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28.03.07: Intestinal Cancer Prophylaxis
Recently number of various lesions of large intestine has increased. 510 000 cases of large intestine cancer are registered in the world annually. American Anti-Cancer Society states 60 000 die from large intestine cancer every year in the US, and about 140 000 of new cases are registered.
Unfortunately, malignant lesions and the most frequent precancerous diseases (polipuses) at early stages have no symptoms and the patient does not feel the need to consult a doctor. That is the reason why colonorectal cancer in 70-90% of cases is revealed at late stages, and polipuses are revealed “by accident” when a patient is investigated in connection with other diseases. About 30% of people aged over 40 years have polipuses found with the help of colonoscopy, while these polipuses rather often may turn into cancer. One should know that tumor may appear in a short period of time (3-6 months), avoiding the stage of a polypus. But in such cases cancer develops not in healthy mucous, but as a result of the so-called diffusion hyperplasia, which may also be revealed in the process of colonoscopy.
The majority of intestinal polipuses are various types of adenoma – benign tumor appearing from mucous glandular epithelium. Biopsy helps to define the type of the polypus. The highest frequency of malignization is observed in cases of intestinal villy tumors (50-95 %). Considering the danger of malignization of both large and small polipuses, timely revealing and removal of all the polipuses helps to prevent large intestine cancer.
Colonoscopy is one of the most effective endoscopic methods of early intestine polypus and cancer diagnostics. Colonoscopy is a method of endoscopic investigations when the doctor with the help of a special apparatus – colonoscope - investigates lumen and mucous of all sections of large intestine. This highly – informative method helps to reveal evident pathology (large polypus, tumors, ulcers, etc.) as well as minor disorders (slight mucous inflammation, small flat polypus, vascular changes, etc.). The advantage of this method is an opportunity not only to see the pathology but also to make biopsy – to investigate minor fragments of changed tissues. Another advantage of large intestine endoscopy is an opportunity not only to diagnose diseases but also to treat them. Due to the fact that the diameter of 90% of large intestine polypus is smaller than 2 cm, they can be easily removed through the colonoscope, that is with the help of non-traumatic endoscopic method instead of traditional abdominal operation under anesthetic.
Any adult, especially those aged over 40 should consult a doctor in case they have the following symptoms: constipation or diarrhea, which have appeared recently, and are combined with weight loss; stool with a touch of blood or phlegm with blood; intestinal discomfort combined with disgust for meat food. The above mentioned symptoms may be rather dangerous in case one’s blood relatives had cases of intestinal polipuses or cancer.
Early endoscopic diagnostics and large intestine polipuses removal help to prevent cancer.
I.V. Kyrianov, Doctor of Science, Gastroenterologist, American Medical Center
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