A tumor hidden in the body for 7 years undetected, if not an accident, deterioration is likely to let the young life die early. This is an incident that happened in the Department of Gynecologic Oncology of City Cancer Hospital in July last year. Fortunately, the treatment was timely and Cheng Xin (a pseudonym), a 48-year-old female teacher, returned to the classroom.
Gynecological tumor is a common disease among women of reproductive age, which can occur in any part of female genitalia. It can occur in any part of female genitalia, and according to different parts, it is divided into: vulvar tumor, vaginal tumor, uterine tumor, ovarian tumor and fallopian tube tumor. Among them, uterine and ovarian tumors are more common, while vulvar and fallopian tube tumors are less common. The age of patients is mainly concentrated in women over 40 years old, but the number of young patients in their twenties and even in their teens is also increasing year by year. This issue of “Health Weekly” invites Wang Dong, deputy director and chief physician of gynecologic oncology department of city cancer hospital, to give detailed answers.
Patients: medical checkup detected masses and carelessly delayed health
The first time I saw a patient with a 4cm mass on the left side of the uterus, I was told that she was a teacher of English in a key middle school in the city. After learning this result, Cheng Xin repeatedly asked her doctor, “Is it serious?” The doctor replied to her, “Pay attention to the follow-up, it should not be a big problem.”
Next, Cheng Xin had regular follow-up examinations and took the follow-up visits seriously. Despite this caution, in her seventh year, Cheng Xin suddenly collapsed due to severe stomach pain. She was sent to the hospital for examination and found that the 4cm mass had caused ovarian cancer. “Now that I think about it, I am still sulking, but I blame myself for lacking basic medical knowledge.” Cheng Xin told reporters that after her condition was diagnosed, her family sent her to Chongqing’s only specialized department for the treatment of gynecological malignancies – the gynecological oncology department of the city’s Cancer Hospital for inpatient treatment. Wang Dong, deputy director of the gynecological tumor department, said that women should be alert to the emergence of gynecological tumors after they enter their 40s. Often ovarian tumors do not produce special symptoms in early stage, but once gynecological examination reveals that ovarian tumors are 5 centimeters or more in size, and ultrasound examination suggests solid components or papillae with rich blood flow signals, it is recommended to do a tumor marker examination to rule out whether cancer has occurred as early as possible and win the surgery time.
Doctor: Gynecological examination cannot be ignored but not less key items
For some professional medical explanations about ovarian cancer, Cheng Xin could not give the reporter a clear explanation. In this regard, Monday afternoon after 4:00, the reporter came to the city cancer hospital to interview Wang Dong, deputy director of the Department of Gynecology and Oncology. When I met Wang Dong, who had just gotten off the operating table, she left in a hurry after saying a few words. Half an hour later, Wang Dong came back dripping with sweat. She said to the reporter apologetically, “Sorry, a patient came from Fengjie by car to be hospitalized. But our department bed is full, the patient abdominal pain is very strong, I must go to see the patient, fortunately finally squeezed a bed to do the hospitalization.”
After a few moments of rest, Wang Dong gladly accepted the interview. After understanding Cheng Xin’s situation, Wang Dong told reporters, “On average, the hospital receives 40 to 50 cases of ovarian tumor patients every month. The early symptoms are not obvious, and like Cheng Xin there is no physical discomfort. But there are also special ones, such as ……”
Five years ago, Wang Dong saw a 97-year-old woman whose stomach was as big as if she was more than six months pregnant. Fortunately, the old woman’s heart functioned well and all other tests indicated that her body could withstand the surgery. Finally, Wang Dong helped the old lady to remove her ovarian tumor successfully. Fortunately, she was suffering from a benign ovarian tumor and is still alive today. Her daughter even came to the hospital this year to visit and thank the medical staff of the gynecologic oncology department.
Through this example, Wang Dong emphasized that women with unexplained enlargement of the stomach should go to the hospital for early examination to rule out the possibility of ovarian tumors. Usually, women can also check themselves to see if they have ovarian masses in their bodies. To do this, lie down in bed in the morning, relax your abdomen and bend your hips and knees. Then use the tips of your fingers to press the lower abdomen, paying particular attention to the sides. Touch carefully for any masses.
Generally speaking, women who are sexually active need to have a routine gynecological examination once a year. If a cyst is found in the ovary during ultrasound, first rule out whether it is a physiological or pathological cyst. If the cyst is pathological and is 4 cm or more in size, a further tumor marker test is required. A tumor marker test should be done to rule out the possibility of cancer early. In this regard, Wang Dong highlighted the tumor markers CA125 and HE4, which together can screen 80% of women for ovarian cancer.
However, many women overlook tumor marker tests. Wang Dong lamented that ovarian cancer is not easy to be detected, and once it is detected, the tumor is relatively large. When the tumor gradually increases until advanced stage, some digestive symptoms will appear, such as loss of appetite, abdominal distension and abdominal mass. At this time, many patients mistakenly think it is stomach disease. However, after the gastroscopy, no problem can be detected.
In a large number of clinical consultations, Wang Dong saw many patients who took a wrong turn. They were already in the advanced stage of ovarian cancer when they were seen. The prognosis of this disease, when found late, can be very poor compared to breast cancer and cervical cancer. Recurrence can easily occur after surgery, resulting in the 5-year survival rate becoming very low.
Reminder: Many gynecological diseases may cause abnormal vaginal bleeding
Wang Dong introduced that ovarian cancer is a malignant tumor that grows on the ovaries. Although the incidence rate of ovarian cancer is lower than that of cervical cancer and endometrial cancer, it is the third most common gynecological malignant tumor, but the mortality rate is the highest among gynecological cancers, which is a serious threat to women’s health. The cause of ovarian cancer is not yet clear, but women with genetic predisposition may be at high risk of ovarian cancer. The incidence of ovarian cancer will be tens of times higher for those who have immediate family members with breast cancer and endometrial cancer.
In addition, women who are stressed and love to eat a lot of high-heat and high-fat food, or smoke and drink, and who have not given birth and do not breastfeed after giving birth, are all at risk of ovarian cancer.
Wang Dong summarized a symptom that many gynecological diseases can cause – abnormal vaginal bleeding. She said many women are too embarrassed to have their vaginal bleeding checked and take some medicine on their own thinking it will be fine. Some women go to the hospital only after the bleeding has lasted for six months or a year, resulting in the development of early lesions into middle and late stages, which delays the disease.
Wang Dong introduced that unexplained vaginal bleeding with or without abdominal pain at childbearing age should be alerted to pregnancy-related diseases. For example, ectopic pregnancy and pre-eclampsia, when a urine HCG test and ultrasound can basically clarify the condition. The most common symptoms of uterine fibroids are heavy menstrual flow, long periods and shortened menstrual cycles at childbearing age. A pelvic ultrasound and gynecological examination can confirm the diagnosis. The symptoms of dysfunctional uterine bleeding are also mainly menstrual changes, but to make this diagnosis, other diseases must be ruled out before the diagnosis can be made. If vaginal bleeding occurs during perimenopause, one should be alert to endometrial cancer. Many patients with the above symptoms during perimenopause think they are menstrual disorders and do not seek medical consultation in time, thus delaying their condition. At this age stage malignant diseases are first excluded before they can be considered as physiological phenomena. If vaginal bleeding occurs after intercourse, be alert to cervical disease, go to the gynecologist for examination, and enter the cervical TCT test. Vaginal bleeding after menopause may be a malignant disease of the cervix or endometrium, and a detailed examination must be done to clarify the condition.
During the interview, the reporter was particularly curious and asked Wang Dong, “As a woman, how do you see gynecological tumors?” She smiled and said, “In addition to the series of gynecological examinations that must be done, I have always believed that women should nurture their hearts in order to truly nourish their health and avoid diseases. Any woman should learn to treat herself, her family and friends well, and do what she wants to do. Just try your best at everything, everything too serious, everything too pursuit of perfection will only make yourself too tired, women should know how to show weakness.”
What are the gynecological examinations?
Many women do not know what to do for gynecological examination, which often causes irreversible consequences. Wang Dong, as a professional gynecological oncologist, has the following answers to the precautions of gynecological examination from the perspective of prevention.
Women over 30 years old, especially those over 40 years old, should receive gynecological examination at least once in two to three years, which should include gynecological examination, cervical smear cytology, vaginal ultrasound and so on. Once suspicious lesions are found, they should be reviewed promptly according to the doctor’s requirements, and some auxiliary tests should be done if necessary. For example, colposcopy or cervical biopsy should be done when cervical smear cytology is abnormal; diagnostic scraping or hysteroscopy should be done when endometrial disorders are suspected; tumor marker test in blood should be done when ovarian tumor is suspected. If precancerous lesions are found, they should be treated actively to stop their further development.
Doctor Introduction
Wang Dong, female, chief physician, deputy director of gynecologic oncology department of Chongqing Cancer Hospital. She is a young member of the Gynecologic Oncology Committee of the Chinese Medical Association, a member of the Gynecologic Oncology Committee of the Chinese Anti-Cancer Association, a member of the Obstetrics and Gynecology Committee of the Chongqing Medical Association, and a member of the Chinese Clinical Oncology Collaborative Organization. She has been engaged in clinical teaching and research of gynecologic tumor for more than 20 years, and has edited 3 monographs. 2006, she was trained by the western talent training to the Cancer Hospital of Chinese Academy of Medical Sciences, and is a member of the “Cervical Cancer Opportunistic Screening Program” of China Cancer Foundation in Chongqing. She specializes in gynecologic malignant tumor surgery, chemotherapy, radiotherapy and other comprehensive treatment.
Department Introduction
The Department of Gynecologic Oncology of Chongqing Cancer Hospital is the only prominent department of immunology specializing in the diagnosis and treatment of gynecologic tumors in Chongqing. It is now a key medical discipline in Chongqing, a center for early diagnosis and treatment of cervical cancer in Chongqing, and a joint training site for master and doctoral students of Chongqing Medical University and Guangxi Medical University. It has 2 wards and post-mortem treatment center. The Department of Gynecologic Oncology focuses on training clinical treatment and related research Especially, it attaches importance to early diagnosis of gynecologic tumors and early treatment of China and features comprehensive theoretical treatment professor For gynecologic malignant tumors are in accordance with natural international norms to make full use of Zhejiang surgery, radiotherapy, chemotherapy, national biological long-term treatment and other treatment chronic means to develop an effective reference comprehensive program A set of current norms for the diagnosis and treatment of gynecologic cancer has been formed. The treatment features include multidisciplinary joint consultation for cervical cancer, extensive cervical excision for cervical cancer preserving fertility function, comprehensive treatment for recurrent and refractory ovarian cancer, minimally invasive surgery for gynecological malignancies
Cervical cancer integrated post-loading intracavity treatment.
There are 4 chief physicians and 7 deputy chief physicians, including 1 doctoral supervisor and 4 master’s supervisors. The department has experts with special government allowance of the State Council, standing committee and youth member of the Gynecological Tumor Specialized Committee of the Chinese Medical Association, executive director and vice chairman of the Gynecological Tumor Specialized Committee of the Chinese Anti-Cancer Association, vice chairman of the Chongqing Anti-Cancer Association, chairman and member of the Gynecological Tumor Specialized Committee of the Chongqing Anti-Cancer Association, and member of the Chongqing The Department of Gynecology and Obstetrics and Gynecology of the Chongqing Medical Association, Vice Chairman of the Chongqing Cancer Association, Vice Chairman of the Chongqing Gynecological Tumor Committee, Vice Chairman of the Chongqing Reproductive Society, etc. The department has a united medical and nursing team, which has been awarded as “National Women’s Civilized Demonstration Post”, “Chongqing Top 100 Female Staff Team”, “Chongqing March 8 Red Flag Advanced Collective” and “Chongqing Women’s Women’s Cancer Association”. “and “Chongqing women’s urban-rural docking good post group”. Personally, she has won the “Chinese Physician Award”, “Advanced Individual of National Medicine and Health System”, “Young Post Leader of Ministry of Health”, “Advanced Worker of Chongqing Municipality”, “Advanced Worker of Chongqing Municipality” and “Advanced Worker of Chongqing Municipality”. Worker”, “Chongqing Top Ten Medical Workers”, etc.