Guo Shifang (Director, Department of Integrated Traditional Chinese and Western Medicine, Chimei Medical Center) Early symptoms of cervical cancer pain: cancer cells oppress the nerves in the pelvic cavity, causing pain in the lower abdomen, lower back or thighs; If cancer invades the rectum, the early symptoms may be poor stool and swelling. If the bladder is compressed, the early symptoms may be frequent urination, urgency, dysuria and hematuria. * * * Irregular bleeding: It usually happens after a couple has sex or defecates. The initial amount of bleeding is small, and it can often stop by itself. * * * Increased secretion: mainly refers to increased leucorrhea, early symptoms have a special smell, and some patients may also suffer from vulvitis. Cervical cancer metastasis: Abdominal distension, anemia, emaciation and fever may occur at this time. The main cause of cervical cancer is viral infection, which is an important disease of female compatriots. Even Anita Mui, a famous Hong Kong star, died of cervical cancer. This is a pity, because as long as cervical smear is popularized and the ratio of carcinoma in situ and early cancer is increased, because the cure rate of carcinoma in situ and early cancer is close to 100%, the mortality rate of cervical cancer can be greatly reduced. According to the calculation of 1996, cervical cancer without carcinoma in situ ranks eighth among the top ten cancers in women, and it ranks second if it contains carcinoma in situ. 1996 There were 5252 newly diagnosed cases, including 3503 cases of carcinoma in situ. Thanks to the effect of promoting cervical smear, early diagnosis and treatment can be achieved, otherwise the consequences will be unimaginable. Figure ▼ Cervical smear examination is very important to prevent cervical cancer. The early symptoms of cervical cancer are not obvious, and smear examination is more important. Cervical cancer is mostly caused by human papillomavirus infection through sexual behavior. It is very common for women with sexual experience to be infected with human papillomavirus. According to the survey, the prevalence rate of human papillomavirus infection in general healthy women is about 9-20%, and it is estimated that women have a 50% chance of being infected with human papillomavirus in their lifetime. However, most women will recover after infection, and only a few persistent infected people will develop into cervical precancerous lesions, and even turn into cervical cancer in the future. Guo Shifang (Director, Department of Integrated Traditional Chinese and Western Medicine, Chimei Medical Center) Early symptoms of cervical cancer pain: cancer cells oppress the nerves in the pelvic cavity, causing pain in the lower abdomen, lower back or thighs; If cancer invades the rectum, the early symptoms may be poor stool and swelling. If the bladder is compressed, the early symptoms may be frequent urination, urgency, dysuria and hematuria. * * * Irregular bleeding: It usually happens after a couple has sex or defecates. The initial amount of bleeding is small, and it can often stop by itself. * * * Increased secretion: mainly refers to increased leucorrhea, early symptoms have a special smell, and some patients may also suffer from vulvitis. Cervical cancer metastasis: Abdominal distension, anemia, emaciation and fever may occur at this time. The main cause of cervical cancer is viral infection, which is an important disease of female compatriots. Even Anita Mui, a famous Hong Kong star, died of cervical cancer. This is a pity, because as long as cervical smear is popularized and the ratio of carcinoma in situ and early cancer is increased, because the cure rate of carcinoma in situ and early cancer is close to 100%, the mortality rate of cervical cancer can be greatly reduced. According to the calculation of 1996, cervical cancer without carcinoma in situ ranks eighth among the top ten cancers in women, and it ranks second if it contains carcinoma in situ. 1996 There were 5252 newly diagnosed cases, including 3503 cases of carcinoma in situ. Thanks to the effect of promoting cervical smear, early diagnosis and treatment can be achieved, otherwise the consequences will be unimaginable. Figure ▼ Cervical smear examination is very important to prevent cervical cancer. The early symptoms of cervical cancer are not obvious, and smear examination is more important. Cervical cancer is mostly caused by human papillomavirus infection through sexual behavior. It is very common for women with sexual experience to be infected with human papillomavirus. According to the survey, the prevalence rate of human papillomavirus infection in general healthy women is about 9-20%, and it is estimated that women have a 50% chance of being infected with human papillomavirus in their lifetime. However, most women will recover after infection, and only a few persistent infected people will develop into cervical precancerous lesions, and even turn into cervical cancer in the future. Cervical smear screening for early symptoms of cervical cancer is sometimes not obvious, so it is necessary to conduct smear screening regularly. However, if ordinary women have abnormal symptoms such as non-specific leucorrhea, abnormal bleeding or post-bleeding, they must seek medical attention quickly. At present, cervical smear is the basic method to screen cervical lesions. If you suspect that the smear is abnormal or the doctor highly suspects that it is the focus of cervical cancer, you can directly observe the cervix by visual inspection or * * * endoscope, and slice the suspicious focus. Generally speaking, slicing can get a more positive answer than smearing. If there is still doubt, obstetricians and gynecologists will use cervical conization for further diagnosis and treatment. SCC-Ag, the tumor index of cervical cancer, is the index of squamous cell carcinoma, while CA 125 and CEA are the index of glandular cell carcinoma, which can be used as pre-treatment evaluation. If the tumor index before treatment exceeds the normal value, it can also be used as a tracking tool to evaluate the therapeutic effect after treatment. Patients with positive biopsy diagnosis must undergo some tests to determine the staging, including chest X-ray, abdominal and pelvic computed tomography to confirm possible invasion of bladder and rectum, so as to evaluate treatment and operation. For some ambiguous cervical smear results, if the biopsy results are benign, we must follow them carefully and not be careless. Be sure to extend the follow-up time after several normal follow-ups. After all, the results of early and late treatment are very different. Cervical cancer belongs to the category of leukorrhagia, leakage and abdominal mass in traditional Chinese medicine. According to the concept of traditional Chinese medicine, the cause is the imbalance of qi and blood in zang-fu organs, the invasion of damp toxin, accumulation in the lower part and damage to the two meridians. It seems a little classical Chinese. To put it simply, qi and blood are not smooth, which causes the damage of Chong and Ren meridians and leads to the accumulation of tumors. Both Chong and Ren meridians originated from female uterus and are closely related to female diseases. Carotene and vitamin C for preventing cervical cancer can prevent virus infection. Nutrient supplementation is related to the prevention of human papillomavirus infection. It has been reported that taking more carotene and vitamin C can prevent virus infection, which may be related to its antioxidation and immune regulation. Carotene foods include carrots, orange fruits and vegetables, such as pumpkins, red sweet potatoes and citrus leaves. And dark green vegetables including rape, chrysanthemum, leek and cabbage. Figure ▼ Diet to prevent cervical cancer. Cervical Cancer Vaccine The recently popular cervical cancer vaccine, also known as human papillomavirus (HPV) vaccine, is an injection vaccine to prevent the most common high-risk HPV 16 and 18, and the most common low-risk HPV 6, 1 1. In principle, women aged 9 to 26 who have no sexual experience can get the greatest benefit of vaccine protection by vaccination against cervical cancer. It is suggested that they can be vaccinated with HPV vaccine, but it is not suitable for pregnant women or women with cervical cancer or precancerous stage. Figure ▼ It is recommended to take 3 doses of cervical cancer vaccine within 6 months, and it is estimated that the vaccine protection will be at least 5 years. It is suggested that three doses of cervical cancer vaccine be inoculated within half a year, and the cost of three doses is about 12000 yuan. Because the vaccine research only lasted for five years, it is estimated that the protective power of the vaccine can reach at least five years. At present, the long-term effect of vaccine is still being observed internationally. This article is excerpted from Guo Shifang: A Complete Book of Cancer Treatment/Guo Shifang (Director of Integrated Traditional Chinese and Western Medicine Department of Chimei Medical Center)/Morningstar Publishing Cervical Cancer Treatment. According to the National Cancer Institute, there are five main treatments for cervical cancer: surgery, placement therapy, chemotherapy, targeted therapy and immunotherapy. In addition, many treatments are in the clinical trial stage. The treatment method should be evaluated and suggested by professional doctors according to the size and location of the tumor. At the same time, no matter any treatment method, it is accompanied by side effects and risks. Therefore, it is recommended to discuss with the doctor in detail to understand the details of the operation and find the most promising treatment through doctor-patient cooperation. Surgical conization: A conical excision of the inner layer of the cervix and cervical canal. The pathologist will check whether the excised tissue contains cancer cells. This kind of surgery can be used for diagnosis or treatment, and the following different surgical methods can be selected according to the location and type of cancer cells: cold knife conization and circular electrosurgical resection, LEEP (laser surgery) total hysterectomy: surgery to remove uterus and cervix, including abdominal surgery, * * * or laparoscopic surgery. Radical hysterectomy: surgery to remove uterus, cervix, part of * * *, and surrounding ligaments and tissues; Ovaries, fallopian tubes and adjacent lymph nodes may also be removed. Modified radical hysterectomy: surgery to remove the uterus, cervix, upper uterus, and adjacent ligaments or tissues. According to the situation, adjacent lymph nodes can also be removed, and the resection range is smaller than radical hysterectomy. Radical hysterectomy: only the cervix, adjacent tissues and lymph nodes, as well as the upper part of * * *, are removed, and the ovaries and uterus are preserved. -Bilateral salpingoophorectomy and pelvic exenteration: In addition to the cervix, ovary and adjacent lymph nodes, the posterior segment of the intestine, rectum and bladder will also be removed. Patients need to place artificial stoma as an alternative channel for urine and feces discharge; Depending on the postoperative situation, plastic surgery and artificial * * * may also be performed. Radiotherapy uses high-energy x-rays or other radiation to kill cancer cells or inhibit their growth. Including two kinds: external radiotherapy: using machines outside the human body to transmit radiation to kill cancer cells. Some methods may protect the surrounding cells from radiation damage, such as intensity modulated radiation therapy (IMRT), which is a 3D radiation therapy. Computer simulates the picture of tumor size and shape, and uses different energy densities and thinner rays to treat tumors from multiple angles. Internal radiotherapy: radioactive substances are encapsulated in needles, particles, pipes or catheters, and then placed in or near tumors for treatment. Chemotherapy is to kill cancer cells with drugs or prevent cancer cells from dividing, thus inhibiting the growth or spread of cancer cells. Systemic chemotherapy: taking chemotherapy drugs orally or injecting drugs into blood vessels or muscles to make drugs enter the blood stream and reach cancer cells all over the body. Regional chemotherapy: drugs are directly put into cerebrospinal fluid, organs, abdominal cavity and other cavities. So that drugs can act on cancer cells in this area. Targeted therapy uses drugs or other substances to identify and attack specific cancer cells so that drugs will not harm normal healthy cells. Monoclonal antibody therapy: In the laboratory, the antibody is made of a single kind of immune cells, which can recognize and combine with substances on cancer cells or normal substances that help cancer cells grow, thus killing cancer cells and preventing cancer cells from growing or spreading. This drug will enter the human body by injection, and it may be used in combination with drugs, toxins or radioactive substances. The common drug is bevacizumab. Immunotherapy is to guide or reorganize the patient's immune system to fight cancer cells by using substances made by the patient's own body or laboratory. One of them is an "immune checkpoint inhibitor", which binds to protein on cancer cells, so the protein of cancer cells can't interact with T cells (an immune cell), so that T cells can kill cancer cells.