Gynecologic tumors can be treated as chronic diseases

For the same patients with locally advanced cervical cancer, for young women, although the reproductive function of the patients cannot be preserved, they can choose to undergo neoadjuvant chemotherapy before radical surgical treatment; and for the elderly patients, most of whom will be combined with hypertension, diabetes mellitus, coronary artery disease, etc., the choice of radical simultaneous radiotherapy will avoid the risk of surgery and will achieve the same satisfactory therapeutic effect. This is the comprehensive treatment of gynecologic malignant tumors. The treatment mode of gynecological malignant tumors is changing from “looking at the disease” to “looking at the person”, designing the best treatment plan for individuals. Comprehensive treatment varies from person to person. In addition to suffering from the pain of surgery, radiotherapy and chemotherapy that other tumor patients experience, gynecologic malignant tumor patients also face a series of problems caused by the loss of fertility and the loss of ovarian function resulting in low estrogen levels, such as menopausal symptoms, sexual dysfunction, and osteoporosis, etc. For gynecologic malignant tumors, except for a small number of patients, the treatment mode is changing from “seeing the patient” to “seeing the person”. For gynecological malignant tumors, except for a few that can be treated through surgery alone, most need adjuvant radiotherapy or chemotherapy after surgery. Advanced patients who cannot undergo surgery, and early patients with serious comorbidities who cannot tolerate surgery can be treated with radiotherapy and chemotherapy to control disease progression, prolong survival, and even achieve cure. This requires gynecologic oncologists to not only master as much as possible the standardized treatment of related diseases and the latest treatment methods, but also combine the patient’s condition, age, whether or not to request for fertility, retention of sexual function and other aspects to tailor-make individualized treatment plans for patients. While applying surgery, chemotherapy and radiotherapy to treat the disease, we should also consider preserving the patient’s sexual and ovarian functions as much as possible, and even preserving the patient’s reproductive function if conditions permit. During and after treatment, psychological, nutritional, hormone replacement, and immune function adjustment treatments are provided. Locking the best treatment focus At present, surgery, radiotherapy, chemotherapy is still the most important means of treatment for gynecological malignant tumors, and the introduction of integrated treatment will provide patients with the most advanced diagnostic and therapeutic techniques, optimal treatment plan, so as to maximize the benefit of treatment. The perfect completion of integrated treatment requires multidisciplinary collaboration among surgical oncology, medical oncology, radiation oncology, pathology, dietitian, psychology and other disciplines. For example, for advanced ovarian cancer patients who are diagnosed for the first time, the treatment goal is to strive to achieve complete tumor remission, and active surgery and standardized chemotherapy are the best choices for the patients; and when the patients have multiple recurrences, applying multiple treatments ineffectively and develop a large amount of ascites, the focus of the treatment changes to improving the quality of survival (controlling the symptoms and alleviating the pain), palliative chemotherapy (choosing a single drug with little side effects, aiming at making tumor slow progression of the tumor), nutritional support, and spiritual care may be more helpful to the patient and his or her family. In many people’s view, radiotherapy and chemotherapy are the most painful treatments, with severe nausea and vomiting, hair loss, and fatigue causing many patients to give up treatment. Nowadays, the application of new anti-emetic drugs, nutritional supportive therapy and psychological therapy will help patients to pass the treatment period easily. In the past, we have always regarded the tumor as the most tenacious enemy, and chemotherapy is not stopping while life goes on. Eventually, the tumor is not controlled well, and the body can not withstand the serious toxic side effects, that is, over-treatment, ignoring the patient’s feelings and quality of life. Nowadays, in the concept of integrated treatment of tumor, the tumor can be treated as a chronic disease, and if the tumor cannot be completely eliminated, the coexistence of human tumors is also a better state of survival. For example, there is a 76-year-old ovarian cancer patient who had chemotherapy resistance after 4 courses of chemotherapy after surgery, and the doctors changed 3 regimens for her without benefit, with multiple recurrent lesions in the abdominal cavity, tumor marker CA125 as high as 2000U/ml or so, and the last regimen had a very big side effect, and the patient suffered severe vomiting and ionic disorders, and extreme weakness, and she passed through the dangerous period after rescue. So the doctors decided to give her palliative care, only oral or chemotherapy drugs with few side effects and immune support therapy, the tumor progressed very slowly, and now the patient has been living a high quality life for more than 2 years and is still under treatment. In conclusion, traditional treatments are easy to accept, but if traditional treatments are combined with new technologies, new drugs and new ideas will bring the best treatment results and the best survival status to patients. Although most gynecological malignant tumors are still incurable, standardized and individualized comprehensive treatment can bring patients the best treatment plan, more opportunities for choice, and greater rights of independent choice, reflecting the whole person, the whole family, the whole treatment and care, in order to fully embody the contemporary human-centered “value-based medicine” concept. The concept of “value-based medicine” can fully realize the contemporary human-centered “value-based medicine”.