2020年11月25日星期三

hemorrhoids lidocaine,Professor Wang Zhigang from Shanghai Sixth Hospital: Colorectal cancer can be cured

    Yin Xuebing, Member of the Medical and Health Professional Committee of Shanghai Science Writers Association

    Intestinal cancer is a kind of cancer with hidden early symptoms. It is easy to be confused with many diseases, especially hemorrhoids. Many people easily regard the bleeding of intestinal cancer as hemorrhoid bleeding, and it is not discovered until the late stage of intestinal cancer. So, how to detect bowel cancer as early as possible and achieve early diagnosis and treatment?

    What are the symptoms of colorectal cancer

    In recent years, the incidence of colorectal cancer in China has increased at an average annual rate of 4%, and more than 80% of cases are in the middle and late stages. If you get colorectal cancer, what kind of symptoms will the patient have?

    Colorectal cancer is mostly asymptomatic in the early stage, so it is often found in the middle and late stages. Of course, some patients may have some symptoms, such as blood in the stool, changes in stool characteristics, and changes in stool regularity. Many patients have hemorrhoids and delays. diagnosis. Of course, if there are systemic manifestations, such as anemia and weight loss, it often indicates that the tumor will be advanced.

    Can colorectal cancer be cured?

    Colorectal cancer is a disease with very good therapeutic effect compared to other tumors of the abdominal cavity. The 5-year survival rate of colorectal cancer in China can reach 60% or even better.

    There are also many treatments for colorectal cancer, such as surgery, radiotherapy, chemotherapy, targeted therapy, etc., even in the middle or late stages or after recurrence and metastasis, it is still possible to effectively control the disease and allow the patient to prolong life; but colorectal cancer has a very disadvantageous The characteristic of treatment is that after surgery, half or even more than half of people will have recurrence or metastasis.

    From a medical point of view, the biological behavior of colorectal cancer tumors is relatively good. Even if metastasis occurs, it may still have a good window period for doctors to treat and intervene to allow patients to continue their lives.

    What to do if colorectal cancer recurs after surgery

    After colorectal cancer recurs, there are many ways to treat it, including the concept of reoperation.

    The concept of technical multi-disciplinary is the cooperation of multiple surgical departments to challenge some techniques that are difficult to complete in a single department, so that many patients who are difficult to operate after recurrence have the opportunity to be surgically removed again.

    The purpose of this is to make such patients truly benefit, and to bring survival gospel to many patients with advanced or recurrent bowel cancer, rather than to challenge technology.

    How to treat colorectal cancer recurrence after surgery

    As mentioned earlier, colorectal cancer has a high recurrence rate. Colorectal cancer tumors recur after surgery, usually in the middle and late stages. Unexpected results may be obtained after surgery. After many years of research and experience accumulation, the efficacy sometimes exceeds expected.

    Some large cancer centers in the United States and European countries are also exploring this aspect of work. After colorectal cancer recurrence, if some cases are carefully selected and accurate preoperative evaluation, complete resection may be obtained again. Preoperative evaluation may have a better prognosis. As for the patient, after another surgical resection, it may bring him effects that cannot be achieved by non-surgical treatment.

    After the recurrence of colorectal cancer, if radical resection can be obtained again, its 5-year survival can reach 40%, and even many patients will survive for a long time.

    In some second-level or smaller hospitals, many patients give up hope and feel that there is no need to actively treat advanced tumors. His life may be only a year or less. In fact, if he is removed by surgery, it is very It is possible to obtain a very good survival and quality of life.

    Colorectal cancer is a special disease, so no matter how late the disease is discovered, or if it recurs, it is still very promising and should not be given up easily. This is also the direction and original intention of our multi-disciplinary integration of outpatient services. It is precisely because of such good results that our multidisciplinary efforts are a very meaningful thing.

    Standardized treatment requires multidisciplinary cooperation

    The current medical treatment is a standardized medical treatment, and we also emphasize individualized treatment. Different patients have the same disease, they have their own rules and different characteristics. This is the heterogeneity of tumors.

    Different patients should have different strategies. We contact patients with locally advanced bowel cancer or recurrent bowel cancer. Each of them has a different situation and is ever-changing. Some people have liver metastases, some are lung metastases, and some people have peritoneal metastases. Some people have affected the surrounding organs, some people have invaded important blood vessels, and some people have a combined transfer of two or three organs.

    In addition to the lesion, the patient's general condition, organ function, surgical tolerance, and possible chronic diseases should also be considered. From these perspectives, each patient has his own characteristics. The focus of the multidisciplinary expert discussion is to tailor a most suitable strategy and program, and the best treatment path for the patient according to the patient's disease progression, general condition, and psychological state.

    At present, the general operation method of the multidisciplinary treatment model at home and abroad is that after the patient is hospitalized, the experts of the multidisciplinary team (MDT) of the ward will discuss whether the patient is suitable for direct surgery or radiotherapy and chemotherapy first, and whether to add a target To treatment and so on, then the patient enters a different path and often needs to be transferred to another department for treatment.

    What to know to prevent colorectal cancer

    People at high risk of bowel cancer, such as those with familial polyposis, family history of bowel cancer, history of intestinal schistosomiasis, or the patient's own history of polyp removal, there are many citizens who don’t know that after cholecystectomy The patient is also a high-risk group.

    According to the current understanding, the occurrence of colorectal cancer is related to many factors.

    First of all, it is related to gene mutations. Gene mutations have family factors, some of which are caused by the environment. In our country, roughly 15% of colorectal cancer patients have family tendencies. Of course, most of them are sporadic colorectal cancers. Mainly it has a lot to do with diet.

    Economic development has brought about changes in the dietary structure. The most important thing is more meat and less vegetables, high calorie and high fat intake, and low fiber intake. This has a great relationship with the increase in the incidence of colorectal cancer.

    Of course, in order to prevent and treat colorectal cancer, in addition to dietary adjustments, some concepts of colorectal cancer screening should also be popularized.

    Carry out general screening of high-risk groups in the community. The census we are talking about includes: tumor indicators, blood tests, fecal occult blood, colonoscopy. We encourage citizens over 40 to have colonoscopy screening once every 5 years if there are no high-risk factors, even if there are no symptoms. check.

    Why pay attention to colonoscopy

    Many patients have missed the chance of early detection of bowel cancer because of fear of colonoscopy. They "prefer" to treat it as hemorrhoids, anal fissures or other diseases, and do not check it with blood in the stool, or if the patient finds CEA in the blood during the general survey. The tumor index has increased and has not attracted attention.

    Among the more than 30 million citizens in Shanghai, if adults over 40 go to get colonoscopy and perform a general survey, our colorectal surgeons will lose their jobs.

    Most colorectal tumors are transformed from polyp adenomas. If you remove them and remove the roots, there will be no bowel cancer. The incidence of bowel cancer in Western countries is decreasing year by year because of the national census and regular adult census.

    Therefore, colonoscopy is the first and most important one, which can be said to be irreplaceable.

    Many patients have been diagnosed with bowel cancer and regret that they did not listen to the doctor's advice earlier. Therefore, I think I must emphasize that early detection and early diagnosis and treatment are the most important. So don't leave hidden dangers to your health because of fear of colonoscopy.

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