Last Tuesday (10th), the singer Preta Gil announced that she was diagnosed with colon cancer (Photo: Ale de Souzaa/Divulgao). Also known as colon and rectum or colon cancer, colorectal cancer is the second most common in both men and women, with the exception of skin cancers in melanoma, after breast and prostate cancer. More than 40,000 new cases are estimated by the end of 2023, according to the National Cancer Institute (Inca). Last Tuesday (10) singer Preta Gil announced that she was diagnosed with the disease. Although preventable in almost 90% of cases, the stigma surrounding colonoscopy tends to delay screening for precancerous lesions in colorectal cancer, which can be done by both fecal occult blood testing and, preferably, colonoscopy. Colonoscopy allows the identification of premalignant lesions polyps in healthy asymptomatic individuals, which are removed, preventing their development into malignant lesions. There is a fear of colonoscopy, the preparation of which requires colonic irrigation and is performed under sedation, but it is a safe, painless and fundamental examination,” explains Alexandre Jcome, oncologist at Grupo Oncoclnicas Belo Horizonte, Doctor of Science and postdoctoral researcher in gastric Intestinal Oncology .
misinterpretation of symptoms
Alexandre Jcome warns that the main obstacles to early diagnosis are lack of access to detection methods for patients in the public health system (SUS) and misinterpretation of symptoms.
Alexandre Jcome, oncologist at Grupo Oncoclnicas Belo Horizonte, warns: “Because the intestinal symptoms associated with colon and rectal cancer also occur in benign diseases, many patients neglect signs such as diarrhea, constipation, abdominal pain and even blood in the stool” ( Photo: Grupo Oncoclínicas/ Disclosure) “Since the bowel symptoms associated with colon and rectal cancer also occur in benign conditions, many patients neglect signs such as diarrhea, constipation, abdominal pain, and even blood loss in the stool, which are common in colon cancer in the presence of hemorrhoidal disease. This misinterpretation of symptoms by patients or even the medical class is particularly common in young people due to the concept of rarity of the disease in these age groups. However, the change in the epidemiological profile of the disease observed in recent years, with a higher incidence in younger people, in addition to the correct identification of symptoms, requires greater awareness of both the general population and the medical class,” warns the oncologist of Grupo Oncoclínicas .The most common symptoms are changes in bowel habits, such as B. a change in the frequency of bowel movements, a feeling of incomplete evacuation, abdominal pain and loss of blood in the stool. “As the disease progresses, we can see unintentional weight loss,” says Alexandre Jcome.
According to the doctor, about 5 to 10% of patients affected by colon and rectal cancer have inherited genetic changes that increase the risk of developing the tumor. This probability is greater the younger the patient is. However, the main risk factor is lifestyle habits; There is a close correlation between the occurrence of tumors and a country’s Human Development Index (HDI).
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“In most patients there is no identifiable hereditary component. Wealthier countries have the highest incidence rates of the disease, consistent with the finding that people who are overweight or obese have a higher risk of developing colon cancer, eat diets high in red meat and fat and low in fiber and fruits and vegetables vegetables. There is also an increased risk with a lack of exercise, smokers and people who consume excessive amounts of alcoholic beverages,” the oncologist describes.
Advances in science ensure personalized treatments with fewer side effects
Treatment for colorectal cancer is defined by its stage, but recent therapeutic developments have increased cure rates. “The treatment of earlystage colon cancer has remained unchanged over the past decade and has consisted primarily of surgical removal followed by adjuvant chemotherapy in selected cases. An advance worth mentioning is the demonstration that we can offer a proportion of patients with a first disease a shorter chemotherapy period, thereby preserving the prospect of a cure with fewer side effects,” explains Alexandre Jcome.
Another advance in early tumors is to carry out all therapeutic steps in the preoperative phase. “Traditionally, rectal cancer has been treated with a first level of chemotherapy and radiation therapy, followed by surgical removal, with a second level of chemotherapy following surgery. It has been shown that there is an increase in cure rates when we already perform the second stage of chemotherapy in the preoperative phase. This modality increases the likelihood that the tumor will disappear from the rectum when it is possible not to perform the surgical removal of the organ, but only in very selected cases and with a very strict followup,” he explains.
The discovery of different subtypes of colorectal cancer was instrumental in defining new treatment strategies for advanced colorectal cancer. “The ability to identify specific genetic changes in each tumor enables targeted approaches and greater therapeutic individualization. In this way, it was found that immunotherapy can benefit around 5% of patients who have a specific genetic abnormality. Likewise, about 8 to 10% of patients have a specific molecular change in their tumors that can be treated with oral medications without the use of chemotherapy. Therefore, advances in cancer genetic sequencing have enabled the identification of specific abnormalities of the disease that can be inhibited pharmacologically,” stresses Alexandre Jcome.