The following is the knowledge about the treatment, pathology and prevention of rectal cancer:
(a) surgical treatment is divided into radical and palliative.
1. Radical surgery can certainly remove the tumor, but there are still residual cancer, regional lymph node metastasis, or tumor thrombus in blood vessels, and the probability of recurrence and metastasis is very high. The surgical method depends on the location of the cancer in the rectum. There are submucosal lymphatic plexus and intermuscular lymphatic plexus in rectal wall, and the metastasis of cancer cells in lymphatic system in intestinal wall is rare. Once cancer cells penetrate the intestinal wall, they will spread to the lymphatic system outside the intestinal wall. Generally, the paraintestinal lymph nodes at the same level or slightly higher than the cancer are involved first, then the intermediate lymph nodes with superior hemorrhoidal arteries are gradually involved upward, and finally the paraintestinal lymph nodes are involved. The above lymphatic metastasis is the most common metastasis mode of rectal cancer. If the cancer is located in the lower rectum, the cancer cells can also invade the obturator lymph nodes along the lymphatic vessels of levator ani and pelvic fascia, or flow to the internal iliac lymph nodes along the middle hemorrhoidal artery. Sometimes, cancer cells can also descend through levator ani and drain along the inferior hemorrhoidal artery to lymph nodes and inguinal lymph nodes in the ischiorectal fossa. Because the lymphatic metastasis direction of upper rectal cancer is almost upward, surgical resection of lymphatic tissue near the cancer and above this plane can achieve the goal of radical cure, and it is possible to preserve anal sphincter during operation. Although the lymphatic metastasis of low rectal cancer is mainly upward, it is still possible to metastasize laterally to internal iliac lymph nodes and obturator lymph nodes. Radical surgery needs to include perianal tissue and levator ani, so it is impossible to preserve anal sphincter.
(1) Combined abdominoperineal resection (miles operation): Suitable for low rectal cancer less than 7cm from anal margin. The scope of resection includes sigmoid colon and its mesentery, rectum, anal canal, levator ani, tissues in ischiorectal fossa, skin around anus and blood vessels. The inferior mesenteric artery or the left colon artery is ligated and cut off, and the corresponding paraarterial lymph nodes are cleaned. Permanent colostomy (artificial anus) was performed on the abdomen, and primary suture or gauze packing was performed on the perineal wound. This operation is thorough and the cure rate is high.
(2) Abdominal low resection and one-stage extraperitoneal anastomosis, also known as dixon operation, is suitable for high rectal cancer more than 12cm from anal margin. The sigmoid colon and most of the rectum were excised in the abdominal cavity, and the rectum below the peritoneal fold was freed, and the sigmoid colon and the cut end of the rectum were anastomosed outside the peritoneum. This kind of operation has less trauma and can preserve the original anus, which is ideal. If the tumor is large and has infiltrated the surrounding tissues, it should not be used.
(3) Resection of rectal cancer with sphincter preservation: It is suitable for early rectal cancer 7 ~ 1 1 cm away from anal margin. If the cancer mass is large, the degree of differentiation is poor, or the upward main lymphatic vessel has been blocked by cancer cells, and there is lateral lymphatic metastasis, this surgical method is incomplete, and it is still better to combine abdominoperineal resection. At present, the methods of anus-preserving surgery for rectal cancer include stapler, transabdominal low resection-transanal eversion anastomosis, transabdominal free-transanal pull-out resection anastomosis, transabdominal sacrectomy and so on, which can be selected according to the specific situation.
2. Palliative surgery If the local infiltration of cancer is serious or the metastasis is extensive and incurable, palliative resection is feasible in order to relieve the obstruction and relieve the pain of patients. Limited resection of intestinal segment with cancer was performed, the distal end of rectum was closed, and sigmoid colon was taken out for stoma (Hartmann operation). If not, just do sigmoidostomy, especially for patients with intestinal obstruction.
(2) Chemotherapy
About half of rectal cancer patients have metastasis and recurrence after operation. Except for some early patients, patients with advanced and postoperative rectal cancer need chemotherapy. Chemotherapy is another important treatment for rectal cancer after comprehensive treatment and relay surgery. Chemotherapy can inhibit the decline of bone marrow hematopoietic system, mainly white blood cells and platelets. At this time, it is necessary to take Zhenqing Powder to make up for the deficiency of chemotherapy and reduce the damage of chemotherapy to hematopoietic system.
(3) Radiotherapy The position of radiotherapy in the treatment of rectal cancer has been paid more and more attention. There are two kinds of comprehensive treatment: surgery combined with traditional Chinese medicine and radiotherapy alone.
1. Comprehensive treatment combining surgery, traditional Chinese medicine and radiotherapy
① Preoperative radiotherapy can control the metastasis of primary focus and lymph nodes, improve the resection rate and reduce local recurrence, which is suitable for stage ⅲ (dukes c grade) rectal cancer. Pelvic anteroposterior irradiation can reach 40 ~ 45gy(4000 ~ 4500 Rad). Surgery was performed 3 weeks after radiotherapy.
Postoperative radiotherapy is suitable for lymph node metastasis confirmed by pathological examination. The cancer has obviously infiltrated outside the intestinal wall and there are residual unresectable lesions in the pelvic cavity. Generally, after the perineal wound is healed 1 ~ 2 months after operation, the radiation dose can reach 45 ~ 50 Gy (4500 ~ 5000 Rad) by using the pelvic anteroposterior field and sometimes the perineal field.
(4) A large number of clinical practices in the treatment of traditional Chinese medicine have proved that high-dose radiotherapy and chemotherapy for patients in the middle and late stage, or chemotherapy for patients who have developed drug resistance, can only lead to weaker life and accelerate the death of patients. Clinically, it is often seen that the death of patients is not caused by cancer itself, but by unscientific and inappropriate lethal treatment. For example, after multiple interventional treatments for liver cancer, liver failure such as ascites and jaundice occurred and died; Pleural effusion died of respiratory failure after chemotherapy for lung cancer; After chemotherapy for gastric cancer and intestinal cancer, nausea and vomiting make patients more tired and die. Leukocyte decline, patients died of infection, etc. Treating cancer with traditional Chinese medicine can alleviate the symptoms and pain of patients, improve the quality of life, prolong life and reduce cancer mortality.
Complications of radiotherapy for rectal cancer
Complications of radiotherapy include local injury and systemic injury. Local injuries include radiation dermatitis, radiation enteritis and radiation osteitis. Systemic injury includes digestive system reaction and bone marrow suppression.
1) local injury: ① radiation dermatitis: at the initial stage of radiation, the skin is red and itchy, similar to the change of solar dermatitis; In the middle stage of radiation, the skin is pigmented, thickened and rough, and the pores are thick and black; In the late stage of radiation, wet peeling, local skin edema, blisters, ulceration, erosion and even ulcers may appear in skin folds and groin areas. ② Radiation enteritis: Patients in the middle and late stage of radiation may feel abdominal discomfort, which will be aggravated after eating or drinking water, and in severe cases, intestinal obstruction may occur. This is due to the congestion and edema of intestinal mucosa under radiation injury; ③ Soft tissue fibrosis: it appears in the late stage of radiation, often showing local tissue sclerosis and normal tissue losing elasticity;
2) General adverse reactions: ① Digestive tract reactions: patients often have dry mouth and dry stool in the early stage of radiotherapy; In the middle and late stage of radiotherapy, patients may have loss of appetite, nausea and vomiting; ② Bone marrow suppression: It mostly occurs in the late stage of radiotherapy, characterized by general weakness and the decrease of WBC in hematological examination.
Indications of radiotherapy for rectal cancer:
Rectal cancer cells are moderately sensitive to radiation damage, so radiotherapy is often used as one of the comprehensive methods in the treatment of rectal cancer, combined with surgery and chemotherapy to achieve the goal of radical cure. Radiotherapy for rectal cancer is suitable for preoperative radiotherapy, intraoperative radiotherapy, postoperative radiotherapy, palliative radiotherapy and the treatment of metastatic cancer.
1) preoperative treatment: preoperative radiotherapy can reduce tumor implantation during operation and reduce the incidence of pelvic intestinal adhesion after operation; It can reduce the volume of the primary tumor. If the tumor is close to the dentate line, it can make the operation of preserving anal sphincter possible from the original impossible, and improve the quality of life of patients. It can reduce the staging of pelvic lymph nodes, reduce the local recurrence rate of tumors and improve the 5-year survival rate of patients, especially for Dukes C patients.
2) Intraoperative radiotherapy: It can reduce local skin radiation injury and local recurrence. For some advanced cases, after surgical resection of tumor focus and lymph node dissection, large-dose whole-field radiotherapy was performed, and then the skin was sutured. Doing so can kill the remaining cancer cells at one time, prevent postoperative recurrence and prolong the survival time;
3) postoperative radiotherapy: it can reduce local and regional recurrence and limit distant metastasis;
4) Simple radical radiotherapy: For some elderly and frail patients with early rectal cancer who suffer from cardiovascular diseases or other visceral diseases and are not suitable for surgery, radical radiotherapy can be performed;
5) Palliative radiotherapy: For some rectal cancer patients who have lost the chance of radical surgery, radiotherapy can still be performed to achieve the purpose of inhibiting tumor development, controlling the disease and prolonging life;
6) Treatment of metastatic cancer: Radiotherapy is the best method to treat bone metastasis pain so far. It can also inhibit tumor growth and delay the life of brain metastasis.
What are the common surgical methods for rectal cancer?
The commonly used surgical methods for rectal cancer can be divided into two categories: anus-preserving surgery and anus-preserving surgery. First of all, introduce the anus-preserving surgery commonly used in clinic. There are many surgical methods, and it is hoped that colorectal anastomosis will be performed after resection of rectal tumor, which is especially important for low rectal cancer. (1) Scope of resection of rectal cancer (Dixon operation): This operation needs to remove the sigmoid colon and rectum long enough, and clean the corresponding mesentery and surrounding tissues and corresponding lymph nodes. After resection, colorectal end-to-end anastomosis was performed. If the anastomosis plane is low, it can be done with the aid of stapler. This operation can preserve the anus, and if it is completely removed, it is an ideal operation method. (2) The difference between abdominoperineal resection and Miles operation is that the perineum cuts off the rectum at the dentate line, preserving the anal sphincter and surrounding tissues, and the bacon stump after tumor resection is pulled out from the perineum and sutured to the skin edge. This operation preserves the sphincter, but has poor defecation reflex and incomplete perineal resection, which is suitable for middle rectal cancer. Such as peritoneal overlap anastomosis, anal eversion anastomosis and transabdominal free presacral anastomosis. In recent years, due to the application of stapler, low colorectal anastomosis has been more convenient, except for some special circumstances, the above operation has been rarely used; (3) Miles operation: The scope of this operation includes partial sigmoid colon, total rectum, lymph nodes around inferior mesenteric artery, levator ani, ischiorectal fossa, skin around anus with a diameter of 5cm, anal canal and sphincter. After resection, the colon stump was a permanent artificial anus in the abdomen, and the perineal wound was closed. During the operation, the abdomen was free and the abdomen and perineum were operated at the same time. The advantages of this operation are complete excision, large wound and inconvenience to life caused by permanent artificial anus. Therefore, in recent years, some surgical methods have been designed, such as replacing sphincter with gracilis muscle, replacing internal sphincter with colon muscle tube, intussusception, angulation of pre-sacrum colon, etc., and attempts have been made to place artificial anus in perineal incision without removing anus and sphincter. Although it has a certain effect, the ability to control defecation is still different.
2. Syndrome differentiation and treatment.
1) damp-heat accumulation type; Pulsatilla soup.
Pulsatilla 30g Cortex Fraxini 15g Rhizoma Coptidis 3g Cortex Phellodendri 9g Caulis Sargentodoxae 15g Herba Patriniae 15g Radix Sophorae Flavescentis 15g Herba Portulacae 15g Flos Hibisci 12g Radix Actinidiae 30g.
2) Type of blood stasis and toxin resistance: Gexia Zhuyu decoction is modified.
Peach kernel 9g safflower 9g Radix Paeoniae Rubra 9g Radix Angelicae Sinensis 9g Rhizoma Chuanxiong 6g Oletum 9g Rhizoma Cyperi 9g Rhizoma Corydalis 15g Rhizoma Curcumae 15g Manicure 9g Rhizoma Smilacis Glabrae 30g
3) Spleen deficiency and qi stagnation type: Xiangsha Liujunzi Decoction.
Radix Aucklandiae 6g Fructus Amomi 3g Radix Codonopsis 15g Rhizoma Atractylodis Macrocephalae 12g Poria cocos 12g Pericarpium Citri Tangerinae 6g August Zagreb 12g Fructus Aurantii 9g Linderae 9g Green Sepals 9g Aquilaria 9g.
4) Spleen and kidney yang deficiency type: Lizhong decoction is modified.
Codonopsis pilosula 15g fried atractylodes 12g stir-fried ginger charcoal 3g nutmeg 9g psoralea corylifolia 12g Schisandra 6g Evodia 3g aconite 6g cinnamon 3g.
(5) Tumor local freezing, laser and cauterization can be used to treat patients with advanced rectal cancer with signs of incomplete intestinal obstruction. Try local freezing or cauterization of tumor (including electrocautery and chemical cauterization) to make tumor tissue shrink or fall off, and temporarily relieve the symptoms of obstruction. In recent years, laser therapy has been developed. When bleeding, the local tumor tissue was irradiated with 65w nd-yag laser at different points. When bleeding, use 40w power to gather irradiation around the bleeding point to stop bleeding, once every 2 ~ 3 weeks. In some cases, the tumor can be shrunk and the symptoms can be temporarily relieved. It can be used as a palliative treatment.
(6) Treatment of patients with metastasis and recurrence
Although the tumor can be removed by surgery, there are still cancer residues, regional lymph node metastasis, or tumor thrombus in blood vessels, and the probability of recurrence and metastasis is very high.
1. Treatment of local recurrence If the local recurrence focus is limited and there is no recurrence or metastasis in other parts, surgical exploration and resection can be performed. If the recurrent focus is confined to the center of perineal incision and neither side extends to the ischial tubercle, extensive resection may be performed. If perineal nodules or masses are recurrent pelvic lesions extending to the lower pole of perineum, they are not suitable for surgery. Because the lesion can not be completely removed, the tumor tissue can be removed, leaving a long-lasting wound.
Radiotherapy for recurrent pelvic lesions, with a course of 20gy(2000rd), can temporarily relieve pain symptoms.
2. Treatment of cancer metastasis In recent years, many studies have confirmed that the surgical resection effect of rectal cancer metastasis is not as pessimistic as originally thought. If the primary lesion can be removed at the same time as liver metastasis, the survival rate can be improved. Segmental or wedge resection is feasible for a single metastatic focus. If multiple liver metastases cannot be surgically removed, the hepatic artery is ligated to make the liver tumor necrosis, and then fluorouracil and mitomycin are injected through the catheter inserted into the distal end of the hepatic artery. Hepatic artery embolization can also be used to significantly reduce the tumor volume. However, the above treatment is prohibited for patients with obvious jaundice, severe abnormal liver function, portal vein infarction and over 65 years old. Radiotherapy can improve the symptoms of some patients.
(7) Radiotherapy can effectively reduce the local recurrence of tumor.
Preoperative and postoperative radiotherapy is feasible. Preoperative radiotherapy can improve the curative effect of operation and reduce the recurrence rate of patients after operation; Postoperative radiotherapy can kill the residual tiny lesions. At the same time, it is suitable for patients with advanced stage or postoperative recurrence.
(8) Immunotherapy is inconclusive.
(9) Gene therapy for rectal cancer is still far away.
It can effectively reduce the local recurrence of tumor.
[Edit this paragraph] How to prevent rectal cancer
Because the cause of rectal cancer is not completely clear, there is no special prevention method so far. The preventive measures listed below are mainly aimed at reducing the chance of canceration and early detection and treatment of patients.
(1), actively prevent and treat rectal polyps, anal fistula, anal fissure, ulcerative colitis and chronic intestinal inflammatory stimulation; For multiple polyps and papillary polyps, once the diagnosis is clear, they should be surgically removed as soon as possible to reduce the chance of canceration.
2, the diet should be diversified, develop good eating habits, not partial eclipse, not picky eaters, not eating a high-fat, high-protein diet for a long time, and often eating some fresh vegetables containing vitamins and cellulose, which may play an important role in preventing cancer.
(3), prevent constipation, keep the stool unobstructed.
(4) Attach great importance to regular cancer screening, pay attention to self-examination at any time, improve vigilance, make timely diagnosis and treatment after discovering "early warning signals", and achieve early detection and early treatment to improve the survival rate of rectal cancer.
Principles of medication for rectal cancer:
Oral gentamicin, erythromycin, kanamycin and metronidazole were taken before operation to prepare the intestine, and plenty of water was used to supplement enteral nutrition drugs.
In addition to continuous infusion and application of antibiotics during and after operation, human albumin should also be infused according to specific conditions.
In case of postoperative complications, besides adjusting the use of sensitive antibiotics, it is necessary to strengthen support and symptomatic treatment.
[Edit this paragraph] Nursing measures and postoperative care of rectal cancer
[Nursing measures]
1, preoperative care
(1) Psychological nursing: When permanent artificial anus is needed, it will bring inconvenience and mental burden to patients. Care for patients, explain the necessity of surgery, and let patients receive surgical treatment in the best psychological state.
(2) Strengthen nutrition, correct anemia and enhance the body's resistance. Try to give a high-protein, high-calorie, high-vitamin, digestible and low-residue diet to increase the tolerance to surgery.
(3) Adequate intestinal preparation can increase the success rate and safety of the operation.
(4) Give intestinal antibiotics 3 days before operation to inhibit intestinal bacteria and prevent postoperative infection.
(5) Give rehydration 3 days before operation, and fast 1 day before operation, so as to reduce feces and facilitate bowel cleaning.
(6) Total intestinal lavage was performed before operation 1 day, and the effect of lavage was observed.
2, postoperative care
(1) Observe the patient's vital signs, the changes of his condition and the bleeding of the wound.
(2) After the operation, you can eat after fasting and gastrointestinal decompression until the intestinal peristalsis recovers. Diet should be gradual.
(3) Keep the drainage unobstructed and wash the drainage tube regularly according to the doctor's advice.
(4) Those who have a long-term indwelling catheter should clean the urethral orifice daily to prevent urinary tract infection.
(5) Keep the skin around the stoma clean and dry, and apply zinc oxide ointment or Lithospermum oil.
(6) Nursing of artificial anus.
[health education]
1, give patients dietary guidance, and eat only after intestinal peristalsis has recovered. Give priority to digestible foods, and avoid foods that are too thin or have too much crude fiber. Eat more soy products, eggs, fish, etc. Make the stool dry and easy to clean.
2. Teach patients to properly master the intensity of activity to avoid excessive activity to increase abdominal pressure and cause prolapse of artificial anal mucosa.
3. Let patients master the use of artificial anal bag. Before using the anal bag, rinse the surrounding skin with clear water and clean the anal bag at any time to avoid infection and reduce odor.
4, guide patients to master the nursing of artificial anus, regularly refers to the expansion, if found narrow or difficult defecation, timely to the hospital for review.
[Edit this paragraph] People at risk of rectal cancer
Colorectal cancer refers to cancers that occur in cecum, ascending colon, transverse colon, descending colon, sigmoid colon and rectum. It is the most common malignant tumor and ranks third among all kinds of malignant tumors. In recent years, the incidence of colorectal cancer in China has shown an obvious upward trend, and the incidence rate in Shanghai alone has increased by 2 ~ 3 times in 20 years. It is particularly noteworthy that the proportion of young people suffering from colorectal cancer is increasing. Although doctors believe that the increase of colorectal cancer is related to the increase of fat content in diet, the exact reason is not clear. At present, the medical community knows that some diseases are closely related to colorectal cancer, and people with these diseases are called high-risk groups of colorectal cancer. Therefore, it is very beneficial to understand these diseases and vulnerable groups from the perspective of prevention and early diagnosis.
Polyp of large intestine: Polyp is a kind of vegetation growing from intestinal mucosa, with different sizes, shapes, numbers and positions. There are more middle-aged and elderly patients over 40 years old, and polyps increase with age. The disease can be diagnosed by colonoscopy. The origin of polyps can be divided into two categories: adenomatous and proliferative (inflammatory). It is known that adenomatous polyp, especially multiple adenomatous polyp with a diameter greater than 1 cm, has a high risk of canceration, which is called precancerous lesion of colorectal cancer and must be removed. Even if patients with adenomatous polyp are cured, they should be reviewed regularly to see if there is any recurrence.
Ulcerative colitis: generally not colitis, the main symptom is recurrent purulent blood. Colonoscopy showed colitis with aphthous ulcer. The canceration probability of ulcerative colitis is 5 ~ 10 times higher than that of normal people, especially when it is young, and the lesion has been active, with a wide range of lesions, and the risk of canceration is greater if the course of disease exceeds 5 years. It is worth noting that in recent years, the number of patients with ulcerative colitis in China has increased significantly, and the number of cancer patients caused by it has also increased.
Schistosomiasis japonica: This disease is prevalent in the south of the Yangtze River in southern China. Schistosoma japonicum eggs exist in the large intestine mucosa for a long time, which stimulates the intestinal mucosa and leads to canceration. Compared with areas without schistosomiasis, the detection rate of colorectal cancer in the hardest hit areas is 12.3 times higher.
Pelvic radiotherapy: patients with uterus and ovarian cancer often receive radiotherapy, and the incidence of rectal cancer is 4 times higher than that of ordinary people, especially those who have received radiotherapy after 10 years and have a large dose.
Patients who have suffered from colorectal cancer before: About 2% ~ 1 1% of patients with colorectal cancer have a second primary colorectal cancer focus (no recurrence) after treatment of the first cancer focus, which is called metachronous multiple. Therefore, patients should not sit back and relax because they have received treatment, but should be reviewed regularly. People who have undergone surgery for ovarian cancer and breast cancer in the past, or who have undergone ureter sigmoid colon anastomosis, are also at high risk for colorectal cancer.
Family members of patients with colorectal cancer: the incidence of colorectal cancer in patients with family history is three times higher than that in those without family history, which may be related to the same eating habits except genetic factors.
Others: patients after cholecystectomy, patients after small bowel anastomosis, workers in asbestos processing industry and textile industry are also at high risk.
Dietary principles of patients with rectal cancer
The diet of patients with intestinal cancer should be diversified, not partial eclipse, not picky eaters, not eating a high-fat and high-protein diet for a long time, and often eating fresh vegetables rich in vitamins and anti-cancer foods. Such as tomatoes, dark green and cruciferous vegetables (celery, radish, cabbage, mustard, radish and so on. ), bean products, citrus fruits, malt and cereals, onions, garlic, ginger, yogurt, etc.
Dietary principles of patients with rectal cancer
(1) Patients with colorectal cancer have recurrent and persistent diarrhea and weak digestive ability, so they should be given food that is easy to digest and absorb.
(2) Patients with colorectal cancer often have bloody stools, and patients with advanced stage often have a lot of bloody stools, so they should eat less or refuse to accept irritating and spicy food.
(3) Patients with chronic diarrhea or late stage have long-term fever, sweating and body fluid damage, so they should drink more water or soup. The staple food can be semi-liquid Yunnan diet such as porridge and noodles.
(4) Patients often have symptoms such as loss of appetite, nausea and even vomiting, so they should eat lightly and avoid greasy food.
(5) Patients with advanced colorectal cancer suffer from long-term diarrhea, bloody stool, fever, massive loss of nutrition and water, emaciation, weight loss and deficiency of both qi and blood, so they should take nutritious and juicy medicated diet.
[Edit this paragraph] Dietary tips for rectal cancer:
Eat less smoked food, fried food, too spicy, too irritating and indigestible food for rectal cancer.
(1) The more animal fat you eat from your diet, the greater the risk of dissolving and absorbing carcinogens.
(2) High-fat diet can increase the secretion of bile acids in the intestine, which has potential stimulation and damage to the intestinal mucosa. If you are in this kind of stimulation and injury for a long time, it may induce the production of tumor cells and lead to colorectal cancer.
Dietary advice 1
(1) Eat less or not eat foods rich in saturated fat and cholesterol. Include lard, butter, chicken oil, sheep oil, fat meat, animal viscera, roe, squid, cuttlefish, egg yolk, palm oil and coconut oil.
(2) Vegetable oil, peanut oil, soybean oil, sesame oil, rapeseed oil, etc. Each person is limited to about 20 to 30 grams a day, about 2 to 3 tablespoons.
(3) Do not eat or eat less fried food.
(4) Eat foods containing monounsaturated fatty acids in moderation, such as olive oil and tuna.
(5) Avoid overheating of animal food and vegetable oil when cooking.
(6) Dietary fiber intake. The main force to prevent colorectal cancer is to increase the intake of dietary fiber, which can reduce the incidence of colorectal cancer. The reason may be that dietary fiber has strong water absorption, which can increase the volume of feces, shape feces, facilitate defecation, and reduce the concentration of carcinogens in the intestine, thus reducing the risk of colorectal cancer.
Dietary advice 2
(1) Take more than 30 grams of dietary fiber every day.
(2) Eat more foods rich in dietary fiber. Such as konjac, soybean and its products, fresh vegetables and fruits, algae and so on.
(3) On the premise of keeping the amount of staple food unchanged, replace flour and rice with some coarse grains.
(4) Intake of vitamins and trace elements. Vitamins and trace elements play an important role. Scientific research shows that vitamin A, beta-carotene, vitamin C, vitamin E and trace element selenium all have potential functions of preventing malignant tumors.
Dietary advice 3
(1) Eat more fresh vegetables and fruits, and supplement carotene and vitamin C.
(2) Eat more walnuts, peanuts, dairy products, seafood, etc. Appropriate vitamin e supplementation ..
(3) Pay attention to ingesting foods rich in trace element selenium such as malt, fish and mushrooms.
(4) If it is difficult to ensure the intake of the above foods for various reasons, a mixture of vitamins and minerals can be supplemented appropriately.
[Edit this paragraph] Common complications of rectal cancer
1, intestinal obstruction tumor enlargement can lead to intestinal stenosis, intestinal contents through obstacles, and lead to mechanical intestinal obstruction.
2. Intestinal perforation has typical clinical manifestations of acute abdomen, such as abdominal muscle tension, tenderness and rebound pain. X-ray plain film shows crescent-shaped free gas under nasal septum, which can be preliminarily diagnosed.
3. Hemorrhage Acute massive hemorrhage is a rare complication of colorectal cancer.
Common complications of radiotherapy
Complications of radiotherapy include local injury and systemic injury. Local injuries include radiation dermatitis, radiation enteritis and radiation osteitis. Systemic injury includes digestive system reaction and bone marrow suppression.
1) local injury: ① radiation dermatitis: at the initial stage of radiation, the skin is red and itchy, similar to the change of solar dermatitis; In the middle stage of radiation, the skin is pigmented, thickened and rough, and the pores are thick and black; In the late stage of radiation, wet peeling, local skin edema, blisters, ulceration, erosion and even ulcers may appear in skin folds and groin areas. ② Radiation enteritis: Patients in the middle and late stage of radiation may feel abdominal discomfort, which will be aggravated after eating or drinking water, and in severe cases, intestinal obstruction may occur. This is due to the congestion and edema of intestinal mucosa under radiation injury; ③ Soft tissue fibrosis: it appears in the late stage of radiation, often showing local tissue sclerosis and normal tissue losing elasticity;
2) General adverse reactions: ① Digestive tract reactions: patients often have dry mouth and dry stool in the early stage of radiotherapy; In the middle and late stage of radiotherapy, patients may have loss of appetite, nausea and vomiting; ② Bone marrow suppression: It mostly occurs in the late stage of radiotherapy, characterized by general weakness and the decrease of WBC in hematological examination.