How to break the red face killer at the top of the "ranking" of gynecological tumors? Oncologists teach you how to get out of the misunderstanding and break each one

From the land of the river to the Qinghai-Tibet Plateau, the "Red Boat Leads the Way to Healthy and Strong Country" 2022 China Oncology Conference Science Popularization Tour in China allows the seeds of tumor science popularization to be sown in all directions
like dandelions.
A few days ago, Wang Naixin, member of the Party Committee and vice president of Zhejiang Cancer Hospital, led a team to Qinghai
.

In Haixi Prefecture People's Hospital, Xie Tieming, Director of the External Relations Department of Zhejiang Cancer Hospital, and Wang Yifan, Dr.
Zhejiang Yuanqing and Director of the Functional Department of Haixi Prefecture People's Hospital, brought popular science lectures "Cancer, Who Do You Say You Like to Entangle" and "Screening of Common Female Tumors", which gathered super popularity
.
"In the past, I was a little resistant to the cervical cancer vaccine, but this time I listened to the lecture and went home to arrange it for my 18-year-old daughter
.
" "It turns out that after menopause, there are still so many gynecological problems that need attention, and if you are not careful, you will get a tumor.
"
After listening to the lecture, the local women gave such feedback
.

"In the outpatient clinic, I met several patients with advanced gynecological tumors, which was distressing
.
Some patients gave up the most basic gynecological examination in the physical examination, delaying the condition; Others do not pay attention to the initial symptoms of the disease at all and wait until the full ascites is full
.
Therefore, it is urgent to improve the awareness rate of cancer knowledge among the general population, especially the health awareness of women
.
As a doctor who assisted Qingqing, Wang Yifan said with deep feelings based on his daily experience in Haixi Prefecture People's Hospital
.
In Qinghai, diseases such as cervical cancer have become common tumors
that threaten women's health.

In fact, not only women in Haixi Prefecture have such troubles and misunderstandings in gynecological tumors, and many problems are of universal significance
nationwide.
How to prevent and treat gynecological tumors? What symptoms do I need to see a doctor promptly? The reporter interviewed a number of experts from the Department of Gynecology Tumor Surgery of Zhejiang Cancer Hospital to solve problems for female friends across the country
.

(The expert group of the provincial cancer hospital led by Wang Naixin, member of the Party Committee and vice president of Zhejiang Cancer Hospital, went to Haixizhou, Qinghai to carry out science popularization activities in China)

Zhu Tao, vice president of Zhejiang Cancer Hospital and chief physician of the Department of Gynecological Oncology Surgery, summarized several misunderstandings in the treatment of gynecological tumors, the first of which is that middle-aged and elderly women are unwilling to undergo physical examination
.
"The reason why many people are reluctant to have a physical examination is for fear of finding cancer, but without going for a physical examination, the tumor also exists, and it grows larger and more advanced
.
"

The second misconception is that if you have a tumor, you will die
.
"Many patients at the moment of diagnosis of cancer, whether in the early or advanced stage, think that the tumor is not good and give up treatment
.
But for many tumors, early treatment is very
good.
Zhu Tao took the treatment of early cervical cancer in Zhejiang Cancer Hospital as an example, the cure rate of early patients is close to 92%, and the cure rate of middle and advanced stages is about
70%.

The third misunderstanding is that the tumor is just surgery
.
Radical surgery in surgery is the first axe of tumor treatment, but in many tumor diagnosis and treatment, surgery is only a part of anti-cancer, and comprehensive treatment is required; Even some tumors can only be treated with radiotherapy and chemotherapy and do not require surgery
.

The fourth misunderstanding is that if you have cancer, you dare not go to a specialized hospital, in fact, the treatment of a specialized oncology hospital is more standardized and cutting-edge, and the initial treatment plan for tumors almost determines the outcome
of most patients.

In the interview, "there are many misunderstandings" and "sense of urgency in popularizing science" are high-frequency words
.
In the "Chinese Guidelines for Integrated Diagnosis and Treatment of Tumors (CACA)", cervical cancer, ovarian cancer and endometrial cancer are the top three
gynecological tumors.
In addition, there are gynecological tumors such as vulvar cancer, vaginal cancer, uterine sarcoma, gestational trophoblastic tumor, etc.
, which threaten women's health
.
Many experts said: Women must pay attention to the warnings issued by the body, screen early and prevent early, so as to stay away from red face killers
.

Cervical cancer

It does not develop quickly, but many patients find out too late

Cervical cancer is one of the common gynecological malignant tumors in women, and the latest report from the National Cancer Center shows that cervical cancer ranks second among the highest incidence of tumors in women, with about
110,000 new cases every year.

"Although there is a huge number of existing case data on cervical cancer, we still believe that cervical cancer is the most likely cancer to be eliminated in the future
.
" Chen Yaqing, deputy director of the Department of Gynecological Oncology Surgery of Zhejiang Cancer Hospital, said
.
"Because cervical cancer is currently the only malignant tumor
with a clear etiology and the existence of a preventive vaccine.
Most cervical cancers are caused
by infection with the HPV virus.
”

Cervical cancer can be prevented early, but unfortunately, due to the public's insufficient awareness of cancer screening, many cervical cancer patients are accidentally discovered
.

Chen Yaqing has received a mother and daughter patient, her daughter is cervical carcinoma in situ, when she was discharged from the hospital, her daughter said in casual chat, my mother's TCT test found that the cells were abnormal, it has been two years, this is okay! The speaker has no intention, but the listener pays
attention.
"As soon as I heard that this situation was wrong, I asked her mother to hurry up for examination, and the result was an early cervical cancer, and the two of them were treated and are currently in good physical condition
.
" Chen Yaqing said
.

Zhu Tao said: "At present, women's attitudes towards cervical cancer show two obvious trends, one is anxiety, HPV+TCT test is done every year, and the results are anxious as soon as they appear abnormal; The other is that it doesn't matter, some patients even three-year physical examination reports show abnormal cervical cancer indicators, ignoring them because they are asymptomatic, and some even give up cervical cancer screening and allow the disease to develop
.
”

Both experts talked about a specific statistic — it takes about 10 years or more
on average from infection with HPV to cancer.
Such a long stage of precancerous lesions provides an opportunity
for cervical cancer screening.
"Experts especially remind women not to give up cervical cancer screening, but to pay more attention to the screening results
.
"

Cervical cancer is screened in this way

At present, China's cervical cancer screening is basically based on HPV detection and cervical cytology screening (TCT), generally speaking, after having sex, cervical cancer screening should be done from the age of 20, and women aged 20 to 29 are recommended one-way TCT examination (liquid-based thin-layer cell detection); 30 years old and above, HPV test (human papillomavirus test) plus TCT can be used for screening
.

Chen Yaqing suggested that if HPV is found to be high-risk positive during the examination, it must be followed up regularly, and judged
by combining TCT and other examinations.
If both cytology and HPV tests are negative, the screening interval can be extended to 3 to 5 years
.
If TCT cytology is negative and HPV16/18 is positive, further colposcopy is required; If you are positive for high-risk HPV other than 16/18, you can repeat the test after 12 months, and if the result of the re-screening is either HPV-positive or cytologically abnormal, further colposcopy is required
.

Ovarian cancer

It is like a hidden "landmine" and is called "the first cancer in gynecology"

The first cancer in gynecology is ovarian cancer
.
Zhu Jianqing, director of the Department of Gynecology Oncology at Zhejiang Cancer Hospital, a nationally renowned expert in gynecological oncology surgery, said: "The disease of ovarian cancer is like a hidden landmine, it is hidden deep in the body, you are not easy to find it, once an explosion occurs, it will form large and small different fragments, scattered in various parts
of your body.
" ”

Zhu Jianqing said: "The treatment of ovarian cancer should not only pay attention to the early and accurate first knife, but also need to have the overall concept
of follow-up treatment.
Early detection of the lesion and complete removal is the most ideal state, but when the tumor reaches an advanced stage, the complexity of the operation can be imagined
.
Therefore, the treatment of ovarian cancer is not a one-size-fits-all solution, most patients will repeatedly relapse and repeated treatment, at this time patients and doctors need to be prepared
to fight a protracted battle.
”

Clinically, three "70%" ovarian cancer is often mentioned: first, 70% of ovarian cancer patients are in the advanced stage when they are diagnosed; Second, 70% of ovarian cancer patients relapse within three years after initial treatment; Third, 70% of patients with advanced ovarian cancer survive for no more than 5 years
.

In the treatment experience of many gynecologists, ovarian cancer patients who survive for more than 10 years are very few, and what impressed Zhu Jianqing was a gathering
of patients last year.
Seven ovarian cancer patients who have survived for more than 10 years got together for a special "birthday party" called the "Decade of Rebirth", the longest of which is more than 20 years old
.
I attended the party with the doctors of the team, and these patients have all relapsed and treated many times, and they have a common feature that is optimism and high cooperation with the doctor's treatment
.

Zhu Jianqing said that although the cause of ovarian cancer is not clear, studies have shown that genetic factors, environmental factors, advanced age, and non-pregnancy may be closely related to the occurrence of ovarian cancer, especially germline BRAC1/2 gene mutations, which are significantly related
to the incidence of ovarian cancer.
Nearly 25% of confirmed patients are caused by genetic factors
.

"Therefore, when we treat ovarian cancer patients, we usually have genetic testing to see if they have BRAC gene mutations, and if there are germline BRAC gene mutations, we will recommend that the patient's female blood relatives also need to assess the risk of hereditary ovarian cancer, and develop targeted health management programs to achieve early prevention, early detection and early treatment
.
"

Ovarian cancer is found in this way

At present, there is no good screening method
for ovarian cancer in medicine.
Ovarian cancer often has no specific clinical symptoms, some unexplained epigastric discomfort, bloating, loss of appetite, short-term abdominal circumference, etc.
, should seek medical attention in time, and consciously check whether there is a problem with the ovaries
.
It is recommended
that adult women have an annual gynaecological examination.
Ovarian cancer is often accompanied by elevated tumor markers, such as postmenopausal women, and CA125 is found to be elevated during physical examination, which needs to be paid enough attention
.
Further testing is needed to rule out ovarian tumors
.

Endometrial cancer

Be wary of "youth" after menopause, it is easy to target three types of people

People age at a certain age, and the most typical aging feature for women is menopause
.
Some women have vaginal bleeding after a period of menopause, Yu Aijun, deputy director of the Department of Gynecological Oncology at the Provincial Cancer Hospital, said that this situation should be extra vigilant, which may be a signal
of endometrial cancer.

Yu Aijun said that a patient he received not long ago, her treatment experience is worth learning from every woman
.
"This patient is 55 years old and well maintained, she came with a local diagnosis of endometrial cancer
.
"

Yu Aijun said that during the conversation, patients were asked how they found out they were sick
.
The patient said that because after menopause, vaginal bleeding occurred, and he thought that this was very abnormal
.
Then a series of actions of the patient, let Yu Aijun sigh is a textbook visit, the patient did not delay for a day, immediately went to the local hospital for examination, did vaginal B ultrasound, found endometrial thickening, hysteroscopy + diagnostic curettage in the local hospital, postoperative pathology: endometrial adenocarcinoma, and then came to Hangzhou to see a doctor
.
Because patients attach great importance to postmenopausal vaginal bleeding, it is found that relatively early endometrial cancer, after our standardized surgical treatment, the prognosis is good, the trauma is small, and there is no need for follow-up treatment, as long as regular follow-up is possible
.

Yu Aijun said that 90% of endometrial cancer patients have irregular vaginal bleeding
.
Nonmenopausal patients may present with menstrual disorders, inexhaustible menstruation, and even heavy bleeding; Postmenopausal patients may present with a small amount of vaginal bleeding, usually in small
amounts.
Therefore, self-awareness of cancer prevention is particularly important
in the prevention and treatment of endometrial cancer.

In addition, Yu Aijun reminded that the high-risk factors of endometrial cancer are closely related to chronic diseases such as obesity, hypertension, and diabetes, which are also known as the "triad" of endometrial cancer, and female patients with these chronic diseases should also pay attention to their physical conditions.

Obesity will not only bring abnormal problems of glucose metabolism and lipid metabolism such as hypertension, hyperlipidemia, diabetes, etc.
, but also may change the endocrine environment of the body, cause and effect each other with pituitary dysfunction, affect the secretion of estrogen, and cause endometrial cancer
.

Endometrial cancer is found in this way

Yu Aijun said that endometrial cancer can be detected
early.
After more than a year of menopause, women suddenly experience abnormal vaginal bleeding, which may be a signal
of the arrival of malignant diseases of the reproductive organs.
Postmenopausal women who have a thickening of the endometrium of more than 7 mm during vaginal ultrasound examination should undergo diagnostic curettage, which is the gold standard
for the diagnosis of endometrial cancer.
In women of childbearing age, if menstrual disorders and abnormal uterine bleeding should be paid attention to, whether it is caused by endocrine disorders, or endometrial dysplasia or endometrial cancer, it is recommended to go to a specialist for investigation
.

#, women should pay attention #

Myth 1: Getting cervical cancer is a disorderly private life
.

Chen Yaqing said that many people associate their private life with cervical cancer, thinking that cervical cancer is caused by improper private life, which is not right
.
Persistent infection of HPV is the most important cause of cervical cancer, as well as other causes, such as premature sexual life, multiple sexual partners, smoking, and low immunity
.
Even if the private life is very regular, there will still be partner infection, resulting in cross-infection
.

Myth 2: If you are vaccinated against cervical cancer, you are safe
.

Cervical cancer vaccination can greatly reduce the occurrence of cervical cancer, but not cervical cancer vaccination will definitely not get cervical cancer, but also regular cervical cancer screening
.
Zhang Yingli, deputy director of the Department of Gynecological Oncology Surgery of Zhejiang Cancer Hospital, said: "At present, we know more than ten HPV viruses that can cause cervical cancer, and this data is expanding
with scientific research.
In China, we all know that there are 3 kinds of cervical cancer vaccines, namely bivalent, quadrivalent and nine-valent vaccines, bivalent cervical cancer vaccines can prevent high-risk HPV16 and HPV18 infections, and on this basis, tetravalent has a preventive effect
on the prevention of genital warts caused by low-risk HPV6 and HPV11.
The nine-valent vaccine is based on the quadrivalent and can prevent the other 5 high-risk types of HPV, so each vaccine covers different and cannot cover all high-risk HPV that induces cervical cancer
.
”

Myth 3: Infected with HPV virus, you will get cervical cancer?

This misunderstanding was jointly mentioned
by Zhu Tao and Chen Yaqing.
"This is the wrong idea, about 70% to 80% of women will be infected with HPV virus in their lifetime, most of them can be cleared by their own immunity, and only a small number of women infected with HPV virus cannot rely on autoimmunity to clear it, and thus cause some reproductive diseases related to low-risk HPV types and some high-risk HPV types related to precancerous changes
.
" Chen Yaqing said
.
She said of a patient, "She tested positive for HPV and normal TCT, so she was so anxious that she didn't sleep well every day, didn't eat well, lest she get cervical cancer
.
" In fact, if emotional damage, decreased immunity, and more harm to the body, do not be overly anxious due to HPV positivity, but should be regularly screened and listen to the advice
of professional doctors.
”

Myth 4: Menstruation after menopause is reverse growth
.

Zhu Jianqing said that although senile vaginitis, endometritis and other gynecological diseases can also cause vaginal bleeding, it is especially important to remind that irregular vaginal bleeding is an abnormal signal of the body and must be paid attention to
.
Yu Aijun took endometrial cancer as an example, the most common symptom is irregular vaginal bleeding
.
Women without menopause may have increased menstrual bleeding and prolonged menstrual periods, intermittently; Women who have been menopausal and have irregular vaginal bleeding after menopause should first be alert to the possibility
of endometrial cancer.

Myth 5: Treatments such as massage can make the ovaries "young" and prevent ovarian cancer
.

Treatments such as massage can make the ovaries younger and prevent ovarian cancer
.
Many experts have said that do not pay an IQ tax
.
Zhu Jianqing explained that the ovaries are located deep in the pelvis, even professional doctors, in the abdominal area, are not so easy to touch, so relying only on the massage and physiotherapy on the stomach, trying to make the ovaries young and cancer-free, a bit fanciful
.

Myth 6: In your 60s, you don't need to prevent uterine diseases
.

In the gynecological tumor surgery ward of Zhejiang Cancer Hospital, more than
60% of the patients with endometrial cancer are aged 50 to 60.
Yu Aijun said that during this period, he has successively received 4 endometrial cancer patients around the age of 55, all of whom are middle and advanced
.
Therefore, do not think that female ionic endometrial cancer entering menopause or perimenopause is far away
.
Some women are in their 60s, estrogen is still at a certain level, even if they do not menstruate, but there is still a risk
of endometrial disease.