Prof. Dr. İbrahim Tek, Medical Oncology Specialist
Medicana International Ankara Hospital
Colorectal cancer is the 2nd most common cancer in women and the 3rd most common cancer in men in the world in terms of frequency
. 70% of this is colon cancer, and the rest is rectum cancer
. Age is an important risk factor, especially in the non-familial type of colorectal cancer:
The risk increases after the age of 40. Especially in the USA, the rate of colorectal cancer is 5% and 90% of patients diagnosed with colorectal cancer are over 50 years old. Its incidence in men is 25% higher than in women. Recently, right side colon cancers are more common than the left side. The increase in the rate of colonoscopy since 1980 has increased the chance of detecting cancers early, and the survival time of patients has been extended with new effective treatment methods.
Genetic factors. effective
Environmental and genetic factors play a role in the development of colorectal cancers. High
People at risk - those with a family history of colon cancer, those with inflammatory bowel disease
with polyps in the colon, and previous radiation to the abdominal area
>Areas - colonoscopy screening should be done more frequently.
Relationship with lifestyle
Obesity is a risk factor. Studies have shown that weight gained during early childhood and middle age
moderately but significantly increases the risk of colorectal cancer
by 15%.
Diabetes and insulin resistance. Studies have shown that the risk of diabetes increases by 38% compared to those without diabetes.
• Long-term and large amounts of red meat and processed meats (salami, sausages, etc.) >The risk of colorectal cancer - especially the risk of left-sided colon cancer - increases in those who consume it.
Cooking them at high temperatures (barbecue, barbecue, etc.) further increases the emergence of polyaromatic hydrocarbons
. World Health Organization (WHO)' In his statement in 2015; The risk of cancer is 17% for consumption of more than 100 grams of red meat per day, and 17% for consumption of more than 50 grams of red meat. It has been declared that processed meat consumption increases it by 18%.
The risk of developing colorectal cancer is 18% higher in smokers than in non-smokers.
. If we look at its relationship with alcohol consumption; The risk is 21.4% in those who drink 2-3 drinks a day; It increases by 51% in those who drink more.
Precautions
Follow-up with colonoscopy is extremely important. Regular physical activity also reduces the risk of colorectal cancer by 25%. Regulations in the diet; especially increasing the consumption of vegetables and fruits,
consisting of fiber foods in the diet, regular use of aspirin and analgesics, and
hormone replacement therapy, lipid-lowering drugs (statins), low blood pressure in postmenopausal women
The use of minerals such as folic acid, vitamin D, magnesium and calcium can reduce the risk of colorectal
cancer. However, when using these micronutrients as auxiliary factors, it should be taken into consideration that their use in excessive doses may cause other problems.
Symptoms
Colon cancer patients sometimes experience atypical complaints; Weight loss, weakness, loss of appetite, vague
abdominal pain, low amount of rectal bleeding confused with hemorrhoid complaints, sometimes during routine
scans; Sometimes in the emergency room with intestinal obstruction, gastrointestinal bleeding, fluid accumulation in the abdomen; Rarely, jaundice is diagnosed with liver failure and respiratory failure due to lung metastases.
Treatment
After diagnosis, the patient's existing disease is first evaluated clinically and radiologically
It is staged. Colon cancer is divided into 4 stages. Stages I and II are early stages, Stage III is locally advanced stage
and Stage IV is advanced stage (metastatic disease). Early stage patients generally undergo surgery first. The situation is slightly different in patients with rectal cancer. In order to reduce the risk of colostomy (the opening of the intestine into the abdomen) in these patients, concurrent chemotherapy and radiotherapy are applied to selected patients before surgery. Additional treatment is generally not applied to stage I colon cancer after surgery. In stage II disease, chemotherapy may sometimes be given depending on the pathology result and the patient's risk factors. III. adjuvant in patients with stage colon cancer
Chemotherapy is given for 6 months in order to reduce the risk of recurrence of the disease and increase the cure rate.
In metastatic disease, treatment usually starts with chemotherapy.
Chemotherapy is extended as long as the patient's performance is good and there is a response to treatment.
"Smart drugs" Life expectancy can be extended with the new generation agents we call.
Radiation therapy is generally applied as a part of the pre- and post-operative treatment for rectal cancer - except for stage I
. Also radiotherapy IV. It is also used to relieve symptoms in patients
and in various situations, such as bone metastasis, brain metastasis, intestinal bleeding,
intestinal compression.
Follow-up after treatment.
Patients whose treatment is completed are usually called for check-ups every 3 months for the first 2 years, every 6 months after the 2nd year, and annually after the 5th year.
At the end of treatment, a repeat colonoscopy is usually performed. If there is no problem, colonoscopy is repeated after 3 years, and if polyps are detected, colonoscopy is repeated after 1 year. After 5 years
it can be said that the patients are healed. IV . Stage 1 patients are generally re-evaluated every 3 months as long as they receive treatment.
To summarize; The earlier colorectal cancer is caught, the greater the chance of cure. For this reason, it is important to exercise regularly, whether there is a risk or not, to have a balanced diet and not to consume alcohol and cigarettes. It is very important for people at risk to have a colonoscopy from the age of 40, and earlier.
Read: 0
