Adenocarcinoma of the sigmoid colon

The most pressing problem in the field of oncology is colon and rectal cancer. One of the varieties of such cancer is adenocarcinoma of the sigmoid colon. In this case, we are talking about the development of a pathological process in the glandular tissues of the sigmoid colon.

The sigmoid colon is one of the sections of the large intestine, located on the left in the lower abdomen. It is called sigmoid because of its location in a certain shape. It begins after the colon and passes into the rectum, making several bends along the way.

Today, the problem of oncological diseases comes to the forefront in many countries of the world. The latest methods of diagnostics and treatment of various types of oncology are being developed and implemented, as the number of cases of oncological problems is growing, and younger groups of people are beginning to encounter such diseases.

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Causes of sigmoid colon adenocarcinoma

Unfortunately, there is no clear opinion about the causes of cancer. But we can talk with a high degree of certainty about the factors that influence the development of tumors, including malignant ones. In the case of problems with the large intestine, the most pressing problems are eating habits, lack of fiber, fresh fruits and vegetables, smoking, drinking alcohol, eating carcinogenic foods, and excessive use of household chemicals. In addition, genetic predisposition to such diseases, frequent nervous stress, and the use of large quantities of medications are important. Also, the most important factor influencing the condition of the intestine in general, and the large intestine in particular, is a sedentary lifestyle and sedentary activity. All this interferes with the normal functioning of the intestine, disrupts peristalsis, leads to stagnation of food masses, and also disrupts the blood supply to certain parts of the intestine. This can especially affect the sigmoid colon due to the peculiarities of its shape and location.

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Symptoms of sigmoid colon adenocarcinoma

The danger of sigmoid colon adenocarcinoma is very high. This is mainly due to the fact that at the initial stages it is completely asymptomatic. And at more complex stages of cancer, symptoms appear that in themselves do not directly indicate the occurrence of a tumor in the intestine. Such symptoms of sigmoid colon adenocarcinoma are called monotonous. Even if many of them manifest themselves, doctors may not only fail to notice possible signs of cancer in them, but also not connect them at all. Therefore, much attention is paid today to preventive measures. In particular, to undergoing regular preventive examinations so that, even if sigmoid colon adenocarcinoma is detected, the disease can be stopped at its earliest stages.

When symptoms are just beginning to appear, patients feel general weakness, nausea, fatigue sets in quickly, abdominal pain may bother them, periodic bowel movements may be observed, and the skin of the face may become pale. Later, a loss of appetite, weight loss, and a perversion of the sense of taste or taste habits may appear.

At later stages of development of sigmoid colon adenocarcinoma, symptoms already appear that indicate the localization of the problem - unnatural impurities and blood appear in the feces, general intoxication of the body occurs, as a result of which the liver enlarges, a yellowish tint of the skin appears, the abdomen enlarges. The most complex and remote symptoms are massive bleeding in the intestines, intestinal obstruction, and intestinal inflammation.

Moderately differentiated adenocarcinoma of the sigmoid colon

When it comes to cancer, it is also common to use such a concept as the level of differentiation of cancer cells among its characteristics. The level of differentiation is also called the Gleason score. According to this indicator, four types of tumors are distinguished: highly differentiated, moderately differentiated, poorly differentiated and undifferentiated tumors. The lower the Gleason score, the lower the level of cell differentiation.

When it comes to moderately differentiated adenocarcinoma, it means that the cells of the tumor are significantly different from the cells of the tissue in which the tumor arose. Although the difference is not so great that it allows us to accurately determine both the tumor site and the tissue that forms it. Moderately differentiated adenocarcinoma is characterized by not very intensive growth, the probability of metastasis is also small, at least in the initial stages of the disease. But in any case, even if the tumor detected in the sigmoid colon is of moderate differentiation, this is not a reason to postpone treatment or choose some kind of the most gentle regimen. Since the risk associated with this form of the disease is very high. Firstly, tumor growth is still present. The fact that it is not as fast as in undifferentiated or poorly differentiated forms of cancer does not mean that this is a completely non-threatening rate. Secondly, the probability of metastasis is quite high and depends on both the condition of the tumor itself and possible provoking factors. The latter may include any external stress, age and concomitant diseases, as well as even the method of treating the tumor itself.

Well-differentiated adenocarcinoma of the sigmoid colon

Highly differentiated adenocarcinoma of the sigmoid colon is one of the least dangerous variants of such a tumor. This is due to the fact that the cells of highly differentiated neoplasms differ little in their structure and properties from the tissue from which they were formed. And thus have a fairly low level of pathogenicity. In addition, if the level of cell differentiation is quite high, then such a tumor is characterized by slow growth, and rarely metastasizes. If we talk about the change in the cells themselves, then the main (and only) change in highly differentiated adenocarcinoma is an increase in the size of the cell nuclei.

Highly differentiated adenocarcinoma is quite successfully treated. Since such a tumor is not very aggressive, it is possible to select the most favorable conditions for the operation, there is an extremely small need to use auxiliary methods of therapy, such as chemotherapy or radiation therapy. Relapses of such tumors are also quite rare. However, constant monitoring is simply necessary. Especially in cases where the patient is at risk for this disease.

Poorly differentiated adenocarcinoma of the sigmoid colon

Low-differentiated adenocarcinoma of the sigmoid colon, like other low-differentiated tumors, is extremely aggressive. First of all, it is characterized by fairly rapid growth, so the situation may change from the moment the problem is detected to the moment of specific surgical actions. In addition, if the tumor cells are poorly differentiated, it is quite difficult to determine which tissue or even which organ is the starting point of the tumor process. Such a tumor itself often metastasizes during its development. In addition, there is a possibility that the operation itself to remove a low-differentiated tumor can provoke the appearance of metastases. Therefore, special attention is paid to the patient during such operations and preparation for them.

Despite the danger of low-differentiated adenocarcinomas, sometimes surgery may not be recommended. This happens when the risk of metastasis during surgery is higher than the risk of the tumor itself (for example, if the tumor growth rate is relatively low for this type of tumor). Low-differentiated adenocarcinoma is difficult to control, but nevertheless, even with this type of tumor, you should not make hasty decisions about its treatment; you need to take into account the patient's other illnesses, general condition, and ability to tolerate certain types of treatment.

Diagnosis of adenocarcinoma of the sigmoid colon

Sigmoid colon adenocarcinoma is diagnosed both based on patient complaints and using hardware methods of examination and inspection. Symptoms of sigmoid colon adenocarcinoma are quite indirect, but at the slightest suspicion that there may be problems with the large intestine, it is worth contacting a proctologist.

The simplest and most basic diagnostic method may be palpation. That is, the doctor manually feels the rectum and sigmoid colon to a certain depth. If there is a tumor there, such an examination will reveal it. More technically complex, but more informative is such a method of examination as rectoscopy. This procedure involves a visual examination of the rectum and the lower third of the sigmoid colon. For this, a rectoscope is used, which is a tube with a lighting device at one end. First, air is supplied through the rectoscope to expand the intestinal cavity, and then an eyepiece is inserted for examination. This allows not only to examine the internal organs, but also, if questionable formations are detected, to take a biopsy from a section of the intestine.

Another informative diagnostic method is irrigoscopy. These are actually X-ray images of the intestine. For this, a contrast agent is introduced through the rectum. This method of introduction allows for the expansion of the intestine due to its dense filling. In this case, the outline of the large intestine (including the sigmoid section), its shape, location, size, and features are first examined. After this, after partial emptying of the intestine and a lesser degree of expansion, possible pathologies and the relief of the intestinal mucosa are examined. Also after this, the intestine can be filled with air for a more detailed study. This method is called double contrasting. As a result of the study, both overview and targeted images are taken.

Another popular method of examination today is colonoscopy. In essence, it is similar to rectoscopy, but the main difference is that with colonoscopy, the entire large intestine can be examined. That is, in this case, it is more informative, since it allows for an examination of the entire sigmoid colon, and not just its lower third. As with rectoscopy, it is possible to perform a biopsy, as well as remove small formations. The procedure is also performed under visual control. In addition, it will be relevant to conduct ultrasound diagnostics of the intestine, which is widely used today.

Diagnostic methods that involve the ability to visually assess the condition of the intestines are more likely to be able to identify adenocarcinoma at the early stages of its occurrence. And the fact that such methods allow tissue samples to be taken allows for a more accurate assessment of the patient's health.

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Treatment of adenocarcinoma of the sigmoid colon

Regardless of the severity of sigmoid colon adenocarcinoma, the main method of its treatment is surgery.

Chemotherapy is also used. It can be mono- or polycomponent. But in this case, it acts as an auxiliary method. Since its low efficiency in this disease has been proven. Chemotherapy can be used both before and after surgery. Radiation therapy is also a popular method of cancer treatment. But in the case of adenocarcinoma of the sigmoid colon, it is used quite rarely. This is due to several factors. Firstly, there is a risk of perforation, that is, through damage to the intestine, and secondly, it has been proven that such a type of cancer as adenocarcinoma has a very low sensitivity to radiation therapy.

During surgical intervention, a resection is performed, that is, the removal of a part of the sigmoid colon. This type of cancer, adenocarcinoma, grows quite slowly, and metastasis is unlikely. Therefore, if the disease is detected at fairly early stages, an operation can be performed that will not only lead to a complete cure, but will also allow for the removal of only a small part of the intestine. If surgical intervention occurs at fairly late stages of the disease, the operation significantly reduces the risk of complications.

Prevention of sigmoid colon adenocarcinoma

When talking about the prevention of a particular disease, it is worth addressing the causes of its occurrence. In the case of adenocarcinoma of the sigmoid colon, preventive measures will mainly be aimed at minimizing irritation of this area of the intestine. The sigmoid colon has a number of features due to its location. It is located immediately in front of the rectum, has bends, due to which stagnation of feces can occur. Thus, the contents of the intestine press on the walls, creating unnecessary irritation. This can be avoided if everything is in order with intestinal peristalsis. An active lifestyle and sports can contribute well to this. Also, the most important role for the proper functioning of the large intestine is the use of fiber. These are fresh leafy vegetables, greens, apples, root vegetables. Eating salads using raw vegetables and fruits. The human body itself does not break down fiber, but symbiotic microorganisms of the large intestine do. Therefore, for its normal functioning it is necessary to maintain the balance of microflora. Fermented milk products, sufficient water consumption, and healthy nutrition can help with this.

More general factors also play an important role. It is necessary to avoid strong nervous stress, eliminate bad habits, reduce the consumption of carcinogenic products to a minimum, monitor the amount of food consumed (overeating will also negatively affect the functioning of the intestines and all internal organs).

But the main means of preventing sigmoid colon adenocarcinoma is regular screening. During preventive examinations, it is possible to detect changes in the intestine that may not yet be adenocarcinoma, but nevertheless require treatment.

Prognosis of adenocarcinoma of the sigmoid colon

The prognosis for adenocarcinoma of the sigmoid colon, like many other diseases, largely depends on when exactly the disease was discovered, the specifics of its development, and the possibilities of maintaining the situation after treatment.

In general, if problems with the sigmoid colon make themselves known quite early, this often happens in cases where the patient is used to paying attention to his digestion, then the prognosis is quite good. Adenocratic colon is a type of neoplasm that has been studied quite a bit to date. In addition, there are a large number of modern treatment methods. Surgery can be performed without large incisions on the abdomen.

However, if the disease occurs in young people, the prognosis worsens. This is due to the fact that in a young organism, cell division is more active, so the tumor will develop more rapidly.

Also of great importance is how much the pathological cells have grown into the intestinal tissue. The deeper the pathological tissue has penetrated, the worse the prognosis.

The presence of metastases plays an important role. The fewer of them, the better the prognosis of sigmoid colon adenocarcinoma.

Of course, the size of the tumor, concomitant diseases, and general health status directly influence the prognosis.