结肠癌的 5 个先兆体征丨医学英语视听学习

5 warning signs of Colon Cancer

结肠癌的 5 个先兆体征

Colorectal cancer usually begins as small, benign clumps of cells called polyps that form on the inside of the colon. Over time, some of these polyps can become cancerous.

结直肠癌通常由结肠内部形成的称为息肉的良性小细胞团发展而来。随着时间的推移，其中一些息肉发生癌变。

The biggest risk factor for developing polyps is being above 50 years old. Almost 50% of people over 50 have precancerous polyps. The larger the polyp becomes, the bigger the risk of it developing into cancer.  

息肉产生的最大风险因素是年龄超过 50 岁。近 50% 50 岁以上的人有癌前息肉。息肉越大，发生癌变的风险越大。

Polyps may be small and produce few, if any, symptoms at first. However, polyps gradually enlarge and may eventually penetrate the bowel wall.  

息肉可能很小，最初几乎不会产生症状。然而，息肉会逐渐增大，最终穿透肠壁。

When they spread, it is usually to the liver, lungs, and brain. If symptoms develop, it may cause one or more of these three main symptoms: 

结直肠癌扩散时，通常扩散到肝脏、肺和大脑。如果出现症状，则可能是以下三种主要症状中的 1 或多种：

One, a change in bowel habits that lasts for more than a few days. Diarrhea is most often seen and can be either a secretory process, the tumor is leaking fluid or from partial obstruction and overflow around the tumor. Constipation is often also seen and is due to increasing bowel obstruction. 

症状一：持续多天以上排便习惯改变。最常见的是腹泻，腹泻可能是肿瘤（渗液）分泌过程或部分梗阻和肿瘤周围溢流。便秘也很常见，它由肠梗阻加剧引起。

Two, blood in the stool. Blood in the stool can show up in a variety of ways, and what the blood looks like can give clues to what's going on in your body.  

症状二：便血。便血的呈现方式多样，血液的颜色和数量提示身体发生的疾病。

An adult's digestive system, including the esophagus, stomach, and intestines, can be as long as 30 feet, and the blood in your stool can come from any part of it. 

成人的消化系统包括食管、胃和肠道，长达 30 英尺（约 9.14 m），便血可能来自其中的任何部位。

A good description of the appearance and amount of blood can help your doctor identify the problem.

详细描述血液的外观和数量有助于医生识别疾病。

If there is only blood on the tissue when you wipe but not in your stool, this is more likely to be hemorrhoids.  

如果擦拭时纸巾上只有血，而不是便中带血，则更可能是痔疮。

Hemorrhoids are swollen veins and can easily get damaged when you pass a stool, causing a little bleeding. This blood will be bright, which means that the blood is fresh and the bleeding is coming from lower in the colon.

痔疮是肿胀的静脉，排便时很容易损伤，导致少量出血。这些血液呈鲜红色，即血液是新鲜的，出血来自结肠下部。

If polyps are located low in the rectum and start bleeding, you may see bright red blood similar to hemorrhoids. Slowly bleeding polyps at the beginning of the colon may result in dark red or black stools.

如果息肉位于直肠下方，且开始出血，则可能出现类似于痔疮的鲜红色血液。结肠起始部的息肉缓慢出血，可能导致暗红色大便或黑便。

As a general rule, the longer blood travels in the gastrointestinal tract, the darker it tends to present in the stool. This is why people with ulcers often have black, tarry stools.

一般而言，血液在胃肠道内流动的时间越长，粪便的颜色越深。这就是胃肠道溃疡患者通常出现黑色柏油样大便的原因。

And 3, cramping or abdominal pain.

症状三：腹部绞痛或腹痛。

Patients often complain of the constant urge to have a bowel movement, and the feeling is not relieved by having one. This could indicate that a tumor is preventing a complete bowel evacuation. 

患者经常抱怨有持续的排便冲动，排便不尽感。这可能提示肿瘤在阻止肠道完全排空。

The presence of a tumor might also create a false feeling of stool remaining even if the bowel is empty.

即使肠道排空，肿瘤的存在也可能产生粪便残留的虚假感觉。

Thankfully, this is a slow-moving process. It's estimated that it takes about 10 years for polyps to take a cancerous turn. This gives us a chance to stay a step ahead of colorectal cancer and brings us to the importance of early detection to identify polyps before they turn into cancer.

万幸，这个过程非常缓慢！据估算，息肉癌变大约需要 10 年。因此，我们有可能提前预防结直肠癌，在其转变为癌症前，及早检测识别息肉则显得尤为重要。

One way to test for colorectal cancer is to look for hidden blood in the stool. The idea behind this type of test is that blood vessels in larger colorectal polyps are often fragile and easily damaged by the passage of a stool.  

结直肠癌的其中一种检测方式是查找大便潜血。这种检测方式的潜在依据是，较大的结直肠息肉往往很脆弱，排便时很容易受到损伤。

The damaged vessels usually bleed into the colon, but only rarely is there enough bleeding for blood to be seen in the stool by the naked eye.

血管受损，血液通常流入结肠，但出血很少，我们不能用肉眼观察到大便中的血液。

You use a special spoon to collect a stool sample and should store it in the container that comes with the test kit. The container is then returned to your doctor.

患者使用一种特殊的勺子收集粪便样本，并将其储存在检测试剂盒附带的容器中。然后，将容器送回给医生。

Another way to test for colorectal cancer is to do a visual exam. 

另一种结直肠癌检测方式是视觉检查。

For this test, the doctor looks at the entire length of the colon and rectum with a colonoscope, a flexible tube about the width of a finger with a light and a small video camera on the end of it.  

检测期间，医生使用结肠镜（一根约手指宽的柔性管，末端带有灯和小型摄像机）观察整个结肠和直肠。

It's inserted through the anus and into the rectum and colon. Special instruments can be passed through the colonoscope to biopsy or remove any suspicious-looking areas, such as polyps if needed.

医生通过患者的肛门将结肠镜插入直肠和结肠。如果需要，医生会通过结肠镜检查特殊仪器进行活检或切除任何可疑的区域，如息肉。

The stool-based tests are typically done at home, so many people find them easier than tests like a colonoscopy.

粪便检测通常在家进行，许多人表示它们比结肠镜等检查更容易。

But these tests need to be done every year, and if the result from one of these stool tests is abnormal, you will still need a colonoscopy to determine whether you have cancer.  

但这些检查需要每年进行一次，如果其中一次粪便检测结果异常，则仍然需要进行结肠镜检查，从而确定是否患癌。

Colonoscopies can be done less often than stool-based tests about once in 5–10 years, but they are more invasive and require more preparation ahead of time.

结肠镜检查的频次通常低于大便检测，大约 5-10 年进行一次，但它们更具侵入性，需要提前做更多准备。

If the cancer is diagnosed at a localized stage, the survival rate is 90%. If the cancer has spread to the regional lymph nodes, the five-year survival rate is 70%; if colon cancer has spread to distant parts of the body, the five-year survival rate is only 12%.

如果在局限期确诊，则患者的生存率为 90%；如果癌症已经扩散到区域淋巴结，则 5 年生存期为 70%；如果结肠癌已经扩散到远处器官，则 5 年生存期只有 12%。