Chapter 1906 [1906] Each Has His Own Temper

Cervical cancer, like other cancers, once distant metastasis and systemic spread is equivalent to losing the chance of surgery. It is best found as carcinoma in situ. Carcinoma in situ of cervical cancer is when cancer cells only occur in the epithelial tissue of the cervix when it is discovered, which is called stage zero.

The probability of timely detection of carcinoma in situ is too low clinically. More often, when patients come to see a doctor, they go straight to the first phase, second phase, and third phase or above. Moreover, cervical cancer is prone to lymphatic metastasis in the early stage of development. Therefore, clinicians advocate that patients should regularly check for early detection of cancer cells.

When cancer cells are found, clinicians must deal with them correctly and scientifically, either by timely surgery or radiotherapy and chemotherapy for palliative treatment. There is certainly not one type of surgery.

Clinicians attach great importance to staging when dealing with cervical cancer as with other cancers. To be more specific, cancer cells in various organs have their own diffusion roadmaps, and they belong to cancers with their own tempers.

The path map of cervical cancer spread is not the path of spreading from the cervix to the uterus as most people imagine, but the path of "cause". So far, the staging of cervical cancer is closely related to whether the cancer cells have invaded the "cause" path. "Because" the path is anatomically close to the pelvis and adjacent to the bladder and rectum, clinically, cervical cancer will have pelvic metastasis at the end of the second stage, and results such as compression of bladder hydronephrosis and rectal tumors will appear in the third and fourth stages. Appear.

Now it is said that the metastases found in the rectum of the patient can only be stage four. A table of doctors was quite surprised after hearing what Dr. Zuo Liang said.

"Did the CT say that the patient had a tumor in the rectum?" Du Haiwei wanted to check the examination report with his own eyes.

When Wang Cui came to the hospital, she didn't look like a terminal cancer patient. She was not thin, slightly fat, and she had no dyscrasia at all. The doctor is practical, not saying that because Wang Cui is not a good person and does not talk about science, Wang Cui loves to go to the hospital for regular cervical smear screening.

Based on the comprehensive judgment, everyone thinks that some patients are admitted to the hospital for surgery.

If the operation is not possible, it will not be admitted to the surgery department but sent to the oncology department. After admission, the clinician's preliminary physical examination showed that the patient's condition may have been discovered in a timely manner, and it was in the first stage. Why did he suddenly say that it was transferred to the rectum.

Too special case?

Du Haiwei got the ct report, see the above, as Zuo Liang said, he wrote a report that there was a foreign body in the rectum, suspected to be metastatic cancer?

Clinicians certainly can't tell what is what because of CT, but should look at it in combination with the patient's clinical performance. We must know that some CT doctors are afraid of missing, and are willing to write all the possibilities and malignancies in the report to avoid the responsibility of missed diagnosis. Anyway, in the end, it is the clinician who checks it.

Zuo Liang went to get the CT scan and prepared to hang it on the light board for the tutor to check.

Du Haiwei said that there is no need for it, and asked other people present what they thought.

Knowing that the teacher wanted to test people, a group of practicing doctors asked two interns to answer the questions first without speaking.

Xie Wanying said: "You can consider doing a colonoscopy first. Colonoscopy is definitely clearer than CT. After taking the specimen, pathology is the gold standard for determining whether it is cancer."

The doctors here are not surprised to hear her excellent answers, they all know that she is a top student.

For top students, the teacher will further increase the difficulty. Du Haiwei asked her again: "How likely do you think it is metastatic cancer?"

"I think the probability is very small, it may just be a benign polyp. Her cervical tumor is small, and the rectal mass found is also small. She herself has no abnormal intestinal symptoms. However, preoperative colonoscopy is required, and it is good for the patient to rule it out Good for the doctor, too."