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| 認識腸癌 Colorectal cancer | |||||||||||
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 腸癌 -結腸和直腸的癌症 - 是本港第二號癌病殺手。腸癌出現於大腸(結腸)，如果發生在結腸的最後6英寸（直腸），被稱為直腸癌。結腸位於消化系統下部，負責將食物轉化能量和協助身體排除廢物。這部分發生癌症的話被稱為結腸癌。這兩種癌症統稱為腸癌。大多數腸癌開始時多數為良性腺瘤或息肉，生長於結腸或直腸內壁。良性腺瘤的蔓延速度非常緩慢，一般需10至20年才發展成癌細胞。定期篩檢可找出並消除息肉，預防癌症病變。但如果腸癌已得到確診，那麽對病情的預期將取決於癌細胞的擴散程度。症狀： 不幸的是，大多數早期腸癌患者不能覺出任何症狀。因此，定期進行一些篩檢程序（例如結腸鏡檢查）是非常有用的預防辦法。一般而言，腸癌的症狀可包括以下各種： *大便習慣的改變 *糞便中有血（這也可以由其他原因引起） *與失血有關的問題（貧血、虛弱、疲勞、氣短、心跳沈重或加快、胸部疼痛和喪失運動能力等） *腹部不適（常有胃氣、腹脹、肚飽感、抽筋和疼痛） *體重下降 *排便疼痛 *感覺大便未能完全排空 原因： 超過一半腸癌未能找到任何致病原因。研究表明，遺傳因素可能有關。某些腸癌患者自己或者其親屬的細胞會發現一些基因突變的情況。吸煙和高脂肪飲食也提高患癌症的風險。所以遺傳因素和生活方式都會影響那些“高危”人士發展成癌。 風險因素： 大腸癌風險因素包括： *年齡（50歲以上） *以前曾患腸癌人士 *曾經發現腺瘤性息肉 *有腸癌家族史 *喜好高脂肪飲食 *吸煙 *體重過高 *大量飲酒 *發炎性腸病患者（如克羅恩病和潰瘍性結腸炎） *糖尿病患者 診斷： 醫生將檢視個人完整病歷，進行身體檢查，同時透過一個或多個測試來診斷腸癌。用於診斷腸癌的標準測試包括乙狀結腸鏡、大腸鏡和鋇灌腸等。 腸癌的各個階段： *前期：最早的階段，癌症只發現於結腸和/或直腸最內壁。 *第一期：癌症已經成長於結腸和/或直腸最內壁，但並未擴散至直腸或結腸壁。 *第二期：癌症已經擴散至直腸或結腸壁更深層，但並未擴散至淋巴結。 *第三期：癌症已經擴散至附近的淋巴結，但並未擴散至身體其他部位。 *第四期：癌症已經擴散至身體其他部位，如肝臟和肺部等。 預防保健： 癌症篩選如能定期檢測篩查腸癌息肉並及早發現，在癌變發生前腸癌是可預防甚至可治愈的。 飲食與運動： 多吃水果和蔬菜以及富含ω-3脂肪酸（三文魚和大比目魚等）和鈣（如海洋中的蔬菜和羽衣甘藍）的食物可以幫助降低患腸癌風險。節制飲酒、戒菸，並減少攝取高脂肪和油炸食品（特別是紅肉類），也有效預防腸癌。保持合適體重和定期運動能減少患腸癌的風險。即使少量定期運動對此也有幫助。美國癌症協會建議每日至少做30分鐘運動。 治療： 腸癌的基本治療方法是手術切除部分結腸腫瘤。根據癌症的各種階段，手術後也會施與化療。如果腫瘤特別大，手術前後或需要接受放射治療（電療）。某些藥物或補充劑有助預防息肉或結腸癌的產生。即使有家族成員有相關病歷，留意生活方式的改變，特別是少吃紅肉、減肥、戒菸，配合多做運動，也有助預防疾病。 膳食營養補充劑 針對腸癌的治療可包括一系列補充劑和替代療法。有些補充劑和草藥可以幫助減少藥物常見的副作用。其他一些則有助降低腸癌風險。以下這些可幫助降低腸癌風險： *多種維他命，每天服含有抗氧化維他命A、C、E和維他命B雜、礦物質和微量元素（如鎂、鈣、鋅、硒等）。 *ω-3脂肪酸，例如每天服用1-2粒。人口研究表明，ω-3脂肪酸可降低患上結腸癌、乳腺癌、前列腺癌等的風險。一些初步研究表明，魚油可能有助於降低結腸癌細胞的增長速度，但需要更多研究支持此理論。深海魚類，例如三文魚或大比目魚，是食物中很好的ω-3脂肪酸來源。 *每日服益生菌補充劑（含有機物混合物，包括嗜酸乳桿菌）5-100億單位。這些對身體“友好”的細菌有助維持消化道健康。初步證據表明，益生菌可能有助於減少那些曾經接受手術切除結腸癌的腫瘤病人的復發率。 草藥 草藥一般能安全地強化身體機能，調理體質： *綠茶標準提取物，每日250-500毫克。綠茶中含有抗氧化劑，可以幫助增強免疫系統。這或許有助於預防癌症，但需進一步研究證明這點。可選用不含咖啡因的產品。另外，泡茶飲用也一樣有益。 *薑黃標準提取物，每日3次，每次300毫克。薑黃素在試管測試中已被證實能殺死癌細胞。現有一些研究正在進行，探究它在人類身上是否能產生同樣效果。 Colorectal cancer Colorectal cancer -- cancer of the colon and rectum -- is the second most common malignancy in Hong Kong. Colon cancer occurs in the large intestine. If the cancer is in the last six inches of the colon (the rectum), it is considered rectal cancer. The colon is the lower part of the digestive system, which processes food for energy and rids the body of solid waste. Together, these cancers are referred to as colorectal cancers. Most colorectal cancers begin as benign adenomas, or polyps that grow on the inner lining of the colon or rectum. These growths spread very slowly, taking from 10 - 20 years to become cancerous. Regular screening tests can identify and remove polyps before they becomes cancerous. Once colorectal cancer is diagnosed, the prognosis depends on how far the cancer has spread. Signs and Symptoms: Unfortunately, most people with colorectal cancer don't experience any symptoms in the early stage of the disease. That's why screening tests, such as a colonoscopy, are so important. In general, signs and symptoms of colorectal cancer can include the following: * Changes in bowel habits * Blood in the stool (can have other causes, too) * Problems related to blood loss (anemia, weakness, fatigue, shortness of breath, pounding or racing heart, chest pain, and intolerance to exercise) * Abdominal discomfort (frequent gas, bloating, fullness, cramps, and pain) * Unexplained weight loss * Pain with bowel movement * Feeling that your bowel doesn't empty completely Causes: More than half of all colorectal cancers occur without any known cause. Studies also suggest that genetics may play a role. Some people with colorectal cancer carry specific genetic mutations or have relatives with the condition. Smoking and eating a high fat diet also raise the risk of developing cancer. Both genetics and lifestyle factors may play a strong role in determining which "at-risk" individuals develop the disease. Risk Factors: Risk factors for colorectal cancer include: * Age (being over 50) * Having colorectal cancer previously * Having a history of adenomatous polyps * Family history of colorectal cancer * Eating a high-fat diet * Smoking * Being overweight * Heavy use of alcohol * Having inflammatory bowel disease (such as Crohn's disease and ulcerative colitis) * Having diabetes Diagnosis: You doctor will take a complete medical history, and will perform a physical exam and may order one or more tests to diagnose colorectal cancer. Standard tests used to diagnose colorectal cancer include sigmoidoscopy, colonoscopy, and barium enema. Stages of colorectal cancer include: * Stage 0: The earliest stage; cancer is found only in the innermost lining of the colon and/or rectum. * Stage 1: Cancer has grown through the innermost lining but hasn't spread beyond the colon wall or rectum. * Stage 2: Cancer has spread to deeper layers of the wall of the colon or rectum, but not the lymph nodes. * Stage 3: Cancer has spread to nearby lymph nodes but not to other parts of the body. * Stage 4: Cancer has spread to other parts of the body, such as the liver and lungs. Preventive Care: Screening Colorectal cancer is highly preventable, even curable, when detected early. Regular screening for colorectal cancer detects polyps before they become cancerous. Diet and Exercise Eating plenty of fruits and vegetables as well as foods rich in omega-3 fatty acids (such as salmon and halibut) and calcium (such as sea vegetables and kale) can help reduce the risk of colorectal cancer. Limiting alcohol consumption, quitting smoking, and reducing the intake of high-fat and fried foods, particularly red meats, may also protect developing colorectal cancer. Maintaining a proper weight and exercising regularly also cut your risk of developing colorectal cancer. Even small amounts of exercise on a regular basis can help. The American Cancer Society recommends at least 30 minutes of physical activity on most days. Treatment: Surgery to remove the part of the colon containing tumor is the primary treatment. Depending on the stage of the cancer, surgery is generally followed with chemotherapy. If the tumor is particularly large, you may need radiation before or after surgery. Some medications or supplements may help prevent the development of polyps or colorectal cancer. Making lifestyle changes, especially eating less red meat, losing weight, quitting smoking, and getting more exercise, may help prevent the disease -- even in people with a family history of the condition. Nutrition and Dietary Supplements A comprehensive treatment plan for colorectal cancer may include a range of complementary and alternative therapies. Some supplements and herbs may help reduce side effects from conventional medications. Other may help reduce the risk of developing colorectal cancer. These supplements may help reduce risk of colorectal cancer: * A multivitamin daily, containing the antioxidant vitamins A, C, E, the B-complex vitamins, and trace minerals such as magnesium, calcium, zinc, and selenium. * Omega-3 fatty acids, such as fish oil, 1 - 2 capsules or 1 - 3 tablespoonfuls oil daily. Population studies suggest that omega-3 fatty acids may reduce risk of developing colon, breast, or prostate cancer. A few preliminary studies seem to suggest that fish oil might help reduce the growth rate of colon cancer cells, but more research is needed to know for sure. Cold-water fish, such as salmon or halibut, are good sources to add to your diet. * Probiotic supplement (containing a mixture of organisms including Lactobacillus acidophilus), 5 - 10 billion CFUs (colony forming units) a day. These "friendly" bacteria help keep the digestive tract healthy. Preliminary evidence suggests that probiotics might help reduce recurrence of tumors in people who have had surgery to remove colon cancer. Herbs Herbs are generally a safe way to strengthen and tone the body's systems. * Green tea (Camellia sinensis) standardized extract, 250 - 500 mg daily. Green tea contains antioxidants and can help boost the immune system. It may help prevent cancer, although studies haven't been able to prove that. Use caffeine-free products. You may also prepare teas from the leaf of this herb. * Turmeric (Curcuma longa) standardized extract, 300 mg three times a day. Turmeric or curcumin has been shown to kill cancer cells in test tubes. Studies are underway to see if it has the same effect in humans.
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