Colonoscopy: cancer treatment without surgery and radiation

“In Ukraine there is still neither screening program for colorectal cancer, nor profile centers which would be dealing with it, that is why the problem of colorectal cancer only aggravates. Excuse my sarcasm, but the appears such an impression that both profile institution, Ministry of Health and the patients themselves solve this problem with a method of an ostrich – head into the sand, and the problem disappears! I do not see it, so it does not exist. Only separate doctors, hospitals and patients by themselves do not leave the trials to push this problem into the informational space, anyway filled with other, more or less important issues. Most patients recognize or remember about colorectal cancer only when this disease is diagnosed in someone from relatives or friends, or when problems arise in their own native. And it’s good if they appear at the initial stage of tumor development. But this rarely happens.

The most common signs of colorectal cancer are blood in the feces and intestinal obstruction, but they appear mainly in the late stages of tumor development, when there is no talk of cure. In the early stages of the tumor, they are asymptomatic or manifest with nonspecific signs that the patient does not pay attention to. Say a change in the nature of the stool or the appearance of mucus in it. Most patients believe that there is no need to run to the doctor because of such trifles. Truth?

The whole civilized world has gone far ahead and came up with colorectal screening. Like mammography, PAP smear or fluorography, and colonoscopy in most civilized countries exist not only as a diagnostic, but also as a screening examination. It allows you to timely identify the precursor of colorectal cancer - an adenoma, and remove it, thereby preventing the development of cancer. Sometimes, screening colonoscopy can be used to find not only adenoma, but also early cancer. Moreover, even at such a stage that the therapeutic effect can be achieved without surgery, radio and chemotherapy. To do this, you just need to come to the colonoscopy on time. In such situations, endoscopy is often not only a method of detection, that is, diagnosis, but also a treatment method (if you're lucky). As in this case: a 64-year-old patient turned to an oncologist about 3 months ago in connection with the appearance of blood in the feces. Colonoscopy revealed the formation of a size of 2.5x3.5 with signs of malignancy (conversion from a benign formation to a malignant one). A biopsy from the most altered site confirmed the presence of a malignant component in the formation - a moderately differentiated adenocarcinoma. But since it did not spread deep into the intestinal wall and into the lymph nodes, the formation was subject to endoscopic removal. Endoscopic submucosal dissection (#ESD) was performed. And after 3 months only a flat post-dissection scar remained at the control examination. For comparison, I recall that with a later treatment, radiation therapy would be necessary, and then a surgery with the removal of at least temporary, and in the case of even later treatment, possibly a permanent colostomy.

In this case, organ-preserving intervention was possible only because the patient noticed blood in the stool. But at this stage, blood appears extremely rarely. Therefore, it should be remembered that screening colonoscopy should not be addressed because of complaints, but by age. 50 years old? Welcome to LISOD for examination!”

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