Famous Doctor Files Sun Dongyan Chief Physician of Hubei Provincial Maternal and Child Health Hospital, Master Tutor. He has been engaged in the clinical work of obstetrics and gynecology for more than 20 years, and has rich experience in the treatment of gynecological malignant tumors, ovarian cysts, uterine fibroids, adenomyosis, infertility, endometrial lesions, and functional uterine bleeding. He is currently a member of the Branch of Integrated Obstetrics and Gynecology and Maternal and Child Health of Integrated Traditional Chinese and Western Medicine of the China Association for the Promotion of Traditional Chinese Medicine, a member of the Minimally Noninvasive Vulvar Cervicology Group of the Chinese Medical Doctor Association, and the president of the Dongxihu Branch of the Provincial Maternal and Child Health Hospital.
Hubei Daily all-media reporter Hu Man correspondent Huang Jieying
Xiao Xu, a 29-year-old who lives in Dongxihu, received the nine-valent HPV vaccine four years ago and has not been screened for cervical cancer since. At the end of last year, when work was over, she decided to go to the hospital for a medical examination. During the gynecological examination, the doctor took her cervical tissue and sent her for examination, and the results showed that hpv16 was positive, cervical squamous cell carcinoma. Thankfully, cancer is early on. At present, Xiao Xu has undergone surgery and his postoperative recovery is also very good. Xiao Xu has always asked herself that she and her husband are clean and self-righteous, and they have been vaccinated against cervical cancer, how can they still get cervical cancer?
"Cervical cancer is the second most common tumor in women, with a peak age of 45 to 55 years old, but in recent years, its incidence has tended to be younger." On January 13, the "Chutian Famous Doctor Lecture Hall" was held at the Dongxihu Branch Outpatient Clinic of the Provincial Maternal and Child Health Hospital, and Chief Physician Sun Dongyan was invited to popularize the knowledge of cervical cancer to the residents.
Q: In life, how to detect the clues of cervical cancer early?
A: In the early stages of cervical cancer, there may be non-specific symptoms such as contact bleeding and non-menstrual bleeding. With the progression of the disease, the tumor enlarges or spreads to neighboring organs, such as the vagina, bladder, rectum, etc., there will be vaginal discharge, urinary frequency, urgency, distension, abdominal pain and other symptoms, or there will be necrosis and shedding of tumor tissue, there will be rotten fleshy tissue shedding and discharging, and there may also be vaginal bleeding during the shedding process.
Q: What is the culprit that causes cervical cancer?
A: The main culprits of cervical cancer are HPV (human papillomavirus), and other related risk factors include smoking and multiple sexual partners. More than 90% of cervical cancers are associated with high-risk HPV infection. There are 14 subtypes of high-risk HPV, of which the most "bad" HPV is type 16 and 18, and 70% of cervical cancer is caused by these two viruses.
Q: How did I get infected with HPV?
A: HPV has a variety of transmission methods, mainly sexual transmission. Having sex too early, having multiple sexual partners, or having multiple sexual partners in a husband can greatly increase the chances of contracting HPV. Of course, daily necessities such as towels, underwear, toilets, and bed sheets used by HPV infected patients may also be infected. In addition, there is mother-to-child transmission.
Q: Is it necessary to get cervical cancer if I am infected with HPV?
A: 80% of women are infected with HPV at least once in their lifetime, just like a cervical cold. At present, there is no specific drug against HPV on the market, mainly relying on our own immunity to clear the virus. The probability of clearance within 2 years is 95%, high-risk HPV clearance generally takes 8 to 14 months, infection with high-risk HPV for more than 2 years we call it persistent infection, from persistent infection to precancerous lesions and the process of cancer takes years to decades, at this stage we need to be vigilant, regular cervical cancer screening, to achieve early detection, early diagnosis, early treatment, block the progression of cervical cancer. Therefore, infection with high-risk HPV does not equal cervical cancer, but a warning and signal to us.
Q: What should I do if I am infected with HPV?
A: Most women who are infected with HPV are anxious. In the face of women infected with HPV, we usually give comprehensive treatment. First of all, improving immunity is the main way to clear the virus, and a pleasant mood, adequate sleep, and proper exercise all help to improve immunity. Second, use condoms during intercourse to avoid repeated cross-infections. Furthermore, some antiviral drugs are used as adjunctive therapy.
Q: How can cervical cancer be prevented?
A: Cervical cancer is the only cancer with a clear cause and can be prevented, and the following four points need to be achieved.
Take care of yourself, practice safe sex, stay away from HPV; live a healthy life, be optimistic, improve immunity, and remove HPV in time; get HPV vaccine; and conduct regular cervical cancer screening. The age of screening is 21 years, TCT is done every three years between the ages of 21 and 29, and the combination of TCT + HPV is recommended for 30 to 63 years of age. It is important to note that HPV vaccination is not a substitute for cervical cancer screening and should be routinely screened in the same way as women who have not been vaccinated against HPV.
Q: After getting the HPV vaccine, can you rest easy?
A: No. At present, 14 subtypes of high-risk HPV viruses associated with cervical cancer have been found. At present, bivalent, quadrivalent, and nine-valent vaccines do not all cover the high-risk HPV subtypes currently found.
Q: Can I get pregnant with the HPV vaccine? Can I fight during breastfeeding?
A: Not recommended. Existing studies have not shown that hpv vaccine has an increased risk of fetal malformations, but vaccination during pregnancy is not recommended due to the lack of large-scale clinical data. If a pregnancy is discovered after vaccination, miscarriage is not recommended, and the unfinished vaccination is stopped and the pregnancy can be continued. Vaccination during breastfeeding is not recommended, and it is not recommended to be given after weaning.
Q: The sooner the HPV vaccine is given, the better?
A: Yes. The HPV vaccine is best protected for women with no history of sex, and after infection, the vaccine is not effective, and the preventive effect of the vaccine decreases as we age. Therefore, the sooner the HPV vaccine is given, the better. The World Health Organization has designated 9-14 years as the optimal age for vaccination.
Q: If the quadrivalent and nine-valent HPV vaccines are not available, can I inject the bivalent vaccine?
A: Nine-valent vaccines can prevent 90% of cervical cancer, quadrivalent and nine-valent vaccines can prevent 90% of genital warts, and bivalent and quadrivalent vaccines can prevent 70% of cervical cancer, so in case of about fourvalent and nine-valent vaccines, domestic bivalent vaccines are also the best choice.
Q: Is there an HPV vaccine for gynecological inflammation?
A: Depending on the condition, if it is chronic inflammation, such as cervical hypertrophy, cervical polyps, etc., it will not affect the injection of HPV vaccine. HPV vaccination during acute infection is not recommended, such as acute pelvic inflammatory disease, acute cervicitis, etc.
Source: Hubei Daily