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Sigmoid adenocarcinoma

 
, medical expert
Last reviewed: 23.04.2024
 
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The most urgent problem in the field of oncology is cancer of the large intestine and rectum. One of the varieties of this cancer is adenocarcinoma of the sigmoid colon. In this case, we are talking about the development of the pathological process in the glandular tissues of the sigmoid colon.

Sigmoid colon - one of the parts of the large intestine, located on the left side of the lower abdomen. Sigmoid it is called because of the location in a certain form. It begins after the colon and passes into the rectum, while making several bends.

To date, the problem of cancer is coming to the forefront in many countries of the world. New methods of diagnosis and treatment of various types of oncology are being developed and implemented, as the number of cases of oncological problems is growing, and younger groups of people are beginning to face similar diseases.

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Causes of adenocarcinoma of the sigmoid colon

Unfortunately, there is no unequivocal opinion about the causes of cancer. But it is possible to talk about the factors that influence the development of tumors, including malignant ones. In the case of problems with the large intestine, eating habits, lack of fiber, fresh fruits and vegetables, smoking, drinking alcohol, eating carcinogenic products, and excessive use of household chemicals remain topical problems. In addition, the genetic predisposition to such diseases, frequent nervous stresses, the use of a large number of medicines is important. Also, the most important factor affecting the intestine in general, and the large intestine in particular, is a sedentary lifestyle, sedentary activity. All this interferes with the normal work of the intestines, disrupts peristalsis, leads to stagnation of the food masses, and also disrupts the blood supply of certain areas of the intestine. Especially it can affect the sigmoid colon due to the peculiarities of its shape and location.

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Symptoms of adenocarcinoma of the sigmoid colon

The danger of adenocarcinoma of the sigmoid colon is very high. This is mainly due to the fact that it in the initial stages is completely asymptomatic. And on more complex stages of the cancer there are symptoms, which by themselves do not indicate directly the onset of a tumor in the intestine. Such symptoms of adenocarcinoma of the sigmoid colon are called monotonous. Even if many of them manifest themselves, doctors can not only not notice in them possible parcels for cancer, but also do not associate them with each other. Therefore, important attention is now being paid to preventive measures. In particular, the passage of regular preventive studies, so that, even with the detection of adenocarcinoma of the sigmoid colon, it was possible to arrest the disease at its earliest stages.

When the symptomatology only begins to appear, the patients feel general weakness, nausea, fatigue occurs quickly, abdominal pain may be disturbed, periodic stools, pale skin of the face can be observed. In the future, there may be a deterioration in appetite, a decrease in body weight, a perversion of a sense of taste or taste habits.

In the later stages of the development of adenocarcinoma of the sigmoid colon, symptoms already appear that indicate the localization of the problem - unnatural impurities, blood appear in the stool, general intoxication of the body occurs, which increases the liver, a yellowish skin tone, and the stomach increases. The most complex and distant symptoms are massive bleeding in the intestine, intestinal obstruction, inflammation of the intestine.

Moderately differentiated sigmoid colon adenocarcinoma

When it comes to cancer, it is also accepted to use such a notion, as the level of differentiation of cancer cells, among its characteristics. Also, the level of differentiation is also called the Glisson index. In this indicator, four types of tumors are distinguished: a highly differentiated, moderately differentiated, low-grade and undifferentiated tumor. The lower the Gleason score, the lower the level of cell differentiation.

When it comes to moderately differentiated adenocarcinoma, this means that the cells of the tumor differ markedly from the cells of the tissue in which the neoplasm originated. Although the difference is not so great that it allows you to accurately determine both the source of the tumor and the tissue that forms it. Moderately differentiated adenocarcinoma is characterized by not very intensive growth, the likelihood of metastasis is also low, at least at the initial stages of the disease. But in any case, even if the tumor found in the sigmoid colon is a moderate level of differentiation, this is not an excuse to delay treatment or choose some kind of maximally sparing regimen. Since the risk associated with this form of the disease is very large. First, the growth of the tumor is still present. The fact that it is not as fast as with undifferentiated or low-grade forms of cancer does not mean that it is not a threatening speed at all. Secondly, the probability of developing metastases is quite high and depends both on the condition of the tumor itself and on possible provoking factors. The latter may include any external stresses, age and concomitant diseases, as well as even the method of treating the tumor itself.

Highly differentiated sigmoid colon adenocarcinoma

The highly differentiated sigmoid adenocarcinoma is one of the least dangerous variants of such a tumor. This is due to the fact that the cells of highly differentiated neoplasms, in their structure and properties, differ little from the tissue from which they formed. And thus have a fairly low level of pathogenicity. In addition, if the level of differentiation of cells is quite high, then such a tumor is characterized by slow growth, it rarely gives metastases. If we talk about the changes in the cells themselves, then the main (and only) change in the highly differentiated adenocarcinoma is an increase in the size of the cell nuclei.

The highly differentiated adenocarcinoma is quite successful in treatment. Since such a tumor is not very aggressive, that is, it is possible to select the most favorable conditions for the operation, it is extremely difficult to use auxiliary therapies, such as chemotherapy or radiotherapy. Relapses of such tumors are also quite rare. But nevertheless, constant monitoring is simply necessary. Especially in cases where the patient is at risk for this disease.

Low-grade adenocarcinoma of the sigmoid colon

The low-grade adenocarcinoma of the sigmoid colon, like other low-grade tumors, is extremely aggressive. First of all, it is characterized by a fairly rapid growth, therefore, from the moment of detection of the problem to the moment of the behavior of specific operational actions, the situation may already change. In addition, if the tumor cells are poorly differentiated, it is difficult to determine which tissue, or even which organ is the initial point of development of the tumor process. The tumor itself during its development quite often gives metastases. In addition, there is a possibility that the operation itself to remove a low-grade tumor can trigger the appearance of metastases. Therefore, in carrying out such operations and preparing for them, the patient is given special attention.

Despite the danger of low-grade adenocarcinomas, the operation may sometimes not be recommended. This occurs in those cases when the danger of metastasis formation during surgery is higher than the risk of developing the tumor itself (for example, if the growth rate of the tumor is relatively small for tumors of this type). Low-grade adenocarcinoma is difficult to control, but nevertheless, even with this type of tumor, it is not necessary to take hasty decisions on its treatment, it is necessary to take into account the patient's other illnesses, the general condition, and the patient's ability to tolerate certain types of treatment.

Diagnosis of sigmoid adenocarcinoma

Sigmoid colon adenocarcinoma is diagnosed both on the basis of patient complaints and with the help of hardware research and examination methods. Symptoms of adenocarcinoma of the sigmoid colon are rather indirect, but with the slightest suspicion that problems can be with the large intestine, one should turn to the proctologist.

The simplest and initial method of diagnosis can be palpation. That is, the doctor hands touch the rectum and sigmoid colon to a certain depth. If there is a tumor, a similar examination will reveal it. More complicated technically, but more informative is a method of research, like a sigmoidoscopy. This procedure involves a visual examination of the cavity of the rectum and the lower third of the sigmoid colon. For this purpose, a device called a sigmoidoscope is used, which is a tube at one end of which a lighting device is located. First, through the sigmoidoscope, air is supplied to expand the intestinal cavity, and then an eyepiece is inserted for examination. This allows not only to examine internal organs, but also when detecting dubious entities, to take a biopsy from the gut region.

Another informative method of diagnosis is irrigoscopy. These are actually X-ray images of the intestine. To do this, a contrast agent is introduced through the rectum. This method of introduction allows you to achieve expansion of the intestine because of its tight filling. At the same time, the contour of the large intestine (including the sigmoid region), its shape, location, size, and features are studied first. After this, after a partial evacuation of the intestine and already a smaller degree of expansion, we study possible pathologies, the relief of the intestinal mucosa. Also after that, you can fill the gut with air for more detailed study. This method is called double contrasting. As a result of the research, both survey and snapshots are performed.

Also a popular method of research today is a colonoscopy. In essence, it resembles a sigmoidoscopy, but the main difference is that with colonoscopy, the entire large intestine can be examined. That is, in this case it is more informative, since it allows to inspect the entire sigmoid colon, and not just its lower third. As with sigmoidoscopy, there is the possibility of biopsy, as well as the removal of small formations. The procedure is also performed under visual control. In addition, the current and widely used today ultrasonic intestinal diagnostics will be relevant.

Diagnostic methods that imply the possibility of visually assessing the state of the intestine with a greater degree of probability will be able to determine adenocarcinoma in the early stages of its onset. And also the fact that in the course of such methods there is the possibility of sampling tissue, allows you to more accurately judge the state of health of the patient.

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Treatment of adenocarcinoma of the sigmoid colon

Regardless of the severity of the sigmoid colon adenocarcinoma, the main method of its treatment is surgical intervention.

Chemotherapy is also used. It can be mono- and poly-compound. But in this case it acts as an auxiliary method. Since it was proven its low effectiveness in this disease. Chemotherapy can be used both before surgery and after. Radiation therapy is also a popular method of treating cancer. But in the case of adenocarcinoma of the sigmoid colon, it is used quite rarely. This is due to several factors. First, there is a risk of perforation, that is, through damage to the intestine, and secondly, it is proved that this kind of cancer, like adenocarcinoma, has a very low sensitivity to radiation therapy.

In surgical intervention, a resection is performed, that is, removal of a part of the sigmoid colon. This type of cancer, like adenocarcinoma, grows quite slowly, with metastasis unlikely. Therefore, when a disease is detected in fairly early stages, an operation can be performed that will not only lead to complete cure, but will also allow for the removal of only a small part of the intestine. In the event that surgical intervention occurs at a fairly late stage of the disease, the operation significantly reduces the risks of complications.

More information of the treatment

Prophylaxis of sigmoid adenocarcinoma

Speaking about the prevention of a disease, it is worth addressing the causes of its occurrence. In the case of adenocarcinoma of the sigmoid colon, mainly preventive measures will be aimed at minimizing the irritation of this area of the intestine. The sigmoid colon has a number of characteristics due to its location. It is just in front of the rectum, it has bends, because of which stagnant stools can occur. Thus, the contents of the gut press on the walls, creating unnecessary irritation. You can avoid this if the peristalsis of the intestine is okay. Emu can be well promoted by an active way of life, playing sports. Also, the use of fiber plays a crucial role in the proper functioning of the large intestine. This and fresh leafy vegetables, greens, apples, root vegetables. Use of salads with raw vegetables and fruits. The human body does not itself break down the fiber, but this is done by the symbiotic microorganisms of the large intestine. Therefore, for its normal operation, it is necessary to maintain a balance of microflora. This can help sour-milk products, sufficient water intake, healthy eating.

An important role is played by more generalized factors. It should avoid strong nervous stress, exclude bad habits, minimize the use of carcinogenic products, monitor the amount of food consumed (overeating also adversely affect the work of the intestine and all internal organs).

But the main means of preventing adenocarcinoma of the sigmoid colon is regular screening. With preventive examinations, it is possible to identify changes in the intestine, which may not yet be adenocarcinoma, but nevertheless require treatment.

Prognosis of sigmoid adenocarcinoma

The prognosis of adenocortinoma of the sigmoid colon, as well as many other diseases, largely depends on when exactly the disease was discovered, what the specificity of its development is, what are the possibilities of maintaining the situation after treatment.

In general, if problems with the sigmoid colon appear early enough, it often occurs when the patient is accustomed to paying attention to his digestion, then the predictions are pretty good. Adenocracinoma is a fairly well-studied variety of tumors. In addition, there is a large number of modern methods of treatment. The surgical intervention is possible without large incisions on the abdomen.

Nevertheless, if the disease occurs in people of a young age, the prognosis worsens. This is due to the fact that in a young organism the division of cells is more active, therefore the tumor will develop more rapidly.

Also of great importance is the extent to which pathological cells have germinated in the intestinal tissues. The deeper the pathological tissues penetrated, the worse the predictions.

An important role is played by the presence of metastases. The less of them, the adenocarcinoma of the sigmoid colon has a better prognosis.

Of course, directly affect the prognosis of tumor size, concomitant diseases, general health.

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