The large intestine, colon in the use of which has always existed a number of confusion, to the strict definition of the large intestine is in contrast to the wording of the small intestine, large intestine, including ascending colon, transverse colon, descending colon and sigmoid rectum. However, in day-to-day use of the large intestine semantic equivalent of the colon, do not include the rectum, so often used clinically colorectal Branch, rather than colorectal Branch, which is discussing the lower digestive tract diseases and don'ts. This article referred to colon cancer, mainly occurred in the colon cancer treatment mainly due to cancer treatment has its special place, and another article to discuss. If in this part of colorectal cancer related to colorectal cancer or another direct statement to rectal cancer.
And generally speaking the treatment of colorectal cancer There are three main types: surgery, radiation therapy and chemotherapy. General physicians will be based on clinical examination with the results of staging of cancer patients recommended to choose the appropriate treatment, and sometimes take only one, sometimes combined. In addition, some doctors will suggest some ways not yet fully conclusive, such as immunotherapy, chemical prevention and so on. Outlined below:
Surgical treatment:
Surgical excision has been the main force of the majority of cancer treatment, because only complete resection can be cured only possible, of colorectal cancer is also true. And according to tumor location, to take the surgery will be slightly different way, in addition to intestinal tumor, the usually nearby lymph organization and removed. According to the location of cancer lesions, the common types of surgical resection of the right side of the large intestine, left colectomy, subtotal colectomy, all colorectal resection, high anterior resection, low anterior resection, perineal resection combined with local excision, etc. and so on. As to whether there needs to be done enterostomy fistula, then out of the intestines from the stomach, usually depends on the extent of the tumor and its violations, generally speaking, if lesions in the rectum 78 centimeters or more, then a better chance of not enterostomy fistula. Sometimes due to intra-abdominal infections, or intestinal pressure is required to carry out fistula colostomy.
Some of the first zero-phase patients with colorectal cancer, it does not necessarily require laparotomy, the current use of endoscopic surgery can be put into effect, but must be very careful, because the so-called limited to the mucosa of the first zero-phase cancer, or was based on histopathologic diagnosis, according to the appearance of diagnostic errors sometimes, as long as that does not, or biopsy of the report found abnormal, or to open surgery. If lesions in the bottom of the rectum or sigmoid colon, it can conduct ultrasound endoscopy helped found in the mucous membrane lesions on the depth, as surgery or endoscopic removal of the reference. But such sonography of lower digestive tract, not every hospital can afford, the domestic medical institutions did not do a few.
And in some terminally ill patients of colorectal cancer is not necessarily acceptable surgery treatment, sometimes only for the treatment of symptoms, when the main purpose of the operation to lift such as intestinal obstruction, massive bleeding and other complications, reduce a patient's discomfort, rather than to seek recovery, but after surgery and sometimes can increase the acceptance of other forms of treatment opportunities.
Chemical treatment:
Chemical treatment of colorectal cancer can be roughly divided into several major categories, and that is in the treatment of patients can not be the mainstay of chemotherapy, post-operative adjuvant chemotherapy treatment, a new pre-operative adjuvant chemotherapy (Neo-Adjuvant Chemotherpay).
In recent years, for the chemical treatment of colorectal cancer, with the understanding of tumor, the usage of drugs in the medical community has a consensus gradually, the current is 5-FU-based, together with other medicines. For more than a decade ago, based on the recommendations the United States, together with the oral Decaris (levamisole), in recent years and replaced by the use of leucovorin (a vitamin), 5-FU to enhance the efficacy and, more recently, the development of high-dose 5-FU continuous injection. As for the direct injection method of mining injection or drip injections, with the first use of 5-FU or other drugs, jury is still out, how long the time interval injection no absolute standard, which has yet to be more research results. There are, however, pointed out that the literature, especially in the second or third phase of patients, chemotherapy can increase the survival rate is true. So as long as circumstances permit, the patient should be accepted chemotherapy. In addition to these drugs, there are also some anti-cancer drugs such as CPT-11, Oxaliplatin, Tomudex, and oral anti-cancer drugs such as UFT, Capecitabine, S-1 are also in development, some drugs in some countries have already listed the use, Some also brought in the near future to begin clinical trials, would like to see better results come out.
In addition In addition to the standard chemical treatment, depending on the use of time to develop a different usage, adjuvant (adjuvant) chemotherapy is one example. The reason why there is adjuvant chemotherapy because the eradication of colorectal cancer after surgical excision, perhaps still may have the naked eye can not see a significant shift of a significant, although the organization is in the initial tests, the second or even third period, but perhaps there are a few With the blood of cancer cells have spread out, after a period of time may be recurrence or metastasis. So after the operation to give the chemical anti-cancer drug treatment, to achieve the objective of prevention, it will be called adjuvant chemotherapy. In recent years, countries around the world on the colorectal cancer studies have shown that, of adjuvant chemotherapy in some patients can significantly reduce the surgical treatment of colon cancer recurrence and metastasis of tumors, contribute to the survival rate, and whether lymph cancer metastasis , it is recommended that the need for adjuvant chemotherapy an important basis. Other practices included in the post-operative radiation therapy or chemotherapy before and after the grant and so on. Details behind the article otherwise, including chemotherapy and don'ts and side effects.
Radiation Therapy:
Radiation therapy is the use of equipment will be released from radioactive sources or particle cluster radiation exposure in cancer lesions and kill the cancerous cells to achieve the purpose of treatment. Depending on the location of radioactive sources can be divided into large exposure in vitro (External beam radiation therapy) with partial body irradiation (Local radiation therapy or brachytherapy). Its purpose is to prevent the possible transfer microscopy, as well as local recurrence of cancer cell growth, and even tumor metastasis.
In fact, radiation therapy for cancer of the lower digestive tract or in the main usefulness of rectal cancer, its sigmoid colon tumor was not above the preferred treatment. Depending on the timing can be divided into the use of adjuvant treatment, including radiation therapy after surgery is aimed at reducing the partial transfer, the organization has violated the vicinity of rectal cancer may also increase the survival rate. In the merits of post-operative irradiation is to remove the lesions before surgery to alleviate the symptoms, and can really understand the actual violations of the scope of cancer cells, but its disadvantage is that after the operation scar and organizations to reduce blood circulation, it will reduce the effectiveness of radiotherapy or chemotherapy. And sometimes lead to retain the anal sphincter damage, caused by difficulties in defecation. Therefore, some violations of the extent of the rectum in patients with more serious, it will take pre-operative radiotherapy, and its advantage is that the tumor has not been removed prior to irradiation, the effect is better, but after irradiation tumor usually reduced, the use of surgical resection of the opportunity to increase. In particular, near the anus of rectal cancer foci in advance of exposure, some patients can sphincter after surgery to relieve a permanent stoma do need. However, the drawback is the pre-operative radiation, making the extent of tumor invasion less doing the right to judge, to increase other forms of treatment difficult. Some physicians also tried in the middle of the implementation of surgery radiation therapy, in the section when such treatment, you need special operating room, can be shielded radiation, but also surgeons, anesthesia, radiation oncology, such as close cooperation only way to do it, not every hospital has such a capacity. The benefits of this treatment is exposure to direct lesions, particularly in violation to the pelvic cavity can not be completely removed the cancer, help to reduce future growth of the tumor and increase survival. Some can not anesthesia for surgery patients, a doctor will recommend mesocaval within the radiation therapy (endocavitary radiotherapy), for local control, some reports indicate there are good results.
Colorectal cancer in recent years, radiotherapy in addition to the combined operation, but also with a combination of chemotherapy, and many documents that have a positive significance. As regards the first radiation therapy or chemotherapy, or even coupled with the use of the sequence of surgery, jury is still out, pending more research. As for the recurrence of tumor after surgery, or too much can not be surgically removed tumor, or metastatic sites lead to discomfort, can be given by local irradiation, to reduce the symptoms, when radiation therapy is the so-called palliative treatment as a means.
Finally, re-emphasized for the treatment of colorectal cancer, of course, not only these types of treatment, but the above-mentioned surgery, chemotherapy, radiotherapy, after all, is the most important force. Patient's attending physician should be most familiar with the condition, and in receiving treatment and doctors should be preceded by a detailed communication and understanding, pre-treatment also need detailed information to check for evaluation. But also recognize there is no 100 percent successful treatment, decided the outcome of the treatment of these many factors, select the type of treatment varies from person to person, depending on the patient's situation should be to select the most appropriate methods of treatment for as long as there is confidence, should be able to achieve the best therapeutic effect.
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