The term "colorectal cancer" refers to a pathological process, the course of which is accompanied by the formation of a malignant tumor. According to statistics, 45% of cases of gastrointestinal tract tumors occur in this particular disease. The disease is included in the International Classification of Diseases (ICD 10). Colorectal cancer belongs to the group of malignant digestive neoplasms.
Currently, there are several ways to treat pathology. With timely access to a doctor, the prognosis is usually favorable.
Pathogenesis
The rectum is the end of the intestine, ending in the anus. It is through the latter that fecal matter leaves the body in the environment. In an adult, the length of the rectum can vary between 15–20 cm. The widest part of it is the ampoule located in the pelvis and surrounded by the fat layer.
In the mucous membrane of the organ is a huge number of cells responsible for the production of mucus. It, in turn, facilitates the passage of feces through the intestines, that is, it plays the role of a kind of lubricant.
Under the influence of various adverse factors, the development of a pathological process that affects the mucous membrane is launched. A tumor, which has a malignant character, gradually begins to form in it. As a result, the patient's condition worsens, emptying of the organ is difficult. Ignoring the pathology poses a threat not only to health, but also to the life of the patient.
Assigned to colorectal cancer code according to ICD-10 C20.
Etiology
The development of the disease can occur under the influence of a large number of triggering factors. The main causes of colorectal cancer (in ICD-10, part of them are also assigned codes):
- Polyps. Clinical significance is their size. These neoplasms are benign in nature, but if their height is 1 cm or more, the risk of degeneration is significantly increased.
- Diffuse polyposis. This is a pathology, the development of which is most often due to a hereditary predisposition. This is not yet rectal cancer (in ICD-10, the pathology has a different code), but already a condition that precedes it. The disease is characterized by the formation on the mucous membrane of a large number of polyps.
- Human papillomavirus. The active life of the pathogen in the anal area also does not always lead to rectal cancer. In ICD-10, the papillomavirus is assigned the code B07, that is, in fact, the pathology is characterized by the formation of warts and genital warts. However, these neoplasms sometimes have a tendency to malignancy.
- Unbalanced diet. Most often found in people who consume a large number of meat products. Such food, getting into the intestines, is a favorable environment for the propagation of pathogens. A decrease in the consumption of fiber of plant origin complicates the output of feces, which is why their contact with tissues becomes longer.
- Hypovitaminosis. With the regular use of foods rich in vitamins A, E and C, the process of inactivation of carcinogens is launched. With their deficiency, the degree of negative effects on the mucosa increases.
- Obesity. According to statistics, overweight people are most often diagnosed with colorectal cancer (ICD-10 also indicates a large number of diseases that develop against the background of excess weight).
- Lack of exercise. Contrary to popular belief, this is a disease. She also has her own code in the ICD-10. Colorectal cancer often develops in individuals whose lifestyle is extremely sedentary.
- Frequent use of alcohol-containing drinks. Ethyl alcohol not only irritates the mucous membrane, but also promotes the formation of cancer cells.
- Regular contact with harmful substances. In this case, we are talking about people whose professional activities are related to working with toxic compounds.
- Genetic predisposition.
Regardless of the severity of the symptoms and causes of colorectal cancer (in the ICD-10, as mentioned above, a large number of provoking pathologies are indicated), it is impossible to delay the treatment of the disease. This is due to the fact that the disease poses a threat to the life of the patient.
Clinical manifestations
According to ICD-10, colorectal cancer is a malignant neoplasm that forms on the mucous membrane. This process is accompanied by the appearance of specific symptoms. Its intensity directly depends on the size and location of the tumor, the nature of its growth and the duration of the course of the disease.
The main symptoms of colorectal cancer (in the ICD-10 some of them are also indicated):
- Isolation of blood from the anus.
- Diarrhea or, on the contrary, constipation.
- Isolation of pus or mucus from the anus.
- Fecal incontinence.
- Flatulence.
- Frequent urge to defecate (up to 16 times a day). As a rule, they deliver torment to the patient.
- Bloating.
- Signs of intestinal obstruction (vomiting, severe pain in the abdomen).
- A sharp decrease in body weight.
- "Symptom stools." A patient with a tumor tries not to sit on hard surfaces with both buttocks, but only one.
- Increased fatigue.
- General weakness.
If any of the above symptoms occur, consult a doctor. At the initial appointment, it is advisable to visit a therapist. The doctor will prescribe a number of studies and, if there is a suspicion of a tumor, will refer to an oncologist and proctologist.
Diagnostics
The first step is to take an anamnesis. The doctor carefully listens to the patient's complaints and asks him questions regarding his lifestyle. Already at this stage, a specialist may suspect the presence of a new tumor in the patient - colorectal cancer. ICD-10 (code), available complaints, examination results - this is a list of what the doctor puts on the medical record. To confirm the diagnosis, consultation of narrow specialists is required. It is they who are involved in the treatment of the patient.
Currently, the following studies are being assigned to confirm the diagnosis of colorectal cancer:
- Inspection in rectal mirrors.
- Irrigoscopy.
- Finger rectal examination.
- Ultrasound
- Sigmoidoscopy.
- CT scan.
- Blood test for tumor markers.
- Biopsy.
- Histological examination.
- Cytological analysis.
If necessary, the doctor prescribes additional studies: radiography of the abdominal organs, fibrocolonoscopy, laparoscopy, intravenous urography.
Based on the results, the doctor writes a diagnosis on the card with the ICD-10 code and signs of rectal cancer. The treatment is also described in detail.
Types of tumors
Each neoplasm has a specific histological structure. In this regard, rectal tumors are classified as follows:
- Adenocarcinomas. Formed from glandular tissue.
- Cancer of the ring-shaped cell. It is extremely rare, has a high mortality rate.
- Solid cancer. It is rare. Tumor cells are located in the form of layers.
- Skirozny cancer. The neoplasm is characterized by a large volume of intercellular substance.
- Squamous cell carcinoma. It is characterized by early metastasis.
- Melanoma. The tumor is located in the area of the anus.
According to ICD-10, colorectal cancer is a malignant process. In the classification of diseases, the above types of tumors are not assigned separate codes. They are all marked with the designation C20.
Tumor growth pattern
The neoplasm can rise above the surface of the mucosa. In this case, it is customary to talk about exophytic cancer. Sometimes a tumor grows into the intestinal wall. This is endophytic cancer. Often diagnosed and mixed form. In this case, the tumors sprout both inside and into the lumen of the rectum.
Degree of aggressiveness
The course of the disease is also classified by the rate of progression of the pathological process. In this case, the cancer can be low-, medium- and highly differentiated. Accordingly, in the first case, the pathology develops slowly and is not accompanied by painful symptoms, in the latter case, the tumor grows quickly, the metastasis process starts in a short time.
Surgical treatment
In ICD-10, colorectal cancer, as mentioned above, belongs to the group of malignant diseases. That is, in some cases, it is possible to get rid of this pathology only with the help of surgical intervention.
Any rectal surgery is traumatic. Currently, there are several methods of intervention that allow you to maintain a normal act of defecation in the future and avoid negative consequences.
The main types of operations used in practice:
- Resection of the anal sphincter and rectal area. It is advisable to carry out this type of intervention in the presence of a tumor in the region of the anus.
- Removal of a portion of the rectum. After resection, the tissues located above are sutured with the anus.
- Abdominal-anal operation. In this case, the rectum is completely removed and a new channel is formed by stitching the tissues.
- Abdominal-anal resection with excision of muscle pulp. The operation is identical to the previous one. The difference is that together with the rectum, the anal sphincter is removed.
- Abdominal perineal extirpation. It involves the removal of the rectum and anal canal. The formation of the reservoir is carried out by lowering the sigmoid colon.
The most difficult operation is considered to be evisceration of the pelvis. It involves the removal of all organs from a given zone. It is advisable to carry out this type of intervention if the tumor has grown significantly in neighboring tissues.
Radiation and chemotherapy
These treatment methods are auxiliary. Radiation therapy is carried out mainly in the preoperative period. The course of treatment is 5 days.
The following complications may occur during therapy:
- Skin ulcers in the irradiation zone.
- Diarrhea.
- Anemia.
- Cystitis.
- Atrophy of the internal organs.
- Leukemia.
- Necrosis.
Chemotherapy is indicated after surgery. The goal of treatment is to consolidate the effect of the intervention and prevent the spread of cancer cells. Drugs are administered to the patient intravenously.
Power Features
With rectal cancer, the diet should be balanced. It is important to limit your intake of foods rich in animal fats. The menu must contain vegetables and fruits. It is necessary to exclude fried, spicy and sour dishes from the diet.
It is recommended to eat food 5 times a day. At the same time, the size of one serving should not exceed 200 g. It is advisable to observe equal intervals between meals.
Forecast
The outcome of the disease directly depends on the timeliness of going to the doctor. According to statistics, with early diagnosis and well-conducted treatment, survival in the next 5 years is 80%. If the first measures were carried out already at the stage of metastasis, this indicator is half as much.
Prevention
To prevent the development of the disease, it is not necessary to follow specific recommendations. General rules of prevention look like this:
- In the diet, it is desirable to reduce the amount of food rich in animal fats.
- Exercise your body regularly.
- Control body weight.
- Timely treat identified diseases of the digestive tract.
- Stop smoking and drinking alcohol.
Persons whose close relatives suffered from colorectal cancer are advised to be screened once a year. It includes both laboratory and instrumental diagnostic methods.
Finally
Colorectal cancer is a disease characterized by the formation of a malignant tumor on the mucous membrane. Pathology is a threat not only to health, but also to life. In this regard, the doctor must be consulted when the first alarming signs occur. The main treatment for the disease is surgery. The choice of methodology is based on the results of diagnostic measures. Additionally, radiation and chemotherapy are performed. Assigned to colorectal cancer code according to ICD-10 C20.