Tumor of the sigmoid colon: symptoms, stages, treatment, prognosis. Sigmoid colon cancer: symptoms, life prognosis for patients after surgical treatment Sigmoid colon cancer 2

Sigmoid colon, shaped like one lying on its side Latin letter S, is an extremely important section of the large intestine, in which the final formation of feces occurs.

It is here that they part with nutrients and water, which are absorbed into the blood, and feces enter the rectum (which is a continuation of the sigmoid) and are excreted from the body.

Concept of illness

Cancer sigmoid colon called a malignant tumor that develops from the epithelial tissues of the mucous membrane of this organ.

The leading importance is attached to surgical intervention: without it it is impossible to cure this disease. In the presence of small cancerous tumors with clear boundaries, they are removed (resection) along with part of the affected intestine and adjacent lymph nodes. After this, the integrity of the intestinal tube is restored.

Small tumors with a low level of malignancy can be removed using a gentle (endoscopic) method - without making a skin incision.

During a laparotomy operation, a specialist makes several small punctures through which fiber-optic tubes equipped with a miniature video camera and endoscopic instruments are inserted into the patient's abdominal cavity.

When treating an advanced tumor that has reached stage IV, an operation can be performed to completely remove the sigmoid colon with a procedure designed to remove gases and feces.

Sometimes a colostomy is removed temporarily, only to improve the results of the operation. A few months later, the colostomy is removed, restoring the natural passage of feces through the anus.

In some cases, the colostomy is made permanent. With this type of operation, the patient is forced to walk with a colostomy bag for life.

Chemotherapy– treatment of cancer using drugs that destroy cancer cells and inhibit their ability to rapidly divide – comes to the aid of even patients with advanced disease and can be used both before and after surgery. When using one drug we talk about monochemotherapy, when using several – about polychemotherapy. Unfortunately, it cannot replace surgical treatment. With its help, doctors only reduce the size of cancer tumors and slow down their growth. As an independent therapeutic method, it is used only in relation to inoperable patients.
Radiotherapy sigmoid colon cancer is performed very carefully, since there is a high risk of perforation of the walls of this organ. In addition, most types colorectal cancer is characterized by low sensitivity to this therapeutic method. However, the use of radiation therapy can give good results in reducing the size of the tumor before surgery and in destroying it. cancer cells, which could remain at the border of healthy and diseased tissues.

Prognosis after surgery

The prognosis (most often moderately favorable) for sigmoid colon cancer primarily depends on the level of differentiation of tumor cells: highly differentiated malignant tumors are treated better.

Just as important early detection cancer and its immediate treatment.

Complex treatment patients (combining surgery with chemotherapy radiation therapy) with single metastases in regional lymph nodes gives a five-year survival rate of 40% of patients. In the absence of such therapy, less than a quarter of patients survive.
If sigmoid colon cancer is limited only to its mucous membrane, after resection of tumor tissue, the five-year survival rate is at least 98%.

Since sigmoid colon cancer is one of the least aggressive and most benign forms of malignant neoplasms, if treated in a timely manner medical assistance Patients still have a very high chance of complete recovery.

Dietary nutrition for sigmoid colon cancer

Postoperative diet is of great importance in the treatment of sigmoid colon cancer. During the first day, the patient is shown fasting (his nutrition is carried out by intravenous administration nutrient solutions containing amino acids and glucose).

For six days after surgery, the patient is contraindicated in eating any solid food. His diet should consist of juices, broths, thin cereals, vegetable purees And herbal decoctions, and after mandatory agreement with the doctor.

Ten days after the operation, the patient’s diet is diversified low-fat varieties meat, fish and dairy products. Ideal ratio of nutritional components in therapeutic diet: 50% should be carbohydrates, 40% proteins, and only 10% fats.

The patient must completely stop using:

fatty meats and fish;
fried foods;
pickles, marinades and canned food;
sausages and smoked meats;
baked goods, chocolate and sweets;
coffee, strong tea, alcoholic and carbonated drinks;
eggs, cheese and whole milk;
freshly baked bread;
vegetables containing coarse fiber;
legumes.

Methods of culinary processing of products intended to feed a person who has undergone colon surgery should be boiling and steaming. Portions should be small. You should eat food at least five times a day.

Vegetables, cereals, dairy products, lean varieties of fish and meat, fruits, biscuits, dried bread, crackers.

The video shows sigmoid colon cancer using colonoscopy:

This section of the organ is located almost at the very end of the intestine. The sigmoid colon is S-shaped and is also involved in digestive function Gastrointestinal tract. She sucks up the leftovers useful substances, enzymes and, most importantly, residual moisture, and then turns the feces into a solid consistency.

About the disease

Sigmoid colon cancer - tumor malignancy from epithelial tissues, which appears as a result of cell mutation. Oncology itself is very common and accounts for about 35% of all cases malignant tumors intestines.

This is due to the fact that feces due to insufficient intestinal motility, poor nutrition or other concomitant diseases stagnate. During stagnation, toxic substances from the stool are absorbed into the intestinal walls. Blood circulation also deteriorates.

The problem with this pathology is that there are practically no symptoms in the first stages. Some scientists suggest that cancerous tumors first release painkillers into the nearby walls. That is why the disease itself is often diagnosed at stages 3 or 4, when it is almost impossible to cure cancer.

Causes

Intoxication- occurs due to alcohol, cigarettes, highly toxic foods, medications, foods with dyes and food additives.
Genetics- if the patient has blood relatives who suffer or have previously suffered from this disease, then they immediately fall into the risk group.
Poor nutrition- flour, animal fats and proteins contribute to the development of tumors.
Diseases- such as ulcerative and chronic colitis, Crohn's disease, diverticulosis.
Intestinal motility is impaired- may be due to medications, illness, sedentary lifestyle, or as a result of injury or surgery.
Sigmoiditis, polyps, adenomatous polyposis- these are precancerous benign tumor formations which can subsequently lead to cancer. Usually the polypoid tumor is removed immediately.
Diabetes— as a result, obesity occurs, which in turn can lead to tumors.
Radiation, ecology— affects the formation of any oncology, including in the gastrointestinal tract.

First signs

The first symptoms of sigmoid colon cancer are very mild, and usually the patient confuses them with a common disorder, diarrhea or other diseases. The symptoms are the same in women and men.

Flatulence and regular occurrence of gases.
Abdominal pain on the left.
Diarrhea alternates with constipation.
Constant loud rumbling in the stomach.
Belching with foul odor.
Pain during and before defecation.
Blood in stool. The difference from hemorrhoids is that blood is mixed into the masses themselves, when, as with hemorrhoids, blood enters from above in the form of drops during the act of defecation. Cancer stools may be darker due to blood clots.

Subsequent symptoms

More pronounced signs appear when the tumor grows, affects nearby tissues, lymph nodes and metastasizes to organs.

Enlarged liver.
General intoxication, headaches, nausea, vomiting.
Low-grade fever, dizziness.
Loss of appetite and weight.
Bloating.
Anemia.
Ascites in abdominal carcinomatosis.
Jaundiced eyes and skin.
Feces in the form of a ribbon. This is due to the fact that the tumor blocks the intestinal passage.

NOTE! The danger may be that the intestinal passage is blocked by a tumor. Then the feces will stagnate and intoxication will be many times higher.

Stages

Degree	Description
Stage 1	The tumor is small in size and located within the mucous epithelial tissue. Survival rate: 97%
Stage 2	2A - grows inside the intestine and occupies half of the passage. 2B - grows into the intestinal walls. In both cases there is no metastasis. Survival rate: 80%
Stage 3	3A - the tumor has big sizes, but does not metastasize. Survival rate: 58% 3B - the neoplasm metastasizes to the nearest lymph nodes Survival rate:40%
Stage 4	Metastasis occurs in all lymph nodes, and the nearest organs: ovaries, bladder, testicles, prostate gland, liver, pancreas, etc. Survival rate: 8%

Metastases

Metastases usually appear at stage 4 of sigmoid colon cancer, a little less often at stage 3. Malignant cells penetrate through the lymphatic system, blood and by germination of the tumor itself into nearby tissues.

Organ damage

Bladder.
Uterus.
Ovaries.
Testicles and penis.
Spinal cord and spine.
Liver
Kidneys and adrenal glands.
Pancreas.
Stomach.
Peritoneum.

Complications

Thrombophlebitis in the venous vessels of the pelvis.
The neoplasm blocks the intestinal lumen and causes partial obstruction. At a later stage it may be complete.
Retroperitoneal abscesses due to inflammation.
Peritonitis or inflammation abdominal cavity.
Additional symptoms for metastases to other organs.
Peritoneal carcinomatosis.
Ascites.

Diagnostics

Palpation And external inspection — after the first symptoms, the patient consults a doctor. He spends initial examination the patient, listens to complaints and palpates the abdomen for swelling and other defects.
Analyzes- common for rent, biochemical analysis blood, urine and feces. In the second case, it is necessary to find out the presence of blood in the stool.
Colonoscopy— if blood is found in the stool analysis, or a more precise examination is needed, then an endoscope is inserted into the anus and the intestines are examined for the presence of tumors. By using endoscopic examination You can take a piece of the tumor for histological examination. Sigmoidoscopy is a rather unpleasant procedure.

Ultrasound of the peritoneum- examine all abdominal organs for the presence of metastases.
Irrigoscopy— Barium contrast solution is injected into the abdominal cavity and an x-ray is taken.
MRI, CT- Very accurate diagnosis, allowing you to see the tumor, its size, shape, and the degree of damage to nearby tissues.
Biopsy- a piece of tumor tissue is examined under a microscope to see the atypicality of the cells, the difference from healthy ones. Differentiation and aggressiveness, as well as benignity of the neoplasm.

Therapy

Correct treatment of sigmoid colon cancer is possible only after diagnosis accurate diagnosis. After this, the oncologist builds a strategy to combat the tumor. Treatment is usually carried out in combination: surgery, chemotherapy and radiation.

Surgery

The task is to remove the tumor with nearby damaged tissues and preserve the integrity of the organ as much as possible.

Resection— only a small part of the neoplasm is removed along with the nearby tissues of the segment. The healthy ends are simply stitched together. The prognosis after surgery in this case is very favorable and most patients are completely cured.
Endoscopic removal— an endoscope is inserted into the intestine and part of the tumor is carefully removed. Several punctures are also made in the abdomen, through which special tubes with a camera and instruments are inserted.
Complete removal- Usually done for more late stages when there is metastasis to the lymph nodes. The diseased piece of intestine with the affected tissues is being cut off. The colon may then be removed through an opening in the abdomen (colostomy) to remove stool and gases.

Chemotherapy

It is used before surgery to reduce a malignant tumor to an operable size, and after surgery to destroy remaining metastases. Used only as a complex treatment with surgery. It is used independently only if surgery cannot be done. A chemical reagent is injected into the tissue near the tumor or the vessel feeding it, which is aimed at destroying cancer cells.

Radiotherapy

Often used after surgery to destroy any remaining tumor. According to statistics, intestinal cancer is very insensitive to radiation, which is why radiation therapy is used in combination with chemotherapy to improve the outcome of treatment.

Forecast

A malignant tumor of the sigmoid colon most often has low aggressiveness and develops for quite a long time. Because of this, the survival rate is quite high. Plus, metastases usually appear only at stage 4 in nearby organs. Adenocarcinoma or glandular cancer has a similar survival rate.

What influences a favorable prognosis?

Differentiation of cancer. A well-differentiated tumor is easier to treat, but with aggressive tumor growth the prognosis is worse.
Patient's age.
Stage of cancer. The earlier it was diagnosed, the higher the survival rate of patients.
Response to chemotherapy and radiotherapy.
Availability concomitant diseases which may complicate treatment.
Presence of metastasis to lymph nodes.
Metastases to organs.

If the tumor has stage 1 and is limited to one tissue plane of the organ, then it is cured and removed quite simply, and the survival rate reaches 98%. With liver metastases, survival rate drops to 5%.

Nutrition

In the first days after resection or removal of the tumor, all nutrients administered intravenously and the patient is contraindicated to eat. Then, over the next 6 days, all food should be liquid:

Vegetable puree soups.
Curd mass with fruits.
Buckwheat, oatmeal porridge.
Juices.
Vegetables: tomatoes, cucumbers, cabbage, cauliflower, broccoli.
Greens: parsley, onion, celery.
Turnip.
Lean meat, fish, chicken.
Red pepper.
Fruits: oranges, tangerines, apples.
Berries: strawberries, cherries, raspberries, currants, blueberries, blueberries.
Cottage cheese, low-fat sour cream, homemade yogurt.

Energy value

Fats - 15%
Proteins - 35%
Carbohydrates - 50%

Basic Rules

All food that will be cooked must be passed through a blender to completely grind it.
Food should only be eaten warm. Cold and very hot foods, which disrupt the production of gastric juice, are prohibited.
Dietary food rich in microelements and vitamins.
All food must be boiled. It is forbidden to eat fried food.
Immediately after the operation, the walls of the colon are fragile and you need to eat no more than 3 kg of food per day.
You need to eat in small portions 5-6 times.
You need to drink a lot of water a day - 6-7 glasses.

Prohibited to accept

All malignant neoplasms are characterized by a progressive course, which implies a gradual worsening of the prognosis. Thus, stage 2 sigmoid colon cancer can manifest itself as tumor growth within several layers of the organ wall, but it is still a localized neoplasm that can be treated surgical treatment. Further spread of the process will lead to a significant deterioration in the prognosis. Medical consultation will help the patient learn more about a disease such as the second stage of well-differentiated sigmoid colon carcinoma: prognosis, treatment, complications and other important aspects.

Information about the disease

In the medical literature, sigmoid colon carcinoma is classified as a type of colorectal cancer. This is a malignant tumor that forms from the epithelial lining of the inner lining of the large intestine. Epidemiological evidence suggests that older people are more susceptible to this disease than younger patients. This can be explained by the prevalence inflammatory diseases gastrointestinal tract in this age group.

There are several histological types of sigmoid colon cancer. A common option is the sigmoid colon, stage 2 of which is already characterized by significant growth. Such a tumor is formed from glandular cells of the mucous membrane of the organ. In addition, this type of carcinoma is also classified according to the characteristics of the malignant cells. Highly differentiated tumors are characterized by a “milder” course.

Oncological diseases have their own characteristics. Neoplasms can be called peculiar organisms that have their own cellular structure. Tumor cells receive nutrition from the blood and have metabolic functions. Sometimes the oncological process even provokes the growth of new blood vessels to improve nutrition. The significance of such features is important for treatment, since the prescribed medications must selectively act on abnormal cells and not harm healthy tissues.

A big problem in oncological practice is the late diagnosis of intestinal carcinoma. This is due to the asymptomatic course of the disease in the early stages of tumor growth. Even stage 2 sigmoid colon cancer most often does not manifest itself symptomatically. To avoid late diagnosis, it is necessary to promptly identify risk factors and undergo annual screening examinations, including gastrointestinal endoscopy.

Features of the second stage

The main classification of oncological diseases involves the division clinical picture on the stage. Thus, each stage differs in the prevalence of the tumor process and the condition lymphatic system. The most important criterion for the transition of a tumor from early to late stages is sometimes considered the process of formation of sentinel lymph nodes containing malignant cells. This is due to the drainage of lymphatic fluid from the affected organ. Late-stage cancers metastasize through the lymphatic system.

Stage 2 sigmoid colon cancer is characterized by the following symptoms:

The tumor grows within the mucous, submucosal and muscular lining of the intestine.
Nearby abdominal organs are not affected.
Absence of sentinel lymph nodes.
No metastases.

This stage is considered localized, since the neoplasm is located within one organ. These features make the early stages of the disease most accessible to surgical intervention. During surgery, the doctor needs to remove the affected organ tissue and a small part of adjacent healthy tissue to prevent relapse. With advanced cancer, such intervention is much more difficult.

If the doctor has detected stage 2 cancer of the sigmoid colon and carried out effective treatment, the prognosis is usually favorable. The patient's five-year survival rate is 80-90%. With poorly differentiated carcinoma, the prognosis may be less favorable due to its aggressive course.

Causes

Adenocarcinoma of the 2nd sigmoid colon can form over several months or even years. First in the epithelial lining of the organ with prolonged exposure negative factors, such as the expression of mutant genes and inflammatory processes, precancerous changes occur. Normal cells change and cease to perform their functions. Gradually formed tumor process, spreading to other tissues.

It should be taken into account that neoplasm of the large intestine is a polyetiological disease. A huge number of factors increase the likelihood of malignancy of the organ mucosa, including bad habits, poor nutrition and the presence of chronic diseases. Timely detection of risk factors is necessary for regular examinations.

Possible risk factors:

Having inflammatory bowel disease, such as Crohn's disease or ulcerative colitis.
Availability benign tumors large intestine (polyps and diverticula).
Hereditary syndromes, including adenomatous polyposis and non-polyposis colorectal carcinoma. Such pathologies are diagnosed between the ages of 30 and 55 years.
Age. Intestinal carcinoma is most often diagnosed in people over 55 years of age, due to the risk of chronic gastrointestinal diseases.
Exposure to radiation during radiation therapy for malignant neoplasms of the abdominal cavity. Ionizing radiation is a powerful factor in the occurrence of genetic mutations.
Family history of adenocarcinoma of the sigmoid colon (especially in the patient's father or mother).
Diet with high content fatty foods and lack of fiber. Another important oncogenic factor is regular use regular and processed red meat.
Absence physical activity and a sedentary lifestyle.
Diabetes mellitus and overweight.
Smoking and frequent consumption of alcoholic beverages.

Preventive measures help avoid tumor formation even in the presence of numerous risk factors.

Stage 2 sigmoid colon cancer: symptomatic picture

Symptoms of any cancer depend on the stage and location of the tumor. Thus, stage 2 sigmoid colon cancer, the prognosis for which is quite favorable, most often has an asymptomatic course, since the small size of the tumor does not imply high risk occurrence of complications. Chronic diseases of the gastrointestinal tract can also mask the manifestations of the early stages of intestinal carcinoma.

Signs of pathology:

Abdominal pain, flatulence and impaired intestinal motility.
Defecation disorders: loose stool, constipation and the presence of blood in the stool.
Nausea and vomiting.
Fast weight loss.
Lack of appetite.
Weakness and fatigue.
Sleep disturbance.
Headache.
Depression and apathy.

Additional symptoms may be associated with individual characteristics of the pathology. At the same time, stage 2 sigmoid colon cancer is not characterized by metastasis, so damage to distant organs does not occur.

Establishing diagnosis

Diagnosis and treatment of oncological diseases are carried out by doctors of various profiles. During the consultation, the doctor will ask the patient about symptoms, review medical history, and perform a physical examination to identify early signs diseases. Since stage 2 sigmoid colon cancer rarely manifests itself symptomatically, instrumental and laboratory diagnostic data will be required to make a final diagnosis.

Additional research:

tumor tissue - sampling a small area of the affected epithelium of an organ to clarify the histological type of oncology. This is an important study, the results of which determine treatment tactics.
Ultrasound examination – visualization of the abdominal organs using high-frequency sound waves.
Radiography – standard method organ scans. Obtaining images of the intestines requires the use of dyes.
Computed tomography and magnetic resonance imaging are high-precision scanning methods with which the oncologist can obtain high-resolution images of organs. CT and MRI data are important for determining the stage of the disease.
Blood test for oncogenic markers, cellular composition, biochemistry and other indicators.
Endoscopic examination of the gastrointestinal tract. Typically, a biopsy is performed during a sigmoidoscopy.

Stage 2 sigmoid colon cancer can be treated only after the patient’s condition has been clarified.

Treatment methods

As already mentioned, surgical treatment is still available in the second stage. The doctor removes the affected part of the intestine and some lymph nodes to reduce the risk of recurrence. This can be an abdominal or laparoscopic operation.

After surgery, the following therapeutic procedures may be prescribed:

Radiation therapy.

During the consultation, the oncologist will be able to tell you more about such a pathology as adenocarcinoma of the sigmoid colon: stage 2, prognosis and risks of complications. It is recommended to undergo examination as soon as possible if negative symptoms are detected.

A malignant tumor of epithelial cells of the skin, mucous membranes of the stomach, intestines, respiratory tract, various glands, etc. A malignant tumor consists of malignant cells. The disease is characterized by the appearance of uncontrollably dividing cells capable of invasion into adjacent tissues and metastasis to distant organs.

What is the sigmoid colon?

The sigmoid colon is the penultimate section of the intestine. He has S-shape and lies up to the rectum. It is where the final formation of feces and the absorption of processed foods with nutrients occurs.

Sigmoid colon cancer is the most common form of cancer, which is due to its anatomical structure. Feces in the sigmoid colon thicken, so the mucous membrane is in contact with carcinogens and fecal toxins for a long time. As a result of this interaction, the growth of polyps is possible - benign tumors hanging into the intestinal lumen and covered with mucous membrane, as well as fleecy pink-red tumors of a round or elongated shape, the surface of which is velvety or papillary.

What does the intestine consist of?

How does sigmoid colon cancer manifest?

Neoplasms are injured by feces and become sources of bleeding and the appearance of cancer cells, from which sigmoid colon cancer develops, the first symptoms of which are almost impossible to detect at an early stage without special diagnostic examination due to the lack characteristic symptoms. Exactly because of this reason important factor successful treatment timely diagnosis of these diseases is important.

Most often, a fleecy, spongy, pinkish-red tumor degenerates. Then the sigmoid colon becomes inflamed, cancer with metastases is observed more in older patients, regardless of gender.

It is important to know! Villous tumor at an early stage can be detected during preventive measures and research analyses. It and polyps are treatable and give a positive prognosis after surgery. They must be removed even if benign process development in order to prevent the transition to an oncological tumor and prevent.

The asymptomatic course of intestinal cancer is always dangerous for sick people, since sigmoid colon cancer, symptoms appear on late stages. If you pay close attention to your health, you can suspect signs of sigmoid colon cancer; the symptoms will be characteristic of the entire intestine and long-lasting. You should consult a doctor if you have:

unknown digestive disorder with alternating diarrhea and constipation;
bloating with increased peristalsis intestines and frequent belching;
sensations of tension in the peritoneum on the left;
in the feces there are particles of pus, mucus and blood, which happens during the development of: benign or already oncological;
pain on the left side of the abdomen.

If you suspect sigmoid colon cancer, symptoms of general poor condition the patient cannot be ignored, since they indicate the third stage of cancer. The patient's face becomes gray, body weight decreases, anemia appears, he quickly gets tired and weakens.

Important! Symptoms of sigmoid colon cancer in women can be hidden behind characteristic features cystitis, inflammation genitourinary organs or . The sooner the examination is carried out, the sooner treatment will begin and the more optimistic the prognosis will be.

Causes of sigmoid colon cancer

The percentage of sigmoid colon cancer increases due to meat consumption more than vegetable fiber. Due to animal proteins, the growth of intestinal flora, which produces carcinogens, is accelerated. If there is insufficient intake of vitamins and antioxidants from plant foods, inactivation of these carcinogenic substances does not occur.

Alcohol and nicotine, carcinogenic products, household chemicals And harmful substances in production aggravate the condition of the body and lead to the appearance of oncological diseases such as intestinal cancer:

If we consider risk factors, then such diseases appear due to:

frequent nervous stress;
medication abuse;
sedentary lifestyle;
senile intestinal atony;
heredity (5%);
precancerous diseases: terminal ileitis, diverticulosis, ulcerative colitis, etc.

In this case, the functioning of the intestines becomes abnormal, peristalsis and blood circulation are disrupted, food and feces stagnate, intoxication of the body occurs and the mucous membrane is injured due to constipation from hardened feces. The sigmoid colon suffers the most due to the peculiarities of its shape and location.

Classification of types, types and forms of sigmoid colon cancer

A number of pathological neoplasms can occur in the sigmoid colon: precancerous benign and malignant.
Oncological tumors are carcinoma of the sigmoid colon. Glandular tissue is a source of development of cancer cells. The most common (75-80%) adenocarcinoma of the sigmoid colon.

She is represented by:

well-differentiated adenocarcinoma of the sigmoid colon is a type that is less dangerous for the body.
moderately differentiated adenocarcinoma of the sigmoid colon, the prognosis for cure is average and depends on the stage and the presence of metastases;
mucinous adenocarcinoma, which is a type of poorly differentiated adenocarcinoma. It is characterized by an unfavorable course;
signet ring cell cancer is less common (3-4%), but the course of the disease is unfavorable.

As for poorly differentiated adenocarcinoma, this is a more aggressive form of cancer, with severe symptoms and rapid development. The prognosis for the undifferentiated form of the tumor is even lower.

Stages of sigmoid colon cancer

Adenocarcinoma of the sigmoid colon is divided into four stages.

Stage 1 sigmoid colon cancer: the tumor is located in the mucous membrane. The prognosis is good - 92-95% cure within 5 years.
At stage 2 sigmoid colon cancer, the prognosis depends on the subtype of stage:

II a - with a tumor not exceeding half the circumference of the sigmoid colon and with the absence of metastases;
II b - with a tumor of the same size, but with growth into the intestinal wall, without going beyond its limits.

Five-year survival rate can be 75-68%.

at stage 3 sigmoid colon cancer, the prognosis depends on the subtype of stage and metastasis:

III a - with a tumor spread to half the diameter of the intestine, no more and without metastases;
III b - with screening out metastases to regional lymph nodes.

The forecast is 35-43%.

Stage 4 sigmoid colon cancer is characterized by tumor growth into organs located nearby and with the elimination of metastases. At this stage, the prognosis for sigmoid colon cancer is 20-30%.

Highly differentiated adenocarcinoma of the sigmoid colon is highly curable with a high survival prognosis of 95%. Poorly differentiated carcinoma of the sigmoid colon predicts a low prognosis - up to 25%.

According to the ICD 10 code, such a disease is designated C18.7.

Diagnosis of sigmoid colon cancer

Primary diagnosis begins with:

finger examination of the rectum;
fecal occult blood test;
if a tumor in the intestine is suspected, a clinical blood test and a blood test are performed;
detected tumor.

To determine, the following diagnostic methods are used:

colonoscopy;
sigmoidoscopy;
irrigoscopy:

How to check the intestines for oncology? It is necessary to examine the abdominal and pelvic organs with ultrasound and perform a general endorectal examination. ultrasonography. It will detect distant metastases and the extent of tumor spread, perifocal inflammation, if any. They are used for diagnosis by percutaneous, endorectal, endoscopic and intraoperative ultrasound methods. When a tumor grows into organs and tissues, CT and MRI are used.

Informative video

Treatment of sigmoid colon cancer

Sigmoid colon cancer: how is surgery performed?

The tumor is removed in a minimally invasive manner with the introduction of a sigmoidoscope into the sigmoid colon through the anus.
cut out traditional method a section of the intestine along with the tumor and affected lymph nodes.

If sigmoid colon cancer is finally confirmed, symptoms - treatment in complex cases is carried out complete removal sigmoid and rectum and the formation of colostomy. It is brought out through the front abdominal wall so that digested food masses: feces and gases are excreted involuntarily, without the control of the patient. Further treatment- chemotherapy for sigmoid colon cancer after surgery promotes recovery normal process defecation and urination. After surgery for a diagnosis of sigmoid colon cancer, radiation therapy is rarely used because perforation (rupture of the intestinal wall) can occur and because some types of adenocarcinoma are too sensitive to radiation.

Chemotherapy for stage 2 sigmoid colon cancer is necessary to suppress the growth of cancer cells in the case of a well-defined tumor. As independent method No chemical treatment is used.

Chemotherapy for stage 3 sigmoid colon cancer, like the second, is carried out with the drug, since cytostatics are ineffective. If the effect of 5-fluorouracil is low, Irinotecan is used.

Chemotherapy for stage 4 sigmoid colon cancer is prescribed with drugs and Ftorafur, if surgery is not possible. The drugs minimize the risk of cancer recurrence.

Preoperative chemotherapy:

destroys cancer cells;
stops tumor growth;
reduces tumor size before surgery or radiation therapy.

Postoperative chemotherapy:

destroys micrometastases after surgery;
reduces the risk of relapse and progression of cancer.

Sigmoid colon cancer: the prognosis after surgery and chemotherapy will be more positive in the absence of metastases and small lesions of nearby tissues and lymph nodes - on early stages- 92-68% In late stages, sigmoid colon cancer - life prognosis for five years - 43-20%.

Diets for sigmoid colon cancer during treatment and after surgery

Prescribe 5-6 times a day. Dishes are served warm and mashed for 3-4 weeks.

Important! Hot and cold food poorly digested and absorbed due to the slow release of gastric juice.

The diet for sigmoid colon cancer after surgery consists of juices, herbal decoctions, and liquid vegetable purees for the first 5-6 days. All diet products are approved by your doctor. Further diet for sigmoid colon cancer is provided with a significant reduction or exclusion from the diet of meat, canned food and fried foods, semi-finished products and confectionery products.

If sigmoid colon cancer is detected, the diet after surgery consists of the following natural and fresh products: cereals, cauliflower, fruits and vegetables in orange and yellow shades.

Sample menu:

Breakfast: biscuits and fresh fruit juice, fruit puree or baked fruit.
Second breakfast: grated porridge and salads from grated vegetables, with the addition of lemon juice instead of salt (1 tbsp) and vegetable oil(1 tsp).
Lunch: liquid pureed vegetable soup, a slice of bread, liquid porridge vegetable stew, you can replace the porridge with spaghetti or pasta in small quantities.
Second lunch: sweet cereals with baked fruits, jelly, mousses, juices with biscuits, homemade yoghurts.
Dinner: baked or stewed vegetables, tea.
1.5-2 hours before bedtime - kefir or yogurt with dry fruits.

Traditional therapy in the fight against sigmoid colon cancer

Complements full therapy and is aimed at stopping the growth of cancer cells and the spread of metastases. Folk remedies for sigmoid colon cancer help strengthen the immune system, alleviate the condition after chemotherapy, normalize intestinal function after surgery, and prolong the patient’s life.

Sigmoid colon cancer: treatment with folk remedies involves the use of:

poisonous herbs: swamp whiteweed, Djungarian aconite, hemlock, cocklebur, wormwood, black henbane, red fly agaric and others;
alcohol infusions, water infusions from medicinal mushrooms and flowers, pine needles and herbs;
minerals and soda, mumiyo, turmeric and goji berries.

Conclusions! Complex treatment of sigmoid colon cancer gives hope for a successful cure. Antitumor folk remedies are part complex therapy and make life easier for patients after surgery and chemotherapy. It is worth remembering that many herbs are poisonous, so the recipe must always be followed.

is a malignant neoplasm of epithelial origin located in the sigmoid part of the large intestine. On initial stages is asymptomatic. Then there are pains and discomfort in the abdomen, flatulence, feeling incomplete emptying intestines. There is an alternation of constipation and diarrhea. Often, a tumor-like formation can be felt in the left half of the abdomen. The diagnosis is made on the basis of complaints, anamnesis, external examination data, ultrasound, rectosigmoidoscopy, irrigoscopy, MRI, biopsy and other studies. Treatment – surgery, chemotherapy, radiotherapy.

General information

Sigmoid colon cancer is a fairly common malignant tumor that affects the area of the large intestine located above the rectum. Comes from cells glandular epithelium. Accounts for 34% of total number cases of colorectal cancer. In 60% of cases it affects patients aged 40-60 years. Men suffer 1.5 times more often than women. At first, sigmoid colon cancer is often asymptomatic or minimally symptomatic, which complicates timely diagnosis. As the tumor progresses, it spreads to nearby organs, giving regional and hematogenous metastases (to the liver, lungs, spine, and less often to other organs). Treatment is carried out by specialists in the field of abdominal oncology surgery and surgical proctology.

Causes

The high probability of developing sigmoid colon cancer is due to the characteristics of this organ. The sigmoid colon is located on the left side of the abdomen, just above the rectum, and is S-shaped. When the movement of contents through the intestines slows down, chyme remains in the sigmoid colon for a long time, which increases the time of contact of toxic food processing products with the mucous membrane of the organ. Factors that increase the risk of developing sigmoid colon cancer are: sedentary lifestyle life and poor nutrition: consumption of foods with a small amount of plant fiber, large amounts of fatty, fried and spicy foods, a predominance of animal fats and light carbohydrates. Both of these factors cause a slowdown intestinal peristalsis. Poor nutrition contributes to an increase in the amount of carcinogenic substances in the intestinal contents.

Among other circumstances that increase the likelihood of sigmoid colon cancer, experts name constipation, in which the mucous membrane not only comes into contact with carcinogens for a long time, but is also injured by solid contents. Alcohol abuse plays a negative role. In addition, sigmoid colon cancer often develops against the background of precancerous processes and inflammatory bowel diseases. More than 50% of neoplasms occur against the background of intestinal polyps, diverticulitis and other conditions accompanied by damage to the mucous membrane. Unfavorable heredity matters.

Classification

Taking into account the growth characteristics, two types of sigmoid colon cancer are distinguished: exophytic and endophytic. Exophytic tumors grow predominantly in the intestinal lumen and are protruding nodes on a thick stalk. As the process progresses, the tumor often ulcerates, bleeding and infection are possible. Endophytic tumors grow predominantly deep into the intestine. They spread along the intestinal wall and can surround the intestine in a circular manner. In the center of the neoplasm, areas of ulceration appear. The circular growth of sigmoid colon cancer causes a narrowing of the intestinal lumen and impedes the movement of feces. Endophytic tumors are more typical for the sigmoid colon.

Taking into account histological structure There are three types of sigmoid colon cancer:

Adenocarcinoma. Originates from glandular epithelial cells. Detected in 75-80% of cases of this disease. It can be highly differentiated, moderately differentiated and poorly differentiated. The lower the level of differentiation of sigmoid colon cancer, the worse the prognosis.
Mucosal adenocarcinoma. It is a type of poorly differentiated adenocarcinoma. It is represented by mucinous cells that secrete large amounts of mucus. Characteristic fast growth and early metastasis.
Signet ring cell carcinoma of the sigmoid colon. Presented atypical cells signet-ring-shaped, formed due to intracellular accumulation of mucin, which pushes the cell nuclei to the periphery. Diagnosed in 3-4% of patients with oncological lesions of the sigmoid colon. It is proceeding unfavorably.

Taking into account the prevalence of the process, they distinguish next stages sigmoid colon cancer:

Stage 1– the size of the tumor does not exceed 2 cm, the node is located within the mucous or submucosal layer. Regional and hematogenous metastases are not detected.
2A stage– the size of the tumor is less than half the circumference of the intestine. Sigmoid colon cancer does not invade the intestinal wall. Regional and hematogenous metastases are not detected.
2B stage– the tumor affects the intestinal wall, but does not extend beyond it. Metastases are detected in the lymph nodes. There is no distant metastasis.
Stage 3A– the diameter of the tumor exceeds half the circumference of the intestine. Metastases are not detected.
Stage 3B– lymphogenous metastases are detected.
Stage 4A– cancer of the sigmoid colon blocks the intestinal lumen. Hematogenous metastases are detected.
4B stage– the neoplasm affects nearby organs with the formation of conglomerates, enterovesical fistulas, etc.

Symptoms of cancer

In the early stages, the course of sigmoid colon cancer is asymptomatic or with scanty clinical manifestations. Patients may complain of bloating and rumbling in the abdomen, alternating constipation and diarrhea. As it progresses, constipation predominates. Impurities of mucus, pus and blood appear in the stool. When the intestinal wall grows and there is a mechanical obstacle to the movement of chyme, cramping or dull pain in the left half of the abdomen. Sometimes the first manifestation of the disease is the development of intestinal obstruction.

Patients with sigmoid colon cancer exhibit weakness, fatigue, pallor or grayish skin tone, hyperthermia, loss of weight and appetite due to cancer intoxication. During development intestinal obstruction paroxysmal cramping pain, repeated every 10-15 minutes, there is bloating, retention of stool and gas. Possible vomiting. When the intestinal wall is destroyed, peritonitis develops. In advanced cases of sigmoid colon cancer, cachexia, anemia, jaundice and liver enlargement are observed. When hematogenous metastases appear, symptoms appear that indicate dysfunction of the affected organs.

Diagnostics

The diagnosis of sigmoid colon cancer is made taking into account the medical history, complaints, objective examination data and the results of additional studies. The most informative are endoscopic methods(sigmoidoscopy and colonoscopy), allowing you to visually assess the volume and location of the tumor, as well as take material for subsequent histological examination. In the process of examining patients with suspected sigmoid colon cancer, irrigoscopy and stool occult blood testing are also used.

Ultrasound of the abdominal organs, chest radiography, spinal radiography and others are used to detect metastases. diagnostic techniques. The final diagnosis is made based on the results of histological examination. Sigmoid colon cancer is differentiated from inflammatory and precancerous diseases of the intestine, with mobile tumors of the mesentery and fixed neoplasms of the retroperitoneal space.

Treatment of sigmoid colon cancer

When treating this pathology, oncological surgeons usually use combination therapy, including surgery, radiotherapy and chemotherapy. In this case, the leading role is given to surgical treatment aimed at radical tumor removal. The extent of the operation depends on the extent of sigmoid colon cancer. In the early stages, in some cases, the use of endoscopic techniques is permissible.

In case of common processes, resection of the sigmoid colon with a section of the mesentery and nearby lymph nodes is performed. The affected area is removed with 5 centimeters of intact distal and proximal intestine. Surgical intervention In case of sigmoid colon cancer, it can be one- or two-stage. In one-stage operations, after tumor removal, the surgeon performs an anastomosis, restoring intestinal continuity. In advanced cases, the intestine is resected to form a colostomy, and the integrity of the intestine is restored several months after the first operation.

In the pre- and postoperative period, patients with sigmoid colon cancer are prescribed chemotherapy and radiotherapy. In advanced cases, palliative therapy is carried out to ensure intestinal patency and reduce pain syndrome. Sometimes sigmoid colon cancer requires emergency surgical interventions, aimed at eliminating intestinal obstruction, sanitation of the abdominal cavity in case of peritonitis, etc.

Prognosis and prevention

The prognosis for sigmoid colon cancer is determined by the type of tumor, prevalence malignant process, level of cell differentiation, patient age, presence of concomitant diseases and other factors. The average five-year survival rate is 65.2%. With stage 1 neoplasms, 93.2% of patients overcome the five-year mark. With stage 2 sigmoid colon cancer, 82.5% of patients survive up to five years from diagnosis. For stage 3 tumors, this figure decreases to 59.5%, for stage 4 lesions – to 8.1%.