Bowel Cancer Symptoms And Different Therapies

Bowel cancer is difficult to diagnose at an early stage because patients are usually asymptomatic early in the disease process. Screening to detect polys and cancer is important for all those deemed to be at risk and for those over the age of 50. Diagnosis of bowel cancer in the older adult is especially challenging because many of the common changes of aging in the gastrointestinal tract can prevent early detection. For example, constipation, change in bowel patterns and fatigue may be inaccurately attributed to the aging process.

Approximately 50% of patients present with hepatic metastases or develop them during the course of disease. Because the protal vein drains blood supply from the colon, the liver is the most common site of metastasis for advanced disease. Isolated lung or liver metastases may be resected in later stage disease. As the disease progresses, patients may experience bowel obstruction. Widespread metastases to abdomen, lung or liver are often the cause of death.

Most cancers of the bowel are moderately or well-differentiated adenocarcinomas. These cancers usually develop as a result of progressive colonic polyp mutations. Screening for and removal of potentially malignant polyps can prevent development of metastatic disease. TNM staging has been modified to correspond with the Astler coller dukes system. This staging process evaluates the depth of bowel wall penetration by the tumor, lymph node involvement, and presence of distant metastasis. The accuracy of the staging in high risk stage II and III is associated with the number of nodes surgically removed. Staging ranges from stage I to stage IV, with overall survival declining from greater than 90% to less than 10% for stage IV disease.

A complete staging work up includes a physical exam, pathologic tissue review, colonoscopy, and baseline computed tomography of the chest, abdomen and pelvis, complete blood count, chemistry profile and carcinombryonic antigen determination.

For resectable bowel cancer surgery remains the standard treatment. Tumor location, blood supply, and lymph node patterns are the area of cancer determine the extent of resection. Examination of a minimum of 12 lymph nodes is necessary for accurate staging. Laparoscopic advances have allowed the use of minimally invasive surgical procedures of resect bowel cancers without increasing recurrence rates. Early mobility, return of pulmonary function, and decreased ileus and adhesion formation have made this procedure desirable for many patients, especially those with advancing age and comorbid illnesses. Surgical management of bowel cancer involves resection with preservation of anorectal sphincter function, and sexual and urinary function whenever possible.

The role of radiation therapy is not well defined for bowel cancer, but more studies are needed, as completed studies are under powered. Debate over the value of pre or post surgical radiation therapy for bowel cancer continues. Although pre operative and post operative radiotherapy has been shown to reduce local recurrence when compared to surgery alone, neither intervention resulted in a statistically significant improvement in overall survival. Pre operative chemoradiotheraphy doubled the rate of bowel sphincter sparing operations and lowered the rates of local recurrence, acute toxicity, and long term toxicity.

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Inflammatory Bowel Disease - An Immune System Disorder That You Don't Get If You Smoke?

Inflammatory bowel disease is a catchall that describes certain strange and troublesome stomach conditions with names like Crohn's disease and ulcerative colitis. Why are these strange? Anytime a disease comes with the name of a scientist attached, you know that there is something about it that is out of the ordinary. And sure enough, inflammatory bowel disease certainly is a mystifying problem - not only is it something you live with your whole life once you get it, coming under the species of an autoimmune disorder as it does, most regular attempts at a cure elude both doctors and those who suffer from it. What does it feel like to have IBD? The abnormal immune reaction that your body reacts with gives you diarrhea, bleeding down there, cramping, a fever, tiredness with no end and most disturbing of all, terrible complications that can require that you go in for surgery to be relieved of your colon.

So what exactly causes inflammatory bowel disease? As far as scientists can tell, it comes to you for reasons of an inscrutable combination of environmental factors and unfortunate genetic disposition. Let's look a little more closely at what kinds of things can actually set off an attack.

For some reason, traditionally, it is people who live in the West who usually come down with IBD. If you happen to live in Europe or North America, you run a higher risk of an association with the disease. What could it be about living in these places? It could be a kind of diet the culture in these places have or it could be something to do with the way smoking and drinking are a part of the culture in the West. Interestingly enough, that's only how it has traditionally been. A new development points to how it isn't anything to do with geographical location. The disease affects those in other parts of the world who Pick a westernized culture by choice - places like Japan, Latin America or the Far East. Of late, these parts of the world have reported such a great spurt in the number of people coming down with IBD each year. Surprisingly, inflammatory bowel disease can also have a lot to do with how in the West, we place a great deal of importance on cleanliness and sanitation. Doctors and scientists suspect that the body doesn't really take well to being denied a little bit of natural dirt in the environment.

Scientists notice that there are other factors that seem to affect the course a case takes as well. For instance, the earlier in life someone gets the disease, the more doctors suspect that genetic predisposition has something to do with it. And the prognosis can be pretty grave - a serious lifelong affliction. How about smoking? The moment you hear about a stomach disorder and smoking, you're probably ready to jump to the conclusion that smoking can only make it worse. With inflammatory bowel disease though, the connection isn't quite as simple as that. With one kind of IBD, ulcerative colitis, smokers actually have it better than non-smokers - they are at a lower risk of getting it. But it doesn't really do you any good getting lucky with the one kind when you are about to get unlucky with the other. With Crohn's disease, your risk multiplies if you smoke.

As with all autoimmune diseases, inflammatory bowel disease can be terribly difficult to track down.

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