Cervical cancer

　　The main factors that trigger cervical cancer include genetic factors, cervical inflammation, inappropriate sexual life, and endometrial hyperplasia.

　　1. Genetic factorsWithout a doubt, any cancer has a certain genetic component, and endometrial cancer is no exception. According to clinical statistics, about 20% of endometrial cancer patients have a family history, and their family history is twice as high as that of cervical cancer.

　　2. Cervical inflammationIf there is long-term damage, skin breakage, erosion, and inflammation of the cervix, they may develop into early cervical cancer cells. Smoking increases the chance of developing cervical cancer, reduces the body's immunity, and accelerates the development of cervical cancer cells, and some substances produced by smoking itself may lead to the development of cervical cancer cells.

　　3. Inappropriate sexual lifeIt is found that women without sexual life usually almost do not develop cervical cancer, and the earlier inappropriate sexual life begins, the easier it is to develop cervical cancer later. In terms of sexual partners, if a woman has two or more male partners, the chance of developing cervical cancer is even more significantly increased.

　　4. Endometrial hyperplasiaEndometrial hyperplasia has a certain tendency to cancer, so it is listed as a precancerous lesion. Its hyperplasia is divided into simple type, complex type, and atypical hyperplasia. The development of simple hyperplasia into endometrial cancer is about 1%; complex hyperplasia is about 3%, and atypical hyperplasia developing into endometrial cancer is about 30%.

　　Uterine cancer combined with pregnancy is relatively rare. Patients may seek medical attention due to threatened abortion or prepartum hemorrhage. Vaginal smear and biopsy can determine the diagnosis. For early pregnant women with vaginal bleeding, routine cervical examination and cervical scraping cytological examination should be performed.

　　The influence of pregnancy on cervical cancer, during pregnancy, due to the increase in blood supply and lymphatic flow in the pelvic cavity, it may promote the metastasis of cancer; and during delivery, the spread of cancer may occur, leading to severe hemorrhage and postpartum infection. Due to the influence of estrogen, the activity of cervical transitional zone cells increases, which may be similar to in situ cancer lesions, but still has directional differentiation and polarity, and these changes can be restored after delivery. There may also be in situ cancer during pregnancy, which cannot be restored after delivery. It should be carefully distinguished.

　　The treatment method needs to be determined according to the development of the tumor and the number of months of pregnancy. For patients with stage I and IIa combined with early pregnancy, radical surgery can be used; or radiotherapy can be performed first, and radical surgery can be performed after the fetus dies and is naturally excreted, or radiotherapy can be continued. For early pregnant women, cesarean section can be performed to deliver the fetus, and radical surgery can be performed at the same time. For patients with cervical cancer in all stages combined with late pregnancy or in labor, cesarean section should be performed, followed by surgery or radiotherapy.

　　Patients with extremely early uterine cancer may not have obvious symptoms, and it may be discovered accidentally during general physical examination or gynecological examination for other reasons. Once symptoms appear, they are mostly manifested as:

　　1. Uterine bleedingIrregular vaginal bleeding before and after menopause is the main symptom of endometrial cancer, usually in small to moderate amounts, rarely in large amounts. It is often mistaken for menstrual irregularity in younger or perimenopausal patients, leading to a delay in seeking medical attention, even if the doctor is often negligent. Some patients may also have delayed menstrual cycles, but the pattern is irregular. In patients after menopause, it often presents as persistent or intermittent vaginal bleeding. Endometrial cancer patients generally do not have contact bleeding. In the late stage of bleeding, there may be necrotic tissue-like substances.

　　2. Vaginal dischargeBecause adenocarcinoma grows within the uterine cavity, the opportunity for infection is less than that of cervical cancer, so in the early stage, there may only be a small amount of bloody leukorrhea. However, with the occurrence of infection and necrosis, a large amount of malodorous purulent fluid may be discharged. Sometimes, the discharge may contain small fragments of cancer tissue. If the cervical canal becomes purulent, it can cause fever, abdominal pain, and an increase in white blood cells. The general condition also deteriorates rapidly.

　　3. PainDue to the accumulation of cancer mass and its hemorrhage and discharge, it stimulates irregular uterine contractions and causes paroxysmal pain, accounting for 10-46%. This symptom mostly occurs in the late stage. Pain can also be caused by the penetration of cancer tissue through the serous membrane or invasion of paracervical connective tissue, bladder, rectum, or compression of other tissues, often presenting as stubborn and progressively severe; and it often radiates from the lumbar sacral region, lower abdomen, to the thigh and knee.

　　The main measures for preventing uterine cancer are:

　　1. Keep clean: Keeping the external genitalia clean and dry is the most basic measure for women to prevent uterine fibroids. Good external genitalia cleaning can prevent pathogens from entering the uterus, causing uterine fibroids.

　　2. Active contraception: Artificial abortion can seriously damage the uterus and increase the chance of women developing uterine fibroids. Therefore, in life, good avoidance measures should be taken to reduce the number of abortions, because frequent abortions can bring certain harm to the uterine repair of patients, stimulate the normal repair of the uterus, and easily lead to the onset of uterine fibroids.

　　3. Reduce high-fat diet: Studies have shown that high-fat foods, after entering the human body, can promote the secretion of female estrogen, which has a certain stimulating effect on the uterus, stimulating the normal repair of the uterus, and causing uterine fibroids. Therefore, women should adhere to low-fat diet in life, drink more water, and avoid spicy and strong刺激性 foods.

　　4. Appropriate control of sexual life: Excessive sexual indulgence can bring hidden dangers to uterine health, especially unclean sexual life, which can allow pathogens to enter the uterine cavity through the vagina, leading to endometritis and causing uterine fibroids.

　　The examinations that need to be done for uterine cancer include cytological examination, iodine test, colposcopy examination, cervical cone biopsy, etc.

　　1. Cytological examination: For any suspicious cases, such as cervical contact bleeding or severe erosion that is not healing after long-term treatment, cervical scraping for tumor cells should be performed. If cancer cells or atypical nuclear cells are found, further cervical biopsy should be performed. During the uterine cancer screening, this method is often used for screening cervical biopsy.

　　2. Iodine test: Sampling in the non-stained area can improve accuracy. When sampling, it should include the junction of the cervical squamous and columnar epithelium, and it is best to perform four-point biopsies at 3, 6, 9, and 12 o'clock to prevent missed diagnosis.

　　3. Colposcopy examination: The colposcope can magnify the cervix by 16 to 40 times, which can allow for a more detailed observation of the changes in the cervical epithelium and can see the junction of the squamous and columnar epithelium. Under the guidance of the colposcope, biopsy can improve accuracy. When the junction of the squamous and columnar epithelium is not visible, cervical canal scraping should be performed, and the scraped material should be sent for pathological examination.

　　4. Cervical cone biopsy: The cervix should be cone-shaped resected. Before the operation, a colposcopy should be performed to determine the location of the lesion, and an iodine test can also be performed. The resected specimen should be subjected to continuous pathological sections to exclude invasive cancer.

　　Uterine cancer is one of the common malignant tumors in women. After the onset of uterine cancer, patients should supplement their own nutrition and some substances with anti-cancer effects or helpful for cancer prevention through diet to accelerate the recovery of the disease.

　　Patients should first consider supplementing beta-carotene. Beta-carotene is a commonly used nutritional supplement, which is a precursor for vitamin A synthesis in the body. Vitamin A has the function of promoting the synthesis of immunoglobulins, which can enhance human immunity. In recent years, it has been found that vitamin A acid substances have the effect of inhibiting tumor growth. In addition, foods with high vitamin A content include animal liver, eggs, etc., and foods rich in beta-carotene include spinach, rapeseed, pickled vegetables, lettuce leaves, and pumpkin, etc.

　　Secondly, attention should be paid to the intake of vitamin C. Since uterine cancer can be caused by viruses, and vitamin C can inhibit the damage caused by viruses to the uterus, and vitamin C has the effect of enhancing the body's immunity, it is necessary to supplement vitamin C to help the body recover. Foods rich in vitamin C include cauliflower, radish, potatoes, rapeseed, etc.

　　In addition, it is necessary to supplement trace elements zinc and arsenic, which play an important role in the production and function of immune cells, and experiments show that low levels of zinc and arsenic in the body can lead to weakened immune systems, and clinical evidence shows that cervical cancer is related to the deficiency of trace elements zinc and arsenic. Therefore, appropriate supplementation of zinc and arsenic should be made after onset. Foods high in zinc content include oysters, fish, lean meat, animal internal organs, pork kidneys, etc., while foods high in selenium content include edible mushrooms, seaweed, sesame, and others.

　　Western Medical Treatment for Uterine Cancer:

　　1. Atypical Hyperplasia: If the biopsy shows mild atypical hyperplasia, it is temporarily treated as inflammation, and follow-up with scraping and biopsy when necessary after half a year. For those with persistent unchanged lesions, continuous observation can be continued. For those diagnosed with moderate atypical hyperplasia, laser, cryotherapy, and electrocautery should be applied. For severe atypical hyperplasia, it is generally recommended to perform a total hysterectomy. If there is an urgent need for childbearing, regular close follow-up can also be arranged after conical resection.

　　2. In situ Cancer: Generally, it is recommended to perform a total hysterectomy while retaining both ovaries; there are also suggestions to remove 1-2 cm of the vagina at the same time. In recent years, laser therapy has been used abroad, but close follow-up is required after treatment.

　　3. Early Invasive Cancer Under Microscopy: Generally, it is recommended to perform an extended total hysterectomy and 1-2 cm of vaginal tissue. Since the possibility of lymph node metastasis in early invasive cancer under microscopy is extremely small, there is no need to remove pelvic lymphatic tissue.

　　4. Invasive Cancer: The treatment method should be based on the clinical stage, age, overall condition, and equipment conditions. Common treatment methods include radiotherapy, surgery, and chemotherapy. Generally speaking, radiotherapy can be applied to patients in all stages; the efficacy of surgery from stage Ia to Ia is similar to that of radiotherapy; cervical adenocarcinoma has slightly lower sensitivity to radiotherapy and should be treated with a combination of surgical resection and radiotherapy.