Introduction
Cancer has become a very familiar illness. In life, one in two people will be cancer, one in three will die from cancer. It is a colorectal cancer that is one of the five major cancers, but it is said that 100,000 people are going to have colon cancer every year, aging and eating habits to Westernized, these two points increase colon cancer It is related.
The wave of aging is difficult to do anything, and what we can do to eradicate colorectal cancer is in the early detection by preventive and medical examination including improvement of dietary habits. However, there is a limit to "Taking one or two foods and nutrients in the diet into issues" in order to prevent specific cancers.
We recommend balanced diet and abdomen, moderate exercise, a good night's sleep, participation in medical examinations. Below is an overview of colorectal cancer.
Diagnosis of colorectal cancer
The length of the colon in general adults is said to be about 1.5 m. Symptoms vary slightly depending on where you can do the same colorectal cancer. For example, if it is on the right side of the large intestine, it touches anemia and a lump, on the left side it is abdomen, constipation finally is bowel obstruction, and furthermore when approaching to the anus side blood mixes with feces (Fig. 1). If you can do it, I would like to have a diagnosis before such symptoms appear.
For early diagnosis
There is a fecal occult blood test that senses a small amount of blood contained in feces from colon cancer and is used for colon cancer screening. If fecal occult blood was positive (a little blood is contained in the stool), further examination is required. However, fecal occult blood is not equal colorectal cancer. In cases where it becomes positive with colon polyp, enteritis, hemorrhoid disease, etc., and, as a result, the cause is not clear, is the majority.
On the other hand, fecal occult blood negatives are not safe. It is because it is not always bleeding from colorectal cancer. PET examination is also a cumbersome and too expensive examination method to find out early colorectal cancer from a large number of people efficiently.
Unfortunately there is no simple, cheap and reliable diagnostic method leading to diagnosis at an early stage. It is a practical way to consult a doctor if you are aware of the symptoms mentioned above or you have a large number of cancer patients in families / relatives with blood, while regularly taking advantage of medical examinations and human dogs.
To diagnose the presence of colorectal cancer and its part
After colonoscopy examining the large intestine by inserting an endoscope of about 1.3 m in length from the anus, we undergo CT colonography at our hospital. It is an alternative to the colonoscopy examination which indirectly looks inside the large intestine by popping barium and air from the anus which had been done so far and it became possible to visualize the running of the blood vessel simultaneously (Fig. 2, 3).
Once diagnosed as colon cancer
If necessary, check whether you are stuck (invading) to the organs in the vicinity of the colon cancer, whether it is flying (transiting to distant organs), chest X-ray examination, CT examination or abdominal echocardiography We will investigate in detail.
Treatment of colorectal cancer
From the point of view of treatment
There are 4 types of surgical therapy (including endoscopic treatment), chemotherapy, radiotherapy, and others.
Laparoscopic surgery: Depending on the progress and size of the cancer, surgery for inserting a television camera or surgical instrument from a tiny wound with tummy is performed actively in our hospital.
From the viewpoint of therapeutic purpose
There are 4 kinds of treatment for cancer which becomes a primary cause in the large intestine, treatment for metastasis, treatment for preventing recurrence.
If the spread of cancer is limited, surgical therapy and radiation therapy are performed, and when cancer is spread throughout the body, chemotherapy is performed. Immunotherapy and gene therapy are still not common.
What is adjuvant therapy
Needless to say, even in the case of early cancer, there are cases where cancer spreads along the flow of blood and lymph at a site away from the cancer lesion that is the primary cause of cancer. After surgery sufficiently removes the cancer, the treatment to control such spread is called postoperative adjuvant therapy. Its purpose is to prevent recurrence, and chemotherapy and radiation therapy can be cited as a treatment method.
On the other hand, there is also a preoperative adjuvant therapy. The aim is to reduce cancer by performing chemotherapy or radiotherapy before surgery for highly advanced cancer. Those that could not be removed become resectable, and in addition, it may be possible to resect with small surgery.
About chemotherapy
Chemotherapy is required depending on the degree of cancer progression (stage). The drugs used include anticancer drugs that kill cancer cells, 5-FU (5-FU), irinotecan (CPT-11) developed in Japan, oxaliplatin, trifluridine, and further cancer Bevacizumab, which is an angiogenesis inhibitor (which is an angiogenesis inhibitor), cetuximab and panitumumab, which is an anti-EGFR antibody that blocks part of the network of cancer cells, and molecular targeted drugs such as legorafenib that blocks in a wider range.
Internal treatment
Treatment by oral administration is also reviewed.
Oral drugs of 5-FU type developed in Japan are attracting attention in Europe and the United States. As adjuvant chemotherapy for postoperative adjuvant chemotherapy for colorectal cancer that has progressed to a certain extent, it is simple compared to intravenous injection and the outcome of treatment is comparable. Even in the case of highly advanced cancer or recurrence which is difficult to resect by surgery, by combining with injectable medicine, a treatment method comparable to the outcome of treatment can be compared with the method by only injection, It came to be seen.
Exogenous chemotherapy
In our hospital considering the patient's burden, we are focusing on outpatient chemotherapy. In chemotherapy combined with the above-mentioned molecular targeted drugs, annual expenses may exceed 10 million yen, so there is a high medical care cost system to alleviate individual burden.
On side effects of antineoplastic drugs
Anticancer drugs are taken up more frequently in cell proliferation rate. Generally cancer cells are expected to be effective because cell division proliferation is active. However, normal human body also has a population of divisive proliferation. Stem cells in the bone marrow that make the origin of blood (blood cells), gastrointestinal tract, reproductive system, cells in the root of the hair. Naturally, many of anticancer drugs are taken into these cells and will be affected. Therefore, side effects such as myelosuppression, nausea / vomiting, diarrhea, hair loss etc. will appear. Although it is called a side effect, it can be said to be the original action if considering the property of anticancer drug that it is taken in and acts on cells with fast growth rate.
However, when chemotherapy is completed, many side effects will be eliminated promptly. It may take more than a few months to completely recover. On the other hand, there is an individual difference. Some race, or even the same Japanese people, have side effects strongly. Irinotecan (CPT - 11) is a commonly used anticancer agent for colorectal cancer, but in people with abnormal enzyme related to this there is a strong toxicity of (CPT - 11). A certain degree of discrimination is possible by genetic testing.
On the other hand, it is a molecular target drug, but there are special side effects. Cancer will make a new blood vessel to secure necessary blood to grow cancer, but there is medicine called bevacizumab (released in June 2007) to suppress this. Although side effects include hypertension and nose bleeding, serious things such as arterial occlusion are rarely caused.
We exchange information to proliferate cancer cells. Cetuximab (released in July 2008) and panitumumab (released in June 2010) are anti-EGFR antibodies that block a part of this information network. Adverse events are mainly skin disorders such as rashes and skin cracks. From April 2010, K-RAS gene mutation testing, which determines the therapeutic effect beforehand, is now undertaken in insurance medical treatment. In May, 20th, Legolafenib which blocks a wider range of information networks was released, there are many skin disorders as side effects, high blood pressure, bleeding, rarely liver failure, etc.
Cancer has become a very familiar illness. In life, one in two people will be cancer, one in three will die from cancer. It is a colorectal cancer that is one of the five major cancers, but it is said that 100,000 people are going to have colon cancer every year, aging and eating habits to Westernized, these two points increase colon cancer It is related.
The wave of aging is difficult to do anything, and what we can do to eradicate colorectal cancer is in the early detection by preventive and medical examination including improvement of dietary habits. However, there is a limit to "Taking one or two foods and nutrients in the diet into issues" in order to prevent specific cancers.
We recommend balanced diet and abdomen, moderate exercise, a good night's sleep, participation in medical examinations. Below is an overview of colorectal cancer.
Diagnosis of colorectal cancer
The length of the colon in general adults is said to be about 1.5 m. Symptoms vary slightly depending on where you can do the same colorectal cancer. For example, if it is on the right side of the large intestine, it touches anemia and a lump, on the left side it is abdomen, constipation finally is bowel obstruction, and furthermore when approaching to the anus side blood mixes with feces (Fig. 1). If you can do it, I would like to have a diagnosis before such symptoms appear.
For early diagnosis
There is a fecal occult blood test that senses a small amount of blood contained in feces from colon cancer and is used for colon cancer screening. If fecal occult blood was positive (a little blood is contained in the stool), further examination is required. However, fecal occult blood is not equal colorectal cancer. In cases where it becomes positive with colon polyp, enteritis, hemorrhoid disease, etc., and, as a result, the cause is not clear, is the majority.
On the other hand, fecal occult blood negatives are not safe. It is because it is not always bleeding from colorectal cancer. PET examination is also a cumbersome and too expensive examination method to find out early colorectal cancer from a large number of people efficiently.
Unfortunately there is no simple, cheap and reliable diagnostic method leading to diagnosis at an early stage. It is a practical way to consult a doctor if you are aware of the symptoms mentioned above or you have a large number of cancer patients in families / relatives with blood, while regularly taking advantage of medical examinations and human dogs.
To diagnose the presence of colorectal cancer and its part
After colonoscopy examining the large intestine by inserting an endoscope of about 1.3 m in length from the anus, we undergo CT colonography at our hospital. It is an alternative to the colonoscopy examination which indirectly looks inside the large intestine by popping barium and air from the anus which had been done so far and it became possible to visualize the running of the blood vessel simultaneously (Fig. 2, 3).
Once diagnosed as colon cancer
If necessary, check whether you are stuck (invading) to the organs in the vicinity of the colon cancer, whether it is flying (transiting to distant organs), chest X-ray examination, CT examination or abdominal echocardiography We will investigate in detail.
Treatment of colorectal cancer
From the point of view of treatment
There are 4 types of surgical therapy (including endoscopic treatment), chemotherapy, radiotherapy, and others.
Laparoscopic surgery: Depending on the progress and size of the cancer, surgery for inserting a television camera or surgical instrument from a tiny wound with tummy is performed actively in our hospital.
From the viewpoint of therapeutic purpose
There are 4 kinds of treatment for cancer which becomes a primary cause in the large intestine, treatment for metastasis, treatment for preventing recurrence.
If the spread of cancer is limited, surgical therapy and radiation therapy are performed, and when cancer is spread throughout the body, chemotherapy is performed. Immunotherapy and gene therapy are still not common.
What is adjuvant therapy
Needless to say, even in the case of early cancer, there are cases where cancer spreads along the flow of blood and lymph at a site away from the cancer lesion that is the primary cause of cancer. After surgery sufficiently removes the cancer, the treatment to control such spread is called postoperative adjuvant therapy. Its purpose is to prevent recurrence, and chemotherapy and radiation therapy can be cited as a treatment method.
On the other hand, there is also a preoperative adjuvant therapy. The aim is to reduce cancer by performing chemotherapy or radiotherapy before surgery for highly advanced cancer. Those that could not be removed become resectable, and in addition, it may be possible to resect with small surgery.
About chemotherapy
Chemotherapy is required depending on the degree of cancer progression (stage). The drugs used include anticancer drugs that kill cancer cells, 5-FU (5-FU), irinotecan (CPT-11) developed in Japan, oxaliplatin, trifluridine, and further cancer Bevacizumab, which is an angiogenesis inhibitor (which is an angiogenesis inhibitor), cetuximab and panitumumab, which is an anti-EGFR antibody that blocks part of the network of cancer cells, and molecular targeted drugs such as legorafenib that blocks in a wider range.
Internal treatment
Treatment by oral administration is also reviewed.
Oral drugs of 5-FU type developed in Japan are attracting attention in Europe and the United States. As adjuvant chemotherapy for postoperative adjuvant chemotherapy for colorectal cancer that has progressed to a certain extent, it is simple compared to intravenous injection and the outcome of treatment is comparable. Even in the case of highly advanced cancer or recurrence which is difficult to resect by surgery, by combining with injectable medicine, a treatment method comparable to the outcome of treatment can be compared with the method by only injection, It came to be seen.
Exogenous chemotherapy
In our hospital considering the patient's burden, we are focusing on outpatient chemotherapy. In chemotherapy combined with the above-mentioned molecular targeted drugs, annual expenses may exceed 10 million yen, so there is a high medical care cost system to alleviate individual burden.
On side effects of antineoplastic drugs
Anticancer drugs are taken up more frequently in cell proliferation rate. Generally cancer cells are expected to be effective because cell division proliferation is active. However, normal human body also has a population of divisive proliferation. Stem cells in the bone marrow that make the origin of blood (blood cells), gastrointestinal tract, reproductive system, cells in the root of the hair. Naturally, many of anticancer drugs are taken into these cells and will be affected. Therefore, side effects such as myelosuppression, nausea / vomiting, diarrhea, hair loss etc. will appear. Although it is called a side effect, it can be said to be the original action if considering the property of anticancer drug that it is taken in and acts on cells with fast growth rate.
However, when chemotherapy is completed, many side effects will be eliminated promptly. It may take more than a few months to completely recover. On the other hand, there is an individual difference. Some race, or even the same Japanese people, have side effects strongly. Irinotecan (CPT - 11) is a commonly used anticancer agent for colorectal cancer, but in people with abnormal enzyme related to this there is a strong toxicity of (CPT - 11). A certain degree of discrimination is possible by genetic testing.
On the other hand, it is a molecular target drug, but there are special side effects. Cancer will make a new blood vessel to secure necessary blood to grow cancer, but there is medicine called bevacizumab (released in June 2007) to suppress this. Although side effects include hypertension and nose bleeding, serious things such as arterial occlusion are rarely caused.
We exchange information to proliferate cancer cells. Cetuximab (released in July 2008) and panitumumab (released in June 2010) are anti-EGFR antibodies that block a part of this information network. Adverse events are mainly skin disorders such as rashes and skin cracks. From April 2010, K-RAS gene mutation testing, which determines the therapeutic effect beforehand, is now undertaken in insurance medical treatment. In May, 20th, Legolafenib which blocks a wider range of information networks was released, there are many skin disorders as side effects, high blood pressure, bleeding, rarely liver failure, etc.
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