2023-07-31 09:03:21
[전문의에게서 듣는다] Lim Seok-byung, Professor, Department of Colon and Rectal Surgery, Asan Medical Center
Lim Seok-byung, a professor of colorectal surgery at Seoul Asan Medical Center (director of the Colorectal Cancer Center), said, “With the great development of endoscopy, if colorectal cancer is detected early, some of it can be excised with a special knife endoscope.” Provided by Seoul Asan Medical Center
Colorectal cancer is cancer that occurs in the large intestine, which is responsible for the end of digestive function in our body. Most of the patients are elderly. As the elderly population in Korea increases, the number of patients with colorectal cancer is also increasing significantly. According to the most recently released National Cancer Registry, colorectal cancer is the third most common cancer in Korea in 2020.
I met Lim Seok-byeong, a professor of colorectal surgery at Asan Medical Center (Director of the Colorectal Cancer Center). Professor Lim said, “It is important to quit smoking and eat all foods in moderation, and you must quit smoking.” “However, ‘extreme vegetarianism’, which does not eat meat at all, is associated with colorectal cancer and consumption of red meat such as pork and beef. can pay,” he said.
– Are diarrhea and bloody stool the main symptoms of colorectal cancer?
“Most of the people who visit the hospital with symptoms such as diarrhea and bloody stool often do not have colorectal cancer. Colorectal cancer, like other cancers, usually has no specific symptoms. There are many times when you don’t have to worry too much.
When colorectal cancer progresses a lot, there are sudden changes in bowel habits such as difficulty in passing stools or frequency of stools, diarrhea/constipation or feeling of stool remaining after a bowel movement, bright red or dark red bloody stools, stools that are thinner than before, and subjective symptoms such as weight loss. It can occur, but most often it is discovered during routine check-ups. Regular check-ups are essential for early detection and treatment of not only colorectal cancer, but also cancer.”
-Which is better for colorectal cancer surgery, laparoscopic or robotic surgery?
“It is one of the most common questions asked by patients about to undergo surgery. There is no best surgical method. Open surgery, laparoscopic surgery, and robotic surgery all have their pros and cons.
Open surgery is a method in which a relatively large incision is made in the patient’s abdomen and the surgeon directly touches the large intestine with his or her hands. Laparoscopic surgery is a method of surgery by making 4 to 5 small holes in the stomach and inserting laparoscopic surgical instruments and operating the tools by the surgeon. During the surgery, only a few small holes are made, so there are few scars and pain. Robotic surgery is similar to laparoscopic surgery in that a few small holes are made in the patient’s abdomen and robotic surgical instruments are inserted, but the difference is that the surgeon controls the surgical tools remotely.
To date, it is known that there is no difference between surgical methods in cancer treatment outcomes. Because each patient has different tumor size, progress, and degree of invasion of surrounding tissue, the patient and the attending physician decide the surgical method considering all factors. Absolutely cannot say which method is better.
In recent years, endoscopic procedures have been greatly developed, and when colorectal cancer is detected early, ‘Endoscopic Submucosal Dissection (ESD)’ is being actively implemented, in which colorectal cancer is excised with an endoscope equipped with a special knife. However, surgery is the primary treatment. Even if the tumor is successfully removed by endoscopy, if the depth of the tumor has invaded to the bottom of the submucosa, or if it is difficult to confirm that there are no cancer cells in the border removed by endoscopy, and if some risk factors remain even a little bit by biopsy, colon resection surgery may be required. .”
– Should I not eat red meat to prevent colon cancer?
“Not like that. Red meat, such as pork and beef, is known to be associated with colorectal cancer, so I know that there are people who extremely limit their intake. Of course, the higher the consumption of red meat, the higher the incidence of colorectal cancer. However, some studies have shown that eating only fiber and vegetables without eating red meat actually increases the risk of colorectal cancer.
Therefore, a balanced diet is of utmost importance. Food should be eaten in the right amount. It is actually difficult to eat while checking each ingredient in daily life. No one eats only what is known to be absolutely unhealthy. So, the most important thing is to eat the right amount of food.
Although a definite relationship between colorectal cancer and dietary factors has not yet been identified, in addition to red meat, consumption of refined carbohydrates such as animal fats, processed meats, alcohol, and sugar, and obesity are known to be the main causes of colorectal cancer.
On the other hand, dietary fiber consumed through fresh fruits and vegetables plays a role in preventing colon cancer, and sour fruits, dark green (dark green) vegetables, and dried beans are also known to have a preventive effect, so it is good to consume them evenly.
Also, if you smoke, it is very important to quit smoking. Smoking is a risk factor for all cancers. You may think that there is no relationship between colorectal cancer and smoking, but smoking is also a very large risk factor for colorectal cancer.”
– What are the results of colorectal cancer treatment?
“The results of colorectal cancer treatment in Korea have improved significantly compared to the past. The 5-year survival rate for colorectal cancer in Korea is close to 80%, which is higher than that of medically advanced countries such as the United States, Japan, and Canada. This is because an integrated treatment system in which related medical staff such as surgery, internal medicine, radiation oncology, and pathology gather together to treat patients who have difficulty setting a treatment direction has been activated, and domestic surgical staff have enriched their surgical know-how. In fact, Seoul Asan Medical Center has performed about 2,000 colorectal cancer surgeries per year, a cumulative total of 36,000, which is a very high figure worldwide.
In addition, the fact that regular checkups have been activated and early detection has increased greatly contributed to improving treatment results. As with all cancers, prevention is important for colorectal cancer, but early detection is very important. It is known that the incidence of colorectal cancer increases steadily after the age of 50.
More than 90% of colorectal cancer patients are diagnosed after the age of 50. Therefore, from the age of 50 onward, it is recommended to periodically perform a colonoscopy as well as fecal occult blood testing, which is included in national cancer screening. If there is a family history, it is okay to start at an earlier age. If detected early, colon cancer can be excised with endoscopic surgery, and even if surgery is needed, the surgical range is relatively small, so the possibility of returning to daily life in good health is higher than when colon cancer is diagnosed in an advanced state.”
Daeik Kwon Medical Reporter [email protected]
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