Image: Huang Tsai | Written by: Six-story Demon Tower|Responsible Editor: Ruoying Original article, please do not reprint without permission
Although medicine is now very developed, to be honest, we are still powerless for many diseases, and it can even be said that we have not been able to study the causes of most diseases.
As you may have heard the medical saying, "Sometimes heals; Help often; Always comforting", we doctors are very limited in what we can help everyone.
Among many diseases, malignant tumors are undoubtedly a type of disease that will make everyone fearful, because, it is no exaggeration to say that once we suffer from malignant tumors, our lives are equivalent to opening the countdown, and what determines the length of this countdown is the level of tumor development at the time of our diagnosis, the degree of malignancy of the tumor and our response to the current existing treatment.
Therefore, imagine how heavy our heartache would be if our clinicians found a patient with an advanced malignant tumor, especially when this malignant tumor has the opportunity of "early diagnosis and early treatment".
However, in the common malignant tumors in women, there are such several tumors, due to the patient's lack of understanding of the disease, when the symptoms appear shy to check, and missed the best time for treatment, today we will talk about those diseases that may make you feel "ashamed", perhaps through today's popular science, can make you look at the disease correctly.
▲Image source: Baotu Network
breast cancer
Perhaps many friends have heard of women's "two cancer screening", but it is very likely that they do not know which two types of cancer "two cancer screening" refers to, the first of which is breast cancer.
Among all types of malignant tumors, the incidence of breast cancer ranks second, and in the ranking of overall malignant tumor mortality, breast cancer ranks fifth, from this ranking, it is not difficult to see that breast cancer greatly threatens women's life and health.
A recent survey study on the incidence and treatment of female breast cancer patients in Indonesia shows that in Indonesia, including many developing countries, due to the backwardness of medical standards and medical concepts, as well as the lack of medical education and resources, many breast cancer patients cannot be regularly screened for breast cancer, so they are often in the advanced stage of the tumor at the time of treatment, missing the best time for treatment.
Through interviews with different patients, it was found that many local women missed the best time for treatment, on the one hand, because of the fear of malignant tumors; On the other hand, when my body is abnormal, I feel ashamed, I feel as if I have an unseen disease, and I am worried that I will burden my family, so I refuse to see a doctor.
In addition, their embarrassment at breast examination, which targets the intimate parts of the body, and their refusal to treat, coupled with superstitions about some traditional local medical methods, all of these reasons have led to the tragedy of female breast cancer patients in Indonesia.
▲Image source: Baotu Network
In fact, breast cancer is a malignant tumor that can be diagnosed and treated early, so the most important thing is to regularly screen for breast cancer.
Screening age
1. General-risk women aged 45~69 years old are recommended for regular screening;
2. General-risk women aged 40~44 can be screened if possible;
3. High-risk women with a family history of early-onset breast cancer and carrying pathogenic genetic mutations of breast cancer should be screened earlier to 35 years old;
4. For other women at high risk of breast cancer, the starting age of screening can be advanced to 40 years old.
Screening methods
1. Mammography screening has been proven to be effective in reducing breast cancer mortality, so it is recommended as a priority;
2. If mammogram screening is negative for women with dense breasts, supplemental breast ultrasound screening is recommended;
3. In women who have never been screened for breast cancer, breast palpation may still improve breast cancer detection rates, so breast palpation can be used as an initial screening tool;
4. If there is a family history, breast MRI is recommended.
Screening interval
1. General-risk women, once every 2 years;
2. For high-risk women, it is recommended once a year.
Here I have to say a little more about breast palpation, presumably everyone should know the meaning of breast palpation, because breast surgery is developed from general surgery, so breast surgery doctors are mostly male.
Just like the obstetrician-gynecologist of Demon Tower, we male doctors are often rejected when examining the intimate parts of female patients, which Demon Tower understands everyone very well.
What Demon Tower wants to tell you is: if it is just a simple screening, you can choose X-rays and B-ultrasound, but if you are highly suspected of breast disease, please be sure to abandon the concept of gender, let the doctor perform a detailed physical examination, do not delay the condition because of shame to check, threatening life safety.
▲Image source: Baotu Network
Endometrial cancer
Demon Tower once saw a grandmother who had been menopausal for many years, and she came to the clinic because she began to have persistent vaginal bleeding after a few years of menopause.
This grandmother is a high-risk group of endometrial cancer, obese, and suffering from high blood pressure, diabetes, persistent vaginal bleeding after menopause, listening to this description, it can be said that more than 80% may be endometrial cancer.
The most consequence was that when she was first treated, the demon tower asked her, "Why did you come to see it after bleeding for so many years?"
She replied: "I didn't have any gynecological diseases when I was young, I was old, I was too clean after so many years of menopause, I was afraid that others would laugh at me."
Endometrial cancer is one of the three malignant tumors of the female reproductive system, according to statistics, the incidence of endometrial cancer in the mainland is 63.4/100,000, the mortality rate is 21.8/100,000, and with the economic development, the improvement of living standards, the incidence of female obesity, hypertension, diabetes increases, resulting in the incidence of endometrial cancer is also rising.
Therefore, early diagnosis and early treatment of endometrial cancer can also avoid many unnecessary tragedies.
In fact, compared with ovarian cancer, endometrial cancer sometimes sends us abnormal signals in the early stage of the disease, the most important is abnormal vaginal bleeding, and more refers to postmenopausal vaginal bleeding.
When we have already had abnormal symptoms, we will go to the examination, and it turns out that it is already a malignant tumor, which is far less suitable than routine screening for it.
Screening methods for endometrial cancer
Transvaginal ultrasound
For postmenopausal women, if the ultrasound endometrium thickness is ≤ 4mm, the chance of developing endometrial cancer is <1%.
Endometrial pathological examination
Obtaining a small amount of endometrial tissue by endometrial ring biopsy for pathological detection is an effective early diagnosis method, but because of its own defects (the content is too professional to be repeated), it is not widely used clinically.
Endometrial cytology
The screening method of endometrial cancer through endometrial cell collector combined with liquid-based cytology preparation technology (similar to reaching into the uterine cavity with a small straw and sucking up partially shed cells) is currently a screening method that is more widely used internationally, but it is also less used in mainland China because of various defects.
Therefore, the current screening methods in mainland China are more limited to the use of gynecological ultrasound to assess the endometrium, and may be assisted with diagnostic curettage or hysteroscopic surgery when necessary.
▲Image source: Baotu Network
Risk factors for endometrial cancer
Clinical studies have shown that endometrial cancer has obvious high-risk groups, as a general population, the risk of disease is very low, do not need to do routine screening, but if you have one or more of the following high-risk factors, then, you must pay attention to it and be responsible for yourself.
1. Obesity, BMI ≥ 30kg/m2;
2. Polycystic ovary syndrome;
3. No history of estrogen use antagonizing progesterone (such as some "three no" health products that claim to make you younger);
4. Age of menopause> 55 years;
5. Have not given birth;
6. Long-term use of tamoxifen;
7. ≥ 45 years old and with diabetes.
If endometrial cancer can be diagnosed early, through simple total hysterectomy, we can save our lives in time.
In fact, in addition to endometrial cancer may cause abnormal vaginal bleeding, uterine fibroids, endometrial polyps, endocrine disorders and other diseases can lead to abnormal bleeding, when we have such symptoms, we must actively seek medical attention, do not delay treatment because of shyness, embarrassment.
▲Image source: Baotu Network
Cervical cancer
The relevant science of HPV virus infection and cervical cancer has been repeatedly said many times before, and interested friends can review the previous articles (search keywords in the public account background number).
As we all know, the infection route of HPV virus is mainly sexual life and skin-to-skin contact, therefore, many people after discovering that they are infected with HPV virus, ignore the attention to viral infection and cervical lesions, but breed a lot of bad emotions, such as the fear of virus infection, the doubt of the transmission route, and some emotions are shame.
There are always people who think that HPV vaccine is only needed for women with very chaotic private lives, and this environment is bound to create some women to have a sense of shame about HPV virus infection, which may lead to patients having a fear of seeking medical treatment, even if they seek medical treatment, they feel that their disease symptoms are difficult to talk about, and then delay the disease.
I believe that for the screening methods of cervical cancer, everyone has some understanding, that is, HPV and TCT detection, but from everyone's background message, there are still many problems in the interpretation of these two test results, if you happen to have HPV and TCT test results in hand, you can refer to the following figure:
▲Click to view a larger image Image source: References[3]
Of course, this picture can not cover the specific situation of all female friends, we also need to combine clinical, such as the patient's age, clinical manifestations, personal wishes, social factors and other adjustments to different programs.
For this part of cervical cancer, there is not much to say, mainly because it has been popularized a lot before, but there are two topics that have to be verbose.
The first is "cervical erosion", if TCT and HPV are normal, then "cervical erosion" may only be physiological changes and do not need to be overtreated.
The second is "HPV infection", most HPV virus infections can heal themselves, relying on our own resistance and immunity, there is currently no specific drug. It may be more effective to exercise and use condoms throughout sex.
The above is all for today, the reason why I talk so much, mainly to tell you that the disease is not ashamed, especially when it may endanger our life safety, do a good job of self-screening of the disease, and actively seek medical attention when symptoms appear, so that we can have a healthier future.
Good morning, I love the world!
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