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Abstract: A 48-year-old woman came to our hospital with post-coital bleeding. After HPV and TCT examinations, she was diagnosed with cervical cancer and underwent radical cervical cancer surgery, after which her condition was stable and her bleeding symptoms disappeared. Cervical cancer is one of the three major malignant tumors in women and is mostly caused by viral infection. Therefore, women with a history of sexual intercourse are advised to have regular HPV and TCT examinations for monitoring and prevention purposes.
Basic information】Female, 48 years old
Disease Type】Cervical cancer
Hospital】Hunan Provincial Maternal and Child Health Hospital
Date of consultation】May 2022
Treatment plan】Surgical treatment (radical cervical cancer surgery) + intravenous injection (cefuroxime sodium for injection, sodium lactate ringer injection, sodium chloride glucose injection, carboplatin injection, paclitaxel injection)
[Treatment cycle] 14 days of inpatient treatment, regular chemotherapy
【Treatment effect】The bleeding symptoms disappeared and the disease was stable after the first cycle of chemotherapy
I. Initial interview
A 48-year-old female patient, who complained that she had not been screened for two cancers in the past, presented to our hospital in March this year with a small amount of vaginal bleeding after sexual intercourse. MRI of the lower abdomen showed that the anterior and posterior diameters of the cervix were about 2.4 cm, and a soft tissue mass with a size of about 1.1 cm × 1.7 cm was seen in the anterior wall, with a long T1 and slightly long T2 signal, poorly defined borders, slightly restricted diffusion, and partial disappearance of the basal ring, and the mass showed heterogeneous enhancement on enhanced scan. Based on the clinical manifestations and examination results, the patient was initially diagnosed as cervical cancer and admitted to hospital for treatment.
II. Treatment history
After admission, the patient underwent colposcopic biopsy and the pathological results were reported: medium-differentiated squamous carcinoma of the cervix at 3, 6 and 9 points, which was to be treated by radical cervical cancer surgery, and six cycles of chemotherapy were required after surgery. The patient’s preoperative blood tests, liver function and Aime B were all normal, so the patient underwent surgery. The patient returned to the ward after surgery and was given anti-inflammatory treatment with cefuroxime sodium for injection and rehydration treatment with sodium lactate Ringer injection and sodium chloride glucose injection to maintain the patient’s fluid balance. After 8 days of admission, the patient basically recovered, and the first cycle of chemotherapy was administered to the patient with carboplatin injection and paclitaxel injection. After 14 days of hospitalization, the patient had no special discomfort and was discharged from the hospital.
III. Treatment effect
The patient returned to the ward safely after the operation. He had a bowel movement and could get out of bed on the first day after the operation, and had a bowel movement and resumed eating and drinking on the second day after the operation. The surgical wound was free of infection and rupture, and the vaginal wound healed well. During chemotherapy, the patient complained of nausea and weakness, which were considered as side effects of chemotherapy drugs.
IV. Precautions
The patient has been actively cooperating with the treatment since she was admitted to the hospital, and I am very pleased about this. Before discharge, I told her to pay attention to rest, strengthen nutrition, pay attention to vulva hygiene, keep perineum clean, change underwear regularly, and forbid intercourse for 3 months. If there is any chill and fever, abdominal pain and vaginal bleeding, she needs to be seen again in time. Since the patient had nausea and vomiting during this chemotherapy, I advised the patient to go home and take more nutrition, mainly a diet with high protein, high calories and high vitamins to enrich the body’s nutrition. Chemotherapy may lead to a decrease in white blood cells, so I told the patient to pay special attention to keep warm after going home, open the windows more often, drink more water and do some exercises in moderation to increase resistance and prevent infection.
V. Personal insight
The elimination of cervical cancer has been treated as a global public health problem. Cervical cancer is the only cancer with a clear cause among all human cancers at present, and persistent HPV infection is an important cause of cervical cancer. The patient in this paper did not undergo screening for both cancers before she became ill, and when she sought medical attention when the disease appeared, she was diagnosed with cervical cancer. How to avoid or reduce the occurrence of cervical cancer is actually very simple, just do two things well. First, standardized cervical cancer screening, including HPV examination and TCT test; second, cervical cancer vaccination, currently there are 2-valent, 4-valent and 9-valent, 3 types, and women aged 9-45 can receive different doses according to their age.