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Signs, symptoms, stages and treatment of colon cancer

Colon cancer stage 2

There are two possible descriptions of this stage in the medical documents with the results of instrumental studies: (T2 N1 M0) or (T3 N0 M0). These variants differ in the size of the tumor. Namely, the size of the tumor are described from a third to a half of the diameter of the intestine (T2 it3). In one embodiment, there are signs of damage to the nearby lymph nodes (N1) and the second damages none (N0). Distant metastases are always absent (Mis 0).

Colon cancer stage 3

This form of colorectal cancer is characterized by a variety of morphological and cytological forms of carcinogenesis.

Seven possible variants of the description, including the more mild symptoms, denoted by:

  • (T4 N0 M0) – the tumor occupies more than 50% of the diameter of the intestine that are not affected lymph nodes, no metastases;

  • (T1 N1 M0) is a small movable tumor, affected the nearest lymph nodes, without distant metastases in the liver;

  • (T2 N1 M0) is a tumor up to 30% of the diameter affected the nearest lymph nodes, no metastases;

  • (T3 N0 M0 ) is a tumor up to 50% of the diameter of the colon, there is no involvement of lymph nodes, no metastases.

Regarding more severe forms of the third stage are indicated by:

  • (T4 N1 M0) – a massive tumor surrounding the intestine, formation of adhesions with the neighboring organs and tissues affected next 3-4 lymph nodes, no distant metastases;

  • (T1-4 N2 M0) – the size of the tumor doesn't matter, hit more than four intestinal lymph nodes (N2), no metastases.

  • (T1-4 N3 M0) – the size of the tumor doesn't matter, the affected lymph nodes along major blood vessels (N3), that is, there is a massive proliferation of onkokletok throughout the body, distant metastases yet.

Colon cancer stage 4

This is the last and most dangerous stage of the disease, characterized by distant metastases in the body. Medical documentation may be denoted (T1-4, N1-3 M1). The size of the tumor and the defeat of the regional lymph nodes are not critical. However, there are always distant metastases, usually liver (M1).


Colon cancer with metastasis

Feature of colorectal cancer – distantliver metastases were significantly less likely to find them in the lungs, brain, reproductive organs and the omentum. Germination of cancer cells in the vital organs repeatedly reduces the likelihood of successful treatment of patients.

Proposed several classifications of the stages of metastasis in this form of cancer, including:

  • L. Gennari;
  • mTNM;
  • EGMTG.

Each classification has supporters and opponents. We will not hold up to scrutiny. In our case, it makes sense to explain the principle of differentiation of metastases.

For this ideal classification by L. Gennari. It was developed in 1984 and is used in scientific research, including the Russian scientists-physicians.

To describe the steps of metastasis L. Gennari and colleagues proposed the following options:

  • the total volume of metastatic tumors – N (cm);
  • if its volume is less than 25% of the volume of the organ (usually the liver) which discovered the metastasis, the stage represent – N1;

  • if the amount is more than 25% but not more than 50%, this stage is denoted H2;

  • if the volume of metastasis of over 50%, represent stage N3;

Classification provides a description of the number of metastases, their symmetry, including:

  • S is a single metastasis;
  • M is more than one metastasis;
  • B – symmetrical arrangement of metastases.

To describe the severity of the lesion following notation is used:

I – germination in neighbouring organs and tissues;

F – the presence of clinically significant lesions of the liver, including:

a – minor;

in massive lesions of the functions of neighboring organs.

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The prognosis of the disease

In Russia there is no system for early prediction of cancer. The reason is a chronic lack of funding of useful activities. Therefore not available for mass application of highly sensitive methods of determining cancer.

Widely used in our clinics study occult blood test give a lot of false results, as DNA diagnosis is still limited mass available for study.

Modern forecasting depends mainly on literacy and careless physician, able to find a link between diseases of the gastrointestinal tract andthe precursors of cancer. The forecast is based on the subjective feelings of the doctor and the results of the visual examination of the patient, so the initial diagnosis – bowel cancer with distant metastases – have up to 20% of patients Russia.

Ways of improving objective methods of forecasting are based on the implementation in mass medical practice high-performance laboratory and instrumental methods.

In the presence of already formed tumors most promising objective methods of forecasting the rate of development of metastases – the identification of specific protein markers, including test Oncotype Dx colon and others.

How I live with bowel cancer?

The question contains a fatal meaning deadly danger of cancer. But let's be optimistic, because in the early and sometimes in the later stages of the disease, doctors reach astounding success in the radical treatment of this form of cancer.

The answer to the question of life expectancy can be divided into two parts:

  • the first concerns the quality and length of life after diagnosis;
  • second, the periodicity of surveys in order to identify cancer at the earliest stages.

Information about five-year survival rate of patients with bowel cancer, often used in scientific research in order to show trends and patterns of disease in the context of a popular article is incorrect, because the body of each person has a different margin, depending on

  • age;
  • comorbidities;
  • bad habits;
  • living conditions;
  • stress and so on.

Of the above, only the age cannot be corrected. Proper treatment of comorbidities, refusal of harmful habits, diet, elimination of stress, significantly increases the likelihood of not getting sick, and the patient's chances of recovery and a significant prolongation of life with the help of surgeons and physicians of other specialties increase.

Possible quality life even with significant excision (resection) of part of the intestine and a colostomy (opening for excretion of feces to the outside, bypassing the anus). The presence of colostomy with normal care it is not a significant factor that reduces the quality of life.

On the other hand, the sooner cancer is diagnosed, the better the chances of successful treatment. Following this logic, we can assume that only frequent examination gives you the chance for early detection of disease and the prolongation of life. Fortunately, it is not so.

Early confirmation of the diagnosis is possible with surveyswith an interval of one year. Because the first mutations before the start of clinical staging on average takes two to three years.

You can significantly improve the length and quality of life after the age of forty, annually screening tests.

The detection of disease in the later stages a major role in the prolongation of life is correct care and maintaining good hygienic condition colostomy.

    If bowel cancer was detected at stage 1, and the tumor still has not spread (rarely under happy circumstances), the chance of success reaches 99%.

    If the cancer is in 2 stages, when the tumor began to grow on the walls of the bowel, the chance for cure is 85%.

    Stage 3, when tumor affects the nearest lymph nodes, the chance of cure drops to 65%.

    In the later stages of colon cancer in lesions distant lymph nodes, the chance of a cure is around 35%.

How many people will live after treatment is dependent on the extent of the disease, as well as other factors listed above.

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Diagnosis of colon cancer

The choice of the circuit the diagnosis is determined by a doctor. Minimum includes screening tests in the first place – analysis for occult blood, which is a very simple and universally available method used in the most primitive laboratories.

  • Patients included in the risk group, should once a year to pass feces to exclude concealed haemorrhage, this method allows to detect a tumor or polyp with a diameter of 2 cm;
  • In case of positive analysis for occult blood prescribed fibrocolonoscopy or rektomanoskopii with video recording or a contrast study of the colon.

A real breakthrough in the diagnosis of colon cancer occurred after the widespread introduction into medical practice of methods of radiation diagnosis, e.g., contrast radiography or newer methods:

  • computed tomography and its modifications (CT, CT);
  • ultrasound diagnostics through the abdominal wall and using sensors introduced into the intestine (ultrasound, TRUS, and others);
  • magnetic resonance imaging and its modifications (MRI)
  • positron emission tomography (PET-CT).

A promising method is the laboratory determination ofDNA markers of colon cancer. Because this form of disease is one of the few that can be identified long before the clinical stage, and thereby save a life without painful medical procedures.


The treatment of colon cancer

Modern methods of treatment of colorectal cancer is based on radical surgical removal of the tumor, surrounding tissues and metastases. Methods of radiation and chemotherapy are used as adjuvant. In the medical literature, there is evidence of significant prolongation of life of patients operated on 3-4 stages of colon cancer. Some sources report three-year survival of 50%, and five-year survival in 30% of patients in the surgical departments. The use of combined methods allows to hope for obtaining the best results of survival of patients.

Chemotherapy for bowel cancer

Main factors limiting the widespread use of chemotherapy in this form of cancer is the resistance of the main forms of tumors of the intestine to cytotoxic drugs.

Systemic chemotherapy is used before or after surgery. In some cases, shown the local introduction into the blood vessels feeding metastases. The main drug used for chemotherapy is 5-fluorouracil. In addition to his use of other cytotoxic agents – capecitabine, oxaliplatin, irinotecan, and others. To enhance their actions prescribed immunomodulators (interferogenic, stimulators of humoral and cellular immunity).

Surgery to remove tumor in the bowel

It is generally accepted that this is the only radical method of treatment of colon cancer. There are a variety of methods, including:

  • traditional methods of resection of the affected segment of the intestine and surrounding vessels;
  • surgery through tiny incisions of abdominal wall;
  • removal of the tumor with the package of lymph nodes and metastases using high-frequency knife.

The methodology and the method of surgical intervention, the treating physician chooses based on the recommendations of the Council. It is proved that training of surgical teams and equip the specialist clinic directly depends on the quality of the operation and the likelihood of recurrence of the tumor.

See also: Other methods of treatment


Prevention of colon cancer

Cancers are cunning and unpredictability. About the prevention it is worth consideringpeople who have a genetic predisposition to cancer, or established illness, is able to transform into cancer, as well as all people over the age of 40 years.

General recommendations concern a correction of lifestyle, including:

  • The increase in locomotor activity;
  • Enrichment of the diet with foods that contain fiber;
  • Avoiding harmful habits (Smoking, alcohol consumption).

Regular aspirin reduces the risk of some forms of colon cancer. Make it a must after a meal. Usually it is an inexpensive drug prescribed for hypertension to reduce blood viscosity. There is strong scientific evidence about the suppression of some forms of colorectal cancer with a daily intake of low doses of aspirin.

Attention! Aspirin cannot be taken in large doses, as high as the probability of occurrence of erosions, ulcers, gastroduodenitis and gastric bleeding.

Even a simple annual screening for occult blood in the stool reduce the likelihood of developing cancer by 18-20%.

To identify early forms of cancer with a high probability up to 90% allows non-invasive diagnosis of PET-CT.

Sensing and visual assessment of the intestinal wall is limited used as preventive diagnosis.