In recent decades, the incidence rate of colorectal cancer in China has increased significantly, and it has become the third largest “killer” of residents among malignant tumors, and the increase is more obvious in big cities such as Beijing, Shanghai and Guangzhou, so it is very important to prevent and control it.
1.What kinds of colorectal cancer are included and what is the incidence situation in China?
Colorectal cancer mainly includes colon cancer and rectal cancer, which can also be called colorectal cancer. Bowel cancer is a tumor of the lower gastrointestinal tract, and to a certain extent, it is related to eating too well, so it is also considered as a kind of “rich cancer”.
Compared with developed countries such as Europe and America, the incidence rate of bowel cancer in China is slightly lower, but the growth rate is faster than them. Thirty or forty years ago, colorectal cancer ranked 6th in China’s “cancer lethality list”, but now it has jumped to the 3rd place.
2.Is colorectal cancer related to living and eating habits?
The answer is very positive. The more you eat, the more pressure the intestines have to excrete, especially the excessive intake of animal protein and fat, which will easily produce many toxins.
The European diet is meat-based, with each person eating at least 50 steaks per month. Excessive intake of meat will increase the chance of colorectal cancer.
3.Is bowel movement related to colorectal cancer and what are the main symptoms of colorectal cancer?
Stool can help us detect colorectal cancer, and to a certain extent, it can tell the health of the intestines. If there is blood in stool, thin or irregular shape of stool, change of bowel habit, diarrhea and unclean stool, you should seek medical attention in time. However, many colorectal cancers are easily misdiagnosed as hemorrhoids in the early stage because they all have blood in stool symptoms. Many patients have blood in stool but always thought it was hemorrhoids, and when they came to the hospital, they were already in advanced stage of rectal cancer. Therefore, when blood in stool occurs, it is recommended to go to hospital for fecal occult blood and other tests in time to rule out the risk of colorectal cancer. This is because if the tumor grows in the colon near the anus and breaks down and bleeds, there will be blood in the stool. If the tumor grows in the ascending colon, although the blood cannot be seen by the naked eye, the fecal occult blood test can detect it. If the result of fecal occult blood is positive, it means that there is something wrong with the colon, so colonoscopy and other tests are needed.
In addition to abnormal stools, people with frequent bloating also need to be alert, especially the elderly. If the bloating is particularly uncomfortable and suddenly worsens over a period of time, you should seek prompt medical attention. In addition, patients with intestinal obstruction also need to rule out colon cancer. Clinically, there are many patients with intestinal obstruction who are found to have colon cancer only after surgery.
Since stool is so important, will constipation increase the risk of colorectal cancer? I would like to say that the occurrence of colorectal cancer is affected by many factors, and there is not enough evidence to show that constipation is directly related to colorectal cancer. However, I would like to remind you that you must have good bowel habits, it is better to defecate at a fixed time every day, rather go to the toilet a little earlier, don’t hold back when you have the intention to defecate and don’t let the waste stay in your body for too long.
4.Who are the high-risk groups of colorectal cancer and how to detect the signs as early as possible?
People with family history of colorectal cancer, multiple colon polyps, chronic enteritis, and intestinal villous tubular adenoma are high-risk groups of colorectal cancer and are prone to cancer. Besides observing the symptoms, clinically, we mainly rely on the following examinations to help early detection of colorectal cancer.
First, anal finger examination and fecal occult blood examination. Tumors within 7 cm from the anus can be detected by anal finger examination in 90% of cases, and data show that more than 70% of rectal cancers in China are low rectal cancers, which can be touched during rectal finger examination. 80% of colorectal cancer patients have blood in stool, and half of them cannot be seen by naked eyes, but can be detected by fecal occult blood test. However, unfortunately, many people give up these two tests.
Secondly, tumor markers CEA and CA19-9 should be further examined if their values are found to be high. Many units and individuals have included tumor markers into the scope of physical examination. If the physical examination report shows normal, it should not be taken lightly. Because the positive rate of bowel cancer tumor marker examination is 50%~60%, which means there are many false negatives, but it can really provide us with a basis for early detection of bowel cancer.
Thirdly, colonoscopy. High-risk people should follow the medical advice and have colonoscopy every year on time. For general population, it is recommended to do one every 3~5 years starting from age 45. Those who have positive fecal occult blood should have colonoscopy in time.
5.Does bowel cancer have precancerous lesions?
Multiple colon polyps have the tendency to become cancerous and are precancerous lesions of intestinal cancer, which are the result of atypical cell proliferation and can be classified into 3 levels of severity: mild, moderate and severe. We must deal with precancerous lesions as early as possible and cut off the growths. For carcinoma in situ, there is a fashionable treatment method of endoscopic resection of carcinoma in mucosa at home and abroad, but I personally think that cancer is like a crab, if we just cut off its shell, the chance of recurrence is higher.
6.What are the treatment methods for bowel cancer?
Surgery is still the first choice, and we should try our best to achieve early diagnosis and treatment. But unfortunately, sixty to seventy percent of bowel cancer patients in China are already in the middle and late stage when they are diagnosed. Clinically, the tumor is mostly treated by comprehensive treatment, in addition to surgery, radiotherapy is also very important. Preoperative chemotherapy for patients who meet the indications can also make the tumor smaller and control the extent of the lesion. In addition, targeted therapies such as epidermal growth factor receptor blockers and vascular endothelial growth factor inhibitors are also highly effective.
Even with radical surgery, 40% of colorectal cancers will still recur or metastasize, and two years after surgery is the peak recurrence period with an incidence rate of about 65%~80%, but the recurrence rate after 5 years is reduced to 6%~8%. Therefore, keeping yourself away from bowel cancer is the most important thing.