Gynecological tumors

　　The etiology of gynecological tumors is still unclear. Epidemiological data research suggests that it is related to the following factors.

　　1. Chronic irritation:Primary vaginal squamous cell carcinoma often occurs in the posterior fornix, and it is believed that this may be related to the long-term use of pessaries by patients with uterine prolapse, vaginal leukoplakia, or local inflammation.

　　2. Pelvic radiotherapy:About 20% of patients with primary vaginal cancer have a history of pelvic radiotherapy. It is generally believed that vaginal dysplasia or vaginal cancer can occur 10 to 40 years after cervical cancer radiotherapy. The incidence of vaginal cancer is higher in women under 40 years old who have undergone pelvic radiotherapy.

　　3. Viral infection:Human papillomavirus, especially types 16 and 18, may be considered as the initiating factor of vaginal malignant tumors.

　　4. Immunosuppression:Patients with congenital or acquired and artificial immunosuppression have a higher incidence of cancer. Vaginal cancer is no exception, and its incidence is higher in immunosuppressed patients.

　　5. Estrogen deficiency:Squamous cell carcinoma of the vagina is more common in elderly women, which may be related to low estrogen levels after menopause, leading to atrophy of the vaginal mucosal epithelium, creating favorable conditions for carcinogens.

　　6. Recently, it is believed that clear cell adenocarcinoma of the vagina is related to endogenous and exogenous estrogen.

　　7. It is speculated that the vaginal endodermal sinus tumor may be caused by the lack of embryonic tissue conductor during the decisive period of germ cell migration, resulting in the misplacement of germ cells into the upper segment of the vagina.

　　Vaginal cancer can lead to the spread of tumors to the skin of the reproductive tract. Due to the special anatomical relationship of the vagina (loose connective tissue, thin walls, rich in lymph), cancer tumors are more likely to spread. The main pathways of spread are direct extension, lymphatic metastasis, and occasionally distant metastasis. The lymphatic metastasis pathways of vaginal upper segment cancer are basically the same as those of cervical cancer; the lower 1/3 is basically the same as that of vulvar cancer; the middle 1/3 can be transferred through both upper and lower pathways, from the vaginal lower lesion through the inguinal lymph nodes; from the vaginal upper lesion through the pelvic lymph nodes; or hematogenous metastasis. Vaginal cancer can directly extend and spread to local para-vaginal tissues, bladder, or rectum.

　　Skin metastatic cancer from the ovary, endometrium, and cervix usually presents as one or more skin-colored nodules, occurring on normal skin or scar tissue from incisions. Occasionally, ovarian metastatic cancer may appear in a scarlet fever-like appearance. Skin metastatic prostate cancer usually presents as flesh-colored or purple nodules. In some cases, metastatic skin cancer may resemble impetigo or appear in a herpes zoster-like pattern due to growth along the nerve sheath.

　　Precursors of reproductive tract tumors

　　1. Appearance of abnormal tumors

　　They can grow at any part of the reproductive organs. External genital tumors, certain ovarian tumors, and larger uterine tumors can be felt by the patient themselves, usually discovered accidentally by the individual. The consistency of these tumors can be hard or soft, with varying degrees of mobility, and the shape is mostly round or irregular, with varying growth rates. Even if these tumors have no symptoms, they are an abnormal phenomenon, and they are mostly due to tumors.

　　2. Abnormal vaginal discharge

　　Under normal circumstances, the secretions of the endometrium, cervical mucosa, and vaginal discharge form leukorrhea, which is generally not excessive and changes with the menstrual cycle. When tumors occur in the female reproductive tract, the necrosis and ulceration of the tumor can cause leukorrhea in a watery, bloody, or rice gruel-like consistency. If there is concurrent infection, there may be an odor. Abnormal leukorrhea may be a manifestation of cervical cancer, endometrial cancer, or fallopian tube cancer.

　　3. Changes in menstruation

　　The cyclic shedding of the endometrium forms the menstrual period. Normally, the menstrual cycle is regular, and the amount of bleeding is moderate.

　　When tumors such as uterine fibroids, endometrial cancer, uterine sarcoma, and choriocarcinoma grow in the uterus, abnormal menstrual symptoms may occur, including excessive menstrual bleeding, irregular menstrual cycles, prolonged menstrual duration, and continuous bleeding. Certain ovarian tumors such as granulosa cell tumors and theca cell tumors can secrete estrogen, interfere with the menstrual cycle, and also cause abnormal menstrual symptoms.

　　4. Postmenopausal bleeding

　　With the aging process, generally around the age of 50, menopause may occur due to the decline in endocrine function. In the first year of menopause, vaginal bleeding may occur occasionally. If there is vaginal bleeding after one year of menopause, it is called postmenopausal bleeding. The causes of postmenopausal bleeding are many, and in most cases, they are caused by benign diseases, but the possibility of cervical cancer and endometrial cancer cannot be ignored.

　　5. Abdominal pain

　　Ovarian torsion, rupture, or infection, uterine fibroids prolapsing through the cervix, or fibroid degeneration can all cause severe lower abdominal pain. The presence of significant abdominal pain in malignant tumors usually indicates advanced stages.

　　6. Changes in urination and defecation

　　The initial manifestations of ovarian cancer may only be gastrointestinal symptoms. When the tumor compresses or invades the bladder or rectum, it can cause frequent urination, difficulty in urination, constipation, and other symptoms.

　　When the above symptoms occur, patients should seek medical attention in a timely manner and should not relax their vigilance because the symptoms are mild and bearable, and delay treatment. Of course, the occurrence of the above symptoms does not necessarily mean that you have malignant tumors. You do not need to be overly anxious. What you need to do is to receive timely diagnosis and treatment.

　　1. Risk signals

　　1. Appearance of abnormal tumors:They can grow at any part of the reproductive organs. External genital tumors, certain ovarian tumors, and larger uterine tumors can be felt by the patient themselves, usually discovered accidentally by the individual. The consistency of these tumors can be hard or soft, with varying degrees of mobility, and the shape is mostly round or irregular, with varying growth rates. Even if these tumors have no symptoms, they are an abnormal phenomenon, and they are mostly due to tumors.

　　2. Abnormal vaginal discharge:Under normal circumstances, the secretions of the endometrium, cervical mucosa, and vaginal discharge form leukorrhea, which is generally not excessive and changes with the menstrual cycle. When tumors occur in the female reproductive tract, the necrosis and ulceration of the tumor can cause leukorrhea in a watery, bloody, or rice gruel-like consistency. If there is concurrent infection, there may be an odor. Abnormal leukorrhea may be a manifestation of cervical cancer, endometrial cancer, or fallopian tube cancer.

　　3. Changes in menstruation:The cyclic shedding of the endometrium forms the menstrual period. Normally, the menstrual cycle is regular, and the amount of bleeding is moderate.

　　When tumors such as uterine fibroids, endometrial cancer, uterine sarcoma, and choriocarcinoma grow in the uterus, abnormal menstrual symptoms may occur, including excessive menstrual bleeding, irregular menstrual cycles, prolonged menstrual duration, and continuous bleeding. Certain ovarian tumors such as granulosa cell tumors and theca cell tumors can secrete estrogen, interfere with the menstrual cycle, and also cause abnormal menstrual symptoms.

　　4. Postmenopausal bleeding:With the aging process, generally around the age of 50, menopause may occur due to the decline in endocrine function. In the first year of menopause, vaginal bleeding may occur occasionally. If there is vaginal bleeding after one year of menopause, it is called postmenopausal bleeding. The causes of postmenopausal bleeding are many, and in most cases, they are caused by benign diseases, but the possibility of cervical cancer and endometrial cancer cannot be ignored.

　　5. Abdominal pain:Ovarian torsion, rupture, or infection, uterine fibroids prolapsing through the cervix, or fibroid degeneration can all cause severe lower abdominal pain. The presence of significant abdominal pain in malignant tumors usually indicates advanced stages.

　　6. Changes in urination and defecation:The initial manifestations of ovarian cancer may only be gastrointestinal symptoms. When the tumor compresses or invades the bladder or rectum, it can cause frequent urination, difficulty in urination, constipation, and other symptoms.

　　When the above symptoms occur, patients should seek medical attention in a timely manner and should not relax their vigilance because the symptoms are mild and bearable, and delay treatment. Of course, the occurrence of the above symptoms does not necessarily mean that you have malignant tumors. You do not need to be overly anxious. What you need to do is to receive timely diagnosis and treatment.

　　Second, prognosis

　　Multiple skin metastases through blood vessels or lymphatic vessels, indicating that the course of the disease has reached the late stage, with a survival period of 3 to 12 months.

　　1. Histopathology

　　Metastatic ovarian tumors are usually moderately to well-differentiated adenocarcinomas, often accompanied by papillary appearance and sand tumor bodies, the latter being small lamellar calcified globules. Metastatic endometrial cancer appears as adenocarcinoma, showing solid glandular structures. Skin metastases from the cervix are usually poorly differentiated squamous cell carcinomas. Choriocarcinoma is composed of cytotrophoblasts (large cuboidal cells with vacuolated nuclei and pale-staining cytoplasm) and syncytiotrophoblasts (large cells with irregular nuclei and alkaline cytoplasm). Clusters of cytotrophoblasts are surrounded by sheet-like and cord-like syncytiotrophoblasts, forming a tuft-like appearance similar to villi. Metastatic prostate skin cancer is usually poorly differentiated clusters and cords of adenocarcinoma cells (rarely forming glands) infiltrating in collagen fiber bundles, and with obvious epithelogenesis.

　　2. Special staining and immunohistochemistry

　　Ovarian adenocarcinoma with positive carcinoembryonic antigen (CEA), but negative for giant cystic disease fluid protein (GCDFP-15), which helps distinguish from breast cancer. Choriocarcinoma associated with high levels of circulating chorionic gonadotropin can be detected in urine. Metastatic prostate cancer with positive prostate-specific antigen and prostate acid phosphatase.

　　First, dietetic recipes for reproductive tract tumors

　　1. Ginseng and Astragalus Invigorating Soup:Selection and proportion: ginseng, astragalus, codonopsis, yam, goji, angelica, dried tangerine peel, longan meat, pork rib or whole chicken, clean water in appropriate amount. Preparation method: clean the traditional Chinese medicine such as ginseng and astragalus, put them in a cloth bag, tie the mouth, and cook with ribs or chicken together with water. Boil first with high heat and then with low heat for 2-3 hours. Remove the cloth bag, add salt, pepper and other seasonings, and it can be eaten with meat and soup. The extra can be stored in the refrigerator. Effect: It has the effects of promoting the flow of qi, dissipating nodules, and dissipating blood stasis;

　　2. Chenxiang beef:Selection and proportion: dried tangerine peel, cyperus rotundus, beef, scallion, ginger, salt in appropriate amount. Preparation method: boil dried tangerine peel and cyperus rotundus in water for half an hour and remove the dregs, then add beef, scallion, ginger, salt and other seasonings, and simmer over low heat until tender, cool and slice to eat. Effect: Soothe the liver and regulate the qi, invigorate the spleen and benefit the qi. The dried tangerine peel in the recipe has the effect of regulating the qi and invigorating the spleen.

　　Second, what is good for the body when eating reproductive tract tumors

　　1. Suitable animal food:Lean pork, beef, mutton, chicken, duck, pigeon meat, etc., yellow croaker, mackerel, eggs; Seaweed: jellyfish, kelp, laver, sea cucumber, seaweed; Bean products: various soybean products, such as soy milk, tofu, vegetarian chicken, etc.; Vegetables: fresh deep green and yellow, orange vegetables, eggplant; Fruits: fresh fruits, nuts such as: jujube, longan, walnuts, etc.; Cereals: various cereals and their products.

　　2. Eat foods containing enough starch and fiber:It is recommended to eat more fruits, vegetables, dried beans, whole grain foods, beans, and their products.

　　Third, it is best not to eat the following foods for reproductive tract tumors

　　1. Do not eat too much salty and spicy food:Do not eat overheated, cold, expired, and deteriorated food; for the elderly, the weak, or those with a hereditary genetic disease, eat some anticancer foods and alkaline foods with high alkalinity in moderation to maintain a good mental state.

　　2. Do not eat contaminated food:Such as polluted water, crops, poultry, fish eggs, moldy food, etc., eat some green organic food, and prevent diseases from entering through the mouth. Tumors are new tissues formed when cells in local tissues lose control of their growth at the genetic level under the action of various tumor-causing factors, leading to monoclonal abnormal proliferation. This kind of new tissue often forms local masses, hence the name.

　　3. Animal food that should not be eaten:Animal food to be eaten less by tumor patients: fatty livestock and poultry, salted meat, fish. Smoked products - sausages, red sausages; beans: dried beans; vegetable food: fresh pickled vegetables, unripe vegetables; fruits: canned fruits or fruit-flavored drinks.

　　Prevention:The female reproductive organs from the vulva to the fallopian tubes and ovaries, the most common are cervical cancer, endometrial cancer, uterine fibroids, corpus uteri cancer, ovarian tumors, choriocarcinoma, and vulvar cancer. Most patients have early symptoms, and everyone should pay more attention to their own physical changes. The best way to detect gynecological tumors is to have a routine gynecological examination at the hospital every year and to undergo cytological and pathological examinations according to medical advice. Because early detection and early diagnosis are very important for the cure of tumors and the extension of life.