March 1 to 31 Large Intestine (Colon) Cancer Awareness Month scope, Turkey Specialist Professor of Gastroenterology Dr. Prof. Dr. Ahmet Kemal Gürbüz and Head of Surgery Dr. Zafer Ferahköşe gave the following information about colon cancer and its treatment methods:
Colon cancer , also known as large bowel cancer, is seen frequently in the community after 50 years of age. In 95% of cases of colon cancer, the onset of the event occurs as colon polyps. Colon polyps are tumoral lesions originating from the large intestine inner tissue that are gradually growing starting from spot tissue growth.
As these polyps become larger, the likelihood of returning to colon cancer increases. The probability of returning to the polyps larger than two centimeters is 50 percent. On the other hand, villous polyps are easily transformed into colon cancer compared to tubular or tubulovillous structures.
Growing polyps can be a precursor to cancer.
The risk of colon cancer is considerably increased if cellular changes are encountered in the pathological examination of biopsies taken over polyps. The duration of doubling the magnitude of the colon polyps is a period of several years. Therefore, follow-up colonoscopy procedures to be carried out at specific intervals may determine whether the polyps of the colon are present and determine whether these polyps have a high risk of cancer.
With regular follow-up, risky colon polyps are diagnosed before reaching larger sizes and can be removed by colonoscopic method (polypectomy procedure). Thus, the event is stopped before reaching the stage of colon cancer.
It should be checked every 5 years without complaint
In Europe and the United States health policies, it has been accepted that colon cancer should be diagnosed before reaching life-threatening levels by performing colonoscopic examinations every year from 50 years in fully healthy individuals who have no complaints. For this reason, intestinal examination has been included in check-up programs since the age of 50 years. Thus, it is envisaged that successful treatment of large bowel cancer will be achieved and life will be saved. In colon cancer patients in the family, this colonoscopic examination programs can be started at a younger age in relation to the characteristics of the cancer case.
The treatment determines the stage of cancer
In the three-layer colon, the cancer spreads from the inner layer to the muscle layer, then to the outer layer layers and to the outside peritoneal cavity. Cancer in the mucosal level is known as early stage cancer and cancer that develops from the muscle layer is known as advanced stage cancer.
Diagnosis is determined by ultrasound, computed tomography and PET after the diagnosis by the doctor is clarified by colonoscopy and biopsy. The treatment methods to be used according to the stage of cancer vary depending on the level, type, extent of the tumor, removal of the tumor, and whether the tumor is closed or not.
Tissue is extracted in the tissues that feed it
Since biopsy taken from colon during colonoscopy shows that colon cancer has already developed, the patient’s life will be saved by a surgical operation since no treatment has been entered into yet.
In the main principle, for the purpose of releasing a tumor-free area, the areas fed by the main artery, together with the main tumor, are removed. The adjacent organ or structure that is in contact with the tumor is removed together with the omentum. If the tumor cannot be completely removed, surgery does not contribute to this chance of survival, but only to allow the passage to open.
If there is a second colon tumor or family adenomas or polypoid structures together with the existing cancer, the whole colon may be at risk. Therefore, surgery should be performed.
Lymph nodes guide treatment
The number of lymph nodes in the extracted specimen is important for oncologic surgery adequacy. The amount and levels of involvement of lymph nodes are also effective in giving life and additional treatment options. At least 12 lymph nodes accepted today are excluded from the specimen. This helps in adequate tumor staging. The proportion of positive lymph nodes and total lymph nodes is also effective in survival.
If unexpected metastasis is encountered during operation, the metastatic site may be removed in addition to removing the primary tumor.
In addition, the condition of the patient and the new tissues observed during the operation direct the course of the surgical operation and subsequent treatment.