Tobacco use or cigarette smoking is also linked to the development of colorectal cancers most especially after more than 35 years of smoking. but, there is no biological explanation for this link.
Colorectal cancer is often incidentally found in screening procedures and may be completely asymptomatic. But approximately half of patients with colorectal carcinoma experience abdominal pain, this is the most common symptom. About 35% of patients have altered bowel habits, 30% with occult bleeding, and 15% with intestinal obstruction. For right-sided colon cancers, there is a tendency that they are larger and more likely to bleed, whereas left-sided tumors tend to be smaller and more likely to be obstructing.
Presenting symptoms of Colorectal Cancer vary with the anatomic location for the tumor. Stool is generally liquid and passes through the ileocecal valve into the right colon. Cancers arising in the cecum and ascending colon may become quite large but does not result in any obstructive symptoms or noticeable changes of bowel movements. For lesions located in the right colon, it commonly ulcerate and lead to chronic insidious blood loss without alteration in the appearance of the stool. For tumors located at the ascending colon, this often present with symptoms like fatigue, palpitations and sometimes even angina pectoris. They are also found to be accompanied by hyperchromic microcytic anemia indicating iron deficiency. Since stool becomes more concentrated as it passes into the transverse and descending colon, tumors arising in that area tend to impede the passage of stool. This results in the development of abdominal cramping, sometimes obstruction and sometimes even perforation. Radiographically the abdomen of a patient with colorectal carcinoma often reveal a characteristic "napkin-ring" or "apple core" sign which is an annular, constricting lesion. For colorectal cancers arising in the sigmoid area, the condition is often associated with hematochezia, tenesmus and narrowing of the caliber of stool. Anemia is also infrequent in this kind of cancer.
On physical examination, there may be a completely normal finding, particularly those in early stages of the colorectal cancer. General or specific findings due to progression of the disease may also be evident, which include weight loss, cachexia,...
A staging system developed by Dukes and applied to a TNM classification method, in which T. stands for the depth of tumor penetration, N represents the presence of lymph node involvement and M. stands for the presence or absence of distant metastases. Dukes a or T1N0M0 numerically represented as I has a pathologic description where cancer is limited to mucosa and submucosa and with an approximate 5-year survival of greater than 90%. Dukes B1 or T2N0M0 numerically represented as I, is when the cancer extends into the muscularis and the patient has an approximate 5-year survival of 85%. Dukes B2 or T3N0M0, numerically represented as II is when the cancer extended into or through the serosa and the patient has an approximate 5-year survival of 70 to 80%. Dukes C. Or TxN1M0 or numerically represented as III is when the cancer involves already the regional lymph nodes and the patient has an approximate 5-year survival of 35 to 65%. And lastly, Dukes D. Or TxNxM1, numerically represented as IV is when there is already distant metastases to the liver, lungs or other organs. The patient in this case has an approximate 5-year survival of only 5%.
Treatment of Colorectal Cancer can either be medical, surgical or both. There have been important advances have regarding the first-line standard therapy of metastatic colorectal cancer. Both a European trial and a U.S. trial found that the rate of response to the combination of 5-FU, leucovorin (LV), and irinotecan (CPT11) was higher than that to 5-FU/leucovorin or CPT11 alone. The higher response rate translated to a greater median survival duration (about 14 mo) with the combination regimen. Studies have also shown that there is an improved response with the addition of oxaliplatin to the 5-FU/leucovorin regimen, while another study reported significantly prolonged progression-free survival with this combination. Anti-VEGF therapy with bevacizumab (Avastin) was shown to increase survival in patients receiving Avastin in combination with irinotecan, 5-FU, and leucovorin.
A clinical trial performed by Herb Hurwirtz and colleagues at Duke University shows that Colorectal cancer was the first cancer type to be responsive to antiangiogenic therapy as demonstrated by the. Standard therapy for metastatic colon cancer is CPT11 plus 5-FU/leucovorin, also known as the Saltz regimen. Another standard therapy was developed for metastatic colorectal cancer in 2005 which is IFL plus bevacizumab (irinotecan, 5-FU, leucovorin, Avastin). Adjuvant chemotherapy is considered for stage II (Dukes B) remains controversial. Patients with Dukes B. disease and any adverse risk factor, those with large primary tumor [T4], pathologic T3 level of invasion >15 mm, left-sided tumor location, obstructing or perforating tumors,
diet and cancer. The Works Cited five sources in MLA format. Food, Diet and Cancer Diet is fuel for our body. On the same account a balanced nutritious intake is what a human body needs more than anything. Hence food is one of the most cardinal factors that determine the quality of our healthy as well as the longevity of our lives. Knowing which food to eat in what quantity and
Digestive System The gastrointestinal system extends from the mouth to the anus. It includes the oral cavity, esophagus, stomach, duodenum, small and large intestine, rectum and the anus. The digestive system also includes other organs responsible for digestion, namely the liver, gall bladder and the pancreas. By way of the peristaltic movements of the tract and enzymes secreted from these organs, food is digested and absorbed; to be either stored in
Producing a Healthier Biscuit: Evidence for Adding Dietary Fiber The importance of fiber One common way to improve the health profile of baked goods is to add fiber, usually in the form of whole grain products vs. refined white flour. It is important to note when developing the nutritional profile of the proposed biscuit that not all types of fiber are created equal. There are two basic kinds of fiber: soluble and
Ulcerative Colitis Initial presentation The patient is an 18-year-old of the Filipino-American origin. He has no known family history of ulcerative colitis or chronic illnesses similar to colitis. He is a high school senior student. Historical information The patient complains of diarrhoea 3-4 times a month although it has been on and off for one year. There is no known allergy that the patient experiences. Presenting Symptoms He experienced rectal bleeding, rectal pain and often had