Saturday, January 14, 2006

cancer, colon and rectal

Cancer of the colon and rectum are among the most commonly occurring malignancies in the United States. More than 40,000 cases of colon and rectum cancer occur in people over the age of 65 yearly. The incidence of bowel cancer is higher in developed countries. Two thirds of the malignancies occur in the sigmoid colon and rectum.
Diet plays a significant role in the incidence of bowel cancer. Eating foods high in dietary fibers and low in animal protein, fats, and refined carbohydrates may offer protection against bowel cancer. Early diagnosis and treatment offer the best chance for a cure. A change in bowel patterns such as constipation or diarrhea, a change in the shape of the stool, or passing of blood should be investigated.
Polyps growing in the lumen of the colon may develop into colon cancer. Partial or total obstruction may result in the lower colon from the formed stool unable to pass through the narrowed lumen. Bleeding may result from ulceration of the lesions. Colon cancer may spread by direct extension or through the lymphatic or circulatory systems. The liver is the major organ of metastasis.
Diagnosis of cancer of the colon is made by physical examination, sigmoidoscopy, colonoscopy, and barium enema examination. Cancer of the rectum is diagnosed by biopsy of a lesion during a proctoscopic examination. The stool is examined for occult blood.
Cancer of the colon is always treated surgically, with the tumor, colon, and lymph nodes being resected. If the growth cannot be treated surgically or has caused an obstruction with inflammation, an opening may be made into the cecum or transverse colon as a palliative measure for fecal contents to escape. When the edema and inflammation around the tumor subside the growth is resected, the bowel sections are rejoined (anastomesed), and the cecostomy or colostomy is closed.
Phipps, W. J. Essentials of Medical-Surgical Nursing. St. Louis: C. V. Mosby Co., 1985.
Steinberg, F. U. Care of the Geriatric Patient, 6th ed. St. Louis: C. V. Mosby Co., 1983.


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