Moderator: Where is the rectum in the human body?
Chen Lin: The digestive tract of human body is divided into esophagus, stomach, small intestine and large intestine. The rectum is located at the end of the large intestine, about 15 cm above the anus, and is divided into three parts: upper, middle and lower, as shown in the figure.
Moderator: What is the main function of rectum?
Luo Chenghua: As shown in the figure, there is an annular sphincter around the lower end of rectum, which plays a role in controlling contraction. Usually in the contraction state, but relaxed during defecation, resulting in defecation reflex. After suffering from rectal cancer, there will be a series of symptoms in defecation, such as stool frequency, stool shape and stool regularity.
Moderator: What is rectal cancer?
Zhenlin: Rectal cancer is a malignant tumor of rectal mucosa epithelium. The incidence of rectal cancer is very high in China. Rectal cancer is mostly in the middle and lower rectum, and the onset age is young, about 45 years old.
Moderator: What symptoms does the patient have after suffering from rectal cancer?
Luo Chenghua: There are no symptoms in the early stage of rectal cancer, but when it develops to a certain extent, there will be symptoms, such as defecation dysfunction, increased defecation times, thin defecation, bloody stool, abdominal pain, vaginal bleeding, bladder compression, sacrococcygeal pain, proctoptosis and so on.
Moderator: Will rectal cancer metastasize?
Chen Lin: Rectal cancer will not metastasize in the early stage, but it will metastasize after it develops to a certain extent, such as to the surrounding lymphatic system and blood system.
Moderator: Why do you suffer from rectal cancer?
Luo Chenghua: Dietary factors, genetic factors, physical factors, benign diseases, familial colon polyps, ulcerative colitis, heart disease, etc.
Moderator: What kind of diet can induce rectal cancer?
Chen Lin: A high-protein, high-fat, high-calorie and low-fiber diet is a factor inducing rectal cancer. In addition, eating too much beef and mutton will lead to a higher incidence of rectal cancer.
Moderator: What foods can prevent the occurrence of rectal cancer?
Luo Chenghua: The dietary formula recommended by the American Anti-Cancer Association: to reduce fat intake, it should account for less than 30% of the total calories a day, eat more cellulose, more than 30 grams a day, and eat more vitamins, among which vitamin C has anti-cancer effect, eat more fruits and vegetables, and also prevent obesity, eat less fried and pickled foods, and do more activities.
Moderator: Can rectal cancer be inherited?
Luo Chenghua: 50% of familial rectal polyps will be inherited. If left untreated, they will eventually develop into rectal cancer. In addition, non-polypoid rectal cancer is also hereditary, and other rectal cancers also have the trend of family aggregation, so the prevention of the day after tomorrow is very important.
Moderator: How to develop rectal cancer at an early stage?
Chen Lin: People should popularize health knowledge and go to the hospital for examination as soon as possible after symptoms appear, such as direct rectal examination, anoscopy and proctoscopy.
Moderator: What is a direct rectal examination?
Luo Chenghua: The doctor put on gloves and put his index finger into the anorectal cavity for examination. 80% of rectal cancer can be found by direct rectal examination.
Moderator: How to treat rectal cancer?
Chen Lin: The first choice for treatment is surgery, which is divided into anus-preserving surgery, that is, no shunt surgery. It is suitable for tumors located above 8 cm, and shunt surgery is needed for tumors located below 6 cm.
Moderator: What about postoperative recurrence?
Luo Chenghua: If the patient's body permits and there is no distant metastasis, it is recommended to have another operation.
Moderator: If you have rectal cancer and want to keep the anus, how to treat it?
Chen Lin: If the position of rectal cancer is more than 8 cm and there is no metastasis, you can keep the anus. The tumor must be completely removed, otherwise it will lead to recurrence.
Moderator: Ms. Wang/KLOC-0 from Beijing had rectal cancer surgery and artificial anus in 1999. She relapsed last August. How to treat it?
Luo Chenghua: It depends on the site of tumor recurrence. Most of them are pelvic local recurrence, which can be diagnosed by B-ultrasound, CT and other examinations. If there is no distant metastasis and no invasion of great vessels, a second operation is recommended.
Moderator: Mr. Li from Hebei has been undergoing Maxwell's operation for two years. Since June 5438+ 10 this year, the coccyx is a little numb. How to treat it? Can Maxwell change it back after surgery?
Chen Lin: I suggest going to a hospital for a checkup to see what causes numbness. If it recurs, it can be removed, and mcnair can't change it after the operation.
Moderator: Ms. Peng from Shanxi has suffered from hemorrhoids for many years, and sometimes she has bloody stool. How is it different from rectal cancer? Will it become cancerous?
Chen Lin: Hemorrhoids are a common disease, similar to the early symptoms of rectal cancer. Patients should go to the hospital for examination. Hemorrhoids generally do not become cancerous.
Moderator: Mr. Xia of Inner Mongolia discovered early colon cancer two years ago, and now it has been very good after surgical resection. Will it happen again?
Luo Chenghua: After resection of colon cancer, the recurrence rate is much higher than that of normal people, so patients should check the remaining rectum regularly every year after operation.
Moderator: What problems should patients pay attention to after operation?
Luo Chenghua: Patients should adjust their diet after operation to prevent constipation. If the anus is preserved, the frequency of defecation will increase. You can take some antidiarrheal drugs If the anus is shunted, the anus should be dilated regularly, at least twice a week for 5 minutes each time to avoid anal stenosis and protect the surrounding skin. Surgery can also affect the bladder nerve, but it will recover after a long time.
Moderator: Ms. Zhang from Fujian 1998 had rectal cancer surgery, which resulted in incontinence after operation. What's the matter? How to treat it?
Chen Lin: Surgery will affect the nerves of the bladder, but usually after a period of time, patients can recover or go to the hospital for treatment.
Moderator: Mr. Zhao in Beijing suffered from proctitis and colitis for 32 years. 1992 basically recovered, but sometimes pus appeared. In the past three months, his weight has dropped from 135 kg to 96 kg. Will he get rectal cancer?
Luo Chenghua: Biopsy is recommended. The canceration rate of ulcerative proctitis and colitis is very high. It is suggested to perform surgical resection and take some antidiarrheal drugs to avoid nutrient loss.
Moderator: Ms. Wu from Hebei has been constipated for a long time, and sometimes she only defecates once every 1 week. Is it easy to get rectal cancer?
Chen Lin: A low-fiber diet can lead to constipation. Long-term constipation is also harmful to health. It is suggested that constipation should be treated as soon as possible.
Compere: Suffering from rectal cancer, if not operated, how to treat it?
Chen Lin: Most patients with rectal cancer can be treated by surgery. If the tumor is in the advanced stage and has metastasized, the purpose of surgical treatment will be lost if the patient's physical condition does not allow it. At this time, local radiotherapy, systemic chemotherapy, biotherapy and traditional Chinese medicine treatment can be performed.
Moderator: Mr. Yuan from Beijing, can rectal cancer be completely cured by gene therapy?
Chen Lin: Gene therapy is still in the research stage and has not been applied to clinic.
Moderator: Mr. Zhu from Sichuan was diagnosed as rectal adenoma. What is the relationship between rectal adenoma and rectal cancer?
Luo Chenghua: Rectal adenoma is a benign tumor, which is related to rectal cancer. Early surgical resection is recommended because the incidence of rectal cancer is also high in areas with high incidence of rectal adenoma. If rectal adenoma is well controlled, the incidence of rectal cancer can be reduced by 85%. Generally, rectal adenoma will become cancerous after growing for more than 5 years. The bigger the adenoma, the higher the canceration rate. If the adenoma is less than 0.5 cm, laser resection can also be performed.
Moderator: Ms. Jilin Ding underwent total pelvic resection for rectal cancer, and the ureter was anastomosed with sigmoid colon. What effect does defecation have on the body?
Chen Lin: A bowel movement will bring inconvenience to the patient's life and may also lead to infection. It is suggested to eat more diuretic food, but the overall impact is still relatively small.
Moderator: Ms. Dai from Shanghai suffers from rectal cancer, which is more than 0 cm away from anus/kloc-0. She has had surgery and chemotherapy for six months. Now she has two or three stools a day, sometimes it is hard. Do you still need radiotherapy? Hyperglycemia occurred after the fifth chemotherapy, and now the blood sugar is 8mg. Is it related to rectal cancer?
Luo Chenghua: After rectal cancer surgery, if the anus is preserved and the resection is not clean, radiotherapy can be done. If the excision is clean, only chemotherapy can be used without radiotherapy to avoid radiation cystitis and frequent urination. In addition, hyperglycemia has nothing to do with chemotherapy.
Moderator: Ms. Wang, a lover of Shaanxi, had a recurrence after rectal cancer surgery. Some doctors say that surgery can be performed, and some doctors say that surgery is of little significance. Under what conditions can it be operated?
Chen Lin: Postoperative recurrence of rectal cancer. If physical conditions permit, you should have another operation. If the recurrent tumor has spread and metastasized, surgery cannot be performed. Chemotherapy, traditional Chinese medicine and immunotherapy can be performed.
Moderator: Mr. Gao's father is 79 years old in Jiangsu. He has rectal cancer, but he has a serious heart disease. The doctor said he couldn't be treated surgically. What kind of treatment can he get?
Luo Chenghua: If physical conditions do not permit, other adjuvant therapies can be used, such as radiotherapy and chemotherapy, traditional Chinese medicine and immunotherapy. The radiation head can be inserted into the rectal cavity and the effect will be better. In addition, chemotherapy drugs can be injected into the rectal cavity to reduce side effects.
Chen Lin: Now the cardiac monitoring instruments are very good, and many patients with heart disease can also have operations under close supervision.
Moderator: Tianjin Mr. Liu's lover has just finished rectal cancer surgery and has a fake anus in his left lower abdomen. Will he swim in the future?
Luo Chenghua: After rectal cancer surgery, if the fake anus is well cared for, the general life will not be affected, and the defecation function of the fake anus should be trained regularly.
Chen Lin: After rectal cancer surgery, we should pay attention to regular review.