[Fat Bear Science] The director of the Department of Gastroenterology said: "Two good friends had colon cancer, one was cured and the other was in the advanced stage." You must do this check after the age of 40

This is the case of a close friend of Chen Weiqing, director of the Department of Gastroenterology at the Affiliated Cancer Hospital of Chongqing University. It is also something that makes him sigh with infinite sadness and regret.

Because the two friends smoked all year round and often socialized, Chen Weiqing, who has been deeply engaged in the diagnosis and treatment of early digestive tract cancer for more than 30 years, repeatedly reminded them three years ago that they must have regular gastrointestinal endoscopy examinations. But three years later, until one of the friends came to the hospital to find him, he realized that the two were facing completely different situations.

Three years ago

They made different choices

Chen Weiqing's two friends are teachers at a university in Chongqing. They are in their 40s, have happy families and successful careers, but they often attend social events.

Three years ago, Chen Weiqing began to remind them that when people reach middle age, regardless of their lifestyle habits or whether they have any discomfort symptoms, they should undergo regular gastrointestinal endoscopy in order to detect early lesions of the digestive tract and avoid development into cancer.

"Early-stage digestive tract tumors are classified as 'silent cancers.' The most typical symptom of patients is that they have almost no symptoms at all." Chen Weiqing further explained to his friend that digestive tract tumors are also one of the most preventable cancers. First of all, we must avoid eating too hot or spicy food, as well as bad habits such as smoking and drinking. The second thing is to have a gastrointestinal endoscopy.

45-year-old Lao Yu (pseudonym) took Chen Weiqing's friendly reminder to heart and went to the Digestive Endoscopy Center of the Affiliated Cancer Hospital of Chongqing University for a gastrointestinal endoscopy the next day. You don't know until you check, and you'll be shocked when you check. Lao Yu's stomach was fine, but the early colorectal tumor was exposed under the endoscope. A 1 cm lesion was found and removed. Pathological examination later showed colon adenocarcinoma, but fortunately it was an early intramucosal cancer.

Despite the previous experience, Lao Chen (pseudonym), who is also in his 40s, still did not take it seriously. He said: "My body has no reaction, I am healthy, and I enjoy everything I eat." Lao Chen believes that Lao Yu's situation is a matter of probability and he is unlikely to be infected.

Three years later

They face different situations

After repeated persuasions failed, Chen Weiqing had no choice but to give up.

Three years later, the two of them developed in different directions:

Over the past three years, Lao Yu has changed his bad lifestyle habits, followed the doctor's advice, and had regular follow-up visits. His condition has not worsened and he can be said to have recovered. Another colonoscopy showed that only one or two hyperplastic polyps had grown, which could be removed under endoscopy.

On the other hand, Old Chen forgot the friendly reminder three years ago. He did not change at all until he had blood in his stool and pain recently. Examination revealed multiple metastases in the abdominal cavity and liver, indicating that he was already in the late stage of colon cancer. He then came to the hospital to find Chen Weiqing.

Chen Weiqing was extremely distressed, but also felt helpless. He said that early-stage colorectal cancer has a cure rate of more than 95%. But when it progresses to the middle and late stages, the five-year survival rate plummets, and the treatment effect is greatly reduced.

Chen Weiqing explained that although colorectal cancer is a "dumb cancer", it can also be considered a "chronic cancer." "Chronic" means that the vast majority of colorectal cancers evolve from adenomas, and the process from polyps to cancer usually takes 10-15 years. But once malignant transformation occurs, it only takes about two years from intramucosal cancer to mid- to late-stage cancer. According to this development trend, Mr. Chen may have developed adenomas, precancerous lesions, or even early-stage colorectal cancer three years ago. "He missed the best period for treatment."

"Therefore, timely detection and treatment through colonoscopy before it turns into cancer can eliminate cancer in its infancy," said Chen Weiqing.

Aged 40 or above

Gastrointestinal endoscopy is a must

"Discovering an early cancer can save a family and bring happiness to a life." Chen Weiqing always keeps this in mind, and it is also the pursuit of his lifelong work. In his more than 30 years of medical practice, he has seen too many advanced cancer patients miss the best treatment period, and he has also witnessed many early cancer patients reborn.

The Digestive Endoscopy Center of the Affiliated Cancer Hospital of Chongqing University receives nearly 800 patients with digestive tract tumors for the first time each year. Among them, the proportion of early-stage cancer is about 20%, which is much higher than the national standard of 10%. In other words, 80% of patients are already in the middle and late stages when they seek treatment.

How to prevent it? Chen Weiqing suggested that we should first change our lifestyle, develop good and regular living habits, eat more vegetables, fruits and whole grains containing fiber, reduce the intake of high-protein, high-fat and refined foods, reduce smoking and excessive drinking, increase exercise and relieve mood.

"When you are 40 years old or above, you must have a gastrointestinal endoscopy, and then have a check-up again in 3-5 years." Chen Weiqing said that if citizens smoke for a long time, drink a lot of alcohol, have unhealthy eating habits, are infected with Helicobacter pylori, have chronic atrophic gastritis, gastric ulcer and other diseases, and if their immediate family members have suffered from colorectal cancer, then they are at high risk. It is recommended that the examination time be advanced and the examination frequency be increased.

Digestive tract cancer screening guidelines

These people are at high risk

These measures can effectively prevent

Colorectal cancer

High-risk groups

1. Family history of malignant tumors and intestinal polyps

2. Positive fecal occult blood test

3. Precancerous diseases such as intestinal polyps, ulcerative colitis, Crohn's disease, etc.

4. The pelvis has been exposed to radiation

Screening recommendations

1. General population: Screening starts at age 40, fecal occult blood test once a year, colonoscopy once every 5 years

2. High-risk groups: For those without intestinal warning symptoms, it is recommended to have a fecal occult blood test once a year starting at the age of 40 and a colonoscopy once every 2 years. For those with intestinal warning symptoms, see a specialist immediately.

(Note: Intestinal alarm symptoms include blood in stool, anal distension, mucus in stool, diarrhea, constipation, alternating diarrhea and constipation, and thin stools for more than two weeks)

Precautions

1. Reasonable dietary structure and increased intake of fresh fruits and vegetables

2. Quit smoking and drinking

3. Exercise appropriately, maintain a healthy lifestyle, and control your weight

4. Treat constipation promptly and actively treat precancerous lesions

Esophageal cancer

High-risk groups

1. Family history of malignant tumor

2. Digestive symptoms such as repeated acid reflux, swallowing discomfort, foreign body sensation in the esophagus, slow stagnation of food passing, and repeated pain or discomfort behind the sternum

3. Bad eating habits, such as long-term consumption of pickled, hot, rough, and moldy food

4. Smoking and drinking

5. Barrett's, esophagitis, or precancerous lesions

Screening recommendations

High-risk people aged ≥40 years should undergo a gastroscopy immediately. If there is no abnormality, it is recommended to undergo a gastroscopy every 2 years. If the examination is abnormal, it is recommended to undergo a gastroscopy once a year.

Precautions

1. Eat more fresh food, quit smoking and drinking

2. Avoid eating hot or hard food, chew slowly

3. Actively diagnose and treat esophageal diseases, such as esophagitis, esophageal polyps, diverticula, etc.

4. Take measures to improve water quality and reduce the nitrite content in drinking water

5. Closely follow up susceptible populations (such as esophagitis, esophageal polyps, diverticula, etc.), and actively diagnose and treat esophageal diseases

Gastric cancer

High-risk groups

1. Family history of malignant tumor

2. People infected with Helicobacter pylori (Hp)

3. Atrophic gastritis, gastric ulcer, gastric polyp, residual stomach, hypertrophic gastritis, pernicious anemia and other diseases

Screening recommendations

1. High-risk groups, aged ≥40 years, should undergo a gastroscopy. If there is no abnormality, it is recommended to undergo a gastroscopy every 2 years. If the examination is abnormal, it is recommended to undergo a gastroscopy once a year

2. Regular testing of Helicobacter pylori, serum pepsinogen, and serum gastrin-17

Precautions

1. Eat more fresh vegetables and fruits, avoid high-salt and moldy food, and avoid overeating and eating overly hot food.

2. Quit smoking and limit alcohol consumption

2. Actively treat chronic gastric diseases, such as atrophic gastritis, etc.

3. Actively treat Helicobacter pylori infection

4. Promote the use of public chopsticks and spoons

■

Chen Weiqing

Director of the Department of Gastroenterology, Affiliated Cancer Hospital of Chongqing University, chief physician, doctor of medicine, and doctoral supervisor.

He has been engaged in the diagnosis and treatment of gastrointestinal, hepatopancreatic and other diseases for more than 30 years, and has conducted in-depth research on the clinical diagnosis and treatment of gastrointestinal bleeding, severe pancreatitis, cirrhosis and its complications, inflammatory bowel disease, etc. He is particularly good at endoscopic diagnosis and interventional treatment of gastrointestinal, hepatopancreatic and other diseases, such as clinical evaluation/diagnosis and treatment of cirrhosis and its complications, EMRL, EMR, ESD, endoscopic ultrasound diagnosis, and endoscopic ultrasound-guided puncture biopsy/injection/drainage.

Clinic hours: Monday morning

Text/Fat Bear

Member of China Medical We-Media Alliance

Science Popularization China Co-construction Base

Chongqing Science Popularization Base/Chongqing Health Promotion Hospital

Chongqing Science and Technology Communication and Popularization Project

Chongqing Grassroots Science Popularization Action Plan Project

National Health Commission National Basic Public Health Service Health Literacy Project