Bowel cancer treatment

Bowel cancer is a malignant neoplasm that develops in one of its departments. It occurs mainly in people over 50 years of age, but can also occur at a younger age. In the initial stages, it is almost invisible, which makes timely diagnosis difficult. But it is at this time that treatment is most effective - in 90% of cases, a complete recovery is achieved.

Oxford Medical has created all the conditions for thorough diagnosis and treatment of bowel cancer. The clinic has installed new expert-class equipment and employs experienced oncologists and oncological surgeons.

To determine the stage of bowel cancer, 3 main parameters are assessed. First, they check how deeply the malignant cells have grown into the intestinal lining. Then, they assess the condition of nearby lymph nodes and the presence of distant metastases.

The following classification is generally accepted:

• Stage 0 is an asymptomatic cancer in which the tumor is small and can be completely removed (after surgery, many patients do not need either radiation or chemotherapy);
• Stage 1 - the tumor is up to 2 cm in size, it grows into the mucous and submucosal layers of the intestine, but does not go beyond it;
• Stage 2 - the tumor is more than 2 cm in size, it affects all layers of the intestinal wall;
• Stage 3 - the tumor increases, metastases appear in nearby lymph nodes;
• Stage 4 – the tumor extends beyond the intestine and grows into adjacent organs, distant metastases appear.

To determine the stage of colon cancer, oncologists use the international TNM classification system, which stands for: T (tumor size) – tumor size, N (nodes) – lymph node status, M (metastasis) – presence of metastases.

Accordingly, the following stages are distinguished according to the T criterion:

• Tis (in situ) – atypical cells are localized in the upper epithelial layer of the intestinal lining;
• T1 – the tumor grows into the submucosal layer of the intestinal wall;
• T2 – the tumor spreads to the muscular layer of the intestine;
• T3 – the tumor covers all layers of the intestine and extends to the outer wall of the organ;
• T4 – the tumor spreads to adjacent organs.

Depending on the degree of lymph node involvement, the following are determined:

• N0 – lymph nodes are not affected;
• N1 – 1 to 3 regional lymph nodes are affected;
• N2 – more than 4 lymph nodes are affected, including distant ones.

The presence and number of metastases are determined by:

• M0 – no metastases;
• M1 – there are metastases in distant organs.

Depending on the location of the tumor, the following are distinguished:

• colon cancer (caecum, colon and its subdivision - sigmoid);
• small intestine cancer (duodenal, jejunal, ileal);
• rectal cancer.

In the early stages, neoplasms usually develop asymptomatically, so people over 40 years of age, as well as those with risk factors, are recommended to undergo preventive diagnostics annually.

The main symptoms of colon cancer are periodic constipation and diarrhea, as well as anal bleeding. In rectal cancer, in addition, fecal incontinence and increased gas formation often occur, and in the later stages, bloody, mucous and purulent discharge appear.

In caecum cancer, patients complain more about changes in the color of feces, as well as pain in the lower right part of the abdomen. General symptoms such as weakness, dizziness and tachycardia also often occur.

Sigmoid colon cancer is characterized by the above symptoms, as well as frequent belching, nausea, bloating and involuntary tension of the abdominal muscles.

The listed symptoms can be caused not only by intestinal cancer, but also by other diseases, including those not related to oncology. For diagnosis, you need to see a doctor and undergo diagnostics: ultrasound, CT scan, colonoscopy, etc.

If you experience symptoms of the disease, you should consult a proctologist. During the consultation, the doctor will ask what is troubling you, study your medical history and ask about your family history. After that, the specialist will conduct an examination and prescribe an examination to determine the diagnosis.

The most common tests are:

• general blood and urine tests;
• coprogram - stool analysis;
• hemoculture test - stool analysis for occult blood;
• blood tests for tumor markers;
• transrectal ultrasound of the rectum;
• colonoscopy - endoscopic examination of the rectum, which allows you to examine its walls using a miniature camera (the image is magnified many times and transmitted to the monitor screen);
• sigmoidoscopy - endoscopic examination of the rectum and distal part of the sigmoid colon;
• esophagogastroduodenoscopy (EGD) - endoscopic examination of the esophagus, stomach and duodenum;
• irrigoscopy – X-ray examination of the intestine with the introduction of a contrast agent;
• biopsy with histological analysis – taking a tissue sample (performed during an endoscopic examination) and its analysis to determine the type of neoplasm;
• immunohistochemical analysis is performed when confirming the malignant nature of the tumor to determine its characteristics;
• ultrasound, CT or MRI of various areas of the body to assess the spread of cancer and detect metastases.

The doctor individually determines which tests and examinations the patient needs, taking into account the symptoms of the disease.

Intestinal cancer requires complex treatment. Its program is drawn up taking into account the stage of the disease and the general health of the patient.

Intestinal cancer is used:

• surgical treatment;
• radiation therapy;
• chemotherapy;
• targeted therapy;
• immunotherapy.

When diagnosing a tumor at stage 1 or 2, surgery is first performed. Sometimes this is enough and it is possible to do without radiation and chemotherapy. At stages 3 and 4, treatment is more complicated. The patient may need radiation or chemotherapy before surgery to reduce the size of the tumor, and then for the prevention and treatment of metastases.

Radiation therapy has a local effect and promotes the destruction of tumor tissues. Chemotherapy affects the entire body. It is carried out with drugs of two groups that inhibit cell division and promote their destruction, thereby slowing down the development of the tumor and causing its destruction. Due to this, chemotherapy is effective in the treatment of distant metastases and the prevention of disease recurrence.

As for surgical treatment, depending on the location of the tumor and its size, one of the following operations is performed:

• endoscopic surgery - a minimally traumatic organ-preserving operation, during which the tumor is removed through the rectum;
• intra-abdominal resection - a part of the organ affected by the tumor is removed, and the upper and lower ends are sewn together;
• abdomino-anal resection - an organ-preserving operation, during which the entire rectum is removed, "replacing" it with a descending colon, which is stretched and sewn to the anus;
• Hartmann's operation - if stitching the ends of the rectum is impossible, the lower one is sewn up, and the upper one is brought out into the abdominal cavity in the form of a colostomy (an opening for the removal of feces into a special bag);
• Rectal extirpation – the rectum and anus are removed, and a colostomy is formed.

Risk factors for colon cancer include:

• benign intestinal neoplasms (adenoma, polyps);
• inflammatory bowel diseases (ulcerative colitis, Crohn's disease);
• previous cancer;
• genetic predisposition;
• diabetes;
• obesity;
• smoking;
• alcohol abuse;
• unbalanced diet;
• age over 40 years.

Experts note that the likelihood of cancer increases significantly in the presence of polyps and inflammatory bowel diseases. They can lead to the development of dysplasia and, over time, atypical cells.

Also, according to the World Health Organization, a significant risk factor is the prevalence of red meat (sausages and other meat delicacies), high-calorie and quickly digestible foods in the diet. It has been established that such nutrition leads to stool retention in the intestine and prolonged exposure to carcinogenic substances on its walls.

Oxford Medical has created all the conditions for accurate diagnostics and effective treatment. We employ some of the best oncologists and surgeons in Kyiv and Ukraine with many years of experience, who are familiar with all modern methods of cancer treatment, including targeted and immunotherapy.

Surgical treatment is performed in a high-tech surgical hospital with two operating rooms, an intensive care unit and intensive care wards. Operations are performed using both classical and minimally invasive techniques.

To make an appointment for a consultation, call our contact center or write to the chat on the website.