This is a popular science lecture that I recently gave for the People’s Livelihood Channel of Henan TV Station. I hope it will be helpful to interested friends.
Introduction: Colon cancer is a more common and highly malignant disease among digestive system tumors. In recent years, with the improvement of people's living standards and changes in dietary structure, the incidence rate has been increasing year by year. How is colon polyps related to colon cancer? What causes the two? How should these two diseases be treated? "The prevention of colon cancer starts with the prevention of colon polyps" from the Minsheng TV Clinic will be broadcast soon.
Guest introduction: Feng Changwei
Moderator: Director Feng, hello!
Director Feng: Hello, host!
Moderator: Director Feng, what role does the intestine play in the process of human digestion and absorption?
Moderator: Where is the colon in the human body?
Director Feng: Please look at this picture. The colon is located in the abdomen of the human body, on the outer part around the umbilicus. His main function is to absorb some residual nutrients and water from the digested food left behind by the small intestine to form feces and excrete them from the body.
Host: Director Feng, the theme of our current program is "Preventing Colon Cancer Starts with Preventing Colon Polyps". Colon polyps and colon cancer are two diseases, right? Why does the prevention of colon cancer start with the prevention of colon polyps?
Director Feng: Let's start with the current status of cancer in China. The current incidence of malignant tumors in China ranges from 130.3/100,000 to 305.4/100,000 males and 39.5/100,000 to 248.7/100,000 females. The top ten male malignant tumors (86%) were lung cancer, stomach cancer, liver cancer, colon/rectal cancer, esophageal cancer, bladder cancer, pancreatic cancer, leukemia, lymphoma, and brain tumors. The top ten female malignant tumors (82%) were breast cancer, lung cancer, colon/rectal cancer, stomach cancer, liver cancer, ovarian cancer, pancreatic cancer, esophageal cancer, uterine cancer, and brain tumors. In our view, colon/rectum, which is what we call colorectal cancer, is the fourth place among male tumors and the third place among females. Moreover, with the improvement of people’s living standards, the incidence of colorectal cancer is also increasing. The trend of getting older and younger, has become a serious threat to the health of the Chinese people.
Most colon cancers arise from colon polyps. Studies have shown that approximately 70% of colon cancers are caused by colon polyps.
Colon polyps are neoplasms that protrude from the epidermis of the colon mucosa and protrude into the cavity. Colon polyps mostly occur in the sigmoid colon and rectum. There are more men than women. The older the age, the higher the incidence. The canceration rate of colon polyps is related to the type, size and epithelial dysplasia of the polyps. In general, adenomatous polyps have a higher rate of canceration. The carcinogenesis rate of severe dysplasia is 27-60%, and the carcinogenesis rate of adenomatous polyps greater than 2cm in diameter can reach more than 60%. It is estimated that the time from polyp to cancer development is 5 to 15 years.
Moderator: It turns out that colon polyps and colon cancer are so closely related. Director Feng, what might cause colon polyps?
Director Feng: The exact cause of colon polyps is currently unclear, and may be related to the interaction of the following factors:
1. Dietary factors: Dietary factors have a certain relationship with the formation of colon polyps. Medical research has found that a high-fat, low-fiber diet can promote the secretion of bile from the liver, prolong the time of feces in the intestine (constipation), and bile in the intestine Under the action of the tract flora, it becomes secondary bile acids such as deoxycholic acid and lithocholic acid. The secondary bile acid has a cytotoxic effect on colonic crypt epithelial cells and causes irreparable DNA damage. These DNA-damaged cells Under normal circumstances, it is cleared by apoptosis, but the long-term effects of high concentrations of secondary bile acid and carcinogens can make some cells that antagonize apoptosis mutations or mutations survive DNA damage and selectively survive, proliferate and gradually Evolve into an adenoma. In particular, the interaction between bacteria and bile acid may be the basis for the formation of adenoma polyps.
2. Genetic factors: It is generally believed that the formation of polyps is closely related to genetic mutations and genetic factors.
3. Inflammation stimulation: The rectal mucosa is stimulated by inflammation for a long time, which can cause the formation of polyps in the intestinal mucosa.
4. Stool, foreign body irritation and mechanical damage: coarse feces and foreign bodies stimulate the intestinal mucosal epithelium for a long time, and other reasons cause rectal membrane damage, causing dysplasia of cells to form polyps.
Moderator: Who are more at risk of colon polyps and colon cancer?
Director Feng: First of all, people with a family history. If one of the parents has colon polyps or colorectal cancer, the risk of polyps and colorectal cancer in the children can be more than three times higher than that of normal people; people with long-term constipation; like high fat, high Those on a protein diet; and those over 50 years of age.
Moderator: Director Feng, what symptoms are there that may indicate colon polyps?
Director Feng: Three symptoms suggest that you may have colon polyps
1. Hematochezia: Patients with colon polyps are most likely to have hematochezia, but many people mistake stool bleeding as a symptom of hemorrhoids, which delays the best treatment opportunity. Bleeding caused by hemorrhoids is often manifested as bleeding after stool, which is bright red, while bleeding caused by colon polyps is often mixed with stool and is bright red or dark red. This is mostly caused by fecal trauma polyps or polyps themselves.
2. Changes in bowel habits: including changes in the time and frequency of bowel movements, as well as constipation or unexplained diarrhea. Especially when constipation and diarrhea alternately occur, or when abdominal pain occurs, it is even more vigilant.
3. Abnormal stool shape: Normal stool should be cylindrical, but if the polyp is large and presses the stool in the colon cavity, the stool will tend to become thinner or flattened, with grooves, and sometimes blood stains when it is discharged.
Moderator: Once colon polyps develop into colon cancer, the symptoms you mentioned will become more obvious, right?
Director Feng: You are absolutely correct. When there are irregular abdominal distension, abdominal pain, changes in bowel habits, mucus or bloody stools, especially when accompanied by unexplained weight loss and anemia, it is the alarm symptom of colon cancer. Perform colonoscopy to confirm the diagnosis.
Moderator: I heard that the length of an adult’s intestines is four times the height. The intestines are so long. If there is a suspected colon polyp, is there any examination method to check the position and shape of the polyp?
Director Feng: We have already mentioned that the total length of the human digestive tube is about 7~9 meters, but the length of the large intestine is only 1~1.5 meters. Our current electronic colonoscope can clearly show the size of colon polyps. And the specific location, we can find polyps the size of rice grains through the colonoscope, and can remove them while doing the colonoscopy.
Moderator: Director Feng, what preparations need to be done before colonoscopy?
Director Feng: Before doing colonoscopy, you only need to start eating a liquid or low-residue semi-liquid diet 1 day before the examination. On the morning of the examination, you should have an empty stomach. The night before the examination, taking castor oil to lubricate the intestines has a laxative effect. Take mannitol and other cathartic agents and appropriate amount of warm water to clean the intestines, or clean the enema to ensure the cleanliness of the intestines. If you have patients with habitual constipation, you should also take some laxatives in advance, such as fruit guide tablets, Fusong powder, Maren pills, etc., to ensure that the intestines are cleaned to a satisfactory level.
Moderator: Director Feng, you mentioned above that if colon polyps are not treated in time, colon cancer is likely to be induced. If colon polyps are diagnosed, the section of intestine with polyps can be removed directly, can it reduce the chance of cancer? ?
Director Feng: Removal of the intestine with polyps can indeed reduce the cancer rate of polyps. This is an ancient treatment method. However, the excised intestines can no longer grow. Moreover, surgical operations are traumatic and risky, as well as intestinal adhesions, diarrhea and other sequelae. Besides, polyps can be repeated and repeated. We can't cut everything again. Cut off all the intestines, right? The emergence of colonoscopy has revolutionized the treatment of colon polyps. We can now perform colonoscopy very easily. We can basically observe every part of the colon in a comprehensive way. We can also use the staining and magnification functions of the electronic colonoscope to observe the lesions, and we can also use special equipment Perform a surgical operation under a colonoscope to remove the polyp from the root. This operation can be performed in a pain-free state. The patient only needs to take a short nap, and all operations have been completed in his/her sleep. Most postoperative patients can walk home directly without hospitalization. The excised polyps can also be sent for further pathological examination. If there is no cancer, or the cancer is limited to the top of the polyp, the disease is completely cured. Why not do such a good method?
If colon polyps are not treated in time, once they progress to colon cancer, the nature will be completely changed. At this time, the treatment is not only an operation to cut the intestines, but also chemotherapy and radiotherapy. Some patients may not be able to save the anus and have to open the belly. , To make an artificial anus, you need to live with a dung bag for life, thinking about it, you might get a big head.
Moderator: What else should I pay attention to in daily life for patients with colon polyps treated by colonoscopy?
Moreover, regular review is very important, because polyps have genetic characteristics and will occur frequently and reoccur. Regular review can detect recurring polyps in time, thereby eliminating colon cancer in the bud.
Moderator: Director Feng, is there any way to prevent colon polyps and colon cancer?
Director Feng: There are the following points;
1. Develop good and healthy living habits, eat healthy food, avoid high-fat, high-protein, these fat and sweet foods, eat less refined foods, and eat more foods that contain more fiber;
2. Develop the habit of defecation regularly, avoid constipation, and prevent the stool from staying in the intestine for too long;
3. Appropriate calcium supplementation. Data has confirmed that appropriate calcium supplementation can prevent or reduce the occurrence of polyps and colon cancer;
4. Appropriate physical exercise and maintain a normal weight, because studies have shown that obesity is a risk factor for colon cancer;
5. Take aspirin appropriately. Data shows that aspirin has a certain effect in preventing colon polyps and colon cancer;
6. Maintain a good mood, a good mood, and a good mood can regulate the body's immune system and reduce the occurrence of tumors.
Moderator: For those with familial colon polyps, what should they pay more attention to in their daily lives?
Host: At the end of the show, please Director Feng to give a key reminder for today's show.
Director Feng: Colon polyps are precancerous lesions of colon cancer. Early detection of colon polyps and reasonable treatment can block and prevent the occurrence of colon cancer.
The symptoms of colon polyps mainly include blood in the stool, constipation, abdominal pain, changes in stool characteristics, and positive stool occult blood. The best examination and treatment methods are colonoscopy and treatment under the microscope. Colonoscopy is now basically painless, low risk, easy to operate, and relatively low cost. Therefore, it is recommended that people with family history, symptomatic patients, and if possible, people over 50 years old should have a colon. Microscopic examination can effectively prevent and reduce the occurrence of colon cancer. (Outline the main symptoms of colon polyps and colon cancer, remind people that they should be treated early if they are found)
Moderator: After listening to Director Feng’s explanation, I believe that you in front of the TV have a certain understanding of the treatment of colon polyps and the relationship between colon polyps and colon cancer. If you have any questions, you are welcome to call 12580 to transfer to the Minsheng TV Clinic Make a consultation.