He turned to doctors only two years later
“It started more than 2 years ago. – bleeding from the outlet, I noticed blood impurities in the feces. I thought it was hemorrhoids, I asked my colleagues, one of them had this problem, so she could advise. Anyway, I was completely healthy, strong, lived at a normal pace, traveled. Now that I think about it, yes, sometimes I had flatulence, thinking that I ate the wrong fruit or too much. Of course, I didn’t go to the doctors,” says Asta A.
Asta A. remembered that she saw more blood about two years later. “The Covid-19 pandemic was already over, I thought it was time to worry about my health. I went to the doctor. I was completely calm, the test did not show occult blood in the feces, but when I got the answer after the colonoscopy, it was said bluntly – you have a rectal tumor, you will need a stoma for the rest of your life, when do we make an appointment for surgery?
In one moment, everything turned upside down. I was shocked and said no, I’d rather die. I was 56 years old when I heard the verdict. I really wanted to die, I was already burying myself. The fear was endless, I read everything on the subject and kept coming across bad stories.
I decided to go to Vilnius, to the National Cancer Institute – I trusted this medical institution very much. With his diagnosis – a malignant tumor of the rectum, as the doctors say, a low tumor. At the outlet. There was a council of doctors who decided that I could choose one of two options – surgery with a stoma or 25 chemoradiation treatments plus 4 chemotherapy treatments. Of course, I chose the second one and the treatment lasted about 3 months. With spaces. At the end of this stage of treatment, tests were carried out, which showed that the tumor was gone.
I am very happy, I want to thank Dr. Audriis Dulskas and Dr. Edita Baltruškevičieni, the entire staff of doctors and nurses, who were very attentive and patient. I really needed a good word – that everything will be fine. I asked various questions and they listened to my whining.
Of course, the family helped a lot – husband, son, sisters. They took me to Vilnius, for procedures. But it is very important to deal with yourself inside. I went to both a psychologist and a nutritionist who helped me adjust my diet. There was also diarrhea, and the oral mucosa was ulcerated after chemotherapy. And ointments were distinguished from side effects of radiation.
Now I’m talking to people in a support group: it’s so important to talk to someone who’s been through the journey themselves. Red meat will have to be given up, although I love meat very much, but this result makes it easy to give up. I am happy for this day, I am alive, I have strength, I am walking. I remain under medical observation, they will do a magnetic resonance examination every three months,” Asta A cheerfully tells the story of her illness.
More and more young people are getting colorectal cancer
“There is no single reason why the incidence of colorectal cancer is increasing. However, there is data that obesity, an unhealthy lifestyle – low physical activity, fast food, red processed meat, smoking, alcohol consumption, some chronic inflammations – are associated with the occurrence of this disease,” said Dr. A. Dulskas.
The symptoms of rectal cancer are clearly felt: bleeding from the anus, bloating, if the tumor is large enough, defecation may be disturbed. “If bleeding occurs, a person notices it immediately – blood remains on toilet paper, feces. Therefore, I strongly urge people who experience symptoms to come to the National Cancer Institute without delay. Unfortunately, patients often start treating hemorrhoids and turn to oncologists a year or a half after the onset of the symptoms I mentioned, and cancer is diagnosed,” Dr. A. Dulskas.
A very important issue when it comes to rectal cancer is early diagnosis. Since a person does not feel any complaints, as in the case of cancer of many other localizations, we can detect an early-stage tumor only if the population participates in screening programs. “I don’t even know anymore how it is possible to encourage people to get checked for cancer more actively. In March and other months, I and many of my colleagues try to do that with all our power. I wish famous people would get more involved in promoting cancer prevention. Most likely, a generation must change, which will understand that it is completely simple to come and get checked, without waiting for signs of illness,” says Dr. A. Dulskas.
Colorectal cancer is the third most common oncological disease in Lithuania and the world. In terms of mortality, this cancer has the second place. Every year in Lithuania, 1600-1700 people fall ill with this disease. The guidelines of the World Health Organization (WHO) indicate that by 2030 the incidence of this cancer will increase to 20-30% in the age group of young people. According to dr. Audrius Dulskas, both in Lithuania and in the world there are noticeable trends that this cancer is getting younger. “If previously we found about 8% of people under 50 years of age. of cancer cases, now the incidence of colorectal cancer in this age group is 12-13 percent,” says Dr. A. Dulskas.
The patient’s quality of life after surgery
How is rectal cancer treated? According to dr. A. Dulska, we can immediately operate on rectal cancer in the early stages, both by preserving the rectum and by removing it. “For advanced disease, we can use surgery, chemoradiation, chemoradiation and chemotherapy. There are many options. In the council of doctors, we decide which treatment would be most suitable for a particular patient.
The patient’s quality of life also depends on what treatment was applied. If there was a surgical treatment, the patient’s quality of life is quite poor, because the person loses one of his organs – the rectum, which is a reservoir for feces. After the operation, another hose is led to the exit channel. However, unlike the rectum, it cannot store feces. Therefore, patients who usually complain of urinary and sexual dysfunction often also complain of voiding disorders.
When the patient wants to go to the toilet, he must know in advance the nearest place where he can do it within 10-15 minutes. Therefore, the quality of life suffers, especially when you have to leave the house somewhere – you have to follow a diet, a nutrition plan. Patients often tell us that they don’t eat for several hours before going to the doctor just so they don’t have to rush to the toilet later. As the patient’s quality of life deteriorates significantly after surgery, alternative treatment methods such as chemoradiation with chemotherapy are sought.
Clinical studies show that the complete response rate of such treatment (when the tumor disappears completely and the patient is sufficiently monitored) is 50%. and more. A new method, which has been described in several clinical trials so far, is immunotherapy. For a given mutation, which occurs in 5-10% in patients with immunotherapy, the tumor disappears completely. In this case, the patient preserves the function of his rectum and pelvic organs,” says Dr. A. Dulskas.
Neoadjuvant therapy is a step towards better results
In order to improve the patient’s quality of life, a new treatment method is used to treat rectal cancer, where chemoradiation is given, and chemotherapy is also given before or after it. After these stages of treatment, the patient undergoes surgery or, if the tumor has been diagnosed at a low stage and a complete response to treatment has been obtained, the patient is followed up.
“Chemotherapy, immunotherapy, radiation therapy in the treatment of rectal cancer become an integral part of the entire treatment of the disease. Medicinal treatment is prescribed before surgery, and with good results, organ function can even be preserved. Currently, the methodology of treating locally advanced rectal cancer is gaining popularity, when neoadjuvant – preoperative treatment is performed before surgery, that is, both radiation therapy and chemotherapy are prescribed. The goal of this treatment is to shrink the tumor. In cases where a complete response to treatment is achieved, the patient can avoid rectal cancer surgery,” says NVI oncologist and chemotherapist dr. Edita Baltruškevičienė.
Non-adjuvant therapy for rectal cancer lasts about 3 months. Medicines can be given together with radiation therapy. Such chemoradiation treatment takes about 5 weeks. According to dr. E. Baltruškevičienė, the treatment is not long and can provide a complete response to the disease.
How can you help yourself if you are having radiation treatment?
According to NVI doctor and radiotherapist Ernest Šileikas, before the radiation therapy treatment is started, the patient is first subjected to a computerized tomography examination in order to create a treatment plan. It takes about a week, then treatment begins. Treatment can last from 1 to 5 weeks. Irradiation is performed once a day, only on weekdays. In Lithuania, the 5-week treatment option is usually applied. Along with radiation therapy, chemotherapy is also used. Chemotherapy, which is dripped, is given in the first and last week along with radiation treatment for 4 days. If the chemotherapy treatment is given in tablets, they are taken daily,” says E. Šileika.
During radiation therapy, the patient may experience radiation reactions. They usually appear at the end of radiation treatment and are divided into early and late. “Early reactions occur within 3 months from the start of treatment. Late radiation reactions occur 3 months after the start of radiation treatment. The patient may feel weakness, lethargy, drowsiness, nausea. Reactions can also be felt in the area that is irradiated.
During rectal irradiation, the patient may experience frequent, difficult or painful urination. Diarrhea, difficult or painful defecation may also occur. Redness, sores in the anus area may appear,” says E. Šileika about the possible side effects of radiation treatment.
According to the radiotherapist, such complaints can be prevented. “An hour or half an hour before the procedure, you should urinate and drink half a liter to a liter of water. How exactly to do this is explained to the patient by the attending physician. This is necessary in order to fill the bladder equally before each procedure. When it is full, less radiation is received, so the patient feels less side effects. In addition, a full bladder elevates the bowel from the pelvis into the abdominal cavity, resulting in less exposure and fewer side effects for the patient.
It is advised not to consume flatulent foods such as carbonated drinks, fresh vegetables, and fruits while the radiation therapy is in progress. It is better to choose stewed, boiled vegetables. If the rectal tumor is located in the lower part, near the anus, after using the toilet you should wash yourself, do not use wet wipes, toilet paper, try not to sit directly on the anus, try to sit on one side, stand more often. It is very important that if the patient experiences side reactions, he should not suffer and contact the attending physician. Side reactions may occur even after the treatment has ended. This should not be forgotten even after 10 years,” says E. Šileika about how a patient should behave after feeling the side effects of radiation treatment.
2024-09-02 04:50:41