Content Sources:
1. Zhang Hongmei, & Li Na. (2018). Research progress on the pathogenesis and prevention of cervical cancer. International Journal of Gynecologic Diseases, 1(2), 45-49.
2. Chen Ping, & Zhou Ligong. (2019). Research progress on the relationship between human papillomavirus and cervical cancer. Chinese Journal of Gynecologic Oncology, 3(1), 22-26.
3. Min Wang, & Jing Zhang. (2020). Research progress on cervical cancer screening and prevention strategies. Chinese Journal of Modern Medicine, 30(4), 66-70.
Xu Jia, a 37-year-old Chaoshan girl, has been in great health since giving birth to her second child, especially on rainy days, and she can't straighten her waist with backache at every turn. In March 2017, Xu Jia returned from her parents' home with her child. After arriving home, he cleaned up the housework as soon as he got home, but after a while, Xu Jia was too tired to work.
When sitting on the sofa to rest, Xu Jia felt some itching in her intimate parts, and she couldn't make any moves in front of her family, so she could only endure it, and within two minutes, the symptoms disappeared. That night, Xu Jia was lying on the bed reading a book, with a warm current in her lower abdomen, she thought it was a menstrual visit, and hurriedly got up and went to the toilet.
After checking, it was found that the underwear was covered with wet white belt, the texture was like tofu residue, and there was no peculiar smell. After changing her underwear, Xu Jia went to bed early. Until midnight, I was disturbed by a bout of abdominal pain. At this time, there was also an indescribable burning pain in the lower body, and after scratching through the underwear, the situation was considered to have improved.
For two or three days in a row, similar symptoms recurred. Years of experience have told Xu Jia that this is just ordinary gynecological inflammation. After taking some anti-inflammatory drugs, the symptoms were relieved a lot. But the good times didn't last long, and a month later, Xu Jia once again had abnormalities such as redness, swelling and itching in her lower body.
On April 29, her husband came back from a business trip and wanted to have a good time with Xu Jiawen, but her lower body was sore and itchy at that time, so she naturally refused this request, but in her husband's view, it was a sign of betrayal. Helpless, Xu Jia had no choice but to agree. Halfway through, bright red blood stains appeared on the sheets.
"You're on period?" The husband asked nervously. But Xu Jia shook his head and said no. Seeing this, the husband continued to ask, "Then what's going on?" ”
Xu Jia looked at the pool of bright red blood, his eyes suddenly widened, and he asked tremblingly, "Yes, what's going on?" The couple quickly got dressed and went to the hospital. After communicating with the doctor, it was found that she was not a rupture of the corpus luteum, but contact bleeding.
On pelvic examination, the cervical lesions can be seen to be cauliflower-like, and the ultrasound shows hypoechogenicity of the posterior and right walls of the cervix, and MRI shows cervical mass. In order to confirm the diagnosis, Xu Jia underwent a pathological examination. One week later, the report showed that a raised mass was visible in the patient's cervical canal, about 3.0cm*2.8cm*1.5cm, with poorly differentiated squamous cell carcinoma of the cervix, and no cancer was found in the left and right parametrial tissues, bilateral appendages and vaginal wall.
Cervical cancer is a common cancer that threatens women's health, and its incidence is mostly related to HPV infection, which can be divided into stage I.B, II.A, II.B, III. and IV. according to the course of the disease, and the corresponding recurrence rates are 10%, 17%, 23%, 42% and 74%, respectively. The survival rate of cervical cancer patients within five years is about 10%, and most patients have entered the middle and advanced stages at the time of onset.
May 10th. Xu Jia was pushed into the operating room. After the surgery, she began chemotherapy as scheduled by her doctor. During the treatment, Xu Jia was regurgitated by chemotherapy drugs, her hair fell out a lot, her nails were black, and her appetite was lost.
After being discharged from the hospital, Xu Jia changed her habits. In order to help recover, she specially invited her mother-in-law to help take care of the children, and the burden on the family and outside the home was suddenly reduced a lot.
In May 2018, the time for the first year of review arrived. Xu Jia did all the inspections with apprehension. After reading the examination report, the doctor was full of joy and said, "Congratulations, you are recovering well, continue to keep it up." These words gave Xu Jia great encouragement, and her steps were much blower when she left the hospital.
Soon, the time came to the second year. Once out, Xu Jia accidentally contracted a cold. After returning home, I had a high fever that did not go away, and my body temperature fluctuated for several days, especially at night, when the temperature once approached 39 degrees. In addition to fever, Xu Jia always coughs non-stop, sometimes coughing up yellow thick phlegm.
After taking cold medicine for a few days, Xu Jia's symptoms still did not improve. So she went to a nearby community hospital and had a few days of fluids, and then she slowly got better. In less than a week, Xu Jia had a cough again. It resolves spontaneously most of the time, usually at night. She thinks it takes time to recover from the disease, and she doesn't take the cough seriously.
As time passed, Xu Jia observed that coughing was accompanied by chest tightness, as if someone had choked her throat, and she couldn't breathe at all.
Seeing that it was already April, less than a month before the second year's re-examination, she thought that the symptoms were not serious, so she simply waited until the re-examination to make plans. In late April, Xu Jia was tidying up at home, and suddenly there was another violent cough, she quickly covered her mouth and nose with a tissue, and when she looked closely, there was red bloodshot!
On the day of the re-examination, Xu Jia mentioned the frequent cough in the early stage, which lasted for about a month and a half. When the doctor heard this, he couldn't sit still and asked, "Why did you come to the hospital?" As soon as she heard this, Xu Jia knew that her condition was not simple.
The doctor asked her to take a chest X-ray, and sure enough, the patient had a solid nodule of about 2cm in the right lung, which had not appeared a year ago. In order to confirm the diagnosis, Xu Jia did chest CT and lung puncture with contrast, and confirmed that it was cervical cancer and lung metastasis.
"Wasn't it all good to review before, how could there be a transfer? And it was transferred to the lungs that couldn't be hit by the cervix. Xu Jia asked incredulously.
In the face of Xu Jia's question, the doctor patiently explained that this is a manifestation of distant metastasis, although it is rare, there are still many patients with similar symptoms. Rao is like this, but the question in Xu Jia's heart has not been answered, where does the transfer begin?
These words made the doctor have to ponder for a long time, and with questions, he reviewed Xu Jia's onset process, trying to find some clues. At this moment, Xu Jia's words reminded him. Suddenly realized, patted his thigh and said: "Lung metastasis did not find you for no reason, everything is because of your ignorance, you made this fatal mistake!" ”
Smoking has been hailed as a contributing factor to a variety of diseases, especially in the formation and progression of cancer. For cervical cancer patients, smoking not only increases the likelihood of developing the disease, but also greatly increases the risk of lung metastasis after surgery.
Smoking can cause a systemic inflammatory response, increase the production of free radicals in the body, lead to DNA damage, and inhibit DNA repair mechanisms, thereby promoting the formation and accumulation of cancer cells. These destructive processes are also applicable in cervical cancer patients, making the original tumor more susceptible to genetic mutations and increasing the likelihood of malignant metastasis.
Second, nicotine and other harmful compounds in tobacco promote angiogenesis, which is one of the key factors in tumor growth and metastasis. By adding new blood vessels, cervical cancer cells are able to receive more nutrients and oxygen, enhancing their ability to survive and spread. More importantly, the newly formed vascular system provides a pathway for tumor cells to enter the blood circulation, increasing the likelihood of cervical cancer metastasizing to distant organs such as the lungs.
In addition, smoking can also affect the immune system of cervical cancer patients and reduce the body's ability to defend against cancer cells. Tobacco smoke contains a variety of harmful substances that can inhibit the activity of immune cells and reduce their ability to recognize and eliminate tumor cells. This means that smoking not only helps cervical cancer cells grow and multiply, but also clears the way for them to metastasize to areas such as the lungs.
In addition, studies have shown that long-term smoking may further exacerbate the progression of cervical cancer by affecting patients' hormone levels, while promoting the metastasis of pre-existing tumor cells to distant organs such as the lungs. Because tobacco smoke contains chemicals that can mimic or interfere with hormone signals in the body, this may exacerbate the condition of cervical cancer patients and increase the risk of lung metastases after surgery.
In summary, smoking exacerbates the risk of lung metastasis after cervical cancer surgery through a variety of mechanisms, including but not limited to promoting inflammatory responses, DNA damage, angiogenesis, immunosuppression, and abnormal hormone levels. Therefore, for cervical cancer patients, smoking cessation is one of the important measures to reduce the risk of lung metastasis after surgery.