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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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