April 17, 2024

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11 important questions about recurrence and metastasis of bowel cancer

11 important questions about recurrence and metastasis of bowel cancer


11 important questions about recurrence and metastasis of bowel cancer.  You must not eat high-fat foods in your usual diet, because the occurrence of bowel cancer is closely related to animal fat and meat.

The incidence of bowel cancer is closely related to our lifestyle. The incidence of bowel cancer is closely related to high-fat and low-fiber diets, chronic inflammation of the large intestine, genetics and other factors.

Another very important point is that the early symptoms of bowel cancer are not very obvious. Many patients have already metastasized when they are discovered. Therefore, regular physical examination and screening are particularly important. If patients can be detected, diagnosed and treated early, they can be cured Sexual surgical resection completely removes the cancer cells inside the body. Most patients with early bowel cancer can be completely cured.

Although the overall prognosis of bowel cancer is relatively good, its postoperative recovery is affected by many factors. However, most patients with bowel cancer will relapse after surgery. The main reason is the tumor itself, preoperative treatment, postoperative treatment, postoperative rehabilitation, and so on. According to the common questions that patients and their families care about, we sorted out 10 common questions and invited Professor Wang Zhigang from the Sixth People’s Hospital of Shanghai Jiaotong University to answer them one by one.


1. Is the recurrence rate of bowel cancer high after surgery?

The first five years after bowel cancer surgery is the peak period of recurrence, especially the first two years after surgery. If there is no recurrence or metastasis 5 years after the operation, the probability of recurrence and metastasis is quite low. Therefore, doctors often say that the 5-year survival rate is that if there is no recurrence or metastasis 5 years after surgery, then clinical cure can be considered.

But after bowel cancer surgery, don’t relax your vigilance just because the surgery is very successful. In fact, many patients still have various problems, so it is necessary to maintain long-term follow-up and regular review within 5 years. It is necessary to follow up very closely. Once recurrence and metastasis, there are many very effective methods. The important thing is to find it early, so as not to find it to a very serious degree and miss the best time for treatment.



2. What are the symptoms of postoperative colon cancer metastasis?

In most cases, the postoperative metastasis of bowel cancer has no symptoms. Some patients have extensive liver metastasis or even lung metastasis one year or six months after the operation. The patient feels nothing at all, or even weight loss. From this perspective, we cannot rely solely on symptoms to determine whether bowel cancer has recurred or metastasized after surgery.

The most important thing to judge whether metastasis is through some clinical examination indicators. The main examination items include blood routine, biochemical examination, tumor marker examination, abdominal ultrasound, abdominal CT, colonoscopy, liver MRI, and PET/CT.

However, some clinical symptoms can be used as a reference for recurrence and metastasis. The symptoms of colon cancer recurrence and metastasis are as follows:

In the early stages of recurrence and metastasis, abdominal pain, indigestion, and abdominal discomfort usually occur.

In the middle of recurrence and metastasis, symptoms such as diarrhea, stomach pain before defecation, constipation, and sudden increase in the frequency of bowel movements will occur. As the disease worsens, the patient may also experience symptoms such as weight loss, jaundice, abnormal abdominal masses, and anemia. There may also be pus and blood in the stool, mucus in the stool, and both mucus and blood in the stool.

However, considering that the location of metastasis is different, the specific symptoms may also be different. Once you find that you have colon cancer, you should go to the hospital for treatment in time. After that, regular review should be conducted to monitor whether there are symptoms of recurrence or metastasis at any time.



3. What is the most prone to recurrence and metastasis of bowel cancer?

Intestinal cancer can be metastasized through blood circulation, lymphatic system, and local spread. The most common site of hematological metastasis of colorectal cancer is the liver, and some patients have liver metastases when they are discovered. The second most common site is the lung. Lung metastasis takes a long time and develops slowly. In addition, colon cancer is also prone to metastasis to some lymph nodes in the abdominal cavity and retroperitoneum, and the most common is liver metastasis.



4. What is liver metastasis from bowel cancer?

Liver metastasis of colorectal cancer means that the tumor cells of colorectal cancer invade the lymphatic vessels and blood from the primary site and are brought to the liver to form tumors. The blood returning from the intestine is the first stop to the liver. Therefore, the most prone to colorectal cancer is liver metastasis .

More than 50% of patients with bowel cancer have liver metastases. At present, there are many clinical treatment options, including surgery, chemotherapy, targeted drugs, and interventional treatments. The effects are still good. After the operation, the patient needs to be reviewed regularly according to the doctor’s advice, so that the metastasis of colon cancer can be detected early, and the intervention effect is best at this time.



5. How long can I live after colon cancer liver metastasis?

The survival rate of liver metastases from colon cancer depends on whether the patient undergoes surgical resection and the patient’s sensitivity to chemotherapy drugs. If colon cancer liver metastasis can be completely removed, the prognosis is good, and the 5-year survival rate can reach 30%-50%.

Specific to the treatment of liver metastases from bowel cancer, it is necessary to find a professional team to make the most targeted and individualized comprehensive treatment plan to achieve the best treatment effect. In addition, it also requires patients to have good compliance and regular review standards. Treatment, thereby improving the quality of life and survival rate.



6. How long can bowel cancer metastasize to the lungs?

Intestinal cancer metastasizes to the lungs. The current treatment is quite satisfactory. For isolated lung metastases, partial removal of lung tissue can be selected. After surgery, it is also necessary to cooperate with intravenous chemotherapy of the whole body, and radical resection of intestinal cancer is also required. The survival time of many patients can reach 1-2 years or even longer.



7. The bowel cancer has recurred, can I have another operation?

For patients who have recurred after early bowel cancer surgery, the recurring lesions in the patient’s body can generally be removed through a second operation, so that the patient can recover.

The difficulty in the treatment of recurrent bowel cancer is not distant metastasis (the liver and lung are the most common), but local recurrence. The former can be cured by surgical resection, while the latter often spreads through the peritoneum and invades adjacent organs (pelvis, lungs, etc.). Abdominal wall, kidney and ovary, bladder, ureter, etc.), reoperation is difficult and risky, and non-surgical treatments such as radiotherapy, chemotherapy and targeted therapy are not effective.

A multidisciplinary surgical team (MDT) is used in the clinic to study the multidisciplinary combined treatment strategy for complex bowel cancer, evaluate the possibility of surgical resection, design individualized surgical strategies, perioperative support, implement complex operations, formulate postoperative rehabilitation plans, and evaluate Quality of life, establishment of medical files, long-term follow-up.



8. How should bowel cancer liver metastasis be treated?

For those who have indications for surgical treatment, the general condition is better, and there is no contraindication to this part of the population, surgical treatment is recommended;

For people who have lost the opportunity for surgery, systemic treatment options such as chemotherapy, targeted therapy and immune drugs can be considered;

For some patients with a particularly large tumor burden, local treatments, such as radiofrequency, microwave, and hepatic artery infusion chemotherapy, can also be considered.

For each patient’s different conditions and different periods, different programs and individualized comprehensive treatment methods are given.



9. Who are prone to recurrence and metastasis after bowel cancer surgery?

There are some pits that can be avoided!

There are four main factors related to postoperative recurrence and metastasis of bowel cancer:


Some characteristics of the tumor itself: the depth of the tumor infiltrating the intestine and the amount of lymph node metastasis are the most important factors affecting postoperative recurrence and metastasis.

Insufficient preoperative treatment: Insufficient preoperative treatment often occurs in locally advanced rectal cancer, and the scope of rectal cancer surgery can be smaller. Therefore, preoperative radiotherapy and chemotherapy for locally advanced rectal cancer are recommended to improve the postoperative cure rate and reduce relapse.

Impact of surgical operation: The factors of surgery are also critical. Is the tumor removed completely? Less than 12 lymph nodes were detected after surgery, and some large medical centers have detected 20 or 30 lymph nodes after surgery. Lymph nodes can more accurately stage tumors, which is of great significance for treatment.

Insufficient postoperative treatment: postoperative adjuvant treatment of bowel cancer is mainly chemotherapy. When the indications for postoperative chemotherapy are clear, chemotherapy can reduce the risk of recurrence and improve survival.



10. Does the treatment of recurrent bowel cancer have to undergo multidisciplinary discussion?

Colorectal cancer is one of the common malignant tumors in some countries. Although surgery is the main treatment for colorectal cancer, the recurrence of colorectal cancer after surgery is a key factor affecting the efficacy, and the recurrence rate after surgery is as high as 60%.

Recurrent bowel cancer not only includes distant liver and lung metastasis, but also includes local recurrence. Liver and lung metastases can still achieve better results through surgery, intervention, and chemotherapy. Local recurrence, including peritoneal dissemination, invasion of adjacent organs such as pelvis and abdominal wall, kidney and uterine appendages, bladder, prostate seminal vesicles, etc., is one of the difficulties in clinical treatment. The treatment of recurrent bowel cancer requires multidisciplinary joint diagnosis and treatment, including general surgery, radiology, internal oncology, radiotherapy, pathology, urology, obstetrics and gynecology, and bone oncology.

First of all, imaging plays an important role in the diagnosis of recurrent colorectal cancer. CT, MRI and PET-CT can determine the location, number, size, lymph node metastasis, and peritoneal metastasis of recurrent colorectal cancer. Through the radiologist’s analysis of imaging, the next treatment plan can be determined. Secondly, patients with surgical indications can be fully evaluated by general surgeons. When suitable for surgery, surgical treatment is performed. If recurrent bowel cancer invades the uterus and uterine appendages, combined surgical treatment by gynecologists and obstetricians is required. If it invades the bladder, ureter, etc., general surgery combined with urology is required for surgical treatment.

Of course, if the bone is invaded, general surgery combined with bone tumor surgery is required to remove the invaded bone. The surgical procedure for recurrent bowel cancer is complicated, and it often requires joint operations of two or more departments.

Third, patients who have no possibility of surgery need to provide treatment options, including chemotherapy and radiotherapy, from the oncology department or radiotherapy department. In short, the diagnosis and treatment of recurrent bowel cancer is one of the clinical difficulties. It is often necessary to combine experts from multiple departments to evaluate and provide the most appropriate individualized treatment plan for the patient.



11. How to prevent the recurrence of bowel cancer in life?

Many patients worry about the recurrence of their bowel cancer. They are worried every day. If they have a headache or brain fever, they are terribly scared. In fact, there is no need to worry so much. Changes in some habits in life are particularly important to prevent the recurrence of the disease.

We must adjust our eating habits and lifestyle. Intestinal cancer has an important relationship with our living habits and diet. In our daily diet, we need to eat more foods with high dietary fiber, such as bananas, green vegetables, potatoes, sweet potatoes, etc. Food can help prevent recurrence.



Obesity is also a cause of bowel cancer. Too little physical activity is also a very dangerous factor. Strengthening exercise is conducive to the peristalsis of the large intestine, which is of great significance for improving constipation and preventing recurrence.

You must not eat high-fat foods in your usual diet, because the occurrence of bowel cancer is closely related to animal fat and meat. 


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