2020年12月14日星期一

hemorrhoids zinc oxide,Colorectal cancer is preventable and curable, focusing on prevention

    1. The incidence of cancer continues to rise:

    Every one of us seems to be able to feel that cancer has become a not-so-distant disease. Almost no one dares to say that there is no cancer in their circle of friends. Not only the elderly but also young people get cancer. The situation of cancer prevention and treatment is very high. Serious, each of us can't ignore it.

    Authoritative data: The World Health Organization (WHO) published the "Global Cancer Report 2014". The study found that the number of cancer patients and deaths worldwide in 2012 was disturbingly increasing. Nearly half of the new cancer cases occurred in Asia, and most of them Partly in China, China ranks first in new cancer cases.

    Regardless of whether it is in cities or rural areas in China, since 2007, malignant tumors have ranked first among deaths. The incidence of malignant tumors in the country is 235 per 100,000, but in Shanghai it is already 274 per 100,000, which is much higher than the national level.

    According to the data provided by the "2012 China Cancer Registry Annual Report", the incidence of colorectal tumors is 29 per 100,000, second only to lung and gastric cancer, ranking third. The annual average number of new cases of colorectal cancer in China reaches 130,000. With an average annual growth rate of 4%, the proportion of young people under the age of 40 suffering from colorectal cancer accounts for about 20% of the total number of colorectal cancers. The incidence of colorectal cancer in Shanghai is 54/100,000. China has entered the ranks of areas with high incidence of colorectal cancer. The high incidence and mortality of colorectal cancer are increasingly threatening people's physical and mental health.

    2. Colorectal cancer is preventable and curable:

    It is generally believed that with the improvement of urban modernization, the improvement of living standards, lifestyle changes, changes in dietary structure, the increase in intake of high-calorie, high-fat, and high-protein foods from chickens, ducks and fish, and the aging of the population, the problem of high incidence of tumors will become more common. It's getting more prominent. This phenomenon is indeed a fact, but from this it is considered that the continued increase in the incidence of colorectal cancer cannot be curbed, and that it is an inevitable price accompanying the modernization process, and it is biased.

    Let’s take a look at the situation in a developed country like the United States. The United States is also a country with a high incidence of colorectal cancer. In 2001, the incidence of colorectal cancer was as high as 61 per 100,000. However, since 2001, the incidence and mortality of colorectal cancer in the United States have been For more than ten consecutive years, it has been declining at a rate of 3%; in the past ten years, the incidence of colorectal cancer patients over the age of 50 has decreased by 30%, and the 5-year survival rate of colorectal cancer has increased from 50% to 70%. It is a very remarkable achievement. Why has the incidence and mortality of colorectal cancer in the United States dropped so significantly? In fact, the public health system and medical institutions have done a lot of work in the prevention and treatment of colorectal cancer, mainly the three-level prevention measures for colorectal cancer have played an important role. Researchers suggest that the decline in the incidence of colon cancer may be due to the application of colonoscopy screening. Since 2000, the application of colonoscopy screening in people aged 50-65 has nearly tripled. Their successful experience tells us that colorectal cancer is preventable and curable.

    3. Cancer prevention is more important than cancer treatment:

    Many tragedies could have never happened. The problem is that we have missed many of the best opportunities to attack cancer. Simply speaking, it takes at least five years to change from a normal intestinal mucosa to a colorectal cancer, most of which take nearly 10 years. 80% of colorectal cancers evolve from adenomatous polyps. The normal intestinal mucosa first manifests as a small benign hyperplastic change, then becomes a benign polyp, and then gradually becomes cancerous. If we can find it at the stage of polyp, then of course it will be easy to solve , There is no chance of cancer. Even if cancer has occurred, if it can be found very early, it can be easily and completely cured, and the effect is very good, and it can reach the standard of cure. Colorectal cancer actually takes a long time from its occurrence to the development of cancer. It provides time and opportunities for our prevention work. Compared with other tumors, such as lung cancer, liver cancer, pancreatic cancer, etc., for colorectal cancer In other words, we have more means to prevent, and cancer prevention is more important than cancer treatment.

    4. Build a line of defense against cancer:

    Colorectal cancer is preventable, and we can build a line of defense against colorectal cancer. We understand a series of rules of occurrence and development of colorectal cancer, from normal mucosa to hyperplastic polyps, to adenomatous polyps, to early cancer, to advanced cancer, and so on. We can build three ways to attack the colorectal against such a process. The line of defense for cancer, namely the tertiary prevention measures, including primary prevention for the cause, secondary prevention for precancerous lesions and early lesions, tertiary prevention for cancer rehabilitation, participating in different stages, tertiary cancer prevention and prevention The ultimate goal is to reduce the incidence and mortality of cancer.

    5. Primary prevention of colorectal cancer:

    Primary prevention is a very important stage of prevention and treatment; to prevent the occurrence of cancer, we must first remove the cause of cancer. Then what is the cause of colorectal cancer? Scientific research shows that colorectal cancer is a malignant tumor closely related to lifestyle, and the most important thing is related to diet and lifestyle habits. It can be said that colorectal cancer is a disease of wealth. For example, when we were relatively poor in the past, we ate more vegetables and seldom ate protein or fish. At that time, the incidence of colorectal cancer was very low, but these Over the years, we have eaten better and better, and our lives have become more comfortable and comfortable. As a result, the incidence of colorectal cancer has continued to rise.

    (1) Avoid eating too much high-protein and high-fat foods: We eat too many high-protein, high-fat foods. It is easy to differentiate through bacteria in the intestines, produce toxins, and induce colorectal cancer. High-protein, high-fat foods can easily increase the secretion of bile acids in the intestine, and the latter can cause irritation and damage to the intestinal mucosa. Protein and fat are still needed by our body. In fact, we are not saying that high-protein and high-fat foods cannot be eaten, but we should limit its amount.

    (2) Avoid eating too finely: we eat too fine, and the intestinal peristalsis is too slow, so that the feces stay in the intestine for too long, leading to the accumulation of carcinogens, which will easily induce malignant transformation of intestinal cells in the long run. We must pay attention to increasing the appropriate vegetables and fruits, because vegetables and fruits have a lot of fiber and vitamins, high-fiber vegetables such as sweet potatoes, cauliflower, celery, leeks, water spinach, can stimulate bowel movement, help the bowel defecation, at the same time, plants Fiber in the intestine can also absorb carcinogens in food residues, dilute and reduce the concentration of carcinogens in the intestine. So you must eat more fruits and high-fiber vegetables.

    (3) Exercise moderately and control weight: Too little physical activity and obesity are risk factors for colorectal cancer. Physical activity can promote bowel movement and facilitate fecal discharge, thereby achieving the effect of preventing colorectal cancer. Insist on proper exercise and maintain a suitable weight.

    (4) Non-smoking and alcohol restriction, healthy living: The relationship between smoking, alcohol and colorectal cancer is not very sure, but smoking and alcohol are risk factors for colorectal adenomas, and it has been confirmed that reducing alcohol intake will help prevent colorectal cancer.

    (5) Stay happy, optimistic: Studies have shown that a happy, sunny, and optimistic mental state can also help prevent cancer.

    We start by improving the diet and lifestyle, reducing the intake of high-protein, high-fat, fine, pickled and smoked foods; increasing vegetables, fruits, whole grains, and fiber-rich foods; reducing smoking and drinking; strengthening Exercise, control weight, prevent from the cause, build the first line of defense against colorectal cancer.

    6. Secondary prevention of colorectal cancer:

    Most colorectal cancers are benign lesions of the large intestine, which gradually evolve over a long period of time, such as adenomatous polyps of the large intestine and inflammatory bowel disease. We call them precancerous lesions. If we can actively treat precancerous lesions and control these precancerous lesions as soon as possible, or even cure them completely, there will be no chance for precancerous lesions to develop into colorectal cancer, and the incidence of colorectal cancer will naturally decrease. In addition, we must strive for early detection, early diagnosis, and early treatment of colorectal cancer that has occurred. Early-stage malignant tumors are completely curable. Compared with middle-advanced colorectal cancer, the treatment cost, treatment difficulty and treatment effect are completely different. The early stage of colorectal cancer is very superficial and limited. Local resection can achieve a radical cure without other radiotherapy and chemotherapy. Therefore, if we can detect and treat it early, colorectal cancer will become not terrible.

    Secondary prevention includes active treatment of precancerous lesions and active efforts for early diagnosis and treatment. The screening of healthy people is an important means of secondary prevention. Anyone has the opportunity to suffer from cancer. Popularize more healthy life knowledge and cancer prevention knowledge, so that everyone can participate in the secondary prevention of cancer.

    (1) Active treatment of precancerous lesions: There are not many people suffering from colorectal adenomatous polyps and inflammatory bowel disease in our population. Research results show that 80% of colorectal cancers are transformed from colorectal adenomas In the past, 20% to 30% of people may have colorectal adenoma. If we can find it at the stage of polyp, it can be easily removed to achieve the effect of eliminating it in the bud. Among them, colonoscopy is the biggest contributor. Colonoscopy can not only search for tumors, but also characterize tumors through biopsy, and can also cut polyps and even early cancers. There is such a study in the United States. They have performed colonoscopy for 100,000 people on a regular basis. Once adenomas are found, they will be removed in time. After several years, the chance of this group of colorectal cancer is lower than that of the general population by more than 80%. .

    (2)重视结直肠癌筛查:

    许多结直肠的癌前期病变和早期癌都是没有特异性临床症状甚至没有任何症状的,我们如何才能够发现结直肠的癌前病变和早期癌呢?目前参照欧美国家一些成功的经验就是积极开展对健康人群结直肠癌的筛查普查。欧美发达国家从上世纪70年代就开始进行结直肠癌筛查了。他们的筛查方法,基本上是大便隐血和肠镜的组合。实践证明,结直肠癌筛查工作有明确的降低结直肠癌发病率和死亡率的作用。我们国家如上海、北京、天津也在制定这样的筛查普查的标准,一般来讲60岁开始,五年做一次,如果有腺瘤的话,要两三年一次,如果有家族史的, 40岁开始做第一次检查,同时他的频度也不是五年了,就是两到三年一次。

    上海市结直肠癌的筛查,使得上海市的结直肠癌筛查成为“十二五”的一个重要项目,目标人群50到74岁的上海成人,通过大便隐血到调查表,指定医院的检查。在2013年对110多万人进行了筛查,癌前病变9500多例被处理,恶性肿瘤914例被处理,早期占了40%,这是非常重要的变化。虽然社会卫生服务系统搞了大范围的筛查普查,支付了一定的费用,但是明显减少了结直肠癌的发病,减少了中晚期结直肠癌的比例和数量。我们知道进展期结直肠癌的手术、放化疗治疗费用很高,对家庭社会都是很大的负担。相比之下,筛查普查的支出还是相当划算的,节省了医疗资源,医疗保险费用,和社会负担。虽然在大多2-3线城市,这种大肠癌筛查普查还没有开展,但我们广大听众朋友应该增加健康保健意识,重视肠道症状,有问题及时肠镜检查。我们治疗的许多结直肠癌症病人,有不少都是健康体检发现的,治疗效果非常好。

    在结直肠癌筛查中,有些特殊人群应给于重点关注。医学研究已经证明,结直肠癌不仅和饮食结构、生活方式密切相关,遗传因素也很重要。结直肠癌家族史的人群是结直肠癌高危人群。必须定期对其进行监测。我们对接诊的病人都要了解其家族史,如果患者家族中有多人患结直肠癌,我们就会建议其尽快去做肠镜检查,确实也发现了一些直系亲属中患腺瘤和肠癌的病人。

    有一种疾病叫家族性腺瘤型息肉病,有明确的遗传性,患者整个大肠可以有数量很多的,甚至是无法计数的密布腺瘤,青年就可发病,45岁后几乎100%癌变,比如说我们前一段治疗一个病人就是这样,常年腹泻,肠镜发现大肠有大量腺瘤,并癌变,这个病人到我们医院诊断是家族性腺瘤型息肉病,癌变,追问病史他父亲死于肠道疾病。我们明确告诉他,家中直系亲属应该在40岁以后都要去做肠镜检查。结果就在这个患者手术期间,他的妹妹,在听到我们医生告知后做了肠镜,发现患有家族性腺瘤型息肉病,一同住院,作了全部大肠切除,手术后病理显示,有部分腺瘤已经癌变,这样的病例其实并不是罕见,所以对这一类结直肠癌遗传易感人群必须密切监测。

    (三)重视大肠癌危险信号

    早期发现、早期诊断、早期治疗。就是说你发现有症状了,你要把它诊断明确了,明确了以后要治疗,在这个里头我想在大肠癌早期诊断是最关键问题,,因为我们知道如果说从治疗来讲的话,单纯手术就可以治愈,中晚期的肠癌即使医学快速发展,多种手段综合运用一些病人仍治疗效果不满意,所以早期发现是非常重要的。早期诊断还要靠人们自己多了解大肠癌的相关知识,了解大肠癌早期都有什么症状

    如何及早发现大肠癌

    1.首先经常察看粪便是否带血,带脓??血液呈红色或鲜红色,与早期内痔的症状非常相似,后期便血多为暗红色,混有粪便之粘液血便或脓血便。

    肠癌的早期症状非常隐秘,很容易被忽视,事实上从大肠癌患者出现不适到确诊一般需要 3 到 12 个月,几乎大多患者都会有初期被自己或医生诊断为痔疮、肠炎、蛔虫症或胃病等曲折经历早期诊断率困难,一个人重视不足很多人认为痔疮是个小毛病没什么大不了的,殊不知痔疮不可怕,The scary thing is that patients with rectal cancer hiding behind hemorrhoids lack medical knowledge, self-diagnosis and self-medication based on experience, there may be many people who have such a mentality, because they are afraid of illness, they are more taboo from doctors or people around to give him such advice He always feels that I don’t necessarily have it, and he doesn’t even go for the check if he has symptoms. He doesn’t think it’s necessarily a tumor. It may be better after two years, but the result is a delay. We often have such patients. If you can run into it, misdiagnosing a patient with bowel cancer as hemorrhoids, a case that could have been detected early may be delayed to an advanced stage.

    The other is to go to the hospital and be delayed by the doctor. This kind of hospital is often a relatively small hospital, because blood in the stool is one of the common symptoms of bowel cancer, and patients have diarrhea or constipation, always thinking they are Treat dysentery or enteritis as hemorrhoids or inflammatory diseases. Take some anti-inflammatory drugs and it was delayed. The patient came and said that I had blood in my stool. This doctor could not be serious and was unwilling to open his hand to do an anus. Refers to the examination, saying that it was probably hemorrhoids, so it was delayed. In our clinical practice, we found that most of the patients who were admitted for treatment were delayed by ourselves for a period of time. Generally speaking, once the patients have these similar symptoms?? If there is an unknown cause for more than two weeks, it is best to find an experienced specialist to do a diagnosis and treatment?? This will be of great help to your diagnosis of this disease. Generally, if you go to a major hospital, this kind of opportunity will be much less.

    2. Then look at whether the stool characteristics change?? For example, the stool bar becomes thinner or flat??

    3. In addition, do you have any changes in your bowel habits?? For example, the number of bowel movements or the intention to defecate increased?? And there is always a feeling of uncleanness??. Due to the secretions produced by rectal masses and their cancerous ulcers, intestinal irritation can occur, causing patients to experience frequent bowel movements, incomplete defecation, tenesmus and other symptoms, but the discharge is mostly mucus, pus, blood, and stool shape. It has also changed, and the stool is getting thinner.

    4. Next, do you have a dull pain in your abdomen or other uncomfortable sensations? Also, do you have constipation or alternate constipation and diarrhea, and a lump in your abdomen?

    5. In addition, unexplained anemia occurs. For unexplained weight loss, fatigue, and loss of appetite, patients must pay attention to and go to a professional hospital for examination and treatment.

    If the patient observes himself more carefully, for example, we say that there are some blood in the stool, and changes in stool habits?? If you can catch these clues early, you should go for some related examinations and find some doctors. If you look at it, I think you may find that the probability of early bowel cancer will be greatly increased.

    Tertiary prevention and tertiary prevention 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, standard comprehensive multidisciplinary treatment, the complexity of colorectal cancer treatment, and the effectiveness of multiple methods require us to correctly choose the reasonable and most appropriate rehabilitation treatment plan to reduce tumor recurrence and/ Or transfer, prolong survival time, and put forward higher requirements for doctors. In Europe and the United States, colorectal cancer treatment doctors are colorectal surgeons who have received specialized training to obtain colorectal cancer treatment qualifications. I will soon introduce a colorectal cancer treatment admission system. We recommend that the diagnosis and treatment of colorectal diseases should go to regular specialized institutions to avoid treatment failures. Standardization, under-treatment, over-treatment, ensuring treatment effect

    Every doctor is not only a healer but also a preventer! Only by disseminating the correct concepts of changing lifestyles, seeing a doctor in time, actively participating in screening surveys, actively treating precancerous lesions, and standardizing the treatment of clinical tumors, can the incidence and mortality of colorectal cancer be reduced, and the quality of life of colorectal cancer patients can be improved. .

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