Dr. Guo Xiaoqing: Doctor of Medicine, Chief Physician, Doctoral Supervisor, and Director of the Gynecologic Oncology Department at Shanghai First Maternity and Infant Hospital.

Areas of Expertise: Radical surgery for cervical cancer, endometrial cancer, ovarian cancer staging surgery, fertility-sparing surgery for early-stage cervical cancer, surgery for pregnancy-associated gynecologic tumors, pelvic floor dysfunction disorders, and complex surgeries for challenging conditions such as severe endometriosis.

Professional Affiliations: Vice President of the Gynecologic Oncology Branch of the Shanghai Medical Doctor Association, and Deputy Director of the Surgical Rapid Rehabilitation Committee of the Chinese Association of Rehabilitation Medicine. Dr. Guo spent nearly two years conducting foundational and clinical research in gynecologic oncology at the University of Texas MD Anderson Cancer Center in the United States.

Professional Focus: Dr. Guo has long been engaged in the standardized diagnosis and comprehensive treatment of benign and malignant gynecologic tumors. She has achieved a high academic level and professional expertise in laparoscopic minimally invasive surgery. Her primary research interests include the mechanisms of ovarian cancer invasion, metastasis, and immune evasion, as well as the mechanisms and early diagnosis of cervical cancer. She has led and conducted multiple research projects, including the National Natural Science Foundation General Program, and has published dozens of SCI-indexed papers in these fields.

Preface

Let me share a story," said Guo Xiaoqing, who had just stepped off the operating table, dusty and weary, but with a poised grace. Though slightly fatigued, her sharp and decisive demeanor remained undeniable.

It was a blooming season, much like this sunny afternoon, when a young woman and her close friends gathered in an elegant café, savoring delicious afternoon tea. Sunlight streamed through the windows, casting a warm glow on their faces as laughter filled the air. Suddenly, a topic struck a chord among them— “menstruation.”

The young women began sharing stories about their experiences with menstruation, reminiscing about the days spent with their sisters. Yet, amidst the joyful atmosphere, this young woman couldn’t hold back her tears.

As her sisters-in-spirit looked on in worried confusion, she sobbed, “I just realized that not only did that surgery save my life, but it also saved my future. Years ago, if I hadn’t followed Dr. Guo Xiaoqing’s advice and opted for a hysterectomy, I would have lost not just the chance to become a mother, but also the opportunity to share these precious memories with my friends. How heartbreaking that would have been!”

This young woman’s story is just one of many that reflect Dr.Guo Xiaoqing’s impact on her patients.

To her, medicine is not only a science but also an art. In her view, a doctor is not merely a skilled craftsman but also a psychologist and sociologist.

In the field of obstetrics and gynecology, she has achieved remarkable success, while embodying the philosophy of “patient-centered” care in medical humanities, enhancing the treatment experience for her patients.

With decades of experience, she has always emphasized providing comprehensive and personalized treatment plans for her patients. This reflects her understanding and respect for humanity, and it is the cornerstone of trust between a doctor and patient.

Since moving to Shanghai a decade ago, she has dedicated herself to alleviating the suffering of many women patients, showcasing unwavering determination and courage in the treatment of gynecologic cancers. Her team continuously innovates treatment approaches, striving to reduce the psychological and social pressures on patients, ensuring they maintain dignity and peace while undergoing treatment.

Compassion Without Borders

“Spirit needs to be carried on, and medicine needs to be passed down.”

In Dr. Guo Xiaoqing’s memories, there is an unforgettable image: the figure of Professor Gu Zushan, a gynecologist, during his lectures. It was a legacy of a physician’s integrity, a mark of medical spirit.

“Professor Gu Zushan was not only a distinguished disciple of Lin Qiaozhi, China’s renowned obstetrician and gynecologist, but also an outstanding physician who dedicated his life to medicine,” Dr. Guo Xiaoqing recalled. “After graduating from Peking Union Medical College, he served as a resident physician and chief resident physician at PUMC Hospital’s Department of Obstetrics and Gynecology. In 1965, he resolutely embarked on a journey to Xinjiang to participate in the construction of Shihezi Medical College.” In Guo Xiaoqing’s eyes, Professor Gu Zushan’s image has always been vivid. She remembers that he was always full of passion during his lectures, with every word reflecting his love for medicine and his deep care for patients. “As his students, we didn’t just learn medical skills; we absorbed the essence of a physician’s integrity and a profound respect for life.”

Professor Gu Zushan’s dedication deeply influenced Dr. Guo Xiaoqing. Whether it was rounds or outpatient clinics, she never overlooked any subtle clues.

In that hopeful clinic, Dr. Guo Xiaoqing met a woman with a worried expression—Ms. Li (pseudonym). Her eyes revealed long-standing anxiety, all stemming from a seemingly ordinary yet life-disrupting symptom: abnormal vaginal discharge.

Ms. Li poured out her suffering to the doctor: for over three years, her vaginal discharge had been unusually heavy, with intermittent fluid leakage from the vagina, worsening at night. Sometimes she would wake up to find her underwear soaked, which brought her immense embarrassment and discomfort. Despite multiple visits to doctors and cervical biopsies, the cause remained elusive, and the symptoms persisted. This unclear diagnosis not only greatly inconvenienced her daily life but also caused immense psychological stress and fear.

Dr. Guo Xiaoqing listened patiently to Ms. Li’s account. She understood that for patients, a doctor is not only a healer but also a listener and a source of comfort. After a thorough consultation, Dr. Guo Xiaoqing arranged for a detailed colposcopy for Ms. Li. With her extensive clinical experience and keen observational skills, she eventually detected some small yet suspicious lesions within the cervical canal.

The results of the subsequent surgical pathology were unexpected: cervical lobular endocervical glandular hyperplasia (LEGH), with some areas showing atypical lobular endocervical glandular hyperplasia (ALEGH). This is a rare precancerous lesion of a malignant cervical tumor. Ms. Li was promptly admitted to the hospital and received timely and appropriate treatment. Not only did this provide answers to her long-standing symptoms, but it also successfully halted the progression of this malignant tumor.

This story is a microcosm of cervical cancer screening and diagnosis. With the increasing awareness of cervical cancer, more people are beginning to prioritize regular, standardized screenings, enabling the early detection and treatment of many potential cases and effectively preventing the development of cervical cancer. This particular case not only showcased a doctor’s professional competence but also highlighted deep care for the patient. Dr. Guo Xiaoqing demonstrated through her actions to every patient: on the path of medicine, you are not alone—we are here with you.

Light of Healing: Pride in Patient Recovery 

In the gynecologic oncology ward of Shanghai First Maternity and Infant Hospital, stories unfold daily—some joyful, others sorrowful—all weaving together into a symphony of emotions within these walls. 

“Every patient is the protagonist of her own story. Their pain and struggles mark the beginning, while our medical team stands as their comrades, guiding them through adversity. We strive tirelessly to unravel the mysteries of gynecologic cancers, reshaping shattered lives.” As Dr. Guo Xiaoqing spoke, her voice carried a mix of emotions. 

In 2017, a middle-aged woman sought Dr. Guo’s expertise due to severe bleeding. Tests revealed cervical cancer, specifically a rare and aggressive subtype: cervical neuroendocrine carcinoma (CNEC).

 

Cervical Neuroendocrine Carcinoma (CNEC) is a rare malignancy originating from neuroendocrine cells in the cervix. Though accounting for a small fraction of cervical cancers, its invasive biology often leads to poor prognosis and complex treatment. 

“Neuroendocrine cells can produce and secrete hormones, classifying these tumors as part of the neuroendocrine system—a network spanning glands and neural tissues. Such tumors grow rapidly, often diagnosed late, with high recurrence and metastasis rates,” Dr. Guo explained. “When discovered, this patient’s tumor was already advanced, cauliflower-like, and inoperable. At the time, our hospital lacked radiotherapy facilities, so we referred Ms. Wang (pseudonym) to another tertiary hospital.” 

Five years later, a call came from an external radiotherapy department: Ms. Wang’s tumor had recurred after initial treatment success. Despite chemotherapy and immunotherapy, resistance emerged. “Without surgery, the tumor would rage unchecked,” Dr. Guo recalled. “I felt compelled to take charge.”

 

Ms. Wang’s return in January felt like a reunion tinged with fate’s test. Hope and anxiety intertwined as she stepped back into familiar halls. Scans, however, revealed daunting challenges: post-radiation fibrosis had turned her cervix into a “concrete-like” mass, complicating surgery. Tissue ischemia heightened risks of fistulas—devastating complications nearly irreparable after radiation.

 

Yet, Ms. Wang’s trust in Dr. Guo never wavered. Years apart melted away as Dr. Guo’s compassion and expertise reignited her resolve. “Even if it means living with colostomy or urostomy bags,” Ms. Wang declared, “I want this chance.”

 

After multidisciplinary consultations, surgery was scheduled for March. In the OR, tension hung thick. Dr. Guo and her team, draped in sterile gowns, focused intently. Under the glare of surgical lights, her hands moved with precision, navigating the hardened tissue like an artist chiseling marble. Every cut balanced tumor removal with organ preservation.

 

“The vaginal tissue crumbled like tofu. We improvised—using a catheter balloon to support the intestines and slowly close the vaginal stump. This surgery epitomized the challenges of post-radiation cases: boundaries blurred, every step a gamble,” Dr. Guo recounted. Hours later, the tumor was gone. Miraculously, no critical complications arose.

 

Outside, Ms. Wang’s family wept with relief. “It’s a miracle! We knew the risks,” they said. “Three hospitals warned us, but we gambled—and won. Thank you.”

 

Dr. Guo shared that Ms. Wang recovered well, now able to receive radiotherapy and immunotherapy in-house since 2021.

 

This victory was not just medical but a testament to resilience. Through unwavering trust and perseverance, doctor and patient pierced through despair like dawn breaking storm clouds.

 

Dr. Guo’s journey is woven with such moments. Over a decade in Shanghai, her reputation has drawn patients from afar. In quiet hospital corridors, sunlight spills through windows, casting serenity over white walls—a backdrop to countless life stories.

 

One such story involved a Canadian patient whose courage left an indelible mark. “She faced each treatment with hope, even in her darkest hours,” Dr. Guo said, her eyes shadowed. “We exhausted every option, but fate intervened. Yet, in her final days, she donated ¥50,000 to the Soong Ching Ling Foundation’s ‘育爱同行’ (Journey of Compassion) project—a final act of empathy for others still fighting.”

 

“Standing by her bed, I felt profound gratitude and responsibility,” Dr. Guo reflected. “We carry their trust as both honor and duty. It fuels us forward.”

 

Endless trust, a mutual journey between healer and healed—this is the beacon that lights the path of medicine.

The Art of Swift Healing: Exploring the Philosophy and Practice of Enhanced Recovery

“At the forefront of medical excellence, our gynecology department has always balanced innovation with compassion. In 2018, the establishment of our Enhanced Recovery After Surgery (ERAS) Ward marked a transformative leap—not only accelerating postoperative recovery but also conserving medical resources and elevating the quality of care. This pioneering initiative earned recognition as an ‘Advanced and Practical Technology Promotion Project’ by the Shanghai Municipal Health Commission.”

For Dr. Guo Xiaoqing, surgery is not merely about removing disease—it is about minimizing suffering and hastening recovery. Leading her team, she has refined surgical techniques while championing ERAS principles, profoundly enhancing patients’ healing journeys and quality of life.

Today, ERAS has gained widespread acclaim in obstetrics and gynecology. Dr. Guo and her team remain committed to redefining perioperative care, transforming perceptions of gynecologic surgery and offering hope to countless women.

The ERAS Ward combines minimally invasive techniques—with their reduced trauma and faster recovery—and evidence-based perioperative protocols to mitigate physiological and psychological stress, accelerating healing. Surgeons employ precision to minimize tissue damage, turning each operation into a milestone on the patient’s road to recovery.

Here, every healthcare professional embodies empathy. Through attentive care and active listening, they create a warm, reassuring environment—a foundation for both emotional solace and physical recovery.

Innovations in ERAS streamline traditional practices: Simplified bowel preparations, shortened preoperative fasting, and early postoperative feeding reduce discomfort and inconvenience. A multimodal pain management approach, blending medications and techniques, ensures comprehensive relief. By addressing pain proactively, the team encourages early mobilization, reducing risks of thrombosis and complications while shortening hospital stays.

“Why are patients reluctant to move post-surgery? Pain,” Dr. Guo explains. “We prioritize pain control to empower them to walk sooner. Early activity improves circulation, accelerates gut function, and builds confidence. Many patients walk freely on the day of surgery—a testament to their renewed hope.”

The ward also advocates early postoperative nutrition, restoring gut health and reducing malnutrition risks, further boosting patient satisfaction.

Through these integrated strategies, the ERAS Ward offers a safe, efficient, and compassionate recovery environment. Each patient’s swift healing not only validates the hospital’s commitment but also epitomizes the spirit of medical innovation.

In Dr. Guo’s vision, medicine transcends science—it becomes art. An art sculpted with empathy, courage, and love. She believes every patient’s story deserves to be heard, understood, and honored. In the storm of illness, she strives not just to treat but to support, to walk alongside, and to reassure: As steadfast guides, we pledge to harness our passion and expertise, lighting the path through darkness until life’s resilience blooms anew.

Together, doctor and patient weather the tempest of disease, emerging into the dawn of recovery—where vitality is reclaimed, and hope rekindled.

ShanghaiDoctor

Why can cervical cancer be called the only gynecological tumor that can be eliminated?

Dr. Guo Xiaoqing 

Cervical cancer is considered the only gynecological tumor that can potentially be eradicated, primarily because it has a clear etiology, which is closely related to persistent infection with high-risk human papillomavirus (HPV). It is estimated that approximately 98-99% of cervical cancer cases are associated with HPV infection. Therefore, through HPV vaccination, the infection can be prevented, thereby theoretically eliminating the possibility of most cervical cancer cases. While a small percentage of cervical cancers may not be related to HPV, the widespread use of vaccines has made cervical cancer, overall, a preventable and controllable disease.

 ShanghaiDoctor

What challenges do ovarian tumors pose? What new methods are currently available to treat this type of tumor?

Dr.Guo Xiaoqing 

Ovarian tumors are often referred to as “silent killers” due to the lack of noticeable symptoms in the early stages, which often leads to their discovery only when the disease has progressed to an advanced stage, significantly increasing the difficulty of treatment. Currently, methods for diagnosing ovarian tumors primarily include regular physical examinations, such as ultrasound scans, weight monitoring, and measurements of the tumor marker CA-125. For individuals with a family history of ovarian cancer, such as those carrying BRCA1 and BRCA2 gene mutations, preventive surgery can be considered to reduce the risk of developing ovarian cancer. Additionally, the development of new drugs and the gradual emergence of targeted therapies offer new hope for the treatment of ovarian cancer.

ShanghaiDoctor

From the perspective of gynecological tumors, what are the warning signs that we should pay attention to in our bodies?

Dr.Guo Xiaoqing 

Yes, some physical symptoms may serve as early warnings of health issues. For instance, irregular vaginal bleeding or menstrual disorders in women of reproductive age, or irregular bleeding and abnormal vaginal discharge in postmenopausal women, should be taken seriously. These symptoms may merely indicate endocrine issues, but they could also be precancerous lesions or already developed endometrial or cervical cancers. For postmenopausal women, any occurrence of irregular vaginal bleeding should prompt an immediate visit to a specialist for examination, as this could be a severe health warning signal.

ShanghaiDoctor

In the field of gynecological tumors, “the golden first surgery” is not only a concept but also represents the precision and thoroughness of the initial operation, which holds significant importance for the patient.

Dr.Guo Xiaoqing 

In the realm of gynecological tumors, the significance of the first surgery cannot be overstated. It is often referred to as the “golden first surgery,” emphasizing the importance of precision and thoroughness in the initial operation. This approach aims to prevent unnecessary suffering for the patient. During a recent public education event, I had the opportunity to meet a special patient whose journey highlighted the critical nature of this principle.

This patient had undergone a gynecological tumor surgery locally, but unfortunately, the procedure did not go as planned. Upon opening the abdomen, the medical team discovered that the tumor’s location and complexity were far beyond what had been anticipated, making it impossible to complete the surgery at that time. This was undoubtedly a devastating blow for the patient, yet it also marked the beginning of another phase in her battle against the disease.

In response to this challenge, we developed a new treatment plan. Recognizing the complexity of the surgery, we decided to initiate chemotherapy first, with the goal of shrinking the tumor and creating favorable conditions for subsequent surgery. The patient underwent four cycles of chemotherapy. Encouragingly, tumor markers, which had initially been over 1000, dropped to 800 after the first cycle, further decreasing to 200 after the second cycle, and nearly normalizing after the fourth cycle. This significant improvement gave us great confidence in the treatment’s effectiveness.

Building on the positive outcomes of chemotherapy, we conducted a comprehensive imaging assessment and held a multidisciplinary discussion. On June 12, we performed an abdominal ovarian tumor debulking surgery, providing the patient with a thorough operation that achieved satisfactory tumor debulking. All visible tumors were completely removed.

This was a highly challenging surgery, and through this case, we underscore the importance of conducting a comprehensive evaluation before surgery and being cautious with the first operation. This principle not only affects the success of the surgery but also influences the overall direction of the patient’s treatment and their ultimate recovery.

In summary, the concept of the “golden first surgery” is pivotal in gynecological tumor treatment. It underscores the necessity of precision and thoroughness in the initial surgical intervention, aiming to optimize patient outcomes and minimize unnecessary suffering.

ShanghaiDoctor

Since I started practicing medicine, what do you think has been my greatest achievement?

Dr.Guo Xiaoqing 

Looking back on my medical career, what do I consider to be my greatest achievement? It is a deep sense of fulfillment. The medical profession, though filled with complex and high-risk situations, can sometimes lead to overwhelming pressure, making one want to give up. However, after a brief rest and reflection, I am able to reignite my passion and motivation. Each successful treatment brings a deep sense of fulfillment to my heart. Especially in surgeries for complex and challenging cases, these difficulties and challenges inspire me to overcome obstacles, leaving me more energized and accomplished.

ShanghaiDoctor

What advice do you have for the growth of young doctors?

Dr.Guo Xiaoqing 

I hope young students and young doctors will strengthen their initiative and actively participate in the development of their departments and hospitals. They should enhance their own initiative to seek and seize opportunities. As our former President, Dr Duan Tao, said, ‘Subjective initiative is very important.’ I encourage young doctors to always maintain a desire for knowledge and an exploratory mindset towards the unknown. In fact, young people have access to more information channels, a clearer understanding of the world, and broader interests. This means they have the ability to find what they love.

Editor: Qing Chen, ShanghaiDoctor.cn

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