Patient Auntie Li’s story Auntie Li is a 60-year-old retired cadre who usually pays close attention to her health. However, recently she found that she always had blood in her stool. Considering that she has been suffering from hemorrhoids for years, she bought a hemorrhoid cream to solve the problem based on her years of experience. But a few days later, the situation not only did not improve, but also appeared a new problem, not only will there be mucus flow on weekdays, the bowel movement pattern has changed, there is always a feeling of incomplete bowel movement. Not only that, she always felt no appetite for food, and in January she lost a circle of weight. At this point, Auntie Li went to the hospital for a check, the results were shocked, said it was “rectal cancer”, the need to “open the big knife”. Auntie Li is very puzzled, usually always healthy, how did she get rectal cancer? Bowel cancer is not to be underestimated When bloody stools occur in life, most people first consider hemorrhoids, do not go to the hospital, buy their own topical medicine coated with a coating, it is this process ignored rectal cancer. It is this process that ignores rectal cancer. It is not until more serious symptoms appear that they think of seeking medical treatment, and by then the condition is already very serious. How to identify the symptoms of colorectal cancer that are easy to be ignored and confused? Hemorrhoidal bleeding: it is bleeding from blood vessels, just like “water pipe leakage”, with large amount of bleeding and bright red blood. Bleeding from intestinal cancer: it is bleeding from the surface of erosion, just like “water seepage from the wall”, with small amount of blood seepage, dark red blood, accompanied by egg white or pus-like mucus. At the same time, the repeated stimulation of intestinal cancer tumor makes patients have the feeling of incomplete defecation, which leads to the change of defecation habit, such as constipation and diarrhea alternately, and the number of times increases. And due to tumor consumption, it can lead to loss of appetite, weight loss and so on. Some patients with chronic enteritis also “treat themselves” when they have similar symptoms, plus they always think that cancer is unlikely, so it is easy to delay the disease. Among the nearly 1,000 cases of colorectal cancer diagnosed and treated by Prof. Fu Chuangang every year, nearly 80% of the patients were misdiagnosed as hemorrhoids, enteritis, etc. after the symptoms of blood in stool and increased frequency of bowel movement, which resulted in a delay of treatment for 3-6 months and missed the valuable early treatment time. It is recommended that patients find a specialist in time when the above symptoms occur, and high-risk groups should do colonoscopy as soon as possible. Patients can’t help but ask, which group of people is the high-risk group? Bowel cancer should not be ignored How close is bowel cancer to us? In recent years, with the improvement of living standard, aging population and westernized dietary structure, the incidence rate of colorectal cancer has been on the rise, and it is now the third most common malignant tumor in China, and it has reached the second most common malignant tumor in the developed areas such as Shanghai. Nevertheless, the incidence rate is still growing at 4.71% per year, far exceeding the international level. Usually, the incidence of male is more than female, but the rate of increase of female is faster, and its risk increases with age, usually accelerated after 40 years old, and after 50 years old, it is a straight line rise. What kind of people are ‘at risk’ of bowel cancer? Many years of research have suggested that the development of bowel cancer is the result of a combination of environmental, dietary and lifestyle factors and genetic factors. It is usually believed that the following factors are the risk factors of colorectal cancer:1 Genetic factors: family history of bowel cancer refers to the immediate family members who have bowel cancer, which involves the aggravation of more than two generations. In other words, if one of the close relatives is sick, the risk of his/her own disease is two times, and the risk is even greater if more relatives have this cancer. In addition, those who have the disease at the age of less than 50 years old have a significantly higher risk of the disease in their offspring, and the probability is about 20 times higher than that of the general population.2 Disease factors: common chronic inflammation of the intestinal tract, polyps, and adenomas can be progressed to intestinal cancer. The cancer rate of chronic ulcerative colitis with a history of 20 years can be up to 20%, Crohn’s disease is lower than it, but it is 4-20 times higher than that of the general population; 15%-40% of colon cancers originate from multiple polyps of the colon for at least more than one year; adenomas have a cancer rate of more than 40%. In addition, some intestinal parasitic diseases such as schistosomiasis and amoeba also have the risk of cancer.3 Dietary factors: it is often said that “the better the food, the more likely to suffer from intestinal cancer”, which is not unreasonable. Bowel cancer is closely related to high fat, meat and animal protein diet. Usually, the concentration of fecal bile acid in patients with bowel cancer is higher than normal, bile acid is a cancer-promoting agent that can stimulate the occurrence of intestinal tumors, and high-fat diets can greatly increase the concentration of bile acid in the body. In addition, dietary lack of fruits and vegetables rich in fiber is also a risk factor for the development of intestinal cancer.4 Lifestyle: engaged in a certain intensity of physical workers in the incidence of intestinal cancer significantly lower than the long-term sedentary staff, at the same time, irregular bowel movements, smoking, overweight and obesity is also a risk factor for colorectal cancer. Bowel cancer is not difficult to “prevent” The most effective means of treatment is expected to be radical surgery, but the actual successful implementation of the operation is more difficult, due to the obvious symptoms to the clinic has often reached the advanced stage, which often leads to patients with a shorter survival period after surgery. However, research has found that 90% of early bowel cancer patients can realize long-term survival after radical surgery. Therefore, “early prevention, early detection and early treatment” has become the key to good prognosis of bowel cancer. So how to minimize the risk of bowel cancer? ” 1. People with high risk factors need to be vigilant ” The United States is a country with good control of the incidence of bowel cancer, according to the survey, originated from the United States vigorously popularize colonoscopy, so that the early diagnosis rate of more than 25% (less than 15% in our country). Therefore, for the above-mentioned high-risk groups with family history of intestinal cancer and intestinal cancer diseases, including patients with long-term symptoms such as bloody stools, regular medical checkups are needed, and effective and reliable colonoscopies are preferred for timely detection of colorectal lesions, so that treatment should not be delayed. ” 2. Reasonable dietary structure should be ensured ” Life should reduce fatty foods, salted and smoked foods and fried foods, in addition to the above fatty foods can produce bile acids, salted foods contain carcinogenic nitrosamines and high-protein foods after frying to produce heterocyclic amines have carcinogenic effects. Fish, lean meat, low-fat dairy products should be used to replace high-fat meat, boiled, steamed food instead of fried food, and more intake of high vegetable protein, high vitamin, low-fat easy-to-digest food, especially fresh fruits and vegetables rich in vitamins A and C and cereals rich in fiber, which can regulate the acid-base balance in the body. 3, good lifestyle needs to be developed first need to develop good defecation habits, especially need to be alert to the elderly constipation, because the intestinal lumen to stay too long between the feces produced by the toxins, will persistently stimulate the intestinal wall. The key to improving constipation is to drink more water, exercise more, maintain a good diet, eat more fiber foods, appropriate intake of honey, yogurt, reduce the use of rhubarb, aloe vera and other traditional Chinese medicine to assist in defecation. In addition, harmful substances produced by smoking may also induce colorectal cancer. We suggest that people with good general health should include colonoscopy in their medical checkups after 50 years old. At present, rectal cancer accounts for 60% of all intestinal cancers in China, and 70% of them are low rectal cancers, which can be initially diagnosed by simple anal diagnosis, but most people, especially middle-aged and young people, refuse or even resist anal diagnosis. However, most people, especially middle-aged and young people, refuse or even resist anal diagnosis. If patients are diagnosed with colorectal cancer, they need to undergo comprehensive treatment mainly based on surgery. Regarding the specific treatment methods, whether rectal cancer can or is suitable for anus preservation, whether post-surgical radiotherapy and chemotherapy are needed for surgery, and other precautions, please feel free to consult with WeChat, and Prof. Fu ChuanGang will answer the questions in person.