With the improvement of urban modernization, the improvement of living standards, the change of lifestyle and diet structure, the increase in intake of high-calorie, high-fat, and high-protein foods such as chicken, duck and fish, and the aging of the population, the problem of high incidence of colorectal tumors will be It is becoming more and more prominent, and it deserves our attention.
Judging from the current clinical treatment situation, the incidence of colorectal cancer in cities is 2-3, and the proportion of young people under 40 years of age suffering from colorectal cancer accounts for about 20% of the total number of colorectal cancers, and it is rising further. trend.
Some experts have predicted that colorectal cancer is expected to replace lung cancer and become the new cancer king!
China has entered the ranks of areas with a high incidence of colorectal cancer. The high incidence and high mortality of colorectal cancer are increasingly threatening people's physical and mental health.
Therefore, the situation of colorectal cancer prevention and treatment is very serious and needs to arouse our attention.
1. Prevention of colorectal cancer and high-risk groups
With the advancement of medical and health services, people have a deep understanding of diseases, and great progress has been made in the prevention and treatment of colorectal tumors. There are some effective prevention methods, such as:
1. From the etiology,
We improve our lifestyle and reduce our intake of high-protein, high-fat, refined, pickled and smoked foods;
Increase consumption of vegetables, fruits and whole grains; reduce smoking and excessive drinking;
Strengthen exercise, reduce obesity, and prevent colorectal cancer from the cause.
2. Actively treat precancerous lesions,
If we can treat and cure these precancerous lesions early, they will not develop into colorectal cancer and reduce the incidence of colorectal cancer. Actively prevent and treat colorectal polyps and ulcerative colitis; for multiple polyps and adenoma polyps, once the diagnosis is clear, they should be surgically removed early to reduce the chance of cancer.
3. Active health check for high-risk groups,
Who are the high-risk groups for colorectal cancer?
People who eat high protein, high fat and obesity frequently;
I have suffered from colorectal adenoma;
I have had ulcerative colitis;
I have suffered from female reproductive organ tumors (gynecology, breast);
There are more than 2 people in the immediate family, or one under 50 years old suffering from bowel cancer;
Family members of hereditary non-polyposis colorectal cancer;
Family members of familial adenomatous polyposis;
2. Early detection and early treatment are essential
For colorectal cancer that has occurred, we must strive for early detection, early diagnosis and early treatment as possible.
Early treatment of malignant tumors can be cured!
Compared with middle-advanced colorectal cancer, its treatment cost, treatment difficulty and treatment effect are very different. Such early-stage cancer can easily reach the standard of cure. Surgery alone is sufficient, and other radiotherapy and chemotherapy are not required. Even with the rapid medical development of bowel cancer, some patients are still unsatisfactory with the comprehensive use of multiple methods.
Unfortunately, most of our clinical findings are advanced or middle-advanced patients. The treatment is difficult, and some patients have poor treatment effects. The main reason is that the patients themselves did not pay enough attention to some of their abnormal conditions. Seeing a doctor early, early diagnosis depends on people themselves to learn more about colorectal cancer, and to understand the symptoms of early colorectal cancer.
3. How to detect colorectal cancer early and pay attention to the danger signals of colorectal cancer
1. First of all, check whether the stool is bloody.
Speaking of blood in the stool, many people think of hemorrhoids. In fact, blood in the stool may also indicate other hidden diseases in the digestive tract, and may even be a signal of malignant tumors in the intestine. When encountering blood in the stool in daily life, there are generally two attitudes: one is the group of hemorrhoids patients, who disagree and think that hemorrhoids are causing trouble; the other is the group who cares about health, are very panic, and suspect that they have gotten incurable. disease.
In fact, blood in the stool is a very common symptom. Depending on the location of the bleeding, the amount of bleeding, and the speed of bleeding, the color of the blood in the stool will be different. The stool appears bright red, or dark red, or black, all of which are blood in the stool. In fact, blood in the stool is not a disease, but a clinical symptom that may occur in many diseases. However, most of the blood in the stool indicates that the anorectal disease is caused!
The more common three conditions are hemorrhoids, rectal cancer, and intestinal polyps.
Among them, rectal cancer has the most serious consequences! Blood in the stool is one of the common symptoms of rectal cancer.
Worse still, more than 90% of rectal cancer cases will be misdiagnosed as hemorrhoids in the early stage, delaying the best treatment period! Rectal cancer is misdiagnosed as hemorrhoids with serious consequences, but why are so many people misdiagnosed? Part of this is the self-diagnosis of the patient, and part of it is the guesswork of the medical staff. The main reason is that the clinical manifestations of rectal cancer and hemorrhoids have many similarities, such as blood in the stool, increased stool frequency, etc., which makes it easy to be misdiagnosed as hemorrhoids in the early stage of rectal cancer.
So, what kind of blood in the stool is rectal cancer? How is it different from hemorrhoids?
The first is age.
Hemorrhoids can occur in people of any age, and patients with rectal cancer are mostly middle-aged or elderly. Because rectal cancer is the same as other cancers, its formation takes a certain amount of time to accumulate, although there are
It is a trend of younger people, but most of them are middle-aged or elderly people!
The second is the blood characteristics in the stool.
Hemorrhoid patients have blood in their stools because they scratch the affected area during defecation. Most of the blood drips down after the stool is discharged. Therefore, the blood will not mix with the stool. The blood is bright red and there is no mucus. The stool of patients with rectal cancer is often mixed with blood, mucus and thick liquid, and the color is generally darker than the color of hemorrhoid blood! Stool with pus, blood and mucus"---Be careful of intestinal tumors. If the discharge is pus (mucus) and blood in the stool, pay attention, that is, there is both pus (mucus) and blood in the discharged stool. Pus ( Mucous, bloody stools are often found in tumors and inflammations in the rectum or colon. You may have a malignant tumor in the intestine, and you need to go to a regular hospital for detailed examination.
It is very necessary to perform a detailed specialist physical examination of the patient:
Such as digital anal examination, colonoscopy and diagnosis performed by specialists.
2. In addition, whether your bowel habits have changed
For example, the frequency of bowel movements or increased bowel movements,
The bowel habits of patients with rectal cancer will be significantly changed, the frequency of bowel movements will increase, and hemorrhoids will not have a change in bowel habits. In addition, patients with diarrhea will defecate many times a day. If the diarrhea cannot be relieved after taking the medicine, you should pay special attention. And there is always a feeling of uncleanness? Due to the secretions produced by rectal masses and their cancerous ulcers, intestinal irritation can occur, leading to symptoms such as frequent bowel movements, incomplete defecation, and tenesmus, but the discharge is mostly mucus, pus, and blood.
3. The second thing is to see whether the stool traits have changed;
For example, stool strips become thin or flat, stools may become thinner, often out of shape, stools become thinner and thinner, stools with blood and mucus, etc.
4. Secondly, do you have a dull abdominal pain or other uncomfortable feelings,
There may be paroxysmal pain in the abdomen that is not fixed in position, dull pain accompanied by obvious bowel sounds, etc., and whether it is constipation or alternate constipation and diarrhea, and the abdomen feels a mass.
5. In addition, unexplained anemia occurs.
Unexplained anemia, weight loss, fatigue, and loss of appetite, a considerable part of it may be that patients with gastrointestinal tract problems must pay attention to timely and go to a professional hospital for examination and treatment.
If patients are careful to observe themselves, for example, we say that there are some blood in the stool, changes in stool habits, etc., the above symptoms and other colorectal cancer danger signals should be investigated as soon as possible. If you can early Grasping these clues, you go to do some related examinations, see a doctor, I think you may find that the probability of early intestinal diseases will be greatly increased.
Generally, in addition to regular physical examinations, doctors will conduct detailed specialized physical examinations for patients, such as digital anus examination, colonoscopy, etc., to effectively avoid misdiagnosis and delay the condition!
1. Digital anus examination:
Many people give up digital rectal examination during physical examination. I think it is uncomfortable and useless, so I don't want to do it, and some patients give up the digital examination because of fear of pain. Some young people think that rectal cancer is generally middle-aged and elderly, and whether they have any obvious symptoms of discomfort, so they also give up digital rectal examination.
Is digital rectal examination really "uncomfortable and useless"? Under what circumstances do a digital rectal examination? How to check the digital rectal examination?
Colorectal specialist physical examination, with great emphasis on digital rectal examination. Because the digital rectal examination is very simple, painless, low cost, and very sensitive to the diagnosis of rectal cancer, it is a powerful tool for detecting rectal cancer. Digital rectal examination, also called anal examination, is a simple but very important clinical examination method for the doctor to put a finger into the patient's anus and touch it without any auxiliary equipment. Clinical observations have found that more than 70% of Chinese patients have rectal cancer very low, very close to the anus, and can be felt through a digital rectal examination.
Colonoscopy is a diagnostic method used by doctors to examine the internal diseases of the large intestine and colon. The colonoscope enters the rectum through the anus to the large intestine, allowing the doctor to observe small changes in the large intestine mucosa. It is the easiest, safest and most effective method to find intestinal tumors and precancerous lesions. But after all, endoscopy is an invasive examination method, which has certain discomforts and complications. Therefore, many people are afraid of this kind of examination. As a result, some colorectal diseases and even tumors cannot be diagnosed early, and the best treatment time is delayed.
3. Painless colonoscopy.
The essence is to inject a fast-acting and accurate-acting anesthetic before the examination, so that the patient will fall asleep within a few seconds and wake up after completing all the examinations without any discomfort or pain during the examination. Therefore, it is more and more popular with patients.
For patients diagnosed with colorectal tumors, the most effective treatment is surgical resection. The current medical technology advances. With the popularization of laparoscopic minimally invasive surgery, minimally invasive colorectal surgery has been generally carried out, and a large number of patients are rushing. Benefits, surgery has become more minimally invasive, less painful, and faster recovery, but there are still many patients and their families who have questions, including the following non-colorectal surgery professional doctors who are also confused:
For colorectal cancer resection, is it better to be "minimally invasive surgery" or "open surgery". Can laparoscopic minimally invasive surgery without laparotomy be cleaned? What is the long-term effect? ?
1. In fact, the "cut clean" that everyone cares about is the "radical" that our profession emphasizes, and the long-term effect is the prognosis of our patients. The malignant tumor of the gastrointestinal tract must be "cleaned" into two parts: lesion resection + regional lymph node dissection (clearance).
2. Laparoscopic minimally invasive surgery for gastrointestinal tumors and traditional open surgery have the same requirements for the scope of resection and the degree of radical treatment. The two are only different in the tools used, and there is no essential difference.
3. Now a number of clinical studies and practices at home and abroad have confirmed that laparoscopic radical gastrointestinal tumor surgery and traditional open surgery have long-term effects: overall survival rate, tumor-free survival rate, local and remote recurrence rates are not different , But the patient recovers faster, suffers less pain, and the hospital stay is significantly shortened with fewer complications.
To some extent, laparoscopic minimally invasive surgery can not only "open clean", but also can do better than open in many aspects.
4. Laparoscopic surgery has its own unique advantages in "radical treatment":
Although minimally invasive surgery does not make a large incision in the patient’s abdomen, the doctor puts a high-definition camera into the abdominal cavity through a 1-cm puncture hole in the abdomen, and observes the abdominal cavity by magnifying the high-definition TV screen. You can look at the belly again, instead of touching it with your hands).
Magnification of the field of view, such as microsurgery under a magnifying glass, the operation is more delicate, part of the operation of the traditional open surgery is based on the touch of the operator, the operation is not under direct vision, some of the steps are slightly blind and rough, while all operations of laparoscopic minimally invasive surgery Operate under direct vision, finely dissecting.
Less bleeding, zero blood loss, severance of blood vessel roots during surgery, and clearer and more thorough dissection of lymph nodes, so from the perspective of lymphatic dissection, laparoscopic minimally invasive surgery has a better radical cure than traditional open surgery. Instruments replace hand operations. Avoid touching and squeezing the tumor, which is more in line with the basic principles of tumor-free surgery.
In fact, it is precisely because of the emergence of laparoscopic technology that gastrointestinal surgery has entered the era of precise anatomy, and gastrointestinal surgery has entered the era of minimally invasive and microsurgery.
5. Multidisciplinary collaborative treatment model
Traditionally, the treatment of colorectal cancer has three methods: surgery, radiation therapy and chemotherapy drugs. At present, each treatment method plays an important role in the treatment of colorectal cancer, but they also have limitations.
For example, if there is a patient in the clinic, a patient with complex colorectal cancer may see a surgeon and may be recommended for surgery. If he meets an oncologist first, he may be recommended for chemotherapy. If he meets a radiotherapy doctor, he may be told Radiation therapy is needed, and there may be improper treatment strategies. Therefore, the MD Anderson Cancer Center in the United States first proposed a multidisciplinary treatment model in the 1990s.
The concept of "Multidisciplinary Comprehensive Treatment MDT" is that this is a new model of tumor treatment based on evidence-based medicine. It is composed of relatively fixed experts from multiple related disciplines such as surgery, chemotherapy, radiology, and pathology. For a certain disease, through regular, timed, and addressing meetings, the most appropriate treatment plan suitable for the patient’s condition is proposed, and then the treatment plan is executed by related disciplines alone or multidisciplinary. This clinical treatment mode has become the current tumor treatment The main trend.
For patients, this model not only shortens the time from diagnosis to treatment, but also prevents patients from delaying the best treatment opportunity due to traveling between departments. Through multi-disciplinary consultation, patients can obtain treatment plans tailored to individual characteristics, thereby obtaining better treatment results;
6. Standardized follow-up of patients with colorectal cancer
Multiple large-scale clinical studies have shown that after radical surgery, 80% of recurrence and metastasis occurred within 3 years after surgery, and 95% of recurrence and metastasis occurred within 5 years after surgery. Therefore, regular and standardized postoperative follow-up will help to find the recurrence and metastasis in time, and provide the possibility of reoperation for radical cure or long-term survival with tumor.
1~2 years after operation, review once every three months;
3 to 5 years after surgery, review once every six months;
It is recommended that blood tumor markers be tested, chest and abdomen and pelvic CT, colonoscopy at 1 and 3 years after surgery, and colonoscopy every 5 years.
If adenomas are found during routine examinations (such as villous polyps, polyps greater than 1 cm or high-grade dysplasia), they should be reviewed after 1 year.
7. Diet transition after colorectal cancer surgery (in hospital)
Fasting is required in the early stage after colorectal surgery. After the intestinal function is restored, start to drink water first, and then gradually transition to clear liquid food, liquid food, semi-liquid food, and soft food.
The first step: clear liquid food; you can eat sugar brine or thin rice soup, thin lotus root powder, vegetable water, light broth. .
The second step: liquid food; you can eat rice soup, lotus root flour, almond cream, rice cereal, vegetable juice, and essential enteral nutrients.
The third step: less residue and semi-liquid food; rice porridge, rotten noodles, lump soup, noodles, wontons, mashed potatoes, egg custard, yogurt, tofu brain, lean meat balls and fruits and vegetables (tomatoes, winter melon, pumpkin, Zucchini, eggplant peeled), fruit puree, enteral nutrition preparation.
Step 4: Semi-liquid or soft food. Noodles, bread, soft rice, lean meatballs, hard-boiled eggs, vegetables with less residue (cauliflower, lettuce and other tender leafy vegetables) fruits. Starting from 150ml, gradually increase the volume to 200-300ml. Gradually transition to general food.
8. Out-of-hospital diet for patients with colorectal cancer:
1. Eat more dietary fiber-rich vegetables: such as green leafy vegetables such as celery, leeks, cabbage, and radish. Vegetables rich in dietary fiber can stimulate bowel movements, increase the frequency of bowel movements, and remove carcinogenic and toxic substances from the stool.
2. Give digestible and soft semi-liquid foods; such as millet porridge, thick lotus root powder soup, rice soup, porridge, cornmeal porridge, custard, tofu, etc. These foods can reduce intestinal irritation and prevent intestinal obstruction.
3. A reasonable combination of sugar, fat, protein, minerals, vitamins and other foods: Every day, there must be cereals, lean meat, fish, eggs, milk, various vegetables and soy products, and do not exceed the amount of each.