If it is checked early, it is still a polyp, at most early cancer; if it is late, it is advanced cancer. The prognosis, treatment cost, and quality of life are worlds apart.
What is colorectal cancer?
Colorectal cancer is a common malignant tumor in the gastrointestinal tract and one of the key cancers in China. The incidence of colorectal cancer in China is the highest in the 40-50 age group, and about 5% of patients are under 30 years old.
With economic development and changes in lifestyles, especially dietary structure, people have changed from coarse tea and light meals to meat-based refined foods. In recent years, the incidence of colorectal cancer in China has been increasing year by year. Data show The harm of cancer in China is becoming more and more serious. Colorectal cancer has become one of the common diseases that endanger the lives and health of Chinese people.
The latest cancer report in 2018 shows that colorectal cancer ranks only after lung cancer and gastric cancer, and has successfully been promoted to the top three tumor mortality!
The life span and prognosis of colorectal cancer are closely related to the early or late discovery. Data show that the five-year survival rate for early colorectal cancer (Dukes A) after surgery can be as high as 90%-98%, while that for advanced cancer is only 10%. (Editor’s note: The latest data shows that five years of advanced colorectal cancer in China The annual survival rate has reached about 30%).
The five-year survival rate of early and late colorectal cancer is so different, which shows how important the early detection of colorectal cancer is.
Symptoms are hidden, easily misdiagnosed and missed
The early symptoms of colorectal cancer are not obvious, usually only manifested as blood in the stool, diarrhea or constipation, and these symptoms can easily be misdiagnosed as hemorrhoids, anal fissure, chronic colitis, ulcerative colitis, constipation, appendicitis and other diseases, which cannot cause the patient or even the doctor enough Attention.
The misdiagnosis rate of colorectal cancer is 41.5%, among which the misdiagnosis rate of colon cancer among young people is as high as 72.8%-80%; and more than 80% of low-level colon and rectal cancer are misdiagnosed as hemorrhoids!
The reason is the lack of a colonoscopy or digital anus examination.
According to relevant data, only 8.8%-10% of colorectal cancers are diagnosed within one month after symptoms appear, 25% are diagnosed within 3 months, and 64.3% are diagnosed within 6 months. Some were even treated with colitis for as long as half a year, and some were treated with hemorrhoids and anal fissures, which caused the condition to become more and more serious. In the end, colonoscopy revealed that it was not hemorrhoids but colorectal cancer. With a good time for treatment, the lesson is very profound.
The failure to diagnose colorectal cancer in time and the delayed diagnosis are important reasons that affect the prognosis. Compared with other tumors, colorectal cancer develops relatively slowly and metastasizes later. If you can improve your vigilance against this disease, you can do related examinations as soon as possible (colonoscopy is preferred) to eliminate it in its budding state.
Clues of middle and early colorectal cancer
Early and mid-stage colorectal cancer often has some warning signs, and special attention should be paid to the following symptoms:
1. Blood in the stool
Colorectal cancer is deep in the disease and has an insidious onset. It is asymptomatic before the tumor is small, without necrosis, bleeding, or infection. Bloody stool is one of the early symptoms of all colorectal cancer. The amount is small in the early stage, and fresh blood stains are often attached to the surface of the stool. A small number of patients discharge more drops of fresh blood after the stool is discharged; sometimes because of the low blood volume or the long stay in the body, the naked eye cannot detect it, but the stool occult blood test is positive, and the stool gradually becomes bloody and mucous.
The blood in the stool of colorectal cancer needs to be distinguished from the blood in the stool caused by hemorrhoids, anal fissure, bacillary dysentery, enteritis, intestinal polyps, ulcer perforation and other diseases to prevent misdiagnosis and mistreatment.
2. Changes in bowel habits
Changes in bowel habits or frequency, as well as constipation or unexplained diarrhea, occur when the colorectal tumor is relatively large, with erosions, ulcers, and infections.
Patients with rectal cancer may have more bowel movements, but they do not defecate much each time, or even have no feces at all. They only discharge some mucus and blood, and have a feeling of incomplete defecation. This phenomenon is medically called anal tenesmus. Some patients may have diarrhea after constipation, or only the beginning of the stool is dry and the end becomes thinner, or repeated constipation and diarrhea alternate.
Three, stool deformation
If the cancer protrudes in the rectal cavity and compresses the stool, the stool discharged is often thin and deformed, which can be flat or concave, and sometimes some blood stains are attached to the deformed stool.
Some patients have diarrhea as the first symptom, and the number of stools per day is increased, which can be mucus blood in the stool, thick blood in the mucus, and may be accompanied by tenesmus, unclear stool and gas in the anus.
Five, bowel pain
About 50% of patients with rectal cancer have pain during defecation, ranging from mild to severe.
Six, abdominal pain
In the middle and late stages of colorectal cancer, if it occurs in the right large intestine, it will produce dull pain in the right abdomen, and sometimes postprandial abdominal pain. Left colon cancer often complicates intestinal obstruction, sometimes with abdominal cramps, accompanied by abdominal distension, hyperintestinal sounds, and difficulty defecation.
Seven, abdominal mass
It is more common in the right abdomen and is one of the manifestations of right colon cancer. It suggests that it has reached the middle and advanced stages. The surface of the mass may have nodules, which can generally be pushed, but it is fixed at the advanced stage of the tumor. There may be tenderness when combined with infection.
Eight, fatigue, anemia, weight loss
Due to the consumption of tumor growth and long-term chronic blood in the stool, patients may experience paleness, fatigue, dizziness, weight loss and other anemia symptoms, as well as low-grade fever, progressive weight loss, hepatomegaly, edema, jaundice, and ascites.
Why colonoscopy can effectively prevent colorectal cancer?
First, colorectal cancer is different from other cancers in that the symptoms are insidious, and most of them have no symptoms in the early stage;
Second, most of it evolved from intestinal adenomas (polyps); and before polyps become cancerous, we can find and treat them through colonoscopy, and eliminate them in the budding state;
Third, it grows extremely slowly, from polyps to bowel cancer, it takes about 10-15 years.
Therefore, we can achieve early detection and early treatment. As long as it has a colonoscopy before it becomes cancerous, it can be found and removed.
But unfortunately, many patients are always worried about the pain and do not receive the colonoscopy in time when the doctor advises them to perform colonoscopy according to their condition. Others may be delayed repeatedly due to busy work and other reasons, missing precious time for early investigation and treatment. Early detection, early diagnosis and early treatment of cancer are one of the main strategies to reduce mortality and improve survival. Proper application of existing technology and methods can reduce cancer mortality by about 1/3.
At present, less than 10% of patients in China are in the early stage. The treatment costs are high but the results are small, and the waste of resources is serious. Early detection and immediate treatment and treatment after late detection have a difference of more than 10 times in medical fees. For example, for a patient with early polyp carcinogenesis, most patients do not need laparotomy and only undergo colonoscopy. The medical cost is only about 3,000 yuan, while for advanced colorectal cancer, open surgery plus chemotherapy is at least tens of thousands of yuan. Not only is the cost of medicine expensive, but the patient suffers from pain, complications, and sequelae, and the prognosis is poor.
What are the advantages of colonoscopy?
Electronic colonoscopy is a special inspection instrument for large intestine diseases that passes from the anus through the rectum, sigmoid colon, descending colon, transverse colon, ascending colon and finally into the deepest part of the large intestine, the cecum and even the end of the ileum through a flexible tubular instrument. The electronic colonoscopy is clear and intuitive. At the same time, if a lesion is found during the inspection, tissue specimens can be sent to pathological examination for diagnosis, filming, and microscopic resection of early cancerous tissues, which can avoid the pain of open surgery.
Colonoscopy has the highest sensitivity and is an ideal method for colorectal diseases, especially colorectal cancer. It is regarded as the gold standard for diagnosing colorectal diseases.
High detection rate of colonoscopy?
Studies have shown that the detection rate of polyps in the general population is as high as 15%-20%, and the population of 60-75 years old is as high as 75%-80%; other data shows that through the analysis of 16282 cases of electronic colonoscopy, 371 cases of colorectal cancer were found. The detection rate of colorectal cancer was 2.28%; the age of onset ranged from 20 to 88 years old; 28 cases were 20-40 years old, accounting for 7.62% of colorectal cancer in this group. 1500 cases of precancerous diseases such as colorectal adenoma and polyps were detected, accounting for 9.21% of the people examined.
In other words, many people have the time bomb of polyps in their intestines, and the weapon they find is colonoscopy!
Is colonoscopy painful?
Generally speaking, whether the colonoscopy is painful and the severity of the pain is mainly related to factors such as the inspection method, the familiarity of the examiner, and the individual condition of the patient under the same conditions of the colonoscopy.
At present, colonoscopy in China mainly uses two-person operation, and patients often have obvious pain. In recent years, the widespread use of painless colonoscopy has provided many friends who are afraid of the scope with more choices.
Is there a completely painless colonoscopy?
Yes, for particularly stressed or younger children, a small amount of sedative and analgesic drugs can be injected from the vein under the operation of the anesthetist. The patient can complete the colon examination in more than 10 minutes without pain, and it is very safe. However, inspection costs will increase.
Capsule endoscopy is also a good choice. It is painless, noninvasive, and non-cross-infection, but the cost is a bit high.
Which patients must undergo colonoscopy?
It is generally believed that people with the following symptoms are at high risk of colorectal cancer, and colonoscopy should be performed in time to help detect early colorectal cancer.
• People with unexplained blood in the stool, bloody mucous stool, positive fecal occult blood test, abdominal pain, diarrhea, weight loss, abdominal mass, anal drop, and anemia;
• People with precancerous lesions of colorectal cancer, such as colorectal adenomatous polyps, familial polyposis, ulcerative colitis, and schistosomiasis;
• People with mental stimulation, history of appendix and gallbladder surgery;
• Those who rely mainly on meat and fine diet and those who lack exercise;
• Those with a history of colorectal cancer and a positive carcinoembryonic antigen test;
• A history of pelvic radiotherapy for the uterus and prostate, a history of gallbladder or appendectomy.
If you have the above symptoms and the above-mentioned high-risk groups of colorectal cancer, it is recommended to go to the relevant specialists of the hospital for colonoscopy in time to rule out the possibility of early colorectal cancer or precancerous changes.