Adenocarcinoma of the large intestine

Adenocarcinoma of the large intestine is a cancerous disease that occupies one of the leading places among oncological lesions of internal organs. Let's consider features of the given illness, a symptomatology, stages, methods of treatment and the forecast on convalescence.

Such a concept as colon cancer includes malignant tumors of various types that are localized in the anal canal, the blind, the rectum and the colon. The disease develops from epithelial tissues and metastases with lymph flow, so a favorable prognosis is possible only in the early stages. The danger is that it is almost impossible to recognize cancer at the initial stages.

Most often, the disease is diagnosed in elderly patients. The risk of developing an ailment increases significantly if a person is more than fifty years old. But timely identified and properly differentiated adenocarcinoma facilitates the process of treatment. There are several degrees of cancer differentiation, which are included in the international classification of intestinal tumors, consider them:

• Highly differentiated.
• Moderately differentiated.
• Low-differentiated (mucocutaneous adenocarcinoma)
• Undifferentiated cancer (aggressive course and poor prognosis).

[1], [2], [3], [4], [5]

Causes of colon adenocarcinoma

The causes of adenocarcinoma of the colon are due to many factors. Having identified the cause of the disease, you can prevent its development. There are a number of factors that significantly increase the risk of oncology:

• Hereditary predisposition.
• Elderly age.
• Irrational nutrition (deficiency of vitamins, minerals and trace elements).
• Papillomavirus infection.
• Adverse effects of various drugs.
• Anal sex.
• Prolonged constipation.
• Diseases of the large intestine (fistulas, tumors, colitis, polyps).
• Nervous disorders.
• Harmful working conditions, including work with asbestos.

Of course, most often combine several factors that cause the disease. Restricting yourself from predisposing factors can prevent the development of oncology.

[6], [7], [8], [9], [10]

Symptoms of adenocarcinoma of the colon

Symptoms of adenocarcinoma of the colon at an early stage of the disease are of an uncertain nature. The patient complains of periodic abdominal pains, constipation and diarrhea, poor appetite and even nausea. But, none of these symptoms points directly to the oncologic lesion of the large intestine. At the first stage of the disease, bloody and mucous traces appear in the feces, which later turn purulent. Such phenomena are of a permanent nature, but do not reach a significant extent. Through time all of the above symptoms increase. When examined by a doctor, a specialist can propalp the tumor through the abdominal wall, it is mobile, dense and tuberous.

The main symptoms are:

• Periodic aching pain in the abdomen.
• Poor appetite, nausea, rapid weight loss.
• General weakness and fever.
• Alternation of constipation and diarrhea.
• Flatulence, difficulties with defecation.
• Pale skin.
• Blood, mucus and pus in stool.

Against the background of the above-described manifestations of the disease, gastric ailments appear-nausea, a feeling of heaviness, heartburn, vomiting. As the tumor grows, the pain becomes more intense. Its growth is associated with the fusion of malignant neoplasm with surrounding tissues and organs. Due to local specific conditions, that is fecal masses and regular mechanical and chemical effects, the tumor is ulcerated. Against this background, an infection that increases local symptoms, causes a rise in temperature, intoxication and changes in the composition of the blood. If the infection spreads to the retroperitoneal tissue, then there are painful sensations in the lumbar region and peritoneal phenomena.

In the early stages, the cancer has the appearance of overhanging formations in the form of fungi. The tumor is divided into three types: annular, mushroom-shaped and infiltrating forms. When cut, its surface can be granular, solid or grayish-white. If we consider the disease from the point of view of the spread of the tumor process, then four stages are distinguished with this symptomatology:

• The tumor does not go beyond the submucosal and mucous membranes.
• It bulges on the internal lumen of the intestine, but does not metastasize. If metastases occur at this stage, they affect the entire thickness of the intestinal wall.
• Metastasizes to regional lymph nodes.
• Neoplasm reaches large dimensions, affecting neighboring organs, metastasizes to lymph nodes and far-away organs.

Differential adenocarcinoma of the colon

Differential adenocarcinoma of the colon is well treatable, unlike other histological variants of the tumor. If the disease was detected at an early stage of development, then the treatment is used chemotherapy or radiation therapy. This allows you to slow the growth of the tumor and prevent metastasis. Later, the patient is operated and completely removed the malignant tumor with further restoration of intestinal integrity.

Differential cancer has a positive prognosis of five-year survival for patients of all ages. To prevent its development, it is necessary to undergo regular medical examinations, and at the first pathological symptoms do not postpone the trip to the doctor.

[11]

Highly differentiated adenocarcinoma of the large intestine

Highly differentiated colon adenocarcinoma has the most favorable prognosis and course. Oncology of this type has a minimal number of malignant cells. During the pathological process, the affected cells increase in size, and their nuclei are lengthened.

Five-year survival of patients with this type of disease is at the level of 50%. Positive prognosis are of elderly people, since cancer practically does not metastasize and does not affect neighboring organs. But young patients have a 40% chance of recovery and a five-year survival rate. There is a high risk of recurrence of the disease in the first year after surgery and distant metastasis.

Moderately differentiated adenocarcinoma of the large intestine

Moderately differentiated adenocarcinoma of the colon is the most common form of malignant involvement of this organ. Progression of the disease leads to serious consequences, since the expanded epithelial cells fill the entire lumen of the intestine, causing intestinal obstruction. If the tumor reaches a large size, then this can lead to rupture of the intestinal wall and strong internal bleeding.

Treatment should be carried out from the earliest stage, since with the onset of injury, damage to nearby organs begins. Very often the disease leads to the formation of fistulas and peritonitis, which significantly worsens the prognosis and the overall course of the disease. Oncology is not amenable to therapy, because of the difficulties in selecting effective drugs for chemotherapy. Radiation irradiation or surgical intervention does not bring the required results without additional treatment. Therefore, the prognosis depends entirely on the early diagnosis of the disease.

Low-grade adenocarcinoma of the large intestine

Low-grade adenocarcinoma of the colon differs in expressed cellular polymorphism. Neoplasm rapidly proliferates and metastasizes, so it has a poor prognosis. This form of cancer is much more dangerous than other differentiated species. Unlike mucous, colloidal or squamous cell carcinomas that have an aggressive course, the prognosis and course of the low-grade form are much worse.

Treatment does not bring positive results, so the survival prognosis is unfavorable. The only thing that can help a patient with this ailment is symptomatic therapy. It is aimed at reducing painful sensations, to alleviate the condition of the patient.

Tubular adenocarcinoma of large intestine

Tubular adenocarcinoma of the colon for a long time could not be diagnosed. This is due to the fact that in the early stages it does not have severe symptoms, but with further progression causes latent intestinal bleeding and anemia. In certain cases, the neoplasm can produce a large amount of a protein and potassium rich mucous substrate, which provokes the development of hypokalemia and hypoproteinemia. Most often, this type of tumor is detected by chance, for example, with X-ray examination.

The tabular form has a characteristic implanted in a fibrous stroma and a branched structure. Tumor cells can be cylindrical, and sometimes also cubic. The disease is difficult to treat and has an unfavorable prognosis.

Metastases with colon adenocarcinoma

Metastases with colon adenocarcinoma affect other organs, as well as lymph nodes. Metastasis is carried out in several ways: during implantation and germination of the tumor in surrounding tissues and organs, by hematogenous and lymphogenous pathways. Hematogenous spread of tumor cells is observed in 10% of patients, and lymphogenous in 60% of cases. Most often, metastases are found in patients with cancer in the last stages.

In addition to metastases, cancer can be complicated by ulceration, bleeding and decay, which cause secondary infection, and in some cases, cachexia. Infectious lesions lead to abscessing and further perforation of the necrotic area of the neoplasm. About 40% of patients suffer from partial or complete obstruction. The pathological process can adversely affect the urinary system. Possible the formation of fistulas between the large intestine and the bladder, ureter, prostate or female genital organs.

Diagnosis of colon adenocarcinoma

Diagnosis of colon adenocarcinoma begins with an anamnesis. The doctor asks the patient about complaints, conducts an external examination and palpation. To accurately determine the disease, the patient is prescribed contrastive x-ray of the large intestine, blood tests, urine and feces, finger and endoscopic rectal examinations. Many of the above procedures are unpleasant, but very important. According to the results, the doctor will be able to diagnose, carry out therapy and give a prognosis for recovery. In some cases, the diagnostic results completely disproved the early diagnosis.

Basic diagnostic methods:

• Recto-manoscopy - examination of the surface of the intestinal mucosa with the help of an endoscope. This method is especially effective in the early stages of the disease.
• Contrast X-ray. The main signs of the tumor are: disruption of the mucosal relief, filling defect (jagged, single, uneven), expansion of the intestine over the tumor, increased peristalsis.
• Ultrasound - used to detect a focus of oncology and distant metastases. Depending on the clinical picture, endorectal or percutaneous ultrasound may be used.
• Biopsy - is carried out with the help of endoscopy. The obtained materials are used to determine the type, stage and degree of differentiation of tumor lesion.
• Colonoscopy - visualizes neoplasms in any part of the large intestine.
• MRI, CT - have high accuracy, determine the features of the structure and location of the tumor, signs of damage to neighboring organs and the prevalence of the pathological process.

Particular attention is paid to differential diagnosis with other diseases of the intestine, abdominal organs and retroperitoneal space. The tumor is differentiated from the polyps that are most commonly found in children. In this case, contrast radiography is crucial. Simulate neoplasm may be fecal stones in any part of the large intestine. But in the course of anamnesis, that is, when palpation they have a soft consistency and the so-called "pit symptom". When recognizing colon cancer with diseases of the abdominal cavity, special attention is paid to congenital anomalies of the kidneys, ovaries, liver of the spleen and ureters.

[12], [13]

Treatment of colon adenocarcinoma

Treatment of adenocarcinoma of the colon depends on its stage and shape. Most often, combined therapy is used, since the cancer is sensitive to the effects of radiation. After the course of irradiation in most patients, the tumor decreases as the malignant cells die. Radiotherapy improves the results of surgery by reducing the likelihood of inflammation of the tissues and the transfer of tumor cells. Obligatory is the therapy with medicines and the observance of a special diet.

Let's consider the basic methods of treatment of a malignant lesion of a thick intestine:

1. Chemotherapy - a combination of preparations of 5-fluorouracil with leucovorin or irinotecan is used. The efficacy of drugs are Capecitabine, Fluorafur and Raltitreksid. The listed facilities can be used in combination.
2. Irradiation is rarely used to treat colon cancer, since all its departments except the rectum are very mobile and change the location of the position in the abdominal cavity depending on the patient's posture. Irradiation can be used as a preparation for or after an operation. This reduces the volume of neoplasm and suppresses the appearance of metastases.
3. For patients with this type of cancer there is no special diet, but there are a number of recommendations on nutrition. In the diet should be a lot of fruits and vegetables. Special attention should be paid to vitamin therapy. If the patient has had a resection of the intestine, then the diet should have a light meal that does not stay in the stomach, does not cause flatulence and nausea. To eat it is necessary on a mode, observing the water balance.

There are alternative methods of treatment, they can be used as an auxiliary therapy. But before starting their use, consult a doctor.

• Mix a spoonful of root ayr marsh, three and a half spoons of potato, one and a half spoons of marigold flowers and four spoons of wormwood root. Pour the mixture with boiling water and insist for 5-6 hours. The resulting infusion should be filtered and taken in 100 ml before each meal.
• Tumor lesions are treated by enema. For these purposes, use purified water with copper sulfate (two liters of water per 100 ml of vitriol concentrate). The duration of treatment should not exceed 14 days.
• A tablespoon of herb celandine, pour 200 ml of boiling water and insist for 20-30 minutes. Broth strain and take 1 spoon 2-3 times a day before eating.
• The anti-cancer properties of the ground squirrel. Eat 4 tablespoons of fat a day or cook all the food on it. Such therapy during the month significantly improves the patient's condition.

Operation with colon adenocarcinoma

Operation with adenocarcinoma of the large intestine is considered the most effective method of therapy. During the operation, not only the tumor is removed, but also the tissues affected by metastases. Before the operation of the patient, special preparation is awaited, which is a slag-free diet, intake of laxatives and cleansing enemas 3-5 days before surgery. In addition, it is possible to wash the digestive tract with the help of a special Lavage or Fortrans.

During the operation, it is very important that the tumor cells are not transferred with the blood flow through the body, so they do not touch the neoplasm. For these purposes, compress the blood vessels and cut the site of the affected bowel. With distant metastases, removal is not effective, but the operation is still carried out. Surgical intervention is necessary to prevent possible complications, that is, bleeding, inflammation and pain syndrome. If the disease has a severe degree, the operation is necessary to normalize the work of the intestine due to the formation of colostomy.

If the cancer gives complications, then surgical intervention is carried out urgently. At the first stage, remove the tumor and eliminate complications. At the second stage, a colostomy is formed, it can be single-barreled or double-barreled. In the first case, the process of excretion of fecal matter passes through the colostomy, and in the second case, the movement of the stool is possible naturally. Normal functioning of the intestine is restored 2-7 months after the operation.

Prophylaxis of colon adenocarcinoma

Prophylaxis of adenocarcinoma of the colon is aimed at preventing malignant disease. Preventive measures begin with an examination with a proctologist who will help to solve problems with the large intestine in the early stages. Obligatory is the treatment of diseases of the organs of the gastrointestinal tract and infectious lesions. Healthy eating and active lifestyles also apply to methods of preventing disease. In your diet should be a lot of plant foods, rich in fiber.

Hereditary predisposition and anal sex are among the risk factors, therefore in this issue, prevention will not be superfluous. It is worth knowing that the disease is very rare when exposed to only one risk factor. The less negative impact on your body, the lower the risk of developing the disease.

Prognosis of colon adenocarcinoma

The prognosis of adenocarcinoma of the colon depends entirely on the stage at which the disease was detected and how the treatment was treated. The prognosis is based on the extent of the lesion, the presence of metastases, the stage of the development of the disease. If the patient has undergone surgery, then the next 5 years are considered critical, since a possible return of the disease. With a radical surgical intervention, which involves the removal of a large area of the intestine, the survival rate reaches 90%. But, the higher the stage and the prevalence of the disease, the fewer patients survive for 5 years after the operation. If the cancer metastasized into the lymph nodes, then the survival rate is 50%.

The main factors affecting the survival of patients:

• Size, stage, depth of tumor germination.
• Results of histological analysis.
• Presence of regional metastases.
• The degree of differentiation of the tumor.

Prognosis of survival in adenocarcinoma of the colon of different differentiation:

1. Highly differentiated - has the most favorable forecast. Five-year survival rate of patients at 50%. In patients with advanced age, the tumor practically does not metastasize and does not affect adjacent organs. But the survival rate of young cancer patients is 40%.
2. Moderately differentiated - poorly treatable, as it is difficult to choose an effective drug for chemotherapy. Surgery is possible with additional therapies.
3. Low-differentiated - the most dangerous form of cancer, which is characterized by aggressive currents and rapid growth. This type of oncology is almost not treatable, so the forecast is unfavorable.

Adenocarcinoma of the large intestine is a malignant disease requiring urgent treatment. The sooner it is found, the faster will be selected effective treatment, and therefore higher chances of restoring normal functioning of the body.