Core Science of Oncology Prevention and Control | Screening

alopah Date:2021-08-03 09:34:50
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Core scientific knowledge of tumor prevention and treatment (2021)




I. Early warning signals of tumor: “Five words”.


Blood, Block, Pain, Burn, Decrease


1. Blood (bleeding)


Except for normal menstruation of women, unexplained bleeding from any organ of human body, which does not heal, may be an early alarm signal of tumor. For example


► unexplained nasal bleeding, excluding transient nasal bleeding caused by trauma, external force, dry weather or high blood pressure, may be tumors such as nasopharyngeal cancer and blood disorders.


► coughing up blood or blood in sputum, excluding temporary bleeding caused by dry weather, bleeding gums or overwork, which may be a sign of lung cancer.


► blood in urine, especially the presence of painless hematuria with lumbar discomfort, may be bladder cancer or kidney cancer.


► blood in the stool, if accompanied by changes in bowel habits, urgency (abdominal pain and distress, occasional urge to defecate, heavy anus and unpleasant bowel movements), may be an early manifestation of colorectal cancer.


► bloody discharge from female nipples, which may be breast cancer or ductal tumor of the breast


► A woman who has menopause and then finds vaginal bleeding may be a manifestation of cervical cancer.


2. Lump (abnormal lump)


Tumors, especially solid tumors, are ugly in appearance, often one or several irregular lumps.


► superficial parts of the body with lumps that do not go away for a long time or increase rapidly within a short period of time, especially with itching, ulceration, oozing, etc.


►Irregular lumps in the breasts with bilateral asymmetry, especially with “orange peel” changes, which are most likely to be breast cancer.


►If a lump is found in the thyroid gland and you suddenly can’t make a sound or your voice suddenly becomes hoarse, you should go to the oncology department in addition to the endocrinology department to avoid missing the diagnosis of thyroid cancer, laryngeal cancer and other tumors.


prevent cancer


3. Pain (ache)


Any pain that continues to worsen for a long time may be an early sign of tumor.


► Headache, progressive aggravation, accompanied by nausea and vomiting (jet vomiting is more critical) and blurred vision may be a manifestation of brain tumor, or it may be caused by lung cancer and other tumors flowing to the brain (brain metastasis). When the above symptoms occur, some patients often just go to neurology for medical treatment, but it is important to see neurology and then consult oncology to check whether there is a brain tumor to avoid delaying treatment.


► pain in the neck with pressure, tightness, hardness and facial edema, which may be caused by tumor invasion and compression of human superior vena cava, resulting in obstruction of blood return.


► pain behind the sternum, burning sensation and dysphagia, these may be the manifestations of esophageal cancer and cardia cancer and stomach cancer.


4. Fever (fever)


► If the fever lasts for more than a week especially more than ten days, diseases other than cold must be considered, and the suspicion of tumor cannot be ruled out except for combined lung infection, etc.


► If the fever persists, especially if it is prolonged low fever, accompanied by weight loss, night sweats (sweating after sleeping at night), etc., children should be alert to hematological system tumors such as leukemia (a household name of the late child star Deng Ming He, leukemia was discovered in this way), and adults should rule out the possibility of incoming tumors such as lymphoma, liver cancer, kidney cancer, etc.


5. reduce (weight loss)


►Adults, especially young and middle-aged people, without deliberate weight loss, lose weight for unknown reasons in a short period of time and show progressive decline. After excluding diseases such as hyperthyroidism, diabetes and tuberculosis, it is possible that tumors such as digestive tract tumors, kidney cancer and lymphoma are playing a role. Because the tumor, a glutton, is competing with our organism for nutrition, all the food we eat is stolen by the tumor.


If weight loss is accompanied by yellowish skin tone and pain, it is more important to actively check to rule out the possibility of tumors such as pancreatic cancer, the king of cancers.


Cancer checkup is the most important way to detect cancer at an early stage


►Professional cancer checkups can detect and diagnose cancer at an early stage so as to achieve the purpose of early treatment, which is the most ideal way to prevent and treat cancer at present, and is also the most advocated method with the least cost and pain.


► Cancer prevention physical examination is different from the general health examination, especially refers to the cancer prevention examination of corresponding parts by oncologists, taking into account the medical examinee’s own situation and individual needs. For example, for lung cancer prevention physical examination, CT examination of lung is emphasized during physical examination; for patients suspected of having stomach cancer or having family history of high-risk stomach cancer, gastroscopy can be focused on; anal examination is a simple method to detect rectal cancer, and must be done for those who have long-term blood in stool or abnormal stool habit.


Elevated tumor markers do not necessarily mean that you have cancer


►Our body produces tens of thousands of cancer cells every day, so almost all tumor marker test results will not be “zero”, there is a normal range, as long as the value is within the normal range, it is normal.


► The presence of cancer cells in the body does not mean that one will get cancer. The normal immune function of human body can swallow cancer cells in time, so people are not easy to get cancer in general.


►Tumor marker elevation has various influencing factors, which can only detect “suspect” but not “convict”. Therefore, when you see a single elevated tumor marker in the physical examination report, do not be overly alarmed, but go to a specialized oncology hospital for another examination.


The causes of elevated tumor markers include.


(1) Malignant tumors: this is the main reason for the elevation of tumor markers.


(2) Benign diseases: Many benign diseases may show mild to moderate elevation of tumor markers. For example, patients with benign liver diseases: elevated methemoglobin and carcinoembryonic antigen are often seen; patients with renal insufficiency and psoriasis: elevated squamous cell carcinoma antigen is often seen.


(3) Drug use: for example, biologic agents such as thymidine may cause transient elevation of tumor markers after use.


(4) Special circumstances: For example, smokers and pregnancy may show corresponding elevation of tumor markers.


(5) The cause of tumor marker elevation is not only malignant tumor, but also many physiological factors, drugs, bad living habits, inflammation and benign tumor may cause pseudo elevation of tumor marker.


Low-dose spiral CT is the most important means to screen for early lung cancer


► Although the radiation of chest X-ray is low, it may not be able to detect small lung lesions at an early stage, and the small nodules or tiny nodules of lung on chest X-ray are easily obscured by ribs, diaphragm, mediastinal tissues and organs, especially the tiny nodules of lung less than 1cm or so are often missed on chest X-ray. Therefore, some lung masses found on chest radiographs with clinical symptoms and elevated blood tumor markers are already locally advanced or late stage when lung cancer is clinically diagnosed, and the best time for radical surgical treatment is lost. Therefore, the current national or local provincial and municipal lung cancer screening program is to use low-dose spiral CT of the chest, which can “detect lung cancer at an early stage”, but not “detect early lung cancer at an early stage”.


Precancerous lesions are not cancer, but should be actively treated


►The so-called precancerous lesions are some lesions that may become cancerous if they continue to develop, such as: mucosal leukoplakia, junctional nevus, chronic atrophic gastritis, colorectal multiple adenomatous polyps, etc.


► Precancerous lesions are not cancer and do not mean that they will definitely develop into cancer, so they cannot be equated with cancer.


►Not all precancerous lesions will eventually evolve into cancer, and the category of precancerous lesions should not be expanded to cause unnecessary psychological burden, for example, common skin nevus and peptic ulcer, etc.


►Not all cancers have precancerous lesion stage in the process of development.


►When pre-cancerous lesions are found, we need not panic and carry a heavy burden of thought, but should adopt a positive and correct attitude to face it. Those who need surgery should be treated actively; those who need review should take the initiative to review regularly. We should pay attention to good diet and living habits, keep our mood happy, and attend regular medical checkups to strive for early detection, early diagnosis and early treatment, so as to truly prevent “cancer” before it happens.

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