~ how to judge the middle and early stages of cancer?

How to judge the middle and early stages of cancer

It depends on the pathological situation, whether the tumor has infiltrated, reached the mucosa or muscle layer, and whether there is distant metastasis. There are special criteria for judging the staging of each cancer, including clinical and pathological criteria. Generally, the pathology shall prevail, and general professional doctors shall determine the staging according to the international TNM staging (T refers to tumor size, N refers to lymph node status, and M refers to whether there is organ metastasis).

Tell me the general situation.

Ten Early Signs of Common Cancer

(1) Hard choking, retrosternal pain, tightness and discomfort, esophageal foreign body sensation or epigastric pain when swallowing food are the first signs of esophageal cancer.

(2) Upper abdominal pain. It's always good at ordinary times, and I gradually find that my stomach (equivalent to the upper abdomen) is uncomfortable or painful, which can't be alleviated by taking analgesic and antacid drugs, and it's not good to continue digestion. At this time, we should be alert to the occurrence of gastric cancer.

(3) Irritating cough, persistent cough or blood in sputum. Lung cancer mostly grows on the bronchial wall. Because of the growth of cancer cells, it destroys the normal tissue structure, strongly stimulates the bronchus and causes cough. Antibiotics and cough medicine can't relieve it well, and it gets worse gradually, with occasional bloody sputum and chest pain. This cough is usually considered as an early sign of lung cancer.

(4) Breast lump. Normal female breasts are soft in texture. If you feel a lump and you are over 40 years old, you should consider the possibility of breast cancer.

(5) Abnormal vaginal bleeding. Normal women menstruate once a month and usually have no vaginal bleeding. If you bleed after sexual intercourse, it may be a signal of cervical cancer. The amount of bleeding after sexual intercourse is generally very small. If we can pay attention to it, it is possible to find early cervical cancer.

(6) nosebleeds. Nosebleeds are mainly characterized by a small amount of bloodshot in the nose, especially in the morning, which is often an important signal of nasopharyngeal carcinoma. In addition to bloody nose, nasopharyngeal carcinoma often has nasal congestion, which is caused by the oppression of nasopharyngeal carcinoma. If cancer compresses the eustachian tube, tinnitus will appear. Therefore, nosebleeds, nasal congestion, tinnitus and headache, especially unilateral migraine, are all dangerous signals of nasopharyngeal carcinoma.

(7) Abdominal pain, falling from the building and bloody stool. Anyone over 30 years old who has abdominal discomfort, dull pain, abdominal distension, changes in stool habits, feeling of falling and bloody stool, and then anemia, fatigue and abdominal mass should be considered. Among them, localized and intermittent dull pain along the colon is the first warning signal of colorectal cancer. The feeling of falling is obviously accompanied by bloody stool, which is often a signal of rectal cancer.

(8) Pain under the right rib. Pain under the right rib is often called liver pain, which is common in hepatitis, cholecystitis, liver cirrhosis, liver cancer and so on. The incidence of liver cancer is hidden and develops rapidly, and some patients are diagnosed with liver cancer after several months of right rib pain. Therefore, the pain under the right rib should be a signal to see liver cancer.

(9) Headache and vomiting. Headaches often occur in the morning or at night, and are often manifested in the front of the forehead, the back pillow and both sides. Vomiting has nothing to do with eating, and often appears with the aggravation of headache. Headache and vomiting are common clinical symptoms of brain tumors and should be regarded as dangerous signals of intracranial tumors.

(10) Long-term fever of unknown cause. Cancer of hematopoietic system, such as malignant lymphoma and leukemia, often has fever. The clinical manifestation of malignant lymphoma is painless progressive lymphadenopathy. At the same time of lymph node enlargement, patients may have symptoms such as fever, emaciation and anemia. Therefore, unexplained long-term fever should be suspected as a signal of malignant tumor in hematopoietic system.

If it's more serious, it's the middle stage.

Twenty early symptoms of cancer

First of all, unexplained emaciation, weakness and irregular pain in the upper abdomen. Loss of appetite, especially anorexia meat food.

Second, non-pregnant women and lactating women have pus on their nipples or can express juice.

Third, any part of the body, such as the breast, neck or abdomen, has a gradually increasing mass.

Fourth, dry cough, bloody sputum, chest tightness, chest carbuncle, which can not be cured for a long time.

5. Women over middle age have a small amount of vaginal bleeding after having sex with friends, or irregular vaginal bleeding at ordinary times, or menstruating again after menopause for several years. Leucorrhea increased significantly.

Six, not accompanied by jaundice and upper abdominal mass with abdominal pain gradually deepening.

Seven, hepatomegaly is brisk, and the well is accompanied by pain in the liver area.

Eight, unexplained painless hematuria.

Nine, skin ulceration can not heal for a long time.

Ten, the mole suddenly increases, accompanied by itching, ulceration, bleeding pain or hair loss on the mole.

Eleven, repeated fever and intractable tooth bleeding, subcutaneous bleeding and progressive anemia.

12. Recurrent unexplained high fever.

Thirteen, oral mucosa, or female vulva or male penis glans appear white spots, and rapidly expand and burning itching discomfort.

Fourteen, progressive weakness of both lower limbs, abnormal sensation. Dyskinesia or sometimes incontinence.

15. There is no obvious fracture of femur and humerus caused by external force.

Sixteen, when eating and swallowing, there is a sense of foreign body infarction, tingling or conscious food passing slowly.

Seventeen, nasal congestion, often a small amount of bleeding or nosebleeds, accompanied by migraine. Dizziness and tinnitus, swollen lymph nodes below the upper neck earlobe.

Eighteen, stool habits change. Or diarrhea and constipation often alternate. Or the stool often carries pus and blood, or the stool becomes thin and flat.

19. Headache is getting worse gradually, accompanied by sudden short-term visual impairment and vomiting.

Twenty, teenagers elbow or knee pain, swelling. Antirheumatic drugs or antibiotics are ineffective.

Common symptoms of patients with advanced cancer

(1) Infection: After receiving various treatments, the body's defense function is damaged to some extent, especially after radiotherapy and chemotherapy, it is easy to be infected by pathogenic bacteria and lead to death. Therefore, the prevention and treatment of infection is very important for advanced patients.

Antibiotics are usually used to control infection. Before bacterial culture and drug sensitivity test, carbenicillin and gentamicin are often used to treat bacterial infections. Amphotericin B is the most commonly used drug to treat fungi. For patients with advanced cancer, antibiotics are mainly used to relieve pain and improve the quality of life. Treating urinary tract infection can get rid of the troubles of frequent urination, urgency and pain. Treating bronchitis and pneumonia can reduce cough and respiratory secretions and relieve dyspnea.

(2) Gastrointestinal symptoms

Nausea and vomiting: it is a common symptom of patients with advanced cancer, and it is often more distressing than cancer pain. Nausea and vomiting may be side effects of treatment; It may also be caused by cancer invading the digestive or nervous system; It may also be psychological effects such as anxiety. General patients should be treated according to different reasons.

Loss of appetite: It may be related to general malaise or depression, nervousness and anxiety, gastrointestinal candidiasis and constipation, or it may be caused by the tumor itself. Patients lack interest in food, and even the mention of food makes them sick. Family members and medical staff should help patients find ways to stimulate their appetite, such as paying attention to the color, aroma, taste and shape of food, eating a small amount of food, drinking a small amount of aperitif or drink before meals, and being accompanied by others. The most effective drug is corticosteroid.

Constipation: it is a common side effect of morphine painkillers: decreased activity, too little food and too little fiber in patients with advanced cancer are also the reasons for constipation; Mental stress will aggravate constipation. The treatment is to eat more fruits and vegetables rich in cellulose, and more importantly, to prevent constipation. While using morphine painkillers, laxatives should be used. Commonly used laxatives, stool softeners and drugs that stimulate intestinal peristalsis are: senna leaf, magnesium hydroxide, liquid paraffin, magnesium sulfate and fructose lactate. The dose is gradually increased; When the patient's rectum is full of feces and the laxative is ineffective, the feces can be pulled out by using a plug, enema or fingers.

Diarrhea: Dysabsorption caused by chemotherapy, lower abdominal radiotherapy or intestinal surgery can all cause diarrhea. Bacterial infection, difficulty in fat absorption, allergy to special foods and psychological factors may all be the causes of diarrhea. Mild diarrhea can be relieved by diet adjustment; Long-term diarrhea can be treated with secret medicine or other intestinal sedatives; For patients with diarrhea caused by rectal cancer, colostomy or radiotherapy or laser treatment is feasible; For severe cases, an anesthetic compound containing morphine can be used for treatment; Patients with chronic diarrhea need nutrition and potassium supplements.

Hiccup: It is often caused by the diaphragm stimulated by tumors in the stomach, lower esophagus or liver. Inhalation of carbon dioxide can temporarily control symptoms; Chlorpromazine, diazepam and metoclopramide can relieve symptoms; Corticosteroids can help reduce the pressure on the diaphragm, and furosemide is sometimes effective. Phrenic neurotomy is feasible for intractable hiccups.

(3) Respiratory symptoms

Dyspnea: it is one of the symptoms that are difficult to treat in patients with advanced cancer, and should be treated according to different reasons: for example, bronchodilators can treat dyspnea caused by bronchospasm; Sensitive antibiotics can be used for dyspnea caused by lung infection; Dyspnea caused by heart failure can be controlled by diuretics to prevent pulmonary edema. Can dyspnea caused by superior vena cava obstruction be treated with dexamethasone 12 every day? /FONT & gt； 16 mg, and emergency radiotherapy. Instructing patients to maintain normal breathing exercise is more important than any treatment. Severe dyspnea easily leads to fear, and fear itself aggravates dyspnea. Patients should be allowed to express their fears and be given appropriate counseling and sedative drugs. 、

Some patients have difficulty breathing due to extensive lung invasion, secondary metastasis or cancerous lymphangitis. At this time, the main cause of dyspnea is excessive breathing exercise, not the change of blood gas level. Therefore, oxygen inhalation can not improve symptoms, but will aggravate anxiety. Small doses of morphine preparation, such as morphine solution, should be injected every hour. /FONT & gt； 5 mg or morphine sulfate tablets 10 mg once, twice a day, to reduce the sensitivity of the center to abnormal blood gas levels, reduce unnecessary breathing movements, and also relieve anxiety. Sometimes giving small doses of phenothiazine or steroid drugs is also effective.

Respiratory difficulties caused by pulmonary sclerosis (such as lymphatic metastasis) can be given 0.25%? /FONT & gt； 0.5% sibbecaine solution atomization inhalation is effective and can improve ventilation function. An electric atomizer is usually used to promote the deposition of liquid drugs in alveoli. It should also provide a quiet environment for patients, and keeping sitting or semi-lying position is also beneficial to improve patients' breathing conditions.

Respiratory tract infection: The main causes of respiratory tract sensation in patients with advanced cancer are respiratory tract obstruction, low immune function, bed rest, excessive use of sedatives and aspiration (secondary to pharyngeal and esophageal dysfunction or obstruction). Pathogenic microorganisms often come from oral flora, such as streptococcus, anaerobic bacteria and gram-negative bacteria. Treatment is controlled by sensitive antibiotics. However, in patients with advanced cancer, antibiotics are often difficult to play a role because of the large amount of antibiotics used in the early stage and the low defense function of patients.

Trimethoprim (TMP)? /FONT & gt； SMZ is effective for pneumonia caused by Gram-positive aerobic bacteria (such as pneumococcus), Gram-negative aerobic bacteria (such as Haemophilus) and Pneumocystis carinii. Fungal infections (such as candida, cryptococcus, Aspergillus, coccidia and algae) are common in advanced patients, but blood cultures are often negative. Amphotericin B is still the first choice, and ketoconazole is also effective. There is no specific treatment for viral infection, so you can try high-dose interferon and immunoglobulin. Can people who cough take narcotic cough medicine such as codeine 30? /FONT & gt； 60 mg, 4 times a day, if you still can't control it, you can switch to morphine 5? /FONT & gt； 10 mg, every 4 hours 1 time.

Respiratory secretions: there are often a lot of secretions in the lungs of patients with terminal stage, and "death sounds" can be heard by auscultation. Anticholinergic drugs such as scopolamine 0.4? /FONT & gt； 0.6 mg, intramuscular injection,/kloc-0 every 4 hours can reduce respiratory secretions, or a small amount of diacetylmorphine is also effective. When there is too much phlegm to cough up, you can change your posture or suck it out with a sputum aspirator.

(4) Symptoms of urinary system

Urinary tract infection: Urinary tract infection is common in patients with obstruction in any part of urinary tract or patients who need long-term indwelling catheter. All patients who use Foley catheter will eventually develop asymptomatic bacteriuria. Asymptomatic bacteriuria usually does not need antibiotic treatment, but sensitive antibiotics should be used for those with urinary tract irritation or systemic symptoms, and compound SMZ and ampicillin are the first choice.

Frequent urination and urinary incontinence: patients with urinary tract infection, pelvic surgery or extreme weakness should be treated accordingly. If urinary incontinence occurs at night, wake the patient at night, or only urinate in the morning, or use condoms. Taking some medicine at night can improve frequent symptoms. For patients with frequent micturition and serious urinary incontinence, the urinary catheter should be kept and bladder irrigation should be carried out regularly to prevent urinary tract infection.

(5) Neuropsychiatric symptoms

Insomnia: Insomnia is generally caused by pain, depression, anxiety, night sweats or side effects of treatment. Before treatment, the patient's sleep must be asked to find out the cause of insomnia. Commonly used hypnotics are: diazepam 5? /FONT & gt； 10 mg or nitrodiazepam 5? /FONT & gt； 10 mg, amitriptyline 25? /FONT & gt； 125mg, taken orally or combined with other sedatives and antidepressants. Chlorpromazine 25? /FONT & gt； 50 mg, used at night can strengthen the effect of other hypnotics. For patients with sleep difficulties, traditional hypnotics such as diazepam are effective, while those who wake up repeatedly at night need antidepressants such as amitriptyline.

Insanity: It often brings more pain to patients' families, and it is also a difficult problem for medical staff to deal with dying patients. The common reason is drug-induced: sedative drugs such as acridine acid often cause hallucinations; Opioid analgesics can cause paranoia; Glucocorticoids can cause hypomania. Other reasons come from the disease itself, and patients with brain metastasis may have mental disorders without other neurological symptoms; In addition, uremia, hypercalcemia and hypoglycemia may all lead to insanity. If it is caused by drugs, the symptoms will subside after stopping the drug. Can droperidol 10 be given in an emergency? /FONT & gt； 20 mg, intramuscular injection, and then give 5 each time? /FONT & gt； 10 mg. If you need to strengthen sedation, you can add chlorpromazine 50 immediately? /FONT & gt； 100 mg, then 25? /FONT & gt； 50 mg, in divided doses.

Paralysis (hemiplegia or paraplegia): it is a common complication of patients with advanced cancer, and it is treated routinely. Medical staff and their families can encourage patients to exercise actively through psychological suggestion, help patients to exercise passively and turn over, and prevent limb contracture and bedsore.

Organic brain syndrome: We should provide a stable and quiet environment for these patients, arrange their daily lives and avoid mental disorders and disorientation. Patients with severe anxiety, paranoia or irritability can be treated with sedatives. Medical staff and their families should always remind and hint patients to avoid noise interference, and it is best to have lights at night.

(6) Systemic complications

Skin symptoms: Itching and bedsore are the two main complications of end-stage patients. If itching stems from dry skin, moisturizers and skin creams can be used to relieve symptoms. If there is a local infection (such as scabies), the infection should be treated; If it is caused by drugs, it should be stopped; Severe patients can be locally applied with 1% hydrocortisone; For itching caused by allergies, antihistamines should be used.

Keep the skin clean and dry, and change positions frequently to avoid long-term pressure on local skin. Bedridden patients can use semi-air mattress to prevent bedsores, or massage the parts prone to bedsores with 5% safflower alcohol once a day. Once bedsore occurs, it should be kept clean and changed regularly.

Herpes zoster: Herpes zoster usually occurs in the chest or back and often involves the trigeminal nerve. Most of them are born a few days after the pain, which is characterized by unilateral herpes zoster. Herpes zoster is more common in patients with lymphoma or Hodgkin's disease, and can also occur in other cancer patients with impaired immune function, often invading internal organs. Postherpetic neuralgia is particularly common in elderly patients, 25%? /FONT & gt； 50% of patients over 50 years old and 3/4 of patients over 70 years old will have neuralgia; Among these patients, 50% will have pain for more than a year. Corticosteroids can reduce the incidence of postherpetic neuralgia. Auxiliary drugs such as antidepressants can relieve symptoms, and can be used with morphine painkillers when necessary.

Pathological fracture: patients with bone metastasis in the late stage of cancer are prone to pathological fracture. Such patients should be gently moved and rolled over, and sometimes they need to be fixed with splints.

(7) Sexual dysfunction

For patients with advanced cancer, sexual life is not taboo, because of the consequences of treatment (such as colostomy, genital stenosis, pelvic or perineal and breast surgery, etc.). ), pain, physical weakness, lack of sexual knowledge and other late symptoms, all affect sexual function to varying degrees. Medical staff should actively, enthusiastically and appropriately provide medical consultation for patients and their families. Patients can exchange views with their spouses and adjust their expressions to meet sexual requirements. Spouses should also actively cooperate and take care of patients so that they can spend the last stage of their lives happily.

Cancer is not an incurable disease, the key lies in early detection. A preventive medicine expert believes that if cancer can be found early, it can be regarded as one of the most curable chronic diseases. Because after proper treatment, half of them can survive for more than 5 years. This survival time is longer than that of patients with cirrhosis or severe heart disease.

How to find cancer early?

With the development of modern medicine, it has been possible to find the clues of cancer through various detection methods. For example, liver cancer can be diagnosed by detecting whether there is a substance called alpha-fetoprotein in blood, and antibodies to EB virus in blood can also be detected early. The chest X-ray, which we are most familiar with, will have nowhere to hide if it can be performed regularly. Computed tomography (CT) provides an accurate and effective means for early detection of cancer. It is precisely because of the effective methods mentioned above that once you find yourself in some abnormal situations, you should go to the medical department in time for some necessary examinations, so that it is possible to find cancer at an early stage.

After observing and summarizing a large number of cases, experts summed up seven situations, which are called "early warning signals of cancer". They are:

1, the habit of defecation has changed. This may be an early sign of colorectal cancer or malignant tumor of urinary system.

2. Abnormal bleeding or secretion. For example, nosebleeds from nasopharyngeal carcinoma and vaginal secretions from cervical cancer are bloody.

3, breast or other parts of the lump. It is worth emphasizing that special attention should be paid to those painless masses.

4. Dyspepsia or dysphagia. Pay special attention to gastric cancer and esophageal cancer at this time.

5. Annoying cough or hoarseness. There are bloodshot sputum when coughing, so pay attention to the possibility of lung cancer. Besides lung cancer, laryngeal cancer can also cause hoarseness.

6, warts or moles have obvious changes. This suggests the possibility of malignant transformation.

7, the pain is not limited.

Beware of women's cancer

She mingde

In clinical practice, the author found that any of the following situations in non-lactating women's sexual life should arouse enough vigilance and go to the hospital for examination immediately.

First, breast tenderness:

When hugging or stroking, I found tenderness at some point on one side of my breast. When you touch the pain point with your palm, you can find small lumps and tenderness. You should be alert to breast tumors.

Second, nipple milk overflow:

There is milk overflow when touching and squeezing breasts or sucking nipples, so we should be alert to the possibility of pituitary microadenomas.

Third, nipple bleeding:

When squeezing breasts or sucking nipples, bloody secretions may be a precursor to early breast cancer. Or if there is light yellow liquid overflowing when squeezing the breast, you should also be vigilant.

Fourth, the lower abdomen bulge:

Attention should be paid to the uplift of women's lower abdomen, especially when lying on your back, there is still a strong feeling when touching with your palm. The clinical manifestation may be ovarian tumor.

Five, vaginal bleeding:

The mucus discharged after sexual intercourse contains blood, which is often an early signal of cervical cancer. Even if it is extremely small, you should be vigilant. Because this "red light" signal does not appear every time during sexual intercourse, it may appear four to six months later, but by that time, the cancer may have reached the advanced stage and may have lost the opportunity of early surgical radical treatment. Therefore, once vaginal bleeding, we should pay attention to it.

Sixth, frequent urination and urgency:

The symptoms of frequent urination, urgency and pain in women are acute urinary tract infection. But soon after sexual intercourse, I felt frequent urination, urgency and pain, accompanied by an increase in leucorrhea. I may have trichomonal vaginitis, fungal vaginitis or gonorrhea from my husband.

Seven, fishy smell:

During or after sexual intercourse, the vagina emits fishy smell, accompanied by vulvar itching and vaginal burning pain, which may be caused by sexually transmitted Gartner's vaginitis. In recent years, many cases of this disease have been found in clinic.

Eight, dome tenderness:

The vault is located in the deepest part of the vagina. When the husband and wife have sexual intercourse, the wife feels tenderness here, indicating that she has pelvic inflammatory disease; If accompanied by a history of secondary dysmenorrhea, it suggests endometriosis, which can lead to infertility.

Nine, lower abdominal cramps:

Abdominal colic occurred shortly after sexual intercourse, accompanied by nausea and vomiting, which may be an acute torsion of primary ovarian tumor. Sometimes with the change of posture, the pain may be relieved or even completely disappeared, but we should not give up our vigilance.

We must pay enough attention to the above diseases, check and diagnose them in time, and strive for early treatment and early recovery.