les règles, après les rapports sexuels, ou après la ménopause. Ils sont généralement le premier signe d’alerte.
Des pertes vaginales inhabituelles : Les pertes peuvent être plus abondantes, plus liquides, ou avoir une odeur désagréable.
Des douleurs pelviennes : Ces douleurs peuvent être ressenties dans le bas du ventre et s’aggraver lors des rapports sexuels.
Des difficultés urinaires ou intestinales : En cas de cancer avancé, la tumeur comprime les organes voisins et provoque des troubles de la miction ou de la défécation. Par ailleurs, notez que ces symptômes ne sont pas spécifiques au cancer du col de l’utérus et peuvent avoir pour origine d’autres affections bénignes. Toutefois, si vous constatez l’un de ces signes, il est essentiel de consulter votre médecin afin d’en déterminer la cause et d’écarter tout risque de cancer.
Le diagnostic du cancer du col de l’utérus
Le diagnostic du cancer du col de l’utérus repose sur plusieurs examens complémentaires. Le but de ces examens est de confirmer la présence de cellules cancéreuses et d’évaluer l’étendue de la maladie.
Le frottis de Pap : C’est l’examen de dépistage le plus courant. Le médecin prélève de petites cellules du col de l’utérus à l’aide d’une brosse. Ces cellules sont ensuite analysées au microscope pour détecter d’éventuelles anomalies.
La colposcopie : Si le frottis de Pap révèle des anomalies, une colposcopie est réalisée. Cet examen permet d’examiner de plus près le col de l’utérus à l’aide d’un microscope équipé d’une lumière spéciale.
La biopsie : La biopsie est un examen qui consiste à prélever un petit morceau de tissu suspect pour l’analyser au microscope. C’est l’examen qui permet de confirmer ou d’infirmer la présence de cellules cancéreuses.
L’imagerie médicale : Des examens d’imagerie médicale , tels que l’IRM, le scanner ou l’échographie, peuvent être réalisés pour évaluer l’étendue de la tumeur et rechercher d’éventuelles métastases. Ainsi, si le diagnostic de cancer du col de l’utérus est confirmé, on procède à d’autres examens complémentaires afin de déterminer le stade de la maladie et de planifier le traitement le plus adapté. Le stade d’un cancer correspond à son étendue et à sa capacité à s’être propagé à d’autres organes.
Les traitements du cancer du col utérins Le traitement du cancer du col de l’utérus dépend de plusieurs facteurs, notamment du stade de la maladie, de la taille de la tumeur, de l’état général de la patiente et de ses préférences. Le choix du traitement se fait en concertation avec une équipe médicale pluridisciplinaire .
Les principaux traitements sont la chirurgie , la radiothérapie et la chimiothérapie. Il existe deux types de chirurgie :
Conisation : On utilise ce traitement pour les lésions précancéreuses ou les cancers de très petite taille. Il consiste à retirer une partie conique du col de l’utérus.
Hystérectomie : Cette intervention chirurgicale consiste à retirer l’utérus. Elle peut être totale (ablation de l’utérus et du col) ou partielle (ablation de l’utérus en laissant le col).
La radiothérapie consiste à utiliser des rayons pour détruire les cellules cancéreuses.
La chimiothérapie utilise des médicaments pour détruire les cellules cancéreuses. Elle s’administre par voie intraveineuse, orale ou par injection directe dans la tumeur. L’équipe médicale administre ces traitements seuls ou en association. Par exemple, une chimiothérapie peut être administrée avant une chirurgie pour réduire la taille de la tumeur, ou après une radiothérapie pour détruire les cellules cancéreuses restantes.
En outre, le choix du traitement dépendra du stade de la maladie. À un stade précoce , la chirurgie est souvent suffisante. Aux stades avancés , une combinaison de traitements (chirurgie, radiothérapie, chimiothérapie) est généralement nécessaire.
En conclusion, il vaut mieux prévenir que guérir La prévention est la clé pour réduire le risque de développer un cancer du col de l’utérus. La vaccination contre le VPH, associée au dépistage régulier par frottis de Pap, constitue un rempart efficace contre cette maladie. En adoptant un mode de vie sain , en limitant le nombre de partenaires sexuels et en consultant régulièrement votre médecin, vous contribuez à votre bien-être.
Il est important de rappeler que le cancer du col de l’utérus guérît dans la plupart des cas s’il est détecté à un stade précoce. Ne négligez donc pas les recommandations de votre médecin et participez activement à votre suivi médical.
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En conclusion, le cancer du col de l’utérus est une maladie qui peut être maîtrisée grâce à la prévention et à un dépistage régulier. Prenez donc soin de vous et n’hésitez pas à poser toutes vos questions à votre médecin !