Colorectal cancer includes colon cancer and rectal cancer. In the past, the incidence was mainly high in Europe and the United States. In recent years, the incidence in China has also increased year by year.
Rectal cancer is the most common site of colorectal cancer, accounting for 56%-70%, with an average of 60%. There are 88.5% of rectal cancer with blood in the stool, followed by changes in stool characteristics, peptones, etc. Therefore, a considerable part of rectal cancer can be detected early, but the actual clinical situation is far less optimistic. According to data Statistics show that the detection rate of early rectal cancer in China is only 2% to 5%, and it takes an average of one year from the onset of clinical symptoms to the diagnosis of rectal cancer. One year is not long in a person's life, but it is too long for a tumor, because if the tumor is confined to the intestinal wall in rectal cancer, the 5-year survival rate of treatment can reach more than 80%, on the contrary, it exceeds the intestinal wall. The 5-year survival rate is less than 40%.
Therefore, paying attention to the early detection, early diagnosis, and early treatment of rectal cancer is of great significance for improving its long-term survival rate.
Why is this happening? There are doctors' negligence and the patient's carelessness, which ultimately lost the opportunity for early treatment.
The first symptoms of rectal cancer, the most common symptoms are blood in the stool, blood in the stool, bright red or dark red, and the number is generally small. People have a saying that ten people have nine hemorrhoids. Many middle-aged and elderly people have hemorrhoids, and one of the hemorrhoids The common manifestation is blood on the surface of the stool or dripping or splashing blood after the stool. Therefore, when the stool is bleeding or bloody, people often think it is caused by hemorrhoids, so they don't pay attention to it. Many non-oncology doctors often think so. In fact, as a doctor, there are many rectal cancers that can be diagnosed at an early stage, because about 80% of rectal cancers are located in the lower half of the rectum, which is very far from the anus. The doctor only needs to do a digital anus examination. The problem can be found, but with such a small effort, many doctors often omit it intentionally or unintentionally, causing a large number of patients to delay diagnosis, and some are not diagnosed until the intestinal obstruction occurs.
Similar tragedies are happening almost every day. There are many reports in the literature on this aspect. A second-class hospital reported that among the more than 20 cases of rectal cancer admitted throughout 1995, none of them were early rectal cancer. Therefore, middle-aged and elderly friends or even young people should not be satisfied with the diagnosis of hemorrhoids when they have blood in their stools. Even if they have had hemorrhoids before, they should check it. At this point, the responsibility of the doctor is greater than that of the patient. Therefore, when the patient sees the doctor, he should look for a specialist, and you can judge whether the doctor has performed a digital anal examination for you. The responsible doctor.
The second early manifestation of rectal cancer that is easy to be misdiagnosed is stool with pus and blood, tenesmus (the stool cannot be solved, the anus is swollen, and the feeling of always wanting to defecate) is often regarded as dysentery. Due to the ulceration of the surface of the rectum, or the concurrent infection, the mucosal necrosis and sloughing off the things mixed with the stool, the symptoms are the same as chronic dysentery. The stool is also pus cells and red blood cell phagocytic cells. Use a little antibiotic temporarily It can also last for a while, these are easy to make patients, doctors treat it as dysentery, the longest misdiagnosis in the literature can reach 1-2 years.
We say that when the stool appears pus and blood, it should be diagnosed and treated as dysentery at first. It is understandable. After all, in this case, dysentery still accounts for the majority and tumors account for a minority, but it always looks like this, months or even half a year. It shouldn't be treated as dysentery. Therefore, if it is a pus and bloody stool in the non-dysentery season, a chronic dysentery that cannot be cured, we should think about the possibility of rectal cancer and do some appropriate examinations. It may not be cancer in the end, but we should have this string in our brain.
For colon cancer, the common first symptoms include abdominal pain, abdominal mass, diarrhea, etc., but these symptoms are generally not at an early stage, so the symptoms of colon cancer are not as obvious as those of rectal cancer, especially the right colon. It mainly depends on colonoscopy. The examination of barium enema, these two examinations need to clean the enema, which is a bit troublesome, but it is very meaningful for the diagnosis. Therefore, as a patient, when the doctor asks you to do the examination, you should cooperate with the doctor and cannot refuse because of trouble. . In addition, the fecal occult blood test is also a useful and simple inspection method. Once the occult blood is positive, the cause should be further investigated.
Anemia of unknown cause should be considered for colon cancer. Due to the improvement of living standards, modern people rarely suffer from anemia caused by malnutrition. Therefore, once anemia occurs, especially if there is no obvious blood loss (such as menorrhagia in women), it should be taken seriously. It is not caused by malnutrition and blood loss. There are three common causes of anemia: gastrointestinal cancer, chronic renal failure, and blood disease. Cancer is especially common among middle-aged and elderly people. The author has diagnosed and treated many patients with anemia found on physical examinations and then diagnosed patients with cancer. For chronic anemia, the compensated patient can have no symptoms of discomfort. Therefore, from this perspective, even if regular physical examinations cannot be performed, a simple blood-fecal routine is also important.