2023-09-06 19:00:21
[대한경제=김호윤 기자] Colorectal cancer is a terrifying disease that ranks third in both incidence and mortality in Korea. People with inflammatory bowel disease, colon polyps, or a family history of colorectal cancer are at a very high risk of occurrence, so caution is needed.
There are many risk factors for developing colorectal cancer, but there are some that you need to be particularly careful about. The first is if you suffer from inflammatory bowel disease. Crohn’s disease or ulcerative colitis is known to increase the incidence of colorectal cancer and to increase the age of onset.
Yoon-Young Park, Professor of Surgery, Kyung Hee University Gangdong Hospital / Photo: Courtesy of Kyung Hee University Gangdong Hospital
The second is when there is a colon polyp. Among the polyps often found in colonoscopy, adenomatous colon polyps can later develop into colon cancer. In addition, age over 50, large intake of red meat and meat products, obesity, drinking, smoking, and family history increase the risk of colorectal cancer.
Park Yoon-young, a professor of surgery at Gangdong Kyunghee University Hospital, said, “The age at onset of colorectal cancer is gradually getting younger. Even if you are under the age of 50, if you have symptoms of suspected colorectal cancer, such as bloody stool, repeated diarrhea or constipation, weight loss and fatigue, or if you have a family history of inflammatory bowel disease or colorectal cancer, it is good to get a colonoscopy.”
In fact, according to a paper published by a research team at the University of Colorado Medical Center in the United States, the incidence of colorectal cancer in Korea between the ages of 20 and 49 was 12.9 per 100,000 population, the highest among 42 countries surveyed.
Even if you have been diagnosed with colon cancer through a test, it is too early to be discouraged. Colorectal cancer is a cancer with a very high mortality rate, but it is one of the cancers whose survival rate continues to rise. According to data from the Central Cancer Registry published last year, the 5-year relative survival rate for colorectal cancer, including colon cancer, between 2016 and 2020 was 74.3% for both men and women, up about 15% from 58.9% between 1996 and 2000.
Professor Park said, “In a study published in an international medical journal in 2018, Korea reported the world’s No. 1 survival rate in colorectal cancer (colon and rectum). You don’t have to worry,” he explained.
What is important in determining the treatment method for colorectal cancer is the extent to which the tumor has penetrated the tissue rather than the size of the tumor. Surgery, chemotherapy, and radiation therapy are usually combined appropriately. Early colorectal cancer has no risk factors such as lymphatic invasion and poor differentiation, and can be treated with only endoscopic resection when it is confined to the mucous membrane or when the depth of invasion into the submucosal layer is very shallow.
The most fundamental treatment for stage 2 and 3 colorectal cancer is surgery. Centered on the tumor, the large intestine is resected in both directions from the distal part (lower part of the tumor) and proximal part (above the tumor) to a place far enough away from the tumor, as well as extensive lymph node resection.
For stage 4 colorectal cancer, multidisciplinary treatment is essential in which specialists from various departments, patients, and guardians gather together to discuss not only the opinions of medical staff but also the patient’s preferences and values to determine the treatment plan. This is because there are numerous cases depending on the degree of cancer progression, the location and number of metastatic lesions, and the like. For colorectal cancer, even in the same stage 4 patients, the 5-year survival rate can be raised to 40% if combined treatment including surgery is actively performed.
Photo: Provided by Gangdong Kyunghee University Hospital
The most common surgical methods are laparoscopic surgery and robotic surgery.
Laparoscopic surgery is the most widely used method in Korea, and so-called ‘single incision laparoscopic surgery’, which uses only one incision, is also being attempted. Postoperative scarring is minimized through a minimal incision, and the pain is very minimal, so the patient’s recovery is fast and there is little concern about complications such as intestinal obstruction.
Robotic surgery enables precise surgery through robot arms and 3D stereoscopic screens. In particular, in the case of rectal cancer surgery located in the narrow and deep pelvic cavity, more detailed autonomic nerve preservation and accurate tissue dissection are advantageous in preventing deterioration in urination and sexual function, as well as rapid recovery, and are gradually being performed.
Colon cancer, like other cancers, is caused by the interaction of various factors. In everyday life, it is best to prevent it by reducing the factors that affect it.
To this end, regardless of the type of food, there is a report that the higher the total calorie intake, the higher the risk of colon cancer, so it is good to reduce it.
Red meat, such as beef, pork, and lamb, is known to increase the risk of colorectal cancer, so it’s good to reduce your intake of processed meat or red meat. Eating plenty of fiber and calcium also helps.
In addition, the lower the amount of physical activity, the higher the risk of colon cancer, so office workers who sit all day should increase their physical activity through exercise. Drinking alcohol increases the risk of rectal cancer, especially in men, and smoking is known to increase the risk of both colorectal adenoma and colorectal cancer.
Reporter Kim Ho-yoon khy2751@
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