2020年10月23日星期五

hemorrhoids rupture,The tertiary prevention of colorectal cancer

    Colorectal cancer, including colon cancer and rectal cancer, is one of the tumors with the fastest increase in incidence and death in most countries and regions in the world in recent decades. The incidence of colorectal cancer in the world is increasing at an average annual rate of 2%. According to epidemiological data in recent years, colorectal cancer has risen to the third most common cancer in the world. In 2000, 700,000 people worldwide suffered from colorectal cancer, of which 500,000 died. Its incidence ranks second in malignant tumors in developed countries in Europe and America. In the past, the incidence rate in China was generally around the fifth and sixth place. Judging from the recent epidemic trend, the number of patients worldwide is increasing year by year.

    In China, with the changes in people's lifestyle and eating habits, the number of patients is increasing, especially in developed cities or regions such as Beijing and Shanghai.

    According to the Beijing Institute of Cancer Prevention and Treatment, there are currently about 20,000 new cancer patients in Beijing each year, with an incidence rate of 179 per 100,000, of which colon cancer ranks second. According to a survey in Shanghai, the incidence of bowel cancer in China is increasing at twice the world average. Therefore, the prevention and treatment of bowel cancer is urgent.

    Primary prevention of colorectal cancer

    The factors related to the incidence of colon cancer in China are as follows:

    1. Excessive intake of animal foods and oils and reduced intake of grains

    Comparing the food consumption of Chinese residents in the past two 10 years, an obvious trend is that Chinese residents eat less and less food, and more and more animal food and fat;

    2. Reduced activity

    In the past 10 years, the physical activity of Chinese residents, both male and female, in the workplace has been greatly reduced;

    The National Fitness Survey found that only 20% to 25% of people of working age in China take 30 minutes of physical activity 3 times a week, and only 40% of people over 50.

    3. Drinking and smoking

    In 1992, Chinese residents drank less than 3 grams of alcohol per standard person a day, and in 2002 they drank more than 25 grams.

    In the three and a half years after China signed the World Tobacco Control Framework Treaty, tobacco consumption has increased by 20%;

    4. Excess weight

    The latest cancer prevention report has determined that excessive body fat is closely related to the increased risk of cancer. For more than ten years, whether it is in the city or in the countryside, whether it is adults or children, the population of overweight and obese people has increased significantly.

    5. Drug factors and genetic factors

    Long-term use of non-steroidal anti-inflammatory drugs has a lower incidence of colorectal cancer. Taking a small dose of aspirin 10 to 15 times a month can reduce the relative risk of colorectal cancer by 40% to 50%.

    Those with a family history should be screened or treated in advance.

    Although the cause of cancer is complex, the scientific evidence of the impact of existing risk factors on the occurrence and development of various cancers is sufficient to support effective primary cancer prevention. There is sufficient evidence that a healthy lifestyle can reduce various major cancers in China. Among them, maintaining a healthy weight, proper physical activity, a balanced diet based on plant foods, quitting smoking, and limiting alcohol are the main strategies for cancer prevention and control.

    Keywords: primary prevention to achieve "two more":

    1. Exercise more

    In recent years, bowel cancer is getting younger, especially some elites around 40 years old are susceptible to bowel cancer. While people feel sorry for them to leave at the peak of their careers, should they also reflect on the following reasons? They have several things in common: because they are busy at work, they eat irregularly, the circadian rhythm of the digestive tract is disrupted, and the intestinal tract is not functioning smoothly; they are busy at work and lack leisure exercise, and they cannot arrange regular and regular time for exercise.

    British scientists pointed out that exercise can reduce the risk of bowel cancer by half. A report jointly published by the "Cancer Research Campaign" and the "Scottish Cancer Fund" pointed out that recreational activities such as exercise, physical work, walking or gardening can keep people away from bowel cancer. Relevant studies have shown that people who exercise regularly are less likely to develop bowel cancer, even if they have risk factors such as dieting, obesity and smoking.

    2. Eat more fruits, vegetables and other foods rich in dietary fiber

    After 3 years of research and "selection", the World Health Organization announced the world's top ten junk foods.

    Six types of food may cause cancer:

    Fried foods,

    Preserved food,

    Processed meat products (containing nitrite),

    Convenience food,

    Huamei preserved food, barbecue food.

    In barbecued foods, a roasted chicken leg is equal to the toxicity of 60 cigarettes.

    In recent years, people in large cities such as Shanghai, Beijing, and Guangzhou have eaten more and more high-fat and high-calorie foods, while cellulose-rich coarse grains and vegetables are rarely eaten or not eaten, which contributes to the incidence of colorectal cancer. The rate has risen significantly. Studies by scientists in western countries have shown that if the diet is rich in fiber, it will greatly reduce the incidence of colorectal cancer.

    Why do high-fiber foods prevent colorectal cancer?

    First, fiber cannot be digested in the intestine, which can stimulate the gastrointestinal tract to accelerate peristalsis, increase the volume of the gastrointestinal tract, and soften the stool, so it can speed up the excretion of stool.

    Second, fiber in the gastrointestinal tract can stimulate the brain through nerves, allowing the brain to have sufficient time to realize that the body is not hungry, thereby preventing excessive eating and reducing the burden on the gastrointestinal tract.

    Third, the cellulose in vegetables is fermented in the intestinal tract to promote cell differentiation and prevent colon cancer.

    Fourth, fiber can protect intestinal cells and reduce the stimulation of bile on intestinal wall cells, thereby reducing the incidence of intestinal cancer.

    Fifth, the undigested fiber can also adsorb carcinogens in food residues in the gastrointestinal tract, such as nitrosamines, polycyclic aromatic hydrocarbons, etc., so that these carcinogens can be excreted in the feces.

    Sixth, fiber can reduce fat intake and prevent the body from becoming obese. Obesity is also a risk factor for colorectal cancer.

    British nutritionists suggest that at least 35 grams of fiber should be consumed every day for prevention and health care. Therefore, when living conditions are better, you need to eat "remembering bitter rice" and eat it often.

    Secondary prevention of colorectal cancer

    Bowel cancer is mainly colorectal cancer, but small intestine cancer is rare. The higher the tumor stage, the later the discovery.

    According to foreign data, the 5-year survival rates of patients with stage I, II, III, and IV rectal cancer are 93%, 84%, 44%, and 8%, respectively. It can be seen that early detection, early diagnosis, and early treatment are the keys to improving the efficacy of gastrointestinal malignant tumors.

    Note the following changes:

    1. Changes in bowel habits and stool characteristics are often the earliest symptoms, which are mostly manifested as increased bowel movements, diarrhea, constipation, and blood, pus or mucus in the stool.

    2. Abdominal pain is also one of the early symptoms. It is often a persistent dull pain with inaccurate positioning, or abdominal discomfort or bloating.

    3. Symptoms of abdominal mass or intestinal obstruction may appear when it develops to a certain stage. It shows typical symptoms such as inability to eat, vomiting, anemia, weight loss, and a lumps in the abdomen.

    For middle-aged and elderly people over 40 years old and people with a family history of tumors who have the above-mentioned early symptoms, special attention should be paid to them. They need to seek medical treatment in time, early diagnosis and treatment, so as to get a good treatment effect. Once the typical symptoms appear, the disease is often In the late stage, the opportunity for radical surgery was lost.

    The examination methods mainly include X-ray barium enema, fiber colonoscopy, tumor markers, and methane-hydrogen breath test.

    Keywords: secondary prevention to do: "two mornings"

    Early morning: early detection of bowel cancer

    Colonoscopy, recommended for 40 years old, must be done for 50 years old! Click to understand

    People pay more and more attention to regular physical examinations.

    The current view is that at least one colonoscopy should be performed at the age of 40, and if no abnormalities are found, then it can be performed every 5 years.

    1. If you have intestinal polyps or other tumor-related lesions, you must treat them accordingly and shorten the interval between follow-up and review. About 90% of bowel cancers develop from adenomatous polyps. Therefore, timely removal of polyps is very important.

    2. Secondly, according to the more or less manifestations of most diseases in the early stage, decide whether to do colonoscopy or digital rectal examination.

    3. Bowel cancer is a kind of cancer with very hidden early symptoms. It is easy to be confused with many diseases. Doctors and patients may miss and misdiagnose due to negligence.

    4. The early symptoms of rectal cancer are very similar to hemorrhoids, and the special part of hemorrhoids is a place where people are taboo. 50% of rectal cancer patients are misdiagnosed as hemorrhoids at an early stage.

    5. Colorectal cancer has its own unique expression in the early stage, such as blood in the stool, mucus and pus and blood in the stool, changes in bowel habits, alternation of diarrhea or constipation, abdominal pain and bloating, anemia and weight loss.

    6. When you find blood in your stool, you can go to the hospital surgery for a digital rectal examination. Don't get lucky.

    People at high risk of colorectal cancer with blood in their stools-those with colorectal polyps, ulcerative colitis, and those in their families who are prone to intestinal tumors, should have regular blood draws, carcinoembryonic antigen tests, tumor factor tests, etc. Especially do colonoscopy regularly.

    Two morning: early treatment of bowel cancer

    When diagnosing bowel cancer, treat it with a positive attitude. Some patients experience depression, pessimism and other emotions, and they do not even actively cooperate with treatment. This is wrong. Because the human immune system is closely related to one's emotions and willpower. When the mood is depressed, the immune cells that defend themselves against tumors will be in a state of depression, unable to monitor the occurrence and development of tumor cells, and they cannot effectively kill tumor cells.

    If a colorectal mass is found, it should be removed as soon as possible and sent for pathological examination to clarify the nature of the mass. Now, the technology of direct polypectomy and biopsy under colonoscopy is quite mature, the patient's pain is very small, and the early diagnosis and treatment of bowel cancer can be obtained. Regular follow-up should be done after the operation, and it must not be regarded as a once and for all.

    At present, after the diagnosis of colon cancer, comprehensive active treatment is required, including surgery, chemotherapy, radiotherapy, biological treatment, etc., of which surgery is the most important. Try to completely remove the tumor during the operation, and chemotherapy after the operation will lay the foundation for other treatments in the later period and effectively improve the survival time of the patient.

    Three-level prevention of colorectal cancer

    Tertiary prevention is mainly to actively treat cancer patients to improve the quality of life of patients and prolong survival. At present, surgical treatment is mainly used for patients with colorectal cancer, supplemented by appropriate radiotherapy and chemotherapy, traditional Chinese medicine treatment, and immunotherapy to improve the treatment effect of colorectal cancer.

    The treatment of advanced (advanced) bowel cancer is generally more successful than gastric cancer, and the 5-year survival rate is higher than that of gastric cancer.

    At present, for bowel cancer that can be cured after radical surgery, the main comprehensive treatment is radical surgery:

    Including radical surgery, chemotherapy, radiotherapy, molecular targeted therapy and traditional Chinese medicine, immunotherapy, etc.

    At present, there are more molecularly targeted drugs for bowel cancer than for gastric cancer, mainly including anti-EGFR antibodies (such as Erbitux, etc.) for regulating tumor growth, and anti-VEGF antibodies (such as Avastin, etc.) for tumor angiogenesis. The treatment effect of advanced intestinal cancer is better than that of gastric cancer, and the survival time is longer.

    Is it possible to operate on distant metastasis of colorectal cancer?

    Colorectal cancer, or colorectal cancer, as a common tumor is a great threat to humans. About one-third of patients with colorectal cancer have metastases when they see a doctor, of which liver metastases are the first, followed by lung metastases and retroperitoneal metastases.

    Different from gastric cancer, the current view believes that distant metastasis of colorectal cancer can also have surgical value, and that the primary tumor and metastasis can be removed at the same time or by stages to obtain a better therapeutic effect.

    Foreign reports have reported that the five-year survival rate of simultaneous or heterochronous liver metastases can reach 35 to 40% after active comprehensive treatment based on surgery. If it is just a simple lung metastasis, simultaneous or heterochronous lung metastases can also be considered for surgical resection, and some patients can also get the chance of radical treatment.

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