Music master Ryuichi Sakamoto died, what kind of disease is rectal cancer? How can it be prevented and detected early?

On April 2, 2023, according to the Nikkei Shimbun, world-class music maestro Ryuichi Sakamoto died of rectal cancer at the age of 71. At the beginning of 2021, Ryuichi Sakamoto posted that he was diagnosed with rectal cancer and underwent surgery. He suffered from cancer twice and fought with cancer for many years, but he finally lost the disease and played the final song of his life.

While commemorating the Master, this sad news also serves as a wake-up call. What is rectal cancer? How can it be prevented and detected early?

01The incidence rate is second only to lung cancer, showing a younger trend

Colorectal cancer, including rectal and colon cancer, is one of the most common malignancies of the digestive tract, and the incidence and mortality rate are increasing year by year. According to the latest global cancer burden data released by WHO's International Center for Research on Cancer (IARC) in 2020, colorectal cancer ranks third in new cases and second in death worldwide.

In February 2022, the latest national cancer statistics released by the National Cancer Center showed that colorectal cancer has become the second highest number of new cases in mainland China (408,000 cases), and it is showing a younger trend.

The rectum is a section of the intestine near the end of the digestive tract, and the cancerous growth of the epithelial tissue of the rectal mucosa is called rectal cancer.

At present, the cause of rectal cancer is not clear. Existing studies have shown that excessive intake of animal fat and animal protein, lack of fresh fruits and vegetables and dietary fiber, obesity, tobacco and alcohol, inflammatory bowel disease, lack of exercise, etc., are all high-risk factors for rectal cancer.

Rectal cancer, also known as "affluent disease", did not have a high incidence in the past. In recent years, with the improvement of living standards, people's diet structure has changed, food is more refined, excessive intake of high-fat and high-calorie foods, as well as fried, pickled foods, processed meat, will increase the risk of colorectal cancer.

02 Mistakenly treat blood in the stool for hemorrhoids, and it is late as soon as it is found

As the second highest incidence of cancer after lung cancer, rectal cancer has strong insidious nature, early symptoms are not obvious, easy to be misdiagnosed as hemorrhoids, indigestion, gastroenteritis, etc., many patients are already in the middle and advanced stages when they are diagnosed. Therefore, it is necessary to attach great importance to the "alarm signal" of rectal cancer.

Typical symptoms of rectal cancer are blood in the stool and changes in bowel habits. Many people tend to think of blood in the stool as hemorrhoids, but there is still a difference between the two.

● Hemorrhoids are mostly blood on the surface of feces, and blood drips after stool, and the blood is only on the surface of feces, not mixed with feces;

● Rectal cancer is mostly mixed with blood in feces, and contains mucus, the blood is darker, and the color is mostly dark red or jam.

In addition, rectal cancer patients will also have changes in bowel habits and stool shape, such as increased frequency of bowel movements, alternating diarrhea and constipation, and thinning and flattening stools. When the disease progresses to a certain extent, rectal cancer patients may have abdominal distension, abdominal pain, abdominal mass, sudden weight loss, anemia and other symptoms.

If the above "warning" occurs, be sure to go to the hospital for screening as soon as possible. At present, the awareness of early screening of bowel cancer in mainland China is not enough, and it is likely to be too late to go for examination when symptoms appear.

03One finger can feel 80% of rectal cancer

There are four screening methods for colorectal cancer: one finger and three tests.

The digital rectal examination, which is known as "one-finger divine skill", is the most cost-effective examination. Without any equipment assistance, professional doctors can judge the patient's anorectal health with only one finger, and 80% of rectal cancers can be found.

A healthy rectal surface is soft and smooth, while the diseased rectum will appear hyperemed, stiff and lumpy, and uneven lumps can be felt on finger examination, and mucus and dark red blood can be seen when fingers are withdrawn.

However, digital rectal examination is powerless for the large intestine other than the rectum. A more effective "gold standard" is colonoscopy screening, and colonoscopy can achieve examination and endoscopic resection, which can be screened, prevented, and treated.

It is recommended that people over 40 years old should do colonoscopy screening with or without symptoms; If there is no abnormality in the examination, it can be checked regularly every ten years.

For high-risk groups of colorectal cancer: if there is a family history of gastrointestinal tumors, colonoscopy should be done every 3-5 years; Long-term inflammatory bowel disease (including ulcerative colitis and Crohn's disease) requires regular review under the guidance of a doctor; Patients with colorectal polyposis also need regular re-examination of colonoscopy.

In addition, there are non-invasive tests such as stool tests and blood tests. A stool occult blood test allows us to monitor stool for bleeding. It can be tested annually or every 2 years, and colonoscopy is performed if positive results are continuous.

04How long can I live if I have rectal cancer?

From rectal mucosal hyperplasia to carcinogenesis, it is a relatively long evolutionary process. In other words, paying attention to early screening, early diagnosis and early treatment may prevent the occurrence of rectal cancer. If it can be detected early, the 5-year survival rate of rectal cancer can reach more than 90%, which will basically not affect the life expectancy.

For medium-stage rectal cancer, most patients can be cured after comprehensive treatment such as chemotherapy, radiotherapy, and surgery. The 5-year survival rate of stage II patients can reach 80%, and the cure rate of stage III patients is 60%. If no recurrence is found within 2 years of follow-up after surgery, the survival rate will be significantly improved after 5 years.

In advanced patients, about 10% survive for more than 5 years. If distant metastases are present, the prognosis is greatly improved after radical surgery on metastases.

In general, the comprehensive treatment effect of rectal cancer is relatively good today, but it is still not to be taken lightly. The key to preventing precancerous lesions and cancer is to maintain good lifestyle habits and regular physical examinations and screenings.

*In addition to the annotation, the pictures in the article are from Photogram and have been authorized by the platform

Resources:

[1] National Health Commission. Chinese standard for diagnosis and treatment of colorectal cancer (2020 edition)[J]. Chinese Journal of Practical Surgery,2020,40(6):600-630.

[2] Latest global cancer data: Cancer burden rises to 19.3 million new cases and 10.0 million cancer deaths in 2020. Retrieved Dec 16, 2020.