Novel Bin Chapter 1906: [1906] Each has its own temper
Timely detection of carcinoma in situ is too low clinically. More often, when patients come to see a doctor, they go straight to Phase I, Phase II, Phase III or more. Moreover, cervical cancer is prone to lymphatic metastasis in the early stage of development. Therefore, clinicians advocate that patients should be regularly checked for early detection of cancer cells.
Clinicians who find cancer cells should take correct and scientific treatment, either timely surgery or radiotherapy and chemotherapy for palliative treatment. Surgery is certainly not the only one.
Clinicians, like other cancers, place great importance on staging. To be more specific, cancer cells in each organ have their own roadmap for spreading and travel, and they belong to cancers with their own temperaments.
The path map of cervical cancer spread is not the path that spreads from the cervix to the uterus as most people imagine, but to the "cause". So far, the staging of cervical cancer is closely related to whether the cancer cells invade the "cause" tract. . The "because" tract is anatomically close to the pelvis and adjacent to the bladder and rectum, which leads to clinical cervical cancer with pelvic membrane metastasis at the end of the second stage, and results such as compression of bladder hydronephrosis and rectal tumor at the third and fourth stage. appear.
Now it is said that the patient\'s rectal metastases can only be found in stage four. After listening to Dr. Zuo Liang\'s words, the doctor at a table was quite surprised.
"Does CT say that the patient has a tumor in the rectum?" Du Haiwei wanted to check the examination report with his own eyes.
Wang Cui did not look like a terminal cancer patient when she came to the hospital. She was not thin, slightly fat, and had no symptoms of cachexia at all. The doctor is practical, and will not say that because Wang Cui is not good and does not speak science, Wang Cui loves to go to the hospital for cervical smear screening regularly.
Based on a comprehensive judgment, everyone believes that some patients are admitted to the hospital after surgery.
If it is an impossible operation, it will not be admitted to the surgery, but will be sent to the medical oncology department. The initial physical examination performed by the clinician after admission showed that the patient\'s condition may be detected in a timely manner.
Too special case?
Du Haiwei got the ct report. See above, as Zuo Liang said, he wrote a report that there is a foreign body in the rectum, suspected of metastatic cancer?
Clinicians must not look at what the CT says are based on the clinical performance of the patient. You must know that some ct doctors are afraid of omission, and are willing to write all possibilities and malignancies in the report to avoid the responsibility of missed diagnosis. Anyway, in the end, there are clinicians who check.
Zuo Liang went to get the CT film and prepared to hang it on the lamp board for the instructor to check.
Du Haiwei said no need for now, and asked other people present what they thought.
Knowing that the teacher wanted to test people, a group of practicing doctors did not speak and let the two interns answer the questions first.
Xie Wanying said: "You can consider doing a colonoscopy first. Colonoscopy is definitely clearer than CT. Pathology is done after taking specimens. Pathology is the gold standard for determining whether it is cancer."
The doctors present were not surprised to hear her excellent answer, they all knew that she was an honor student.
Dealing with 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 be just a benign polyp. Her cervical tumor is small, and the rectal tumor found is also small, and she herself has no intestinal abnormal symptoms. However, it is good for the patient to exclude the preoperative colonoscopy. Good for doctors."
(end of this chapter)