Colorectal cancer, including colon and rectal cancer, is one of the common cancers in China. In recent years, due to changes in living conditions and habits, it is one of the cancers with the fastest increasing incidence, especially in urban areas.
I. Diagnostic points.
(1) Medical history: for those who have a history of adenoma of the colon, colonic polyps, colonic polyps and ulcerative colitis, the possibility of secondary development of this disease should be thought of; for those who are addicted to fatty and sweet food, long-term constipation and those who live in schistosomiasis endemic areas, this disease is also relatively high. Zhou Xiaoyuan, Department of Medical Oncology, Affiliated Hospital of Shandong University of Traditional Chinese Medicine
(2) Symptoms and signs: The clinical manifestations are different in different sites. If the tumor is in the right hemicolectomy, the main manifestation is abdominal pain with dyspeptic symptoms, such as epigastric discomfort, nausea and vomiting, alternating constipation and diarrhea, etc.; in the late stage, abdominal masses can be palpated, accompanied by wasting, weakness, anemia and other systemic manifestations.
If the tumor occurs in the left hemicolectomy, the main symptoms are change of stool habit and incomplete intestinal obstruction. The change of stool habit includes change of stool frequency and shape. Because of the early appearance of intestinal obstruction and stool changes in the left half of colon cancer, the diagnosis is earlier than that of right half of colon cancer. It is reported that 20%~55% of intestinal obstruction is caused by colon cancer.
(3) Laboratory tests.
① Positive fecal occult blood, especially after 3 days of vegetarian diet;
②Anemia;
③Serum carcinoembryonic antigen (CEA) over 2.5ug/L has some significance, but does not have specific diagnostic value, and is mostly used clinically to estimate prognosis and monitor the efficacy of treatment and recurrence.
④Endoscopy: sigmoidoscopy and fiberoptic colonoscopy, which can directly view the lesion site, morphology and size, and take biopsy for pathological examination;
⑤ Rectal finger examination is the first choice for rectal cancer diagnosis, with 90% detection rate;
⑥Imaging examination.
(A):air-barium double contrast enema examination: the accuracy rate can reach more than 90%;
(B):CT examination: it is important for the staging of colon cancer and is mostly used for the examination before and after surgery;
(C):Ultrasound: for the masses that can be palpated in the abdomen and to understand the lymph nodes, liver and other metastases.
II. Treatment principles.
The comprehensive treatment combining Chinese and Western medicine is undoubtedly the best treatment for colorectal cancer. First of all, patients with indications for surgery should be operated as early as possible, while radical radiation therapy is effective, with light reactions and preserves rectal and anal functions, but the case is very selective and can only be limited to a few early patients with superficial tumor and small scope.
Chemotherapy: At present, about 1/3~1/4 of colorectal cancer cases are in advanced stage, in addition, about 40%~70% of local recurrence and distant metastasis occur within 5 years after radical surgery, and these patients obviously need chemotherapy treatment, which also shows the importance of adjuvant chemotherapy after radical surgery. Traditional Chinese medicine treatment has important significance in alleviating clinical symptoms, improving the condition, improving the quality of life, enhancing the immunity of the body, preventing recurrence and metastasis, and prolonging the survival period in all stages of intestinal cancer.
Traditional Chinese medicine treatment.
1. For patients after surgery, treatment is mainly to enhance physical fitness, improve immunity and prevent recurrence and metastasis. If the patient’s vital energy is injured due to caesarean operation or is old and weak, the patient is mainly “deficient”, then strengthening the spleen and nourishing the kidney is the treatment, according to the clinical diagnosis, the formula uses Si Jun Zi, Six Jun Zi, Ginseng and Bai Zhu San, Angelicae and Six Flavored Di Huang Tang with additional flavor, with the addition of Qi, blood circulation and dampness; if the postoperative body is still good, diet and sleep are more regular, then the main treatment is to detoxify and invigorate the blood. If the postoperative physique is still good and the diet and sleep are regular, then detoxification and blood activation are the main ingredients, such as Xihuangwan.
It is proved that the postoperative medication should be mainly “tonic”, because the Chinese medicine of benefitting Qi, strengthening spleen, nourishing blood, consolidating kidney and invigorating blood can improve the immunity of the patient’s body after surgery, which has a positive effect on restoring physical strength, preventing recurrence and metastasis.
2.Medication during chemotherapy: After years of clinical practice, we found that Chinese herbal medicines are effective for leukopenia, anemia, thrombocytopenia and liver function damage caused by chemotherapy and gastrointestinal reactions during chemotherapy, such as nausea and vomiting, nausea, abdominal distension and constipation. It can greatly reduce the discomfort symptoms during chemotherapy and make chemotherapy less unbearable.
By using Chinese medicine in the interval of chemotherapy, the patient’s abnormal indicators such as blood and liver function can be improved more quickly, and the immune system, which has decreased due to chemotherapy, can be improved, so that the patient’s general condition can be improved and chemotherapy can be carried out as scheduled, which is important for consolidating the efficacy and prolonging the survival period.
Third, prevention, conditioning.
1, prevention: usually eat more vegetables and fruits containing coarse fiber, keep the bowel movement smooth, do not eat spoiled food and high-fat diet. For patients with large intestinal polyps (especially familial adenomatosis), once the abnormality is detected, surgery should be removed as soon as possible, such as those who cannot be operated, should be checked regularly, and once the mass is found to increase, surgery should be performed immediately.
2. Patients should maintain a relaxed mood and avoid mental tension and excessive anxiety. If the condition is stable after surgery, it should be reviewed every three months in the first year, every six months in the second year, and annually thereafter. If abnormalities are found, then check and treat at any time.