Bai Zhi Ling:
Common Effects of Colorectal Cancer Prognostic Factors Are:
1. Age – In China, the median of outbreak of colorectal cancer occurs around age 45, ten years earlier than the United States and Europe. Because in young people, colorectal cancer is more common to be manifested as poorly differentiated mucinous adenocarcinoma; tumors easily grow toward outside the intestinal wall and spread distantly. The majority of patients at the time of diagnosis are mostly in the Dukes C, D phase, so young people have poor prognosis in colorectal cancer. Fudan University AffiliatedTumor Hospital’s information shows that a youth group (age= < 30 years old) with colorectal cancer has a 5-year survival rate of 21.83%, was significantly lower when compared with a middle-aged group’s survival rate of 52.97%. But in a lymph node metastasis, Stage I, Stage II youthful patients with age > 30 years old show no big difference (respectively 81.98% and 85.01%). However, 5-year survival rate in patients with lymph node metastasis in Stages III was significantly decreased in the youth group. (The two groups after radical surgery show 5-year survival rates of 49.27% and 73.06%).
2.Clinical Stage -- As mentioned earlier, at the later stages of the disease, the lower the 5-year survival rate.
3.Lesion sites -- Almost all of the data have shown that colorectal cancer is worse than the prognosis of patients with colon cancer. In colorectal cancer, the middle and lower 1/3 of the local recurrence rate is higher and has poor prognosis than upper middle third of the local recurrence rate of colorectal cancer.
4.Pathological features -- Include pathological type, tissue differentiation, lymphatic, vascular invasion, fibrotic conditions, and the extent of tumor tissue infiltration of lymphocytes. The tubular adenocarcinoma 5-year survival rate was 60%, while mucinous carcinoma was 40%; high score differential of 5 year survival rate was 71%, the middle score differential was 60%. Lower score differential was only 30%; Extensive fibrosis of cancer 5-year survival rate was 45%; less extensive fibrosis of cancer 5-year survival rate was 75%; Lymphocytes cells with less invasion show 5-year survival rate of 40%; more obvious invasion show 95%.
5.As previously mentioned, the properties of surgery, radical surgery, palliative surgery and shortcuts surgery, have obvious differences in their 5-year survival rates.
6.Adjuvant therapy, radiotherapy, chemotherapy, and application of adjuvant therapy can all reduce the local recurrence rate of colorectal cancer, metastasis, and the local and distant recurrence rate, and increase patients’ 5-year survival rate.
Colorectal Cancer
Colorectal cancer (also known as colon cancer) is a common gastrointestinal tumors, can occur in any part of the colon. In North America, West Europe has a higher incidence, United States colon cancer deaths accounted rank the second, compared with other cancer death. In China, most provinces and cities, compared with total mortality rate of cancer mortality rate is between 5-6 positions. In recent years there is an upward trend. Its incidence increases with age, starting from 40 years old increase, 60-75 years old reach peaked. Colorectal cancer has obvious geographical distribution, family genetic factors have been reported. Due to slow cancer growth, it will take a long time before showing symptoms and bodily evidence.
Table of Contents
Development
1.Symptoms Reflect
2.Drug Treatment
3.Dietary Health
4.Preventive Care
5.Pathogenesis
6.Disease Diagnosis
7.Inspection Methods
8.Complication
9.Prognosis
10.Pathogenesis (Disease outbreak mechanism)
1 Symptoms Reflect
I.Disease History
Detailed illness history can lead to a diagnosis of colorectal cancer. Wherever there is an unexplained reason such as weight loss at middle-aged plus, anemia, change of pattern of defecation, mucus, blood stools, obstruction embolism, one should consider the possibility of colorectal cancer, for the early detection of colorectal cancer. For some with no obvious symptoms, but have other colorectal cancer risk factors such as any family history of colorectal cancer, or one who suffered multiple colonic polyps, ulcerative colitis, crohn disease, chronic schistosomiasis, or received pelvic radiotherapy, or has a removed gallbladder, all should have regular follow-ups and review.
II. Physical Check up
A comprehensive physical examination not only will help correct diagnosis of colorectal cancer, but also can estimate the severity of the disease, cancer invasion and metastasis status, and help formulate a reasonable treatment plan as a reference. Such physical examination should pay particular attention to localized signs of intestinal obstruction, signs of abdominal mass and abdominal tenderness. Since the vast majority of colorectal cancer happen in the rectum and sigmoid, therefore a digital rectal examination should be essential. Whenever there is a patient with blood in the stool, whenever stool habits change, or when the stool is deformed, and, or other symptoms, a digital rectal examination should be carried out. Check and learn anal or rectal examination with or without stenosis. If finger glove is stained with blood, or if feel a bump, one should clarify its parts, shape, focus, range, or activities at the base of its relationship with the two neighboring organs.
III.Evaluation of early diagnosis of colorectal cancer and its population census.
As previously mentioned, the incidence of colorectal cancer increases year after year, its high mortality and 5-year survival rate is closely related with the Dukes stages. Because the cause of colorectal cancer is unknown, increasing the patient’s survival rate depends on secondary preventions, that is early diagnosis of colorectal cancer. Early detection including two area contents: first early detection, and second, early diagnosis. At present, due to the widespread use of colonoscopy, endoscopic biopsy, histopathology, tissue is very easily obtained, therefore, early diagnosis of precancerous lesions or cancer is not very difficult. The early detection of colorectal cancer is still facing many obstacles. The main symptom of early colorectal cancer is often hidden, and cancer patient often come to treatment sessions too late. Currently, there is a lack of specificity of early cancer diagnosis laboratory methods.
Throughout the asymptomatic population, a census, or a family history of colorectal cancers, or a diagnosis of precancerous lesions in patients with monitoring are all important way to find early cancer. Because cancer diagnosis often depends on colonoscopy and biopsy, as such, any form of census workload must be considered. Barring economic costs and social tolerance, conducted screening tests to reduce high-risk groups can make up for lack of colonoscopy. Even if considered purely from the screening efficiency, screening tests can also improve the detection effectiveness of colonoscopy. For example, in a census of over ten thousand people, we compared the observed sigmoidoscopy alone and with immune occult blood, colonoscopy sequential census results, found by screening test, sigmoidoscopy allows for the detection of cancer rate from 0.14% to 0.43%.
As colorectal cancer screening test not only requires sensitive, special methods, and must be simple to operate, economical and practical, so far, there has been a variety of methods to try in the laboratory to diagnosis of colorectal cancer, but most difficult is to comply with the above requirements. This is because most of the diagnostic criteria compare with the differences in the mean between patients and control patients with colorectal cancer, but they are not specific for, and are difficult to establish the diagnosis of cancer of the threshold. Early cancer is often not sensitive, and colorectal cancer screening data is taken from a worldwide perspective. Screening tests are currently used mainly for fecal occult blood screening test and rectal mucus T-antigen test developed in recent years. Fuller applications of monoclonal antibodies for detection of colorectal cancer in stool solution or associated antigen within the scope of the census small population are currently on trial.
There are more fecal occult blood test methods. Chemical occult blood test methods are simple and easy, but are vulnerable to a variety of factors and false positive result, (such as eating meat, fresh fruit, vegetable, iron, aspirin and other) and false negative (such as prolonged fecal retention, hemoglobin decomposition in the intestine, taking antioxidants such as vitamin C, etc.). An immunoassay follow-up chemical occult blood test is performed after the second generation of colorectal cancer screening test. Its advantage is its strong specificity, not affected by food and drugs. Early research is an agar immunediffusion, however, we found that the specificity of the method was good in the application. But for cancer detection, its sensitivity is not superior to the chemical method, therefore, we have compared the RIHA, (Reverse/Indirect, hemagglutination), immune latex agglutination test, and the SPA synergy test. The principle is the human hemoglobin antibody coated on the carrier. It was found that the immune SPA occult blood test can greatly improve the sensitivity and specificity of detection of occult blood. Our census, in 8233 cases, 934 cases of patients were found positive, which detected four cases of colorectal cancer, 3 cases of early cancer. It is note worthy that the test is an SPA, which includes a staphylococcal protein as carrier and a flag antibody without purification and complex processing. During the test, one just needs one drop of manure at the site mix with SPA reagent. Stable results can occur within 1-3 minutes; therefore, it is very suitable for the general population.
It is worth noting that, the fecal occult blood test is based on the detection of intestinal bleeding and detect colorectal cancer. Therefore, observing no bleeding, or only intermittent bleeding in patients with colorectal cancer may be missed. Many non-tumor intestinal bleeding can be false-positive results. We have 3,000 cases of age over 40 plus of endoscopic screening and have detected 5 cases of colorectal cancer. There are two cases in which the early cancer occult blood test was negative. In the occult blood test, positive patients show more than 97% of non-tumor hemorrhage. In addition, occult blood immune reaction in the reaction of the appropriate amount may be a problem. Liquid manure with excess blood, and hemoglobin molecules may occur false negative results. This is the so-called &Idquo former with &rdquo phenomenon.
In recent years, to overcome the lack of an occult blood test, the United States Shamsuddin test uses the colorectal cancer and precancerous colon mucosa showing similar features expression as T antigen. To express this specific feature, proposed rectal mucus galactose oxidase test the feasibility of screening for colorectal cancer (the shams test). In China, this is our first time we use this method with the effect of colorectal cancer screening and we validated the method for improvements, so that it can be used for large-scale population screening. The results show that its clinical detection of colorectal cancer positive rate is 89.6%. We are using over 3,820 cases of age 40 plus census using the Shams test with SPA immune occult blood test to compare. The results show a former positive rate of 9.1%, and a lesion detection rate of 12.7%, including two cases of early cancer and 28 cases of adenoma. For lesion detection and SPA test, it plays a significant and complementary role.
Looking for a more sensitive and specific method for colorectal cancer screening test is one of the important topics of colorectal cancer prevention. Recently reported ras oncogene mutations can be detected in the liquid manure from colorectal cancer. However, it is too early to use the result of this gene level study for clinical tests. The current study is the use of the existing screening test and optimization of screening programs. Future colorectal cancer screening may no longer be a simple colonoscopy or occult blood-sequential screening colonoscopy. The various experiments are based on the sensitivity, specificity, economic cost, and social subjects’ acceptance and affordability. Comprehensive and complementary experimental trial census is needed to enhance the effectiveness of colorectal cancer screening selection.
Early colorectal cancer symptoms are not obvious, maybe a symptomatic or only vaguely unsuitable, such as indigestion, occult blood, etc. With cancer tumor progression, symptoms become clearer, such as, performance change in bowel habits, blood in stool, stomach ache, abdominal mass, obstruction and fever, anemia and weight loss, and other symptoms of systemic toxicity. Due to tumor invasion and metastasis can still cause corresponding organ change, Colorectal cancer according to their different primary site and show different clinical signs and symptoms.
(1)Right Colon Cancer
Prominent symptoms of abdominal mass, stomach ache, anemia, partially mucus or bloody mucus, urinate frequently, bloating, belly swollen, obstruction embolism. But far rarer than in the left colon, appearance in the right colon large intestine commonly show ulcer lumps. Many patients may have palpable mass in the right abdomen and tumor mass. Unless the cancer directly involves the ilecocecal valve, it generally shows less intestinal obstruction because stool in the right colon still show semifluid thin paste. Therefore bleeding caused by fecal friction foci are less. Most bleeding due to cancer tumor going deadly bad are caused by necrotic ulcers. Due to missing blood and liquid manure evenly and difficult to detect chronic blood loss can cause. Patients are often hospitalized due to anemia. Abdominal pain is also common, often pain, mostly caused by multiple tumors invadingthe intestinal wall. Secondary infection of cancerous tumor ulcers can cause local tenderness and systemic toxemia etc.
(2)Left Colon Cancer
Prominent symptoms of stool habits change such as: bloody mucus or bloody stools, intestinal obstruction, etc., narrow left colon lumen, primary cancer growth mostly infiltrative circular growth ring, prone to cause luminal narrowing of the upper intestine, increased fluid, intestinal creep movement, hyperthyroidism. That’s why after constipation, diarrhea can occur, often two alternating. Because the stool go into the left colon change from paste to slug, thus from stool friction lesions are caused. Commonly, one can visually see stool blood, and patients often seek medical treatment earlier. Anemia due to chronic blood loss does not as stand out as in right colon cancer. Intestinal cancer invasion obstruction caused by narrowing intestinal stenosis from intestinal obstruction mostly are chronically incomplete. Patients often have a longer term discomfort pool stool, and experience paroxysmal abdominal pain. Due to the low obstruction, vomiting is not obvious.
(3)Colorectal Cancer
Prominent symptoms are blood in the stool, change in bowel habits, and due to advanced cancer caused by infiltration, original cancer area position lower, fecal material harder, cancer susceptible to fecal friction can easily cause bleeding, mostly bright red or dark red. Do not mix with the forming stool or feces column attached to the surface and misdiagnosed & idquo hemorrhoids & rdquo bleeding, stimulation of tumor lesions and ulcers due to secondary infections, constantly causing defecation reflex, easily misdiagnosed as & ldquo dysentery & rdquo or & ldquo enteritis & rdquo, growth leads to narrowing of the intestine cancer ring, early performance of deformation tapering column manure, late manifestation of incomplete obstruction syndrome.
(4)Tumor Invasion and Metastasis Disease
Local extension is the most common invasive colorectal form, carcinoma invading, the surrounding tissues often cause the corresponding symptoms, such as colorectal cancer invasion and sacral nerve caused persistent pain from abdominal and lumbosacral, anus incontinence, etc. Because cancer cells grow off, rectal examination in the rectum can find palpable and block material in the bladder rectal fossa, or in the uterus rectal fossa, There may be widely disseminated ascites. Early stage of cancer tumor can spread along the intestinal perineural lymphatic diffusion gap. Later it moves from the lymphatic metastasis to lymph nodes. When cancer metastasis move to the para-aortic lymph nodes into the celiac pool, through the thoracic duct and left supraclavicular lymph node metastasis, it causes that area’s lymph nodes to become swollen. There are a small number of patients which have upward lymphatic blockage of tumor thrombus leaving retrograde spread of cancer cell. In the perineum, it appears as numerous diffuse small nodules. In female patients, tumors can be transferred to both ovaries and cause Kruken-berg’s disease. Advances colorectal cancer can be transferred through the blood to the liver, lung, and bone, etc.
2Drug Treatment
Chemical Treatment of Colorectal Cancer
(1)Indications and Contra-indications:
1)Indications:
a.Preoperative, Intraoperative Chemotherapy
b.Transfer greater danger of Stage II and Stage III patients (its main purpose is to improve the survival rate. Combined overall randomized study found, postoperative chemotherapy increases Stage III patients’ 5-year survival rate by about 5%).
c.Patients with advanced cancer surgery who failed to remove tumors, or who are unable to undergo surgery, and radiotherapy patients.
d.Post operative, recurrence after radiotherapy, transferred but cannot re-operate patient (Its purpose is to alleviate the suffering of and/or to prolong life. Previous studies showed that chemotherapy can make complete tumor disappearance in 20%-40% of these patients. Reduce or stabilize, but relief time generally only 2.5 months. Long-Term relief patients are rare).
e.KPS score 50-60 points and above patients.
f.Expected survival time is greater than 3 months.
2)Contra-indications:
a.Bone Marrow dysfunction white blood cell count at 3.5 x 109/L or less, plates 80 x 109/L or less.
b.Patients with Cachexia state.
c.Liver, kidney, heart and other major organs functionally or severely impaired patients.
d.Patients with more severe infections.
(2)Monotherapy: Previous chemotherapy more effective treatment of colorectal cancer include fluorouracil, nitrosourea, mitomycin (MMC), cisplatin class (DDP), and anthracycline antibiotics, etc. , however, the efficacy of these drugs still have some limitations.
Among them, chemotherapy using fluorouracil for colorectal cancer haveover 40-years history. So far it is still the main drug. However, the use of the method has been improved.
1)5-Fu for Anti-metabolite chemotherapy drugs, function in the cell cycle of the sensitive S period of cancer cells, while other periods are not sensitive. If intravenous injection is used as a method of administration, isonly effective for about 10% of the cells in the S period. However, if the full course of medication with 120 h (5 days and nights) continuous infusion therapy methods (now make more use of intravenous micro pumps). An effective concentration of 5-FU is always maintained during that period. All cancer cells in the S period are all affected by 5- FU effects, therefore, the effects of chemotherapy is improved. The bone marrow toxicity and gastrointestinal reactions are reduced, but chemical phlebitis is increased at the venous injection site.
2) CF (Leucovorin, Leucovorin or folinic acid) which took nearly 20 years to discover, can improve the anti-tumor effect of 5-FU, so treat patients with colorectal cancer whose remission rates doubled. CF venous injection into tumor cells in vivo 2h reached its peak. At this point best give 5-FU (5-FU as intravenous injection, peak plasma lasted only 10 minutes. So if at the time of intravenous injection, immediately bolus 5-FU. If the 5-FU peak has not yet been reached its peak or is over, then CF’s chemotherapeutic role is bound to be adversely affected). For a drug such as 5-FU, preclude continuous giving the drug by day and by night. For CF, oral administration is better. Oral intake 15 mg every two hours. For better sleep quality at night, can change to 30 mg before going to sleep first time.
In recent years, there are three kinds of new drugs used in clinical treatment of colorectal cancer, they are: Oxaliplatin (Trade names are: Eloxatin, L-OHP, Grass platinum, Oxaliplatin etc.), CPT (Irinotecan, CPT-11), Xeloda. According to research, the traditional CF + 5 – FU program allows Stage III patients after surgery, a better 5-year survival rate compared with plain surgery alone. This group’s 5-year survival rate is higher about 5%. Now a new drug application is expected to make the 5-year survival rate increase about 10%, but, its price is more expensive.
(3)Combination Chemotherapy: Combination Chemotherapy with improved efficacy, with decreased or not increased toxicity. Due to various excellent herbs which can reduce or delay, there has been a lot of Combination Chemotherapy used for treatment of colorectal cancer. Clinically often preclude the use of a variety of cytotoxic agents or cytotoxic drugs, and biochemical use in combination with bioregulators, usually 5-FU or its derivatives as a basic medication. Its reported efficient range is around 10%-52%. but mostly are in the 20% or so, effective range.
Chemotherapy Methods commonly used for Colorectal Cancer:
1)FM Program: The total effective rate of 21%, FM Program was considered to be an effective and safe adjuvant chemotherapy program methodfor use after surgery. It can significantly increase the five-year survival rate, currently due to MMC bone marrow suppression and renal toxicity with each decreasing application. 5-FU, 1,000 mg/ml, infusion, the first 1-4 days, repeat every four (4) weeks. MMC, 15-20 mg/ml, intravenous, first day, repeat every eight (8) weeks.
2)5-FU/CF Program: This program is currently the most basic treatment of colorectal cancer. It has been reported that the treatment of advance colorectal cancer effective rate of 23%, can reduce the recurrence rate of 35% after surgery, and the mortality rate by 22%. But most of the results don’t reach this level. Usage is: CF, 100 – 200 mg, add 5% glucose solution or saline infusion 250 ml, after 2h drops, drop to half, add 5-FU 370-400 mg/ml infusion, 1 time/day, continue for 5 days for one treatment, repeat for four weeks. This can be used in conjunction with six treatments.
3)5-FU/LV (Levamisole is a medication available for treatment of parasitic worm infections and certain cancer. Levamisole interferes with the growth of cancer.) Program has been reported to use the program as adjuvant chemotherapy. Reduces the recurrence rate of Dukes C stage colon cancer post-surgery patients’recurrent rate by 40%. Reduces mortality rate by 33%. But because most of the results didn’t reach this good level, it has rarely been used in recent years. Usage is: 28 days after surgery, 5-FU 450 mg/ml infusion, once per day, continue for 5 days. Afterwards, once per week, continue for 48 weeks. 28 days after surgery, start use oral LV 50 mg once every 8 hours, continue for 3 days, repeat once every 2 weeks, total use one year.
4)5-FU/CF/LV Program: This program was also effective for Stage II-III Level colorectal cancer adjuvant chemotherapy. This scenario has been reportedly compared with 5-FU/CF and 5-FU/LV program with a higher effective rate, CF and LV can enhance the role of 5-FU, but with different mechanisms of action, so using CF and LV with double adjustment can further enhance the efficacy of 5-FU. But with the same effect as majority treatments showing poor results, in recent years, there were fewer applications. Usage is : CF 20 mg/ml, 5-FU 370 mg/ml, infusion, once per day, continue for 5 days as one treatment, repeat for four weeks, total use6 Treatments. LV 50 mg at a time, 3 times per day, repeat once every 2 weeks, total usehalf a year. Other Programs also include FAM program (5-FU + ADM + MMC), FAP program (5-FU + ADM + DDP), FP program (5-FU + DDP) etc. Because traditional of CF plus 5-FU treatment of colorectal cancer, most efficient around 20% (CR + PR). The recent application of oxaliplatin, cape expansion, and new drugssuch asXeloda have an effective rate of 25% - 40%. Chemotherapy is bringing new hot spots for colorectal cancer research. Common scenarios and doses are:
a)L-OHP + 5-FU/CF program: CF, 100-200 mg infusion forthe first 1-5 days. 5-FU, 375-425 mg/ml infusion for the first 1-5 days. Eloxatin, 130 mg/ml, infusion to maintain for 2 hours, for the first day. Repeat every 4 weeks. In the above mentioned 5-FU infusion for 5 days dose, a micro pump can also be used intravenously for 5 days and nights, with CF Infusion Oral instead.
b)CPT-11+5-FU/CF program: CF, 200 mg infusion for the first 1-5 days. 5-FU, 300 mg/ml infusion for the first 1-5 days. CPT-11,125 mg/ml, infusion to maintain 90 minutes, once every week, for a total 4 times. Repeat every 6 weeks. Above 5-FU intravenous dose for 5 days with micro pump can also be used intravenously for 5 days and nights, with CF intravenous, oral instead.
c)In the above scheme, 5-FU can use Xeloda instead (1,500 mg, 2 times/day, orally for 14-15 days), Xeloda may be used alone Chemotherapy, Usage is: Xeloda 2,000 mg oral, 2 times per day, continue for 2 weeks, stop one week and repeat the next treatment. Regarding 5-FU, oxaliplatin, CFT-11, joint applications Xelola several drugs (including Oxalilatin + CPT-11, Xeloda + Oxaliplatin, Xeloda + CVT-11, etc.) as well as the efficacy of adjuvant Chemotherapy after surgery, and it continues to be under further study.
(4)Precautions:
1)Chemotherapy drugs can cause decreased bone marrow function and organ dysfunction, and one should therefore periodically check the normality of blood, liver and kidney function during chemotherapy, in order to detect and deal with.
2)Severe stomatitis during chemotherapy, diarrhea, or liver and renal dysfunction, chemotherapy should be deactivated, and the symptoms treated. During oxaliplatin treatment avoid contact with cold objects (cold water,cold food, cold wind) should be avoided. During CPT-11, treatment should pay attention to deal with diarrhea (after medication within 24 hours may use atropine, medication after 24 hours take “Imodium”, 1 pill every 2 hours. Also taken orfloxacin or ofloxacin, need to pay attention to rehydration, until the diarrhea stops after 2 hours). Improper handling can cause dehydration, electrolytic disorders and even shock.
3)No improvement, or worsen condition in 2-3 cycles of illness after treatment. Chemotherapy drugs should be discontinued or replaced. In summary, in the recent 30 years in the field of colorectal cancer chemotherapy, 5-FU still maintains its dominant position. As with transforming acid platinum, CPT and other new drug combination use also reducesthe recurrence and relocation and continues to improve the survival rate with new forward movement.
Chinese Medicine Treatment of Colorectal Cancer
(1)Wet Heat Accumulation: Anorectic Tumor, Abdominal bloating, Increased Stool frequency, with pus and mucus, or Tenesmus–In an emergency, after worsening, eating less. Yellow greasy tongue, slippery pulse. Meal should be light and easily digestible, and with absorption of dietary nutrition of foods.
1)Purslane Green Bean Soup. Fresh Purslane 120g (or dry goods 60g). Using above raw material, add appropriate water, decoction 500 ml. 1-2 times daily, continue use for 2-3 weeks. Purslane is a sour cold, non-toxic disposition. Character of green beans is cold,both play a role in total clear heat detoxification. Diuresis swelling benefits are increased in this fluid and nutrient solution. Two flavor combinationsare more appropriate for patients with wet heat accumulation. This medicine is not suitable for persons with weak spleen, or diarrhea.
2)Fresh Kiwi. 250g Fresh Kiwi. Eat raw food daily. Reduce heat balance stomach, Diuretic through filter. Fresh Kiwi sweet sour will cool, delicious taste, can be used as therapeutic cancer patients’ fruits. Its root is called Tengligen (meaning: vine, pear, root), good for blood circulation, detoxification, and clear heat benefit with moist effects. Best consume with decoction of tea.
3)Red Bean Yi rice porridge. Red small rice50g, deeply soaked raw Yi rice. Boiled to simmer, add rice cook together to congee, add sugar and consume. Clear heat diuresis, with blood detoxification. Prescribe red-bean, sweet sour, calm, add water, clear heat detoxification, clears blood swelling; Raw Yi rice light sweet, slightly cold, strong spleen keep wetting. Clear heat remove pus, shivering chills, dehumidifies. Rice nourishes spleen and balances stomach. Above total use for heat accumulation type of colorectal cancer patients. Continue use for 10-15 days.
(2)Qi Stagnation Blood Stasis: Common during progression of colorectal cancer. Abdominal mass Latong, hard strong unwavering, bloating diarrhea, dysentery purple black pus. In emergency clear after, purple tongue or ecchymosis, yellow moss, pulse astringent sink string. Food should be thin softer, light and easily absorbed, with less oil residue. Due to fluid loss, should drink more multi-drug tea and soup liquid to replenish body fluids.
1)Bergamot Porridge. Bergamot 15g, with Japonica Rice 100g. Add appropriate crystal sugar, and cook Bergamot with spare soup and store. Add water to cook rice porridge. For adults, boil bergamot juice and crystal sugar with porridge. Consume once per day, continue for 10-15 days. Bergamot has a hard bitter acidgoes into spleen, liver, and the stomach nerves. Calms Qi, stops pain, gives strength to stomach and stops vomiting. For the treatment of the patients with abdominal distension.
2)Purple Amaranth Porridge. Fresh Purple Amaranth 100g, Japonica Rice 100g. Clean, chop, and remove root of the Purple Amaranth. Cook with Japonica rice to porridge. Consume twice a day, continue for 10-15 days. Purple Amaranth tastes sweet and has a cooling character. There is clear heat, cool blood, and a spreading stasis effect. Once made into porridge, it contributes to physical recovery.
3)Peach Flower Porridge. Fresh peach petals with Japonica rice. Cook gruel, once every other day, continue for 7-14 days. Liquid water activates blood flow. Peach flower bitter sweet not toxic, removes swelling, foul smells, dieresis, causes less sputum, and less food indigestion, controls the hardness of stool. Combine with Japonica rice to make the role of relaxation. This prescription is suitable for hot dry constipation patient. Stop use once cured, do not use for long time.
(3)Spleen Kidney Yang Deficiency: Hidden throughout the belly, pressing feels warm. Fecal incontinence, frequently dirty from stool falling from anus. Prolapsed cancer mass, pale complexion, shivering chills, cold body, pale tongue, thin white moss, thin weak pulse. Diet should include absorbable, digestible, and nutritious warming foods.
1)Ginseng chicken stew. Danseng 30g, Aconite 30g, one hen (about 1,500g), appropriate spices. Wash the chicken gut. Once chicken is gutted, use aconite and Dangshen. Place spices into the chicken belly, slow cook until mashed, eat the meat and drink the soup. Warming character nourishesthe spleen and the kidney. Prescribe aconite with strong heat, make-up the fire yang, temperature in the warm kidney. Dangshen sweet flat, fill in, benefits Qi and nourishes spleen; chicken sweet warm, benefits the spleen and the kidney. Consistently eat stew for long time; has a therapeutic effect for cancer tumor patients, and also for yang deficiency spleen and kidney patients.
2)Lotus walnut cake. Walnuts 100g, Lotus (remove core) 300g, Gorgon Powder 60g, Glutinous Rice 500g. Add water to walnuts and lotus boiled and mashed. After soaking Glutinous rice into water for two hours, place walnuts and lotus mixture with corn starch in a wide steamer pot of water. Cut after it cools, and sprinkle one layer of sugar, consume daily in the morning and in the evening. Consider amount with serving notice, continue intake for 10-15 days. Warms kidney and strengthens spleen. Thickens the intestine, and ceases diarrhea. Sweet walnut nourishes warm character, nourishes kidney. Sweet lotus has calming, astringent character, can nourish spleen, and astringent intestine, and connect kidney heart. Various drugs together make cake. Thicken intestine stomach, because the essence, remove cold wet. Sweet gorgon is warm natured, nourishes spleen, stops the leaks, benefits kidney, has a stabilizing essence.
3)Nourishes bone grease pill. Psoralen 120g, Nutmeg 60g, Jujube 50 pieces, Ginger 120g. Psoralen Levigation. First clean ginger, cook date together, mashed the date, remove ginger peel. Use date meat Psoralen, make indus size balls of nutmeg powder. Eat 50 pieces each time, use with salt water, once in the morning and in the evening, continue for 10-15 days. Warming character nourishes spleen and kidney, astringent intestine, and stops diarrhea. Nourishing psoralen exhausts astringent temperature, into the kidney, spleen, and channel, nourishes kidney, provides strong Yang, warms spleen, stops diarrhea; Nutmeg puts warm character into spleen, stomach, and large intestine channel. Use when cannot stop diarrhea; ginger jujube warmth nourishes spleen and stomach.
(4)Liver and Kidney Yin Deficiency: Limp, dizziness, dazzled, waist, sore legs. Five hearts annoyed (moody), hot flashes and night sweats, thirsty throat, and knotty dry stool. Red tongue, with little or no moss, thin continuous or broken pulse, drinking nourishing liver and kidney digestible porridge or soup.
1)Ligustrum Wolfberry Pork’s Liver. Ligustrum 30g, Wolfberry 30g, Pork’s Liver 250g, right amount of spices. Cook Ligustrum, Wolfberry with water for 30 minutes, add bamboo thorn poke into Pork’s Liver. Use low heat and simmer for 30 minutes, add spices. Can be eaten sliced. Nourishes the liver and kidney. Ligustrum Wolfberry nourishes the liver and kidney, Pork’s Liver sweet calm character nourishes blood. For Blood Flesh sentient mouth (meaning – keep life alive one needs to eat). Three flavor compatibility usage better
Wolfberry ground Turtle Meat Soup. One turtle, Wolfberry 30g, Ligustrum 15g, Rehmannia 15g. Add water, simmer and stew overnight. Remove Ligustrum, add spices at intake. Nourishes the liver and kidney. Wolfberry, Ligustrum, Rehmannia nourishes the liver and kidney; Yam benefits the spleen and kidney. Eat with turtle, its function is especially good.
2)Ligustrum Mulberry Honey cream. Fresh Mulberry 1,000g (or dry goods 500g), Ligustrum 100g, Early Ink Lotus 100g, White Honey right amount. Ligustrum, Early Ink Lotus decoction intake juice, Add mulberry fry long time, every 30 minutes Kushiro decoction one time. Add water and fry. Total take decoction mix twice, use small fire, until concentrated. Make more viscous by adding honey 300g. When boiling, cease fire, and let cool. When cool, place in bottle for use. Every time when making a soup, record spoon usage, use boiling water mixed for drinking, twice a day. Nourishes the liver and kidney. Previous three tastes all can nourish liver and kidney. Mulberry can produce blood and fluid, water flow reduces swelling; Ligustrumis good for cleaning weak heat; Early prostrate especially can cool blood, and stop bleeding. Also white honey detoxification. With the use of various flavors, can treat Yin type deficient liver patient inner heat bleeding; the effect is quite good.
(5)Qi Blood both Deficiency: Emaciation (physical thinning), pale face, tired, shortness of breath, long, thin, white stool, weak pulse, this symptoms appear more common with advance patients. Should take a digestible and nutritious diet tonic.
1)Ten Complete Big Nourishing Soups. Dangseng 30g, Sunburn Astragalus 30g, Cinnamon 10g, Rehmannia 30g, Fry Atractylodes 30g, Fry Chuanxiong 10g, Angelica 10g, Wine Root of herbaceous Peony 30g, Poria 30g, Roast Licorice 30g, Pork 1,000g, Pork bellies 1,000g, Cuttlefish 150g, Ginger 100g, bone & chicken duck feet, wing, pig skin, use right amount. Above drugs use gauze bag, cuttlefish grow thoroughly remove periosteum, pork bellies, clean pork skin, place above medicine food in wok, add the right amount clear water, high fire heating to boiling, move to simmer cook for 2 hours on slow fire, take out bones, fish, and chicken feet, let cool sliced or thread piece, re-entry drug stew serve. Consume right amount and continue serving for 3-4 weeks. Nourishes Qi and blood. This soup is made by Ten Complete Big Nourishing Soup decoction, former ingredient cures Qi blood loss. Adding pork and cuttlefish benefits Yin and plays and enhanced nourishing role.
2)Astragalus Hericium Soup. Hericium fungus 150g, Astragalus 30g, Tender Chicken 250g, Ginger 15g, White Scallion 20g, clear soup 250g, cabbage heart 100g. Soak Hericium Fungus in warm water until swollen for about 30 minutes, then cut into slices. Chop chicken into small cubes, afterwards, then stir-fried add water and a small amount of broth and simmer Hericium Fungus for about an hour. Remove chicken pieces and Hericium Fungus from the soup, boil Chinese cabbage heart in the soup. Consider taking a portion, and continue to take for 10-15 days. Nourishes Qi and develops blood. Sweet warm character of Astragalus can nourish spleen and kidney, benefits liver Qi, and grows Yin blood; Sweet calm character of Hericium Fungus is nutritious, delicious, and can be refreshing. Cook with chicken enhances nutrition.
3)Astragalus Ginseng Sea Cucumber porridge. Raw Astragalus 300g, Dangshen 30g, Licorice 15g, Japoniea Rice 100g, Jujube 10 pieces. Cook Raw Astragalus, Dangshen, Licorice until thick medicine soup, then take the juice. Cook the Japonica rice and Jujube together, after the porridge is ready, mix with previously made cooked thick soup or juice and blend. Use daily and nightly, and continue for 10 -15 days. Nourishes Qi, and grows blood. Astragalus, Danseng, Licorice based etc. Medicine to nourish and fill in Qi. To help source lacking of biochemical nutrients; Jujube nourishes spleen, and benefits blood growth; Juponica Rice relieves restlessness and thirst; benefits as a Qi fill in. Suitable for patients with blood Qi shortage.
Western Medicine Treatment of Colorectal Cancer:
(1)Surgical Treatment of Colorectal Cancer. Surgical Principles: With increasing incidence of colorectal cancer year after year, all kind of new technologies and new treatments continue to emerge. However, based on the current situation, surgical treatment of colorectal cancer is still the most effective method. The basic principle of colorectal cancer surgery is also consistent with the basic principle of tumor surgery operation. Overall, the three principles are radical, safety, and functionality, among them, in the case of when the tumor can be ressected. The first principle requires respect through radical. Secondly, take into account security, and finally, try to consider the functional principle of surgery:
1)Colorectal Surgical Approach:
a)Local Excision: Local resection refers to resection part of intestinal in the area of tumor, suitable for early colon cancer and benign tumor, confined to the mucosa or muscularis mucosa. Section located in the muscle is mucosa, and if located in the submucosa, malignant tumors can be found. In a few cases, there may be the presence of regional lymph node micrometastases and metastasis. If you only perform local excision, it may not cure root requirements, such cases should be cautious to preclude the use of local excision. Local excision range may include intestinal full thickness, cut fate range from the tumor no less than 2 cm. Can make endoscopic mucosal resection, or by anal mucosal layer, submucosa, and partial resection of the muscle.
b)Intestinal Resection: Intestinal resection refers to the removal of a certain length, including the cancerous tumor of the intestine. General requirements on the bottom cut range from the tumor should not be less than 5.0 cm. Bowel tumor resection should include appropriate mesorectal excision, namely the requirement to achieve the DL. Suitable for large benign tumors, and some limited submucosal, superficial muscle cancer, also including non-lymph node affected metastasis cancer.
c)Radical Mastectomy: Radical mastectomy or absolute mastectomy means absolutely complete surgical resection of the tumor and clearing the regional lymph nodes, and includes the histological examination of the various cut ranges, in all tissue without residual cancer.
d)Joint Exenteration: Combined colon cancer and joint exenteration in cases of invasion of adjacent organs cases, often use as a radical surgical application. However, in some cases, such as when cancer invades other organs, it may occur as an obstruction or a perforation, or fistula formation, and for the expected survival time is longer patient, even if distant spread has occurred, can still use palliative resection combined with organ excision.
e)Palliative Tumor Resection: Absolute palliative tumor resection refers to the ability of the naked eye to see residual tumors in patients. If it already exists in the peritoneum, liver metastasis and distant non-regional lymph nodes, then metastases cannot be resected in the full spectrum of cases. Perform relative palliative tumor resection (or relative radical mastectomy), although the radical surgical mastectomy may be required. During surgery, visually determine if tumor resection has been exhausted. But after histologically confirmed at the tissue margin, even base residual tumor or lymph node removal at the highest level have metastasis.
(2)Radiation Treatment of Colorectal Cancer:
1)Therapeutic Class: Depending on the nature and purpose of treatment, Radiation Therapy can be divided into Radical Radiotherapy and Palliative Radiotherapy.
2)Radiotherapy:
a) Preoperative radiotherapy: Preoperative radiotherapy in the treatment of colorectal cancer overall position has been gradually affirmed.
b) Post-operative radiotherapy: In patients with colorectal cancer operation after five years about half died of local recurrence. This is true for colorectal cancer after pelvic surgery, and for anastomotic, perineum and other local recurrence. In Stage II patients after surgery, the recurrence death rate can go up to 20%-40%; in Stage III patients, the recurrence death rate can be as high as 40%-70%. Therefore, how to prevent and treat local recurrence of colorectal cancer is still the focus of the study. Currently, although the efficacy of post-operative radiotherapy of various reports is also inconsistent, but after colorectal cancer surgery combined with chemoradiotherapy, it is still the standard adjuvant therapy. General believed, after surgery, those that begin early postoperative radiotherapy fared better. Start treatment within two months after surgery for better results. Due to the low rate of postoperative local recurrence in Stage I patients, it is therefore not necessary to do radiotherapy. In Stage II, and Stage III patients, especially those with obvious foreign lesion invasion, thereare more regional lymph node metastasis, after surgery with residues localized, which often need post operative radiotherapy.
c) “Sandwich” type of radiation therapy: Before the day of surgery, or during the morning of surgery shoot 5 Gy, to decrease cancer cell activity. Then perform surgery. If after surgery, pathological examination show Dukes B, or C stages, then use postoperative radiotherapy with 45 Gy/5 weeks. Can also use before surgery 15 Gy/5 times; Postoperative Dukes B or C Stage patients again give 40 Gy/20 times. Mohiuddin report “Sandwich” type treatment of patients with 5-year survival rate was 78%, there are significant differences with the pure surgery groups of 34%. In recent years, due to longer intervals before and after treatment, and lack of integrity, the radiation dose is not easy to grasp, thus, this method, has decreasing usage tendency.
3)Anal Cancer Chemotherapy: Anal cancer is about 85% of squamous cell carcinoma, and squamous cell carcinoma are more sensitive to radiotherapy and chemotherapy. Chemotherapeutic drugs such as 5-FU, Mitomycin (MMC) and Cislatin (DDP), etc. have confirmed radiosensitization. In view of this, currently in the United States and Europe “chemotherapy” has become the preferred treatment of squamous cell carcinoma of the anal canal, and has achieved good results.
4)Radiation reaction and treatment: After radiotherapy, follow-up once every 2-3 months, perform routine inspection, in order to understand the reaction after radiotherapy, and for any complications, and handle in a timely manner. Preoperative radiotherapy dose >= 40Gy perineal can significantly delay wound healing time. However, there is no change in the quality of healing. The results of a randomized trial, Wassif reported that a group considered operative mortality and that complications of preoperative radiotherapy are equal to zero. If radiotherapy can fully comply, split dose, the basic principle of dose volume effects such as radiation biology, preoperative radiotherapy has almost no complications. At the same time, it will not increase complications in patients after surgery due to preoperative radiotherapy. Postoperative radiotherapy can cause perineal scar sclerosis, or a mild enteritis, or cystitis, which can usually be relieved after symptomatic treatment.
(3)Treatment of Recurrence of Colorectal Cancer and Metastasis. After colorectal cancer radical surgery, about 40% of patients had tumor recurrence and metastasis. Recurrence in these patients have 20%-30% of local recurrence, 50%-80% are distant metastases. Usually those prone to colon cancer have distant recurrence of colon cancer, and colorectal cancer patients can easy have local recurrence colorectal cancer. Approximately 80% of patients with distant metastases have lesions confined to the abdomen, the most common site of distant metastasis are the liver, followed by the lung, the bone, and the brain. Less than 15% of patients have single site of tumor recurrence and metastasis, and there is the possibility of radical resection again. Depending on local recurrence range of lesions, choose if surgery is needed again, and decide which type of surgery and scope. For patients with liver metastases, such as no other parts except liver for recurrence or metastasis, for patient with lung metastases, such as no other parts except lung for recurrence or metastasis. Depending on the number and scope of metastases, determine whether to perform surgery, and combined treatment with chemotherapy plus. Under normal circumstances 20%-30% of liver metastases and 10%-20% of lung metastases can be resected. In most reports, the resection overall 5-year survival rate is 20%-30%. Therefore, follow-up found in the liver and lung metastases, depending on the case, should strive for surgery. For patients who can’t have resection if chemotherapy is effective, some patients may still be eligible for resection will have opportunities for cure.
1)Treatment of local regional recurrence: as reported in the literature. For general colorectal cancer after radical surgery, the local regional recurrence rate is about 1/3.
2)Treatment of liver metastases: In colorectal cancer, the liver is the most common site of metastases, Reported 40%-50% of colorectal liver metastases can happen at the same time or at different time, within 20%-25% of the lesions confined to the liver shift. Although previously reported in the literature, after liver metastasis, the prognosis is poor and the average survival period not exceeding 18 months. But in recent years due to the development of applications, and comprehensive treatment of chemotherapy drugs, after aggressive treatment of colorectal liver metastases can still get about 35% of the 5-year survival rate.
3)Treatment of Lung Metastases: Abdominal lung metastasis is one of the most common colorectal cancer, in all colorectal cancer, Lung metastases account for 10%-20%. Lung Metastases are often accompanied by full-body (systemic) metastases. X-ray examination in the diagnosis of lung metastases may provide valuable information. CT examination can accurately estimate the number and location of lung disease. Fiber bronchoscopy brush or needle biopsy can clearly determine pathological type. Sputum cytology check can also provide a reference, however, the positive dectection rate is low.
4)Treatment of Ovarian Metastases: Women with ovarian metastasis of colorectal cancer patients is also a more common problem, and are generalized as a Krukenberg tumor. As reported in the literature, colorectal surgery and postoperative follow-up of ovarian metastases found opportunities to 3%-25%, Within surgery, visual observation of post-surgery pathological examination revealed ovarian metastases each take 2%-5%, and metachronous ovarian metastases take 3%-8%. Half of the primary tumor is located in the sigmoid colon, and the rectum accounted for 25%. B Ultrasound, CT, MRI examination can follow-up preoperative and postoperative ovarian metastases, but still can miss diagnosis of smaller or older metastases mass. Final diagnosis depends on histopathological examination.
3 Dietary Health
1. Dietary Principles
(1) Colon cancer and colorectal cancer patients have recurrent outbreak, delayed healing of diarrhea, and weak digestion. Therefore, one should eat food that is easy to digest and absorb.
(2) Colorectal cancer patients mostly have blood in the stool. Advanced patients often have a lot of blood in the stool, that’s why they should eat less or don’t eat irritating and spicy food.
(3) Diarrhea or terminally ill patients with prolonged fever, sweating, and damaged fluid flow, should drink more water or soup liquid. The main course can include staple porridge, noodles and other semi-liquid diet.
(4) Patients mostly have a poor appetite, nausea and even vomiting. It is appropriate to have an intake of light food, and avoid greasy foods.
(5) Colorectal cancer patients at advanced stage have chronic diarrhea, blood in stool, fever, and a lot of nutrient and water loss, body weight loss, and loss to both Qi blood. Serve a nutritious fluid juice and a medicinal diet.
Also Can Take:
(1) Mushroom Porridge: Fresh mushrooms 30g (or dry goods 9g), red sticky rice 30g, add salt, oil, and appropriate amount of MSG. Take in an empty stomach, process a healthy and effectiveness balance stomach function. Use for colorectal cancer prevention and early treatment of colorectal treatment, or for after-surgery rehabilitation.
(2) Bamboo Leaves Green Bean Dumplings: Fresh Bamboo leaves, Green Bean 500g, Sticky Rice. Clean and drain bamboo leaves. Soak green beans in cold water for half an hour. Wash and drain together with sticky rice, and hammerevenly. Use 4 pieces bamboo leaves, green bean, and stick rice 30-40g. Pack into a triangular dumplings or quadrangular dumplings. Use thread to tie up. Then, put the dumplings in the pot, immerse in cold water,and use high fire to cook for 3-4 hours, until the soup thickens, and until sticky rice and green beans are cooked. Twice daily, drink the dumplings soup in one small bowl each time, and eat 2 pieces of dumpling. Has a detoxifying effect, especially to cure colorectal cancer.
4Preventive Care
Colorectal cancer is a serious threat to human life and health , dueto the ferociousness of the tumors. Throughout the world, epidemiological data indicate that colorectal cancer ranks number three (3), with regard to all kinds of ferocious tumors. In recent years, with economic development, China’s living standards have improved, and incidence of colorectal cancer are showing an increasing trend year by year, so the significance of colorectal cancer prevention are becoming more meaningful and more important.
I. Primary Prevention
Reduce, eliminate pathogenic factors for colorectal cancer, and inhibit normal cells change to cancer cells process,
(1) Dietary Modification
Although colorectal cancer has a certain genetic predisposition, but the vast majority of colorectal cancer is sporadic due to environmental factors. Particularly, it is closely related to dietary factors. Dietary intervention can reduce the incidence of Colorectal Cancer,
1)Energy Intake: Most studies show that energy intake and colorectal cancer occurrence havean association. The total energy intake and colorectal cancer risk relationship, whether the energy intake is protein, fat, or carbohydrates, it is shown that less energy intake may reduce the incidence of colorectal cancer.
2)Fat and Red Meat: Colorectal cancer is closely associated with animal fat and meat, Studies that compared high-fat women and low-fat women injection have shown to increase colorectal cancer risk by 32%. Among meat intake, red meat is a strong risk factor for colorectal cancer occurrence. Reducing the amount of dietary fat, especially after trying to eat less grilled brown meat, will help to prevent the incidence of colorectal cancer.
3)Fruits, Vegetables and Dietary Fiber: Cellulose can increase the amount of manure, and help dilute carcinogens in the colon. Absorption of bile sour salts can reduce incidence of colorectal cancer. Therefore, in the usual diet, one should intake vegetables, fruits, and dietary fiber as much as possible. Proper diet, will aid in reducing the incidence of colorectal cancer.
4)Vitamins and Trace elements: Studies have shown that Vitamin A, C, E can make adenoma patients with colonic epithelial hyperplasia convert to normal. Current study of the relationship of antioxidant vitamins to prevent colorectal cancer, trace elements and colorectal cancer are not known in detail. Folic acid can reduce the incidence of colorectal cancer, but current data do not support the use of. Because the exact mechanism is unclear.
5)Dietary Anti-Carcinogen: Diet includes Garlic, Onions, leeks, scallion contain sulfide citrus containing Terpene grape, strawberries, apples contain phenol, plants, as well as carrots, yams category, watermelon contains carotene, are considered to be capable of inhibiting mutation, and are therefore, anti-cancer. Especially garlic, studies have shown that garlic is the strongest protective effect of leaving people suffering from distant (metastasis) colon cancer.
(2) Change Lifestyle
1) Obesity and Exercise: Obesity, especially abdominal obesity, is an independent risk factor for colorectal cancer. Too little physical activity is a risk factor for colorectal cancer. Physical activity can affect peristalsis knot feces, so as to achieve the role of prevention of colorectal cancer,
2) Smoke: Relationship between smoking and colorectal cancer is not very sure, but smoking is a risk factor for colorectal cancer tumor has been confirmed. Present studies suggest that smoking is a stimulating factor for producing/inducing colorectal cancer genes, but that it needs about 40 years of time to manifest itself.
3) Drinking: There is an alcohol intake and colorectal cancer relationship. Alcohol is also a risk factor for colorectal adenomas. But the exact cause is unclear. Reducing alcohol intake is conducive to the prevention of colorectal cancer.
4) Reproductive Factors: Hormonal and reproductive factors may affect the incidence of colorectal cancer. American studies show a higher incidence of colorectal cancer among single women than married women. Some people think that reproductive hormone scan affect bile acid metabolism.
(3) Drug
Many epidemiological studies have shown that long-term use of non-steroidal anti-inflammatory drugs can reduce the incidence of Colorectal Cancer. Every month taking a low dose of asprin for 10-15 times can reduce the relative risk of colorectal cancer by 40%-50%, but there are also studies do not support this assertion. Also, regarding the dosage and the administration times of taking non-steroidal anti-inflammatory drugs, side effects caused by long-term use also needs further study.
(4) Treatment of precancerous lesions, pathological changes
For patients with colorectal adenomas and ulcerative colitis, the incidence of colorectal cancer is significantly increased. Through census, and follow-up, and early excision of adenoma, and treatment of colitis, can reduce the mortality rate of colorectal cancer. Especially those who have a family history, through genetic testing, and screening of high risk populations, and undergoing a thorough colonoscopy, is an important aspect of the work of colorectal cancer prevention.
II. Secondary Prevention
Secondary Prevention of cancer tumor, namely early detection, includes early diagnosis and early treatment to prevent or reduce death-causing tumors. The progress and development of colorectal cancer is a relatively long process, from pre-cancerous lesions to invasive cancer. It is estimated that after 10-15 years, a census provides an opportunity to detect early lesions, and the census is an important means of secondary prevention.
III.Tertiary Prevention
Tertiary Prevention as an active treatment for cancer patients. To improve the quality of life and to prolong patient survival, it is being taken to the surgical treatment of colorectal cancer patients. This is supported by appropriate chemotherapy, Chinese medicine treatment, immunotherapy treatment, all of which improves the treatment of colorectal cancer.
5. Pathogenesis
The incidence of colorectal cancer in colon mucosa epithelium is caused by a variety of genetic and environmental factors which lead to changes in the results of the expression of multiple genes.
6. Disease Diagnosis
Diagnosis is based on:
1.Changes in bowel habits and stool mucus, or in failed drug therapy resulting in blood and pus. Inaccuracies in diagnosing sustained abdominal pains.
2.Loss weight, anemia, acute and chronic obstruction performance.
3.Palpable tumors, abdomen has hard, less smooth surface, poor activity or can have mass activities.
4.Continuous positive fecal occult blood test. Carcino-embryonic antigen is increased.
5.See ulcers in fiber colonscopy, tumor pump, stenosis. Tissue biopsy confirms cancer.
6.See barium enema colon filling defects, mucosal damage, and intestinal obstruction signs of stiffness or luminal stenosis.
7 Inspection Methods
1. Changes in bowel habits and stool often are the first showing symptoms. Stool can increase, and there may be diarrhea, constipation, and stool filled with mucus, pus and blood. There may be positioning inaccuracies, abdominal pain, or abdominal discomfort, flatulence, etc. In the mid and advanced stage, there is weight loss, anemia, and acute and chronic obstruction.
2. When palpitating abdomen, the texture ishard, the surface is not smooth,and not much stool mass activity. (In horizontal, B colon cancer activity range may be greater).
3. Intestinal obstruction is obvious and peristaltic waves are visible. Occasionally, there is acute bowel obstruction, cancer perforation, or tumor ulceration, inheavily bleeding patients.
8 Complications
I. Colorectal Cancer (Intestinal Obstruction)
(1) Intestinal Swelling
(2) Fluid Loss
(3) Electrolyte Imbalance
(4) Infection and Toxemia
II. Obstruction Colon Cancer
III. Colon Perforation
IV. Anocrectal Tumor Hemorrhage
9 Prognosis
10 Pathogenesis (Disease Outbreak Mechanism)
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