Surgery for stomach and colon cancer
Overview of stomach cancer
Until thirty years ago, stomach cancer was one of the most common cancers. Although its incidence has recently decreased, it remains the 4th most common cancer. About one million people around the world are diagnosed with stomach cancer each year.
Risk Factors for Stomach Cancer
Age and Gender
Although gastric cancer is seen at a young age, its incidence increases with age. It is more common in the 50 to 70 age group and is twice as common in men as in women.
Genetic Factors
People with a family history of stomach cancer are at greater risk than people without a family history of stomach cancer. Again, certain diseases involving the large intestine are more likely to develop stomach cancer.
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The incidence of gastric cancer varies from region to region around the world. There is a 10-fold difference between high-risk and low-risk populations. Gastric cancer has now been shown to be the most common in Japan and Korea.
Helicobacter pylori infection
It is known that HP, considered to be a bacterium responsible for the formation of gastritis, is more common in patients with gastric cancer. However, it should not be concluded from this that gastric cancer will occur in every person with HP that is detected in the stomach. Because in some societies where PH is common, the rate of gastric cancer is low. Therefore, risk factors other than HP are extremely important.
Diet
The World Health Organization reports that 30% of cancers in developed countries are related to nutrition. Gastric cancer is more common in areas like Japan, where people eat a lot of salty and smoked foods. It is believed that barbecued meat, which is widely consumed in our country, may also be a risk factor. Likewise, consuming too much processed meat or fried, gravy and spicy foods or consuming foods contaminated with aflatoxin (such as mold on stale bread) increases the risk.
Salt İntake
Excessive salt intake increases the risk of stomach cancer. Decrease in stomach cancer with increased refrigerator use is associated with a decrease in the need to salt foods.
Fresh fruits, vegetables, vitamin C
Excessive consumption of salty and smoked foods has an increasing effect on the possibility of developing stomach cancer. On the contrary, an abundant consumption of raw vegetables and fruits can have a positive effect on the prevention of stomach cancer. Consumption of fresh vegetables has been suggested to protect against gastric cancer, but this has not been proven.
Those who have had stomach surgery in the past, especially those who have had part of the stomach removed for stomach ulcers, have an increased risk of developing stomach cancer in the past. over the years. For this reason, it is necessary to perform gastroscopy at regular intervals in patients who have had gastric surgery, even if they have no symptoms.
Stomach Ulcer or Gastritis Cancer
Stomach ulcers are not cancerous. However, stomach ulcers can be mistaken for cancer at the time of diagnosis. This causes a delay in processing. The type of anemia caused by the inability to absorb vitamin B12 is called pernicious anemia. The risk of developing gastric cancer is higher in patients with both pernicious anemia and atrophic gastritis.
Lifestyle and Other Factors
Obesity and smoking are risk factors for stomach cancer as well as many cancers. Workers in certain occupations are more at risk (such as those exposed to wood smoke or asbestos fumes, metalworkers, miners and plastics). Previous radiation therapy (radiation therapy) and Ebstein-Barr virus infection have also been reported to have an effect on the development of gastric cancer. Stomach cancer is more common in people with blood group A.
Stomach Cancer Surgery
The main principle of surgical treatment for gastric cancer is the removal of all cancer-related tissues, as well as regional lymph nodes from the organ that caused the cancer. This removes part or all of the stomach as well as all the lymph nodes where cancer is likely to spread.
Can gastric surgery be performed with a closed (laparoscopic) method?
Yes, stomach cancer surgeries can be performed closed (laparoscopic or robotic) in experienced centers. As a team, we favor closed surgeries whenever possible because of the benefits they provide to the patient.
Can you live without a stomach?
Yeah. In gastric cancer, all or a large part of the stomach may be removed, depending on the location of the cancer in the stomach. In both cases, the patient can continue his normal life by following a few loose nutritional rules.
Chemotherapy in the treatment of stomach cancer
If stomach cancer has spread to distant organs such as the lungs and liver (stage 4), the main treatment for these patients is chemotherapy. If severe bleeding or an obstruction develops at this stage and cannot be treated with endoscopic methods, surgery may be necessary. Some of the patients who were initially at stage 4 and who have benefited greatly from chemotherapy can be operated on, provided that they are discussed in a multidisciplinary meeting.
Is it possible to get rid of stomach cancer?
This question is one of the most difficult questions doctors face in a cancer patient. This is because the answer to the question is not known. Because the recovery of a cancer patient depends on many factors such as the stage of the disease, the patient's immune status and the oncological quality of the treatments.
Course of the disease in stomach cancer
Some of the patients who are operated on for stomach cancer can live for many years without any problems. In some patients, metastasis may be seen within the first five years after surgery for the disease. The age of the patient, the presence of concomitant disease, genetic factors, etc. ; the stage of the cancer, its type, the region where it is located in the stomach; The quality of treatment is effective in this.
Colon (cancer of the large intestine)
Over the past decade, much progress has been made in the diagnosis and treatment of colon cancer. Despite this, colon cancer remains one of the biggest health problems in the world and continues to threaten the lives of millions of people every year.
Colon cancer risk factors
Daily life
Colon cancers are more common in people who smoke and drink alcohol, eat foods low in fiber (vegetables, fruits), suffer from diabetes, obesity and have a sedentary lifestyle.
Age
Although it can be seen at a very young age, the frequency of the disease increases with age.
Presence of polyps
Polyps are the most important risk factor. Most cancers start at the base of a polyp.
Family history of colon cancer
The risk of developing cancer is increased in people whose mothers, fathers, or siblings have colon cancer. The risk is even greater if people with cancer are under the age of 50. Likewise, there is a genetic predisposition to colon cancer in certain diseases such as FAP and HNPCC.
Diagnostic methods
Colonoscopy and biopsy, as well as examination, are sufficient for the diagnosis of colon cancer. However, in order to decide on the type of treatment, the extent of the disease must be determined. For this purpose, examinations such as tomography, ultrasound, endo-ultrasound, MRI and PET can be applied.
Processing methods
The main method of treating colon cancer is surgery. However, chemotherapy or radiation therapy (or in combination) may be applied before or after surgery in some patients.
• Minimally invasive surgery
In the past, in the treatment of colon cancer, the only surgical intervention was to make incisions in the patient's abdomen, which could be up to 40 to 50 cm in length. Today, methods such as laparoscopic surgery, single port surgery, and robotic surgery are used in the treatment of colon cancer.
• Abdominal defecation (feeding from a bag)
With the exception of the last part of the large intestine called the rectum, after a certain part of the intestine has been removed during surgery, the two ends are brought together again. In some of these patients, the small intestine may be removed for a temporary period (6-8 weeks) until the joint is fully healed. These patients defecate in the normal way. In cancers near the anus, the anus is canceled and the intestine is placed in the mouth against the abdominal wall. In this way, the patient is made to defecate (colostomy) in a bag attached to the abdominal wall. Today, this surgery is needed in far fewer patients (5% of all colon cancer patients) than in the past, and most patients have normal bowel movements. Removal of the tumor in the large intestine on its own may not be sufficient in surgery for large intestine cancer. Lymph nodes that can spread cancer and, if so; Cancerous tissue that has affected other organs must also be completely removed. If very little cancerous tissue remains in the surgical area, the disease may return after some time in most patients.
Colon cancer spreading to the abdomen
If extension to the peritoneum is not very frequent, these patients can be treated simultaneously with surgery and chemotherapy (Cytoreductive Surgery + Heating Chemotherapy - CHIP) gives positive results.
Treatment procedure in cancers of the obstructed large intestine
Some colon cancers can be detected after causing a bowel obstruction. These patients can be operated on urgently or a stent is placed in the occluded area to relieve the occlusion.
Can colon cancer be prevented?
Colon cancer is one of the diseases that can be treated when caught at an early stage. Cancer needs to be caught at an early stage, or better yet, before it happens. Of course, it is very important for patients who have a complaint to see a doctor immediately, but unfortunately most of the cancers of the large intestine that have caused complaints are past the early stage. Therefore, even if there are no complaints, it is important that healthy people over the age of 50 get tested at regular intervals.
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