Colorectal carcinoma (CRC) is one of the lethal malignant diseases and is the third most common cancer and the fourth most common cause of cancer deaths worldwide. It is the third most common cancer in men (10% of all cancers in men worldwide) and second most in women (9.2% of all cancers in women worldwide)(1). It is a slow developing cancer that begins as a tumor or a tissue growth on the inner lining of the large bowel. The most common type of CRC is adenocarcinoma (more than 95%)(2). Even with advancements in the diagnostic technologies the detection is usually late however accurate pre-operative staging has a definite impact in the treatment plan and is important in selecting patients for pre-operative chemotherapy or radiotherapy or both.
GLOBOCAN 2012 says because of China’s large population size, approximately one-fifth of the world population, these Chinese data contribute significantly to the global burden of cancer: almost 22% of global new cancer cases and close to 27% of global cancer deaths occur in China(3). According to cancer
…show more content…
Particularly, the diagnostic accuracy of pre-operative MRI in predicting the circumferential resection margin (CRM) of rectal cancer was well established through a prospective trial(8).The overall accuracy of MRI in predicting the pathologic stage of non-irradiated rectal cancer is 71-91% (mean 85%) for T staging, 43-85% (mean 75%) for N staging and 92-95% for CRM involvement(9). Due to the therapeutic effects of pre-operative CRT 30-50% of the patients experience down staging of rectal cancer(10). MRI is repeatedly performed after pre-operative CRT. However the interpretation of post CRT MRI in rectal cancer is not easy due to post radiation effects(9). In this study, we analyze on the prediction of pathologic stage with restaging MRI for rectal cancer patients who had received pre-operative
Colorectal cancer mainly starts at colon or the rectum. They are common in most of the way like features, but they have different treatment. What is the different between colon cancer and rectum cancer? Colon cancer happens first four to five feet of the large intestine and rectal cancer happens in the last few inches of the large intestine where it is connected to anus.
Recommended follow up regimen after curative treatment for colorectal cancer and signs and symptoms associated with colorectal cancer recurrence.
The American College of Gastroenterology Guidelines recommend colonoscopy,as the preferred cancer screening test for patients 50 years and older(Rex 2017). The technique of Endoscopic Mucosal Resection (EMR) was developed for removingsessile or flat lesions confined to the superficial layers (mucosa and submucosa) of the gastrointestinal (GI) tract, including the colon, esophagus, stomach, and duodenum. EMR with submucosal injection helps facilitate complete resection of polyps (Hwang 2015; Fyock 2010; Steele 2013), which is critical, as incomplete resections may contribute to the development of colon cancer in patients despite being on a colonoscopy screening/surveillance pathway (i.e. interval cancers). (von Renteln 2017; Bujanda 2010;
MRI due to its high sensitivity for soft tissue enables to view structures clearly which has been a major advance in visualizing rectal tumors and can predict the T stage (mrTstage) with good accuracy Brown G. et al, 2003. Detailed staging using high resolution magnetic resonance imaging (MRI) enables the selection of patients that require pre/ post-operative therapy for tumor regression. This information can be used to select neoadjuvant therapy and adjuvant therapy in those patients with poor prognostic features before disturbing the tumor bed and potentially disseminating disease. Extramural venous invasion (EMVI) is recognized as an independent factor for poor prognosis in rectal cancer and may therefore influence treatment decisions regarding oncological therapy. Extramural venous invasion is seen on MRI as a serpiginous extension of tumor signal within a vascular structure. This is best identified on T2-weighted images where the characteristic signal and morphology differentiates it from nodal disease Smith et al, 2008.
Case Study A 28-year-old married man was referred to the gastrointestinal specialist after a trip to the emergency room. His past medical history included the diagnosis of colon cancer 12 months ago. The tumor was within the transverse colon. The patient underwent a bowel resection.
Colorectal cancer is cancer of the colon. It is also referred to as colon cancer. It is mostly found in people over the age of fifty. In the United States alone, it is the second leading cancer killer in the US. Colon cancer has four stages of cancer. The cancer can either be malignant or benign. The anatomy, signs and symptoms and treatments are all very important things to consider when encountering colon cancer.
Bowel cancer can be detected using various techniques. The most common being colonoscopy and flexible sigmoidoscopy. Flexible sigmoidoscopy detects cancer in “the rectum and sigmoid colon and, at times, the descending colon.” Colonoscopy also focusses on these areas but can “permit inspection of the entire transverse and the right colon.”
Omega-3 PUFAs and the colorectal cancer: a review of the similar and different effect of EPA and DHA
The final Phase Is the most advanced stage of colorectal cancer. If the doctor has been diagnosed with colorectal cancer stage IV or last, it means that cancer spread to distant sites of the body, such as the liver or lungs. Cancer can grow through the wall of the colon and rectum or not, and the lymph nodes can be affected or not. Treatment at this stage depends heavily on chemotherapy and surgery may be used in some cases. For advanced cancers, radiotherapy can likewise be used to help ease side effects, for example, pain. but it is difficult to lead to a
Theres are five stages of colon cancer beginning at stage 0. Stages 0 and 1 indicate the tumor has not grown out of the inner lining of the colon wall, therefore the polyps can be removed by a colonoscope. As long as all the cancerous cells are removed completely, no additional treatment is necessary and the cancer has not spread to the lymph nodes. In stage 2, the cancerous cells have grown through the wall of the colon, possibly to healthy tissue nearby however they have not spread to the lymph nodes. Once an individual has reached stage two, there is a higher risk that a margin of cancerous cells was left behind, and the cancer has blocked the colon off. In stages 3 and 4, more aggressive treatments are necessary in order to rid not only the colon but also the metastases at which the cancer has spread. In stage 3, a partial colectomy is necessary to surgically remove part of the diseased colon as well as any infected area. Chemotherapy may also be required to make sure that all of the cancerous tissue has been removed from the abdominal lining and vital organs like the lungs or liver. Doctors may also use radiation to further target cells left behind that surgery was unable to extract. At stage 4, the cancer has spread far from the colon to other tissues and organs which makes it a lot more challenging to remove with surgery. Chemo is often given before surgery as to hopefully reduce the size of tumors so they may be taken out surgically later on. At this stage of colon cancer, the goal is to elongate the person's life and relieve symptoms rather than rid them of cancer because it is very unlikely chemotherapy and radiation will be enough to demolish all of the cancerous tissues (Treatment of Colon
Generally, treating locally advanced rectal cancer includes radiotherapy (RT), chemotherapy (CT), chemoradiotherapy (CRT), surgery, and subsequent incorporation of molecularly targeted agents. With multimodality treatment, local recurrence rates became less than 10% with the predominant mode of failure is the development of distant metastases (30–35%). Therefore, the addition of induction CT is not aimed to improve local efficacy, but to better control distant disease [1, 2].
Globally more than 1 million people get colon cancer every year resulting in about 715,000 deaths as of 2010 up from
In conclusion the research shows that more clinic trials have been established to find out new methods of preventing colorectal cancer and whether the already existing ways are effective or not. The colorectal cancer
The availability of the peritoneal disease in relation to colorectal cancer has a poor prognosis; therefore, traditional treatment such as systemic chemotherapy is usually associated with less survival rate. Currently, several innovative individuals globally are seeking to utilise more rapid and thorough strategies for the management of colorectal cancer. Cytoreductive surgery (CRS) is one of the most popularised methods of managing the disease in some selected patients. Peritoneal carcinomatosis has been established as one of the major causes of treatment failure among patients with colorectal cancer. Even though it is considered fatal, scientist have postulated that a localised peritoneal carcinomatosis without any other metastases can be considered as a regional disease metastasis and should be pliable to local-regional therapy.8 Despite the fact that curative liver resection for colorectal cancer is well established with a survival rate of 5 years, peritoneal cancer has been considered as an end stage disease. The notion that some individuals who have peritoneal carcinomatosis possess a regional disease rather than a metastatic malignancy has led to the development of multiple complex surgeries that can result in a macroscopic excision of the cancer completely (cytoreduction), which is combined with hyperthermic intraperitoneal chemotherapy to manage some of the microscopic diseases.15
The questions that may arise are why are the rates of cancer in this group of people exceed other ethnic groups? We may also ask if social economic, risk factors, traditional values, education, language barriers halt the direction for reducing the alarming rate. The fact that China has the ninth highest incidence rate of liver cancer of males worldwide while lung cancer incidence among women in China is also the ninth highest worldwide, makes it deserving of special attention.