Today, a netizen, after reading my popular science article, asked me a question: "Dr. Li: Hello! I have differentiated gland A in sigmoid A, T3N0M0. After 8 chemotherapy, I have undergone surgery for four years. Is my condition basically cured? Thank you."
For a colon cancer patient who has undergone surgery, recurrence and metastasis after surgery has always been an indelible fear in his heart! But for this patient, he doesn't have to be too anxious. From clinical experience, he should be considered a basic cure. But the patient should not be careless because there is a very low probability that he will still be at risk of recurrence and metastasis. Why do you say so? Next, I will talk about my own views.
Let me first talk about why he is a patient who is close to cured.
Colon cancer
For sigmoid colon cancer patients with T3 stage, if their lymph node metastasis, it usually metastasizes from mesangial lymph adjacent to the intestinal cancer from near to far to the lymph nodes at the confluence of each confluence according to the direction of lymph reflux in , and then metastasis from the mesangial lymph nodes adjacent to the intestinal cancer from near to far to the lymph nodes at the roots of the inferior mesenteric artery and veins, which often occur in a very small number of patients with sigmoid cancer who have indications for radical surgery and most of them can only undergo palliative surgery. Patients with sigmoid colon cancer who violate this lymph node pattern clinically and have lymph node jumping metastasis in the intestinal cancer are extremely rare in clinical practice. Therefore, patients do not need to worry about this issue.
Radical surgery for sigmoid colon cancer, complete mescolonal resection must be performed according to diagnosis and treatment standards, and lymphatic dissection will also achieve the submesenteric artery and vein roots. The patient's pathological examination indicated that lymph node metastasis was 0 (N0), which means that no metastasis of the intestinal cancer lymph nodes adjacent to the patient's mesenteric cancer to the submesenteric artery and venous roots was found. This situation basically eliminates the risk of lymph node metastasis in the patients.
In addition, netizens who often read colon cancer popular science also know that the lymphatic vessels and microvascular vessels in the intestinal wall are accompanied by T3 stage sigmoid colon cancer, which has invaded and destroyed the lymphatic vessels and microvascular vessels in the intestinal wall, and there is a risk of vascular metastasis in the intestinal cancer cells. If a patient with bowel cancer does not have lymph node metastasis, the risk of hemogenesis of bowel cancer is much lower.
colon cancer
This patient's postoperative pathological histocellular cell classification suggests that the patient's differentiated adenocarcinoma is also proves that the risk of vascular metastasis in the patients is relatively small.
The attending physician of the patient implemented standardized chemotherapy after surgery. In addition, the patient's compliance was also very good, and he truly completed his standardized chemotherapy treatment course as scheduled. This good doctor-patient cooperation method also helps patients further eliminate the risk of residual intestinal cancer cells.
Also, from the characteristics of intestinal cancer cells, if blood metastasis occurs before the surgery, generally speaking, the surgery will definitely not be cleared. Chemotherapy is the method that can remove metastatic colon cancer cells after surgery. If chemotherapy cannot be eliminated, the patients will continue to proliferate and grow during chemotherapy. Most of them will be examined within one or two years and will find recurrent and metastatic tumors that have proliferated and grown. This is also the reason why recurrence and metastasis of bowel cancer often occurs within three years after the operation. But this patient has been four years after the operation. Theoretically, the intestinal cancer cells that cannot be removed and chemotherapy cannot be killed, and recurrence and metastasis have already occurred. Since it has not occurred four years after the operation, his risk of recurrence of bowel cancer is very low.
But why do you say that patients still cannot be careless?
colon cancer
1 clinically cannot be ruled out that the patient may have dormant intestinal cancer cells. Although the risk of reactivated and proliferation of this dormant in the patient's body is low, it is not absolutely non-existent. This is also the reason why regular follow-up is required for bowel cancer?
In addition, during the occurrence of intestinal carcinoma in patients with sigmoid colon cancer, the effect of carcinogenic factors on intestinal mucosal cells is usually involved in all colorectal mucosal cells, rather than limited to sigmoid colon mucosal cells.Therefore, when sigmoid colon mucosal cells become cancerous, it also means that the intestinal mucosa in other parts is more or less on the path of disease progressing toward the intestinal cancer cell disease.
The radical surgery for sigmoid colon cancer is to cure the site of intestinal cancer and does not eliminate the risk of new intestinal cancer in other areas. Moreover, the patient's postoperative chemotherapy cannot eliminate these lesional intestinal mucosal cells that progress towards the course of intestinal cancer, but may also promote the carcinogenesis of lesional intestinal mucosal cells. Standardized follow-up after sigmoid colon cancer is to some extent, to eliminate the harm caused to patients by new bowel cancer.
Of course, patients should not be too anxious. As long as they eat more foods rich in fiber after the operation, eat less high fat and red meat, and avoid other carcinogenic factors, as the patient develops intestinal mucosal cells in the disease, the risk of new intestinal cancer is also low.
