Cancer of the colon and rectum

Cancer of the colon and rectum is after gastric cancer the second place among all malignant tumors of the gastrointestinal tract. Pathogenesis it currently is as unclear as the mechanism of occurrence of malignant tumors of any localization.
Most often the cancer is localized in the left parts of the colon (51,5%), the defeat of the right departments observed in 29.5% of cases (C. I. Knish and others, 1982).
Cancer of the colon and rectum occurs, as a rule, from cylindrical epithelium (adenocarcinoma). Cancer of the anus and perianal skin is in the nature of squamous cell carcinoma.
When assessing the incidence of tumors of the rectum is the value of the designated alperna the degree of infiltration of the tumor. In cases where the tumor is located on the mucosal surface, easily movable and juts out into the rectum (which is more likely to occur when the cancer of polyps), you can count on a limited its character and the absence of metastases.
If tumor spreads to the wall of the rectum, its seal, but the preservation of the mobility of the tumor should be considered with the possibility of regional metastases in the lymph nodes, and occasionally hematogenous. Finally, when the cancer has moved to fiber pelvis and palpation motionless as a rule, are metastases in regional lymphatic nodes, and hematogenous transfers to distant organs.
When a tumor is located in the distal rectum at 5-6 cm from the anal opening metastases can be in the inguinal lymph nodes, hips, and lower - during medium pryamokishechnye arteries. In cancer of the upper section of capsules, and rectosigmoid Department should expect the appearance of metastases in the course of the upper pryamokishechnye and inferior mesenteric artery.
Clinical symptoms of cancer of the colon depends on the stage of the disease, histological structure of tumor, its location and extent of the process.
The most characteristic signs of colorectal cancer occur, usually when the tumor has reached a sufficient size and Izyaslavich. These include primarily the allocation of clots of dark blood, usually before defecation, tenesmus, and the changing nature of the chair - occurrence of constipation, rarely alternating with diarrhea.
In later stages, these signs can join the following: severe anemia with pale-yellowish colour of the skin (intoxication); delay or difficulty selection of feces when strictures cancers; severe pain in the area of small pelvis and sacrum and sometimes dysuric phenomena in cases of tumor invasion fibre in the pelvis or adjacent organs (prostate, urethra, uterus, periosteum of the sacrum).
No doubt that all these symptoms of rectal cancer are manifestations far advanced, or even running its forms. On the contrary, the initial and early stages of cancer of the rectum, when the process hasn't hit ulceration or germination of the rectal wall, poor symptoms. Patients mark in such cases, some violations of the normal rhythm of defecation with constipation, and sometimes a feeling of heaviness or blurred constant filling the rectum. Occasionally, the disease is totally asymptomatic and opened accidentally when finger or rectoskopia the examination of the rectum.
Cancer rectosigmoid Department can be found both in the form of syezjinskaya adenocarcinoma (then the main clinical manifestation of it is the allocation of blood and mucus in bowel movements), and in the form of Skira. In the latter case often circular stricture of the bowel lumen, which cause the appearance of persistent constipation, followed by a relative or even a complete bowel obstruction.
The diagnosis of cancer niinianoaoao Department of the rectum can be supplied with one finger research. However, in these cases it is advisable to perform a sigmoidoscopy, to examine the surface of the tumor and, beating it, if possible, examine the upper parts of the intestine. Sigmoidoscopy is also necessary for a biopsy of the tumor.
It should again be noted that the basic diagnostic method for the detection of tumors of the rectum and distal sigmoid colon is a sigmoidoscopy.
Long-term practice shows that rectoromanoscopy study should be considered complete only if the device is inserted to a depth of 30 cm
In this detailed inspection shall be subject to all the mucous membrane of the intestine, especially in the areas of physiological bends (at a depth of 6-8 cm from the anus, in the field rectosigmoid Department and at the depth 23-25 cm, in the distal sigmoid colon). It is in these "blind" zones, with folds, may be overlooked small tumors.
Experience teaches that in General the most detailed examination of all the mucosa and especially these zones is possible in the process of extraction of rectoromanoscopy, when widely disclosed the bowel lumen, smoothed the folds of mucous, and to some extent straightened physiological bends.
When a tumour in the colon clinical symptomatology very non-specific. A disorder of the bowel, abdominal pain, weakness, weight loss, minor Muco-spotting from the rectum, anemia and other changes in the blood (leukocytosis, left shift formula, elevated erythrocyte sedimentation rate) - all these symptoms are observed like in colon cancer and other inflammatory bowel diseases. Often nonspecific ulcerative colitis, villous tumor, appendiceal infiltrate and other mistakenly regarded as colon cancer.
Differential diagnosis is sometimes so difficult that the final diagnosis is only installed on the operating table.
When cancer blind and ascending colon is a pain, not always corresponds to the location of the tumor. Pain in cancer of the localization can be felt sick in the right kidney, and sometimes iradionet in the right half of the thorax and sometimes regarded as the exacerbation of chronic cholecystitis. The functional bowel disorders are generally mild. In these patients is dominated by somatic disorders and progressive anemia.
In cancer of the transverse colon and splenic angle quite early symptoms occur partial intestinal obstruction, reflected in persistent constipation, bloating, local pain.
When the cancer location in the descending colon and proximal sigmoid intestine in the clinical picture at the forefront are the symptoms of functional bowel disorders (constipation) and pathological discharge from the rectum.
We have described the clinical picture of colon cancer of various localizations in the period already significant development of the pathological process. However, it is extremely important to know the initial symptoms of this terrible disease, to treat them with high cancer wariness. Therefore, we consider it important to emphasize the following.