Can early poorly differentiated rectal cancer be cured?

Chinese and foreign doctors have the same opinion on the principles of surgical treatment for early rectal cancer: surgery is the preferred method, the overall 5-year survival rate after radical resection of rectal cancer is about 60%, and the 5-year survival rate after surgery for early rectal cancer is about 80%. At the same time, due to the application of gastrointestinal staplers, many rectal cancer patients who later need to have colostomy are spared the trouble of artificial anus, thereby improving the patients' quality of life.

The surgical treatment of early rectal cancer emphasizes surgical resection first, and focuses on combined preoperative chemotherapy, radiotherapy, Chinese medicine and other comprehensive treatments to improve the surgical resection rate, reduce the recurrence rate after surgery, and improve the survival rate. The principles of surgical treatment of rectal cancer are: 1. Try to cure it; 2. Try to protect the pelvic autonomic nerves, preserve the patient's sexual function, urination function and defecation function, try to preserve the anus, and improve the quality of life.

The local recurrence rate after rectal cancer surgery is affected by many factors, generally ranging from 4% to 51%, and the recurrence time is mostly within 2 years. Treatment after local recurrence includes surgery, radiotherapy, chemotherapy, etc. The efficacy of various treatments varies from report to report, and there is still controversy.

The consensus reached so far is as follows:

1. Postoperative Chinese medicine treatment to prevent recurrence of rectal cancer

It is uncertain whether rectal cancer will recur after surgery. Chemotherapy and radiotherapy may cause obvious toxic side effects. The therapeutic effect seems to be not worth the side effects. We can give full play to the advantage of Chinese medicine in preventing disease. Chinese medicine has no obvious toxic side effects. The mechanism of treatment of Chinese medicine and Western medicine is different. Western medicine directly kills cancer cells, while Chinese medicine inhibits the proliferation of cancer cells by improving the body's immunity. In China, rectal cancer surgery and follow-up treatment with Chinese medicine after surgery are widely used.

2. Second surgery should be carefully considered

If liver metastasis is relatively localized, re-surgery can achieve a 5-year survival rate of 25% to 30%. If there is a local recurrence in the perineum and pelvis, total pelvic resection can be used according to the situation, which can improve symptoms, relieve pain, and appropriately prolong life. However, it is a palliative surgery after all, and the operation is large and has many complications. A urethral stoma is often added after the operation, so this operation should be performed with caution.

Molecular biological studies in recent years have shown that rectal cancer has cancer cell dissemination in the early stage, and there are often multiple micro-metastases at the time of surgery. 25% of patients in the middle stage and 50% in the late stage eventually die from systemic cancer dissemination. Therefore, Chinese medicine treatment is used for surgical patients after surgery. A large number of clinical studies have shown that it can increase the 3-year survival rate by about 20% and the 5-year survival rate by about 10%. It can significantly reduce local recurrence.