Female reproductive organ is a functionally active organ, and it is a “zone” of tumor, among which women aged 40-60 are the high-risk age group. Gynecologic tumors are the most common tumors in women, which seriously affects women’s physical and mental health as well as quality of life, therefore, proper understanding of gynecologic tumors is an important step in caring women’s health. In this article, we will talk about the main risk factors and prevention methods of gynecological tumors to help women stay away from gynecological diseases.
I. Risk factors of gynecological tumors
1.Individual basic factors.
(1) Age: Different tumors occur at different ages. The incidence of endometrial cancer is 60 years old > 50 years old > 40 years old. The incidence of ovarian cancer peaks at the age of 50. The incidence rate of cervical cancer has a tendency of lower age, and some literature reports that the incidence rate of women around 30 years old has increased to 24% in the past 10 years.
(2) Anatomical tissue embryonic factors: the frequency of tumor occurrence and benign and malignant structures vary greatly depending on the location and tissue. The ovaries have a high potential for tumor development because they are rich in developmental and multipotent germinal epithelium, germ cells and embryonic residual tissue. Moreover, the ovaries are subject to perennial cyclic changes and are susceptible to internal and external factors. And the cervix is an external tissue, so it is more susceptible to inflammation and tumors.
(3) Obesity: fat can store estrogen and slow down its metabolism, which has a pro-cancer effect. From endometrial hyperplasia to endometrial cancer are all related to estrogen.
(4) Local irritation: Cervical cancer is associated with local malignant factors, and it may occur at the site of cervical trauma or repair. Ovarian surface epithelial damage due to prolonged ovulation is one of the causes of ovarian cancer.
(5) Systemic diseases: Abnormal pituitary function and the resulting infertility, anovulation, gonorrhea and various hyperplasia are closely related to the development of endometrial cancer.
(6) Diet and nutrients: 60% of female tumors are related to diet and nutrition. Low standard of living and low intake of animal protein are prone to chylothorax; frequent consumption of green vegetables and carrots can reduce the incidence of cervical cancer; vitamin A can protect epithelium and reduce the occurrence of ovarian cancer; while green vegetables, dairy and liver can reduce the occurrence of endometrial cancer.
(7) Others: oral contraceptives are protective against and prevent ovarian, but can increase the incidence of endometrial cancer by 7 times. Pregnancy and childbirth can reduce the occurrence of ovarian cancer, while cervical cancer occurs more often due to multiple births.
2.Infection factor: The transformation from normal cervical cells to cervical intraepithelial neoplasia and cervical cancer is a multifactorial and progressive process, and high-risk human papillomavirus (HPV) infection is the main factor in the malignant transformation of cervical cells. There are more than 30 HPV subtypes associated with genital tract lesions, classified by their tumorigenicity into low-risk (6, 11, etc.) and high-risk (16, 18, etc.) types. The main mode of transmission is sexual transmission.
Main symptoms of gynecological tumors
Gynecological tumors are mostly asymptomatic in early stage, and the symptoms are non-specific and similar to benign diseases, so they can be easily mistreated as common diseases. The common symptoms include the following four kinds.
1. Vaginal bleeding: including physiological and abnormal vaginal bleeding. Physiological bleeding mainly refers to normal menstruation, which is cyclical, with intervals of 24-35 days, lasting 2-6 days, and a volume of about 30-50 ml. Abnormal vaginal bleeding refers to prepubertal or postmenopausal bleeding, or excessive menstruation in women of childbearing age, intermenstrual bleeding or post-coital bleeding. Common diseases are: ovarian endocrine dysfunction (gonorrhea), inflammation (vaginitis, endometritis and cervicitis), pathological pregnancy (ectopic pregnancy and miscarriage) and tumors (cervical cancer, endometrial cancer and a few ovarian cancers).
2. Masses: Tumors occurring in the internal genitalia often have small masses at first, located deep in the pelvis, and can only be detected by gynecological examination or ultrasound. Common diseases include: benign ovarian tumors; malignant ovarian tumors; functional ovarian tumors; ovarian metastatic tumors; uterine fibroids; staphyloma; endometrial cancer and cervical cancer.
3, leucorrhea abnormal: normal leucorrhea is white thin paste, the amount is not much, the middle of menstruation near ovulation secretion, leucorrhea is colorless transparent egg white, 2-3 days after ovulation leucorrhea becomes cloudy viscous, the amount is small, premenstrual leucorrhea is often slightly increased, are normal. The common diseases of leucorrhea abnormalities are.
① inflammation (common): trichomonas vaginitis, mycotic vaginitis, bacterial vaginitis, cervicitis and endometritis.
②Tumors: cervical cancer, endometrial cancer, vaginal cancer and fallopian tube cancer.
4, abdominal pain: If women of childbearing age have abdominal pain, they should be asked if they have menopause, last menstruation, and if there is irregular bleeding, pregnancy-related diseases should be excluded. Common diseases causing abdominal pain include: ① gynecological tumors: ovarian tumor twisting, rupture and infection; subplasmalemma myoma twisting and red degeneration; invasive staphyloma and choriocarcinoma; endometrial cancer perforation; ② benign diseases: endometriosis and pelvic inflammatory disease.
Treatment of gynecological tumors
1.Surgery.
Indications.
(1) Benign tumors, except for some uterine fibroids, should be treated promptly with surgery as the first choice.
(2) Malignant tumors have different surgical plans according to their stages.
Contraindications.
(1) Malignant tumors with advanced clinical stage and distant metastases.
(2) Obesity resulting in poor surgical field exposure.
(3) Poor general condition and other comorbidities.
Chemotherapy is mainly used for the treatment of gynecologic malignant tumors, but should not be used for benign and junctional tumors. The chemotherapy regimen mainly depends on the pathological type and stage of the tumor, and should be individualized and based on the patient’s specific situation to develop an effective chemotherapy regimen.
Radiotherapy: It is also one of the important means of treatment for gynecological malignant tumors: it can be used as radical treatment for cervical cancer, vaginal cancer and certain endometrial and vulvar cancers, and also as adjuvant treatment for cervical cancer, endometrial cancer and choriocarcinoma after chemotherapy.
Prognosis of gynecological tumors
Clinical stage and pathological grading are the most important factors affecting prognosis. Other influencing factors are: tumor size, age, treatment means and follow-up level. The 5-year survival rates of various tumors are: 50-70% for vulvar cancer; 60% for cervical cancer; 60-70% for endometrial cancer; 30% for ovarian cancer; and 80% for trophoblastic tumors.
Prevention of gynecological tumors
1. Prevention of etiology and high-risk factors: cervical cancer should be treated actively for viral infection and cervical diseases, early detection of cervical precancerous lesions and attention to sexual hygiene. For endometrial cancer, estrogen should be used cautiously before and after menstruation. Prevention of ovarian cancer includes close follow-up of ovaries that can be reached before puberty and after menopause and early detection by ultrasound and CT.
2.See a doctor promptly when there are symptoms.
3.Dietary regimen: eat more fresh fruits and vegetables.
4.Regular screening.
(1) For those who have sex: routinely once a year, including gynecological examination, cervical smear/TCT and ultrasound.
(2) For high-risk group, it should be done once every six months.
In general, gynecological tumor is a heavy topic. Too many women have lost their lives prematurely because of tumor, but as long as they master the knowledge of tumor prevention and control, and pay attention to their health in daily life, early prevention, early detection and early treatment, tragedies can be avoided. I hope this article can help women have a general understanding of gynecological tumors and arm themselves with correct knowledge and healthy lifestyle to prevent gynecological tumors from taking advantage of them.