colorectal cancer

Colorectal cancer



Colorectal cancer - it is usually adenocarcinoma (located in the colon or rectum) which develops on the basis of precancerous lesions. These lesions include: adenomas, genetic syndromes (e.g. familial polyposis), Crohn's disease, ulcerative colitis. Peak of incidence falls between 60 and 75 years of age. Predisposition to disease is inappropriate diet ( red meat, smoking, age). Keep in mind that taking nonsteroidal anti-inflammatory drugs reduces the risk of developing colorectal cancer by 50%. Another issue is Lynch syndrome (susceptibility to cancer) - there is disturbed repairing of badly paired nucleotides.


Types and symptoms


a) Cancer of the rectum and left colon - change in bowel functions, bleeding from the lower gastrointestinal tract, mucosal diarrhea. The tumor can be examined in the rectum (50-70%) during the per rectum;
b) Cancer of the right colon - abdominal pain , sneaking blood, anemia, palpable tumor of the skin layer.
Other symptoms - weight loss, fever, tympanites, intestinal obstruction.


Diagnostics


The gold standard in the diagnosis of colorectal cancer is colonoscopy with biopsy for histopathological examination. It is also used abdominal ultrasound and CT to find potential metastases. The screening tests ( women and men over 50 years old) include: testing faeces for sneaking blood (every year), fiberosigmoidoscopy (every 5 years), colonoscopy (every 10 years). In the case of increased risks (eg. after removal of polyps) performs colonoscopy every year.


Treatment


It depends on the histopathological stage of disease and its possible metastatic. The primary therapeutic method is a complete resection with leaving adequate margins and local lymph node resection. In the case of inoperable tumors of the rectum is possible earlier application radiatiotherapy to reduce tumor mass.

Postoperative treatment regimens include use of 5-fluorouracil after tumor resection in stage III (in case of rectal cancer stage II and III is used in addition radiotherapy and pelvic radiotherapy). Nonoperative cancers require chemotherapy (5-fluorouracil and folinic acid, capecitabine, oxaliplatin, cetuximab, bevacizumab). Palliative treatment (regarding stenoses) includes: stents, laser ablation, argon coagulation and stoma.

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