2021年2月7日星期日

hemorrhoids cancer,Past and present of colon cancer

    Nowadays, with the continuous improvement of people’s living standards, the dietary structure has also changed. It is no longer like the ancestors who used coarse grains and vegetables all day long. It is rare to eat some noodles during the holidays. This is not a song from a year ago. The limerick said: "Every time you get three kilograms of fat during the festive season, take a closer look at three kilograms...".

    Due to the intake of large amounts of high-protein, high-fat, and high-calorie foods, insufficient dietary fiber intake will change the environment in the large intestine. Studies have shown that more than 40% of fat in the diet is an important factor in the onset of intestinal polyps, of course, there are also factors such as chronic inflammation and family inheritance.

    Clinical studies have shown that colon polyps are extremely closely related to colon cancer. Adenomatous polyps have a high cancer rate, and the cancerous rate of adenomatous polyps larger than 2 cm can reach more than 60%. Therefore, the vast majority of bowel cancers evolve from bowel polyps.

    It is estimated that the time from polyp to cancer development is 5 to 15 years. Once it develops into an advanced tumor, the course of the disease will be significantly accelerated, and its therapeutic effect will be affected by various factors such as tumor size, invasion, and metastasis. Many patients undergo various pains including surgery, radiotherapy and chemotherapy despite active treatment. Especially for tumors in the lower rectum, artificial anus must be performed after surgery, and the quality of life is severely reduced. However, the survival period of some patients is only extended by a few months, and ultimately the result is a shortage of people and money.

    The ideal goal of colon polyp treatment is to block the development of polyps before they become cancerous, so that the occurrence of colon cancer can be effectively controlled.

    Siblings of colon polyps

    Colon polyps are actually a very common disease, and there are many types. Generally speaking, the raised lesions that grow on the surface of the gastrointestinal mucosa can be collectively referred to as "polyps". But in fact, polyp is a morphological description, which includes "hyperplastic polyps", "inflammatory polyps", "juvenile polyps", "adenomatous polyps", "familial polyp diseases" and so on.

    According to their pathological characteristics, it is generally believed that the first three are benign polyps. From the histological point of view, they have no abnormal changes, so they are not prone to carcinogenesis. The latter two, especially adenomatous polyps, are also called "adenomas". ", including adenoma, tubular adenoma, villous tubular adenoma, etc. Adenomatous polyps generally do not go away on their own, and there is no definite evidence that certain drugs can make polyps disappear.

    If a polyp is found and not treated in time, as time passes, the polyp will grow up, and glandular abnormality will occur. When the abnormality occurs to severe dysplasia (or called high-grade intraepithelial neoplasia), it is already cancer In the previous state, we can understand it as "standing on the edge of a cliff." Some scholars in Japan have studied that an adenoma is only regularly checked without any intervention, and it often becomes cancerous within 2-10, and this time is unpredictable.

    Predict the occurrence of intestinal polyps

    To prevent colon cancer, a physical examination is necessary. But here comes the question, which test is most effective for bowel polyps and bowel cancer? At present, colonoscopy is still the most effective method. Is it to ask everyone to do colonoscopy? This seems unrealistic, so a preliminary screening is required.

    How can the preliminary screening be carried out? The most direct, simplest, and most economical inspection method is the "fecal occult blood test" inspection. The occult blood test in normal stool routine examination is negative. If the stool occult blood test is positive, corresponding examinations are required. Of course, it may also be caused by upper gastrointestinal diseases.

    Who are the high-risk groups? It is generally believed that people with a family history of tumors are high-incidence groups, and the high-incidence age is usually after the age of 40. However, we continue to detect colon cancer in young people under the age of 35. What should we do?

    This requires everyone to pay attention to it. If there is a change in stool characteristics and bowel habits, it should be checked in time. In addition, in relieving blood in the stool, it is also necessary to pay attention to bleeding from hemorrhoids, rectal polyps or polyp cancerous bleeding. There are already many patients who have long-term hemorrhage solutions mistaken for hemorrhoids, or after hemorrhoids, there are still stool bleeding. Colonoscopy revealed that it turned out to be rectal cancer and could only undergo surgery.

    Colonoscopy is not that scary

    As mentioned earlier, the most effective, intuitive and valuable examination is colonoscopy. This endoscopic diagnosis and treatment technology, it is like a camera directly into the intestines, and the entire colon is checked by the doctor.

    Many patients feel terrible about colonoscopy. The thick tube is inserted in and "pounded" in the stomach, fearing that it will damage the intestines and also fear the pain. In fact, due to the improvement of equipment and technology, especially the improvement of single-person colonoscopy technology and the application of painless colonoscopy, colonoscopy is not very painful now.

    Through colonoscopy, polyps over 3-5 mm can be found, and some inflammatory or hyperplastic small polyps can be directly removed by special biopsy forceps during the examination, which is both diagnostic and therapeutic.

    However, there are some reasons that affect the detection rate of polyps, that is, low-quality diagnostic colonoscopy, low-quality bowel preparation, and doctor's operating experience. Therefore, it is required that before performing colonoscopy, strict diet control and bowel preparation must be followed by appointment requirements, so as to achieve the best bowel cleansing effect and make it easier to find lesions.

    And now more advanced equipment is put into use, coupled with the application of new technology, so that tiny polyps can also be found. Facts have proved that due to the widespread use of colonoscopy, the improvement of patient awareness and the improvement of polypectomy techniques, colonoscopy polypectomy has been successful in preventing the occurrence of bowel cancer, and quite a few patients have benefited from it.

    Colon polyp removal is necessary

    Once colon polyps are detected, they need to be treated. Colon polypectomy is an effective way to prevent colon cancer.

    When the colonic polyp is large, more than 5 mm or more, you need to be hospitalized for endoscopic polypectomy. For polyps with pedicle or sub-pedicle less than 2 cm, endoscopic mucosal resection (EMR) can be used ; When the polyp exceeds this diameter, endoscopic submucosal dissection (ESD) is needed to completely remove it at one time, and the removed tissue will be subjected to pathological examination to determine whether there is a possibility of cancer.

    If there is cancer, further confirm whether it is superficial cancer or deep infiltration. If there is no deep infiltration, we believe that the treatment can be ended and the patient will be followed up for a long time. Once the pathology finds a deep infiltration, additional surgery must be performed to ensure complete removal of the lesion, which is very important.

    Studies abroad have found that even small polyps are 3-10% cancerous. In fact, the smallest polyp that has become cancerous is 5 mm in size. Because the EMR method was adopted for resection, not only the lesion was removed, but also part of the normal mucosa around the lesion was removed. Therefore, a complete and complete resection was achieved without additional surgery.

    In recent years, EMR and ESD techniques can remove large polyps that have a larger area, no cancer or only surface cancer, and can maintain the integrity of the colon structure. The success rate and complications are within a controllable range, which reduces the chance of surgery. , For patients, it is undoubtedly of great benefit.

    Of course, regardless of ordinary resection, EMR or ESD, there is a risk of bleeding and perforation, and usually requires hospitalization. Once delayed bleeding is found, it must be promptly performed under colonoscopy to stop the bleeding. If perforation occurs, timely surgical operation is required. To repair the intestinal wall.

    Pay attention to regular follow-up after operation

    For patients with multiple polyps and familial polyposis, although the polyps have been removed, regular follow-ups must be carried out. The density of follow-ups has a certain relationship with the pathological nature of the polyps, the number of polyps and the age of the patients.

    Don't think that you can get everything right if you have a polyp removed. In fact, there are still some objective constraints. There may be some smaller or hidden polyps hidden in some folds of the colon or missed due to poor intestinal cleansing.

    Therefore, for patients with a history of polyps, according to the situation after the first endoscopic surgery, the treating doctor determines the frequency and length of follow-up of the patient, usually once a year at the beginning. If no polyps are found twice in a row, the follow-up time can be extended , High-standard colonoscopy once every two years or once every three years. Once micro polyps are found, they should be treated in time.

    How to prevent colon polyps and colon cancer?

    Generally speaking, to prevent the occurrence of diseases, it is generally necessary to pay attention to a reasonable diet, proper exercise, regular life, etc., and do the following points to have a certain preventive effect on the occurrence of colon polyps and even colon cancer.

    1. Develop good and healthy living habits, eat healthy food, avoid high-fat, high-protein foods, eat less fried and smoked foods, reduce the intake of salt in the diet, eat less refined foods, eat more whole grains, and increase your diet For dietary fiber, eat more vegetables, especially crude fiber, and foods with a lot of fiber. You can add yogurt (containing lactic acid bacteria) products appropriately, and be careful not to "drinks";

    2. Develop the habit of defecation regularly to avoid the absorption of water in the stool, resulting in dry stools and constipation. If the stool stays in the intestine for too long, the intestine will absorb the toxins in the stool;

    3. Appropriate physical exercise and weight loss, pay attention to maintaining a normal body weight, research shows that obesity is one of the predisposing factors for colon cancer;

    4. Pay attention to maintaining a good mood. Good mood can regulate the body's immune system and reduce the occurrence of tumors. Negative moods are harmful to physical and mental health.

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