The road to the rise of great doctors

Chapter 125 Early Cancer Screening
I received three gastric cancer patients in the morning, and their ages ranged from their 3s to their 30s.Liu Dong felt a little heavy.

He lamented the uncertainty of fate and felt helpless about the effectiveness of current treatments.All we can do is "do our best, obey fate, and fight with all our strength!"

Cancer is like this, although some progress quickly and some are less malignant.But generally speaking, early detection, early diagnosis, and early treatment have the greatest options, and the prognosis or overall survival time is also the best.Don't have the ostrich mentality of "If I don't watch it, it won't exist." That's just deceiving yourself and others.

Liu Dong couldn't help but think of the annual physical examination. For people in their 20s like them, basic testing items are enough.But there are some things you need to pay attention to right after graduation, especially after middle age, let alone old age, which is the age at which cancer is most common.

Ultrasound is the most simple, direct and cheap.Others depend on whether your immediate family members have a history of cancer and whether you have high-risk factors.

Taking the several departments that have been rotated as examples, there are examples of early cancer screening everywhere.

When I was in the urology department, I heard more stories about "phimosis and stinging tumors". The skin that cannot be turned up will allow urine to be retained, which is a high-risk factor for repeated inflammation and malignant transformation; some elderly people are recommended to check the "prostate" The story of "specific antigen + digital anal examination and prostate cancer" screening, the screening age for those with family history should be earlier.

When I went to the gynecology department, I heard more about the story of "human papillomavirus (HPV) vaccine and cervical cancer." Even though it was difficult to make an appointment in China, many people went to the Special Administrative Region to make an appointment for the vaccine.

When I came to the General Surgery Department, I felt closer when I heard the stories.

During the annual physical examination for new employees in the hospital, small nodules are often found during thyroid ultrasound, and after small incision surgery, the pathology report is "microcarcinoma of the thyroid";

A situation in which a medical student discovers a small nodule in the breast during a diagnostic course, internal medicine physical examination practice, self-examination or mutual physical examination of the same gender, and then undergoes a mammography examination to confirm it, and later undergoes minimally invasive surgery;

As well as people around you who have stomach discomfort after work and gastric cancer is found during a gastroscopy;

When I was preparing to graduate, I often stayed up late doing experiments. While writing my thesis, I started coughing repeatedly. Finally, I went to the hospital for a checkup and found out that I had lung cancer.

Some old doctors often lament that when looking at patients in the clinic, they now find that the phenomenon of younger patients with cancer is very serious.However, based on the national conditions, on the one hand, it may be that cancer is getting younger. After all, environmental pollution and environmental deterioration may have this result.But on the other hand, with the update and iteration of diagnostic technology, the promotion and popularization of ultrasound applications, as well as the application of computed tomography, magnetic resonance, PET-CT, etc., as well as the promotion of free clinics or community physical examinations, many of them used to have Only when you have symptoms do you seek medical attention and start examinations. Nowadays, many cases are detected when there are no symptoms and the lesions are relatively small.

Therefore, in Liu Dong's own opinion, whether it is the younger trend of cancer incidence or the improvement in diagnosis rate due to iterative testing methods, he prefers the latter.

"Early diagnosis, early treatment" should not just be a slogan, but a practical measure to improve people's overall condition. "The superior doctor cures the disease before the disease, the traditional Chinese medicine treats the desired disease and cures the disease, and the inferior doctor treats the already sick and cured the disease", this sentence is used by many "health masters" for marketing, but from the perspective of disease, whether health preservation works or not needs further investigation Large sample data to support, but the living conditions are better, it is already a kind of health preservation; and early cancer screening can not only find "precancerous lesions" - the desire for cancer, but also "early cancer" - Treating the disease in its early stages is actually the most economical and effective way at present.

This is also a typical example of "spending a little money to accomplish big things".Of course, corresponding to this is another topic, whether there will be the problem of "over-medical treatment".However, in Liu Dong's view, if the proportion of early-stage diseases found through screening is not low, it does not count as excessive medical treatment, because if everyone just chooses a basic physical examination package, the cost is not high; but if one day, through physical examination screening The proportion of early-stage disease is very low, which means that a satisfactory basic level of control can be achieved without screening, and then it will be considered "passed" if it continues to be implemented.

At this stage, we are still in the transition stage from "the disease is in the late stage when we first seek medical treatment" to "the disease is found in the physical examination (early stage)". "Early cancer screening" is still a long way to go.

Liu Dong quickly finished writing the medical records according to the conditions of the three people, and then seeing that he still had plenty of time, he created three templates for gastric cancer history in the personal template library of the medical record system, so that he can write medical records more efficiently in the future.Before writing the medical record, the doctor's orders are given early, so that the nurses can arrange for the patient to undergo examinations according to the doctor's orders, and prepare medicines and provide treatment in time.

If the patient's affairs are handled properly and communication is in place, a lot of fragmented time can be integrated into a whole piece of time.Moreover, when you go to do something yourself, the patient's family members will not come to ask about the situation but cannot find the person, which greatly reduces doctor-patient conflicts.Of course, this is not necessarily the case, after all, "personnel affairs" are more complicated.

After admitting these three patients, the fixed beds in Liu Dong's medical team were full.For hospitals like theirs, which are relatively large and one of the best in the area, they have the final say on fixed beds. If they want to admit patients to their own group, they must arrange the admission and admission of patients in advance.

If it is not full, other groups may temporarily occupy it depending on the situation.As for the unfixed beds, it usually depends on who takes them first and who occupies them. The arrangement of these beds is coordinated by the head nurse or department director. There are still some differences between the various medical groups regarding the limited number of unfixed beds. The situation of "overt and covert fighting" will not be mentioned here.

In addition, general surgery is basically a major provider of emergency surgeries, and two beds are reserved every day for emergency admissions. This cannot be occupied by patients undergoing elective surgeries or time-limited surgeries.

When Liu Dong learned about these situations, he asked Zhao Gang out of curiosity, "Teacher Zhao, emergency patients are not allowed to shirk their duties. So what should we do if we run out of beds?"

"According to regulations, we have reserved 2 emergency beds, which have met the basic requirements. If they are full, we will notify the emergency department, and the emergency department will call and communicate with the emergency center, so that the ambulance can I'll talk to them and take him to a hospital with beds."

“So, what do you do if you encounter a large number of emergencies?”

"Hey, you're quite curious. If that's the case, it's a matter of coordination with the hospital's chief administrative officer. Besides, there are only a few doctors on duty in the hospital who can perform surgeries. Under normal circumstances, all these doctors will perform surgeries. If there are a large number of emergency operations, the hospital with a slightly larger patient volume will coordinate the beds; if the patient volume is extremely large, the competent department will need to coordinate the admission of various hospitals."

"Oh" Sure enough, you only need to worry about those things when you reach a certain position.As a young doctor, it is enough to do the job in front of you.

(End of this chapter)