Into the consulting room column chair:Reporter Lei KunCorrespondent Cui YanlingZhang Bin paintingLee, who lives in Haizhuqu District, 62 yea
Into the consulting room column chair:
Reporter Lei Kun
Correspondent Cui Yanling
Zhang Bin painting
Lee, who lives in Haizhuqu District, 62 years old this year. Just a few years ago, when retired, aunt Lee also want to enjoy a few years of blessing. I did not expect that, from the beginning of 2001, aunt Lee constantly found illnesses. First, breast cancer, and endometrial cancer. Last year, she was diagnosed with colon cancer. Just a few years time, aunt Lee has done several major surgery. Even more frightening is that this year, she was diagnosed with colon cancer, the beginning of the doctor that she is colon cancer recurrence and metastasis, there is no value of surgical treatment. However, Lee refused to give up, and then came to the Guangzhou Red Cross Hospital, the doctor found not colon cancer, but the blind colon cancer. Although the operation is very successful, but looking back on his experience in hospital surgery for several years, aunt Lee felt very painful: why do all kinds of cancer love to find me? Is there any correlation between these cancers?
Medical guidance / Guangzhou Red Cross Hospital, deputy director of gastrointestinal surgery, tumor doctor Liu Shaojie
Don't focus on cancer metastasis
Multiple primary cancers are multiple primary malignant tumors, including synchronous and metachronous cancers. The so-called simultaneous cancer, refers to the same patient, also found two or more than two tumors. The so-called metachronous cancer, refers to the patient found a malignant tumor, after a period of time and found another malignant tumor. Note that these two tumor histological types, location and nature, they are not the same. In clinical practice, early multiple cancers are often mistaken for advanced cancer recurrence and metastasis, thus missing treatment opportunity.
As for the incidence of multiple causes of cancer may be related to genetic. Liu Shaojie said that there are two kinds of genes in the human body to compete with each other, one is a cancer gene, a tumor suppressor gene. In general, the tumor suppressor gene is relatively strong, cancer can not take root growth in vivo. However, as the age increases, the resistance decreases, the oncogene may be "up"". Once the cancer gene is too strong to suppress cancer gene, it may be a tumor.
Poor physical fitness of the elderly prone to multiple cancers
Elderly people are more prone to cancer, but also a high risk of multiple cancers prone to cancer, this is because the occurrence of cancer often requires a long incubation period. With the increase of age, the decrease of immunity, the carcinogenic factors of the elderly will continue to accumulate, eventually leading to the occurrence of cancer. Good hair in the elderly with multiple sources of breast cancer, colorectal cancer, bladder cancer, the incidence of up to 5% ~ 10%.
Liu Shaojie pointed out that the incidence of colorectal cancer is not uncommon, if not careful, the examination may be found only one, while ignoring the other. As mentioned above, aunt Lee, from her point of view, the incidence of colon cancer and colon cancer should be at the same growth, because cancer growth is relatively slow, the tumor along the intestinal wall spread around 1~1.5 years. But why the last inspection found only in colon cancer? This may be two reasons, one is the colon colonoscopy stop further exploration of the road, two doctors have found a tumor that has been found in all causes, then give further exploration.
Follow up colonoscopy after colorectal cancer surgery
Liu Shaojie warned that colorectal cancer surgery must not ignore colonoscopy follow-up. Six months after surgery should be the first follow-up examination, the next two years is 1 times a year. If found positive to adhere to 1 times a year, beware of canceration. If no positive findings, after 1 years, two years, life-long follow-up. In addition, especially of colorectal adenoma canceration rate is high and the villous adenoma mixed, once found should be electrocoagulation excision, suspected to be malignant and cannot electrocoagulation resection can be surgically removed, in order to reduce the chance of cancer. For some patients with incomplete obstruction of colon cancer patients, colonoscopy can not fully check E. course when the doctor must not let down, can not be satisfied to find a tumor is diagnosed, and should be combined with the CT, MRI, barium enema examination means to exclude the source of colon cancer may.
Early signs of cancer
Any of various parts of the body, such as the breast, neck, or abdomen, especially a gradually enlarged mass of 1.
Any of various parts of the body, such as the tongue, cheek mucosa, skin, etc, which are not damaged by trauma, especially in the 2 years.
3 women over the age of irregular vaginal bleeding or secretions (commonly known as leucorrhea) increased.
4 eating when the chest fullness, burning pain, foreign body sensation or swallowing aggravation is not smooth.
5 long-term fever, persistent cough or sputum with blood.
6 long-term indigestion, progressive loss of appetite, weight loss, and did not find a clear cause.
7 change in bowel habits, or blood in the stool.
8 nasal obstruction, epistaxis, unilateral headache or accompanied with diplopia.
9 mole suddenly increased or ulceration, bleeding, original hair loss.
10 in addition, precancerous lesions should also be considered as early signs. Such as leukoplakia, chronic skin ulcer, fistula, proliferative scars (especially of chemical burns caused by scar), atrophic gastritis and intestinal metaplasia, rectal polyposis and skin keratosis (especially the size of the palm thenar keratosis), breast cystic hyperplasia disease, cervical erosion cervical polyps, may develop cancer.
Patient: I just checked in other hospitals, said last year had the sigmoid colon cancer recurrence and metastasis, it is advanced colon cancer, doctors said that surgery is not meaningful, but the recommended chemotherapy, 6 cycles, the effect is not good. I thought for a long time, or to look at the hospital to rest assured.
Doctor: what did you do with colon cancer last year?
Patient: surgical resection, resection of lesions was very clean, postoperative recovery is also good, did not expect to transfer.
Doctor: is this symptom similar to last year?
Patient: there are some differences. The last row of two months of dark red blood, then do a colonoscopy is found, sigmoid colon cancer, postoperative recovery is relatively fast. This year for a period of time, suddenly thin badly, and anemia symptoms of dizziness, then he could feel a lump in the right lower abdomen, to the original treatment of the hospital, the doctor says is advanced colon cancer recurrence and metastasis in abdominal cavity suggested chemotherapy.
Aunt Lee looked at the recent medical records, indeed like cancer recurrence. To be cautious, the doctor decided to go over it again. From the point of view of colonoscopy, aunt Lee intestinal does have a tumor, and the tumor is relatively large. However, further examination of PET-CT did not reveal any signs of distant metastasis of the cancer, unlike advanced colorectal cancer.
In order to further clarify the doubts, the doctor gave aunt Lee open laparotomy. The discovery, the original aunt Lee intra-abdominal cecum had a tumor. However, this is not related to colorectal cancer and colon cancer, although only ten or twenty cm difference between the two positions, but it is certain that the tumor is the incidence of the two.
Doctor: your situation is not a recurrence of cancer, but multiple cancers, there is a big difference between the two.
Listen to the doctor's explanation, aunt Lee, she told the doctor, see light suddenly, he had been tortured duoyuanriches cancer for many years: in 2001, she felt a lump in the left breast, later found to be breast cancer after radical resection. In 2005, after years of amenorrhea, sudden irregular vaginal bleeding, menstrual cycle significantly with the independent, the examination confirmed the diagnosis of endometrial carcinoma, soon do hysterectomy + double adnexectomy. After that, last year found that colon cancer and suffering from a painful experience of cancer.
To confirm the "murderer", the doctor gave aunt Lee of radical resection of right colon, after aunt Lee recovered well.
Regular review of colorectal cancer surgery is very important. (picture)