HIV Foundation Health The unknown colon cancer: How to prevent tumors in the small intestine

The unknown colon cancer: How to prevent tumors in the small intestine

When it comes to colon cancer, most people think of colon cancer. What is less well known is that the small intestine can also develop malignant tumors. What you should know about it, about symptoms, treatment and the combination of colon and small bowel cancer.

Small bowel cancer accounts for up to five percent of all bowel cancers; around 2,600 men and women were diagnosed with small bowel cancer in 2016, compared with around 60,000 colon cancer. “It is important to classify a carcinoma on the one hand by localization, i.e. in the case of bowel cancer, small or colon cancer, but also differentiate it on the basis of its biological characteristics,” reports Ulrich Graeven, chief physician at the Clinic for Hematology, Oncology and Gastroenterology at Maria Hilf Mönchengladbach Hospital.

Cancer of the small intestine is usually biologically very different from cancer of the colon

While colon cancer is usually adeno tumors, i.e. growths of the mucous membrane, this affects only a small fraction of small bowel cancer. The most common forms of small bowel cancer, depending on the cells that cause the disease, are:

  • Neuroendocrine tumors (NET) with around 50 percent, they arise from hormone-producing cells
  • Gastrointestinal stromal tumors (GIST) make up about ten percent, these tumors originate from the connective tissue in the gastrointestinal tract.

The differing biological characteristics of the two types of colon cancer, colon and small bowel cancer, “make these two diseases so fundamentally different, even though both affect the bowel,” explains the oncologist.

Causes of small bowel cancer and why it is less common than colon cancer

What triggers the fact that the cells in the small intestine no longer act normally, but degenerate and multiply in an uncontrolled manner, is still largely unknown. It is assumed that there is a connection with pollutants in food that come into contact with the small intestine during passage and can thus influence its cells.

It is well known that the small intestine connects directly to the stomach. This first section of the three-part small intestine is called the duodenum, followed by the jejunum and ileum. In addition to transporting the chyme to the large intestine, the task of the five-meter-long small intestine is to break down certain food components and release them into the blood. The most important ones are carbohydrates, which are processed into various sugars, fat, but also vitamins and trace elements.

The chyme is still thin in this section of the intestine and is therefore transported on quickly. The contact time with the intestinal wall is much shorter than later in the large intestine, “which could explain why colon cancer is much more common than small intestine cancer,” the gastroenterologist explains the possible background. In addition, the mucous membrane in the small intestine is less susceptible to certain factors such as pollutants than that in the large intestine.

Risk factor hereditary diseases

However, there is also a familial willingness to develop small bowel cancer: Hereditary polyposis syndromes such as familial adenomatous polyposis (FAP) and Lynch syndrome. Genetically, a large number of polyps develop in the large intestine, sometimes also in the small intestine. These are adenocarcinomas, but are very rare in the small intestine compared to NET and GIST.

Small intestinal tumors associated with FAP are usually only discovered when polyps have been detected in the large intestine. In the course of further diagnosis of the familial predisposition, these rare small bowel carcinomas are also identified.

Small bowel cancer symptoms

Small bowel cancer usually grows slowly. Frequently, signs only appear when the disease has progressed and the tumor is taking up space. Depending on you can

  • Bleeding,
  • Stomach pain,
  • nausea
  • Constipation or diarrhea

occur. If the tumor is large, it can even block the intestines (ileus). The intestinal obstruction manifests itself through massive pain, it is always a medical emergency that is life-threatening and must be treated immediately.

Small bowel cancer prognosis varies

Small bowel cancer is usually only discovered at an advanced stage. In more than 70 percent, the carcinoma is only diagnosed in stage three or four, i.e. later than this applies to this common colon cancer – again the comparison with colon cancer.

The survival rates for small bowel cancer are therefore somewhat lower. “The decisive factor, however, is always the type of cancer of the small intestine,” explains the expert. If a GIST or NET is detected early, the chances of survival are very good. If, on the other hand, it is adenocarcinoma, which is also usually discovered later, the prognosis is not quite as favorable.

Diagnosis of small bowel cancer

The classic examination methods of gastroscopy and colonoscopy only cover the upper or lower part of the small intestine, “the almost five meters in between are not reached with these examination techniques,” explains the expert.

Imaging methods such as magnetic resonance tomography (MRT) or computed tomography (CT) are only used if there are symptoms and suspicion of this intestinal tumor. Capsule endoscopy, which shows images from the small intestine, also provides information.

Only when these examinations reveal an abnormality is it possible to specifically mirror the small intestine. “However, this is very time-consuming and cannot be used as a preventive examination – also because these intestinal tumors are very rare,” emphasizes Ulrich Graeven.

Small intestinal cancer therapies – surgery and its consequences

Overall, the following applies to the various small intestinal tumors: If possible, an operation should be performed. “If the tumor is limited, parts of the small intestine can usually be removed without any problems,” explains the oncologist in more detail.

A stoma, i.e. an artificial anus, is therefore usually not necessary. However, it is crucial which part of the small intestine is missing and which functions it had, which trace elements and vitamins it passed on to the body. This deficiency must then be compensated for through appropriate nutrition or medication.

Treatment for small bowel cancer varies depending on the type of tumor

Parts of the removed tumor are examined histologically. For the therapy plan, it is crucial whether it is NET, GIST or the rare familial adenocarcinoma in the small intestine. “A generally applicable therapy scheme for small bowel cancer is not possible because there is not just one small bowel cancer, but different ones, it always depends on its type,” emphasizes the oncologist.

Accordingly, there are many different therapy options. If a gastrointestinal stromal tumor (GIST) has metastasized, for example, there are very good drugs for further treatment. “This is not the classic chemotherapy, but we use so-called tyrosine kinase inhibitors, with very good results,” reports the expert. These are inhibitors, such as imitanib, that can block certain signaling pathways within the cells. They are sometimes also used before an operation to reduce the size of a tumor that is too large and therefore inoperable, or after an operation to avoid a relapse.

If the cancer of the small intestine is a neuroendocrine tumor (NET), on the other hand, surgery is often the only treatment required. The NET is further subdivided with regard to the need for drug therapy, taking into account its growth rate. This subdivision of the NET is also of crucial importance for planning therapy for metastatic NET.

Ademocarcinoma of the small intestine is treated on the basis of the results from the treatment of colon tumors.

Small bowel cancer prevention

Targeted prevention against these rare tumors is hardly possible – apart from the well-known rules for a healthy life, i.e. without smoking, with a sensible diet, extensive alcohol restriction and sufficient exercise. Because little is known about the possible causes of small bowel cancer, they cannot be influenced.

However, there is an important tip from the expert for everyone in whose families there are genetically determined polyps in the large intestine: Remember to not only limit the preventive measures to the large intestine, but also to extend it to the small intestine. Although this is provided for in the relevant colorectal cancer screening and follow-up programs, it must not be overlooked.

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“Cancer cells are fed” – underestimated health risks lurk in meat and sausage“Cancer cells are fed” – underestimated health risks lurk in meat and sausage

Iron deficiency is often discussed. There is hardly any talk about the opposite, the frequent overloading with heme iron, the iron form made from red meat and sausage. It promotes the common diseases of diabetes, cancer and arteriosclerosis. FOCUS Online shows how you can meet your iron needs in a healthy way.

The trace element iron is indispensable for a number of vital metabolic functions in the body. As a component of hemoglobin in the red blood cells, it supplies every body cell with oxygen. Iron deficiency, which manifests itself in anemia, exhaustion, susceptibility to infection, affects around 20 percent of women and ten percent of men in Germany. The higher risk for women is explained by menstruation and decreases accordingly when the childbearing phase of life is over.

Many people have an excess of iron – and know nothing about it

Iron deficiency is known and many nutrition-conscious people pay attention to adequate iron intake. However, significantly more people could have anything but an iron deficiency, namely too much of this trace element. Probably very few people know about it, although it carries a high risk of disease.

Heme iron and non-heme iron: these are the differences

First and foremost, it is important for these relationships – there are the two known, different forms of iron, only one of which can be hazardous to health:

1. Heme iron , i.e. bivalent iron (Fe), mainly found in red meat and sausage. Heme iron has a high bioavailability, the body can use at least 20 percent from food.

2. Non-heme iron , trivalent iron (Fe3), from plant-based nutrient suppliers such as legumes, whole grains, nuts, oil seeds and various types of vegetables. Non-heme iron must first be oxidized to some form of Fe in the small intestine in order for the body to use it. In this way, only around five percent of the iron from food comes into play.

The iron requirement per day is 15 milligrams for women and 10 milligrams for men.

Underestimated health risk heme iron

What is certain is that most people in industrialized nations have at least a sufficient supply of the trace element. Due to our meat and sausage-heavy diet, a large part is even oversupplied with heme iron, and thus risks diseases. Various studies indicate these relationships .

“We assume that too much heme iron can have negative health consequences through eating meat,” explains Matthias Riedl, board member of the Association of German Nutritionists (BDEM) and diabetologist, nutritionist, internist, managing director and medical director at Medicum Hamburg.

The human organism is not prepared for high meat consumption

Normally, a complex mechanism of substances in the liver and intestines controls the iron level. If too much iron storage protein ferritin is measured, the body slows down absorption. “This does not work adequately with large amounts of heme iron, the body continues to absorb it, simply because this form of iron is extremely easy to use,” says the expert.

The nutritionist explains that the cause lies in our evolutionary history. Up until two million years ago, humans were purely plant-eaters, only then did they add animal consumption. That was sometimes more, mostly less meat – definitely a lot less than is regularly eaten today. The human organism is not prepared for this.

High consumption of heme iron feeds cancer cells

The excess iron is then deposited in the pancreas, liver and spleen, which can put stress on the organs. But that’s not all. “Heme iron can promote mutations via certain chemical compounds – for example in intestinal cells, but also in other cells,” warns the internist.

In addition, these compounds have a cytotoxic effect, so they can not only change cells, but also damage them. “And cancer cells, on the other hand, are properly fed by heme iron, so to speak,” says the expert. Malignant cells have a high demand for this trace element. A high consumption of heme iron means that existing cancer cells grow better and are stronger against the immune system.

Meat lovers are more likely to develop diabetes and arteriosclerosis

In addition to the connection between heme iron and cancer, many nutritional studies have shown two other negative effects of the “meat iron”:

1. Numerous studies show that people who consume a lot of sausage and meat are particularly likely to have type 2 diabetes .

2. In addition, this dietary preference often leads to arteriosclerosis , with the well-known secondary diseases of high blood pressure, heart attack and stroke.

“If people don’t eat ‘appropriately’, they get sick”

The higher the meat consumption, the higher the risks for cancer, diabetes and arteriosclerosis. What actually stands behind it: “If people do not eat ‘species-appropriate’, i.e. eat too much red meat and sausage and thus too much heme iron, they will get sick,” warns Matthias Riedl. It is well known that primitive peoples who still eat originally – eat very little meat and no sausage – do not have arteriosclerosis at all, for example.

Trivalent iron from plants is converted into bivalent iron

So heme iron has a rather negative effect on the body. Non-heme iron, on the other hand, does not pose these health risks – but is converted into bivalent iron in the body in order to make it available. Doesn’t it then become as unfavorable as bivalent heme iron? “No, because the trivalent iron from plants is converted into a bivalent iron, but not into heme iron,” explains the expert.

Providing the body with healthy iron – vegetables and fruits with non-heme iron

In order to provide the body with sufficient iron without meat, there are a number of plant-based foods that have a high content of non-heme iron, such as:

  • Lentils around 2.7mg / 100gr
  • Chickpeas around 2.7mg / 100gr
  • Peas 1,5mg / 100gr
  • Spinach 3,6mg / 100gr
  • Chanterelles 6.5mg / 100gr
  • Elderberry 1.6mg / 100gr
  • Pine nuts 9.2mg / 100gr
  • Millet 6.9mg / 100gr
  • Flaxseed, ground 8,4mg / 100gr
  • Amaranth 8.9mg / 100gr

Spinach contains a comparatively high amount of iron for a plant-based food, but at the same time the substances it contains can prevent it from being absorbed by the body. Beans or lentils are therefore better suited as a vegetarian source of iron.

Intelligently upgrade the bioavailability of iron from vegetables and fruits

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Coffee and tea inhibit iron availability

However, there are also plant substances that have an inhibiting effect on iron absorption. These are phytates and polyphenols, for example, these plant substances are contained in coffee and tea. So avoid these drinks during, immediately before and after a meal containing iron. In wholemeal products, on the other hand, the phytate content plays a lesser role, as they convince with their high iron content.

Cover your iron requirement healthily, certain meats are also allowed

“Those who follow a purely vegetarian / vegan diet can still get too little iron, especially women are at risk here,” says the expert.

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What is the Best Treatment For Peyronie’s Disease?What is the Best Treatment For Peyronie’s Disease?

What is Peyronie? What are the symptoms of Peyronie? What is the cure for Peyronie? Who is at risk if I’m infected with Peyronie? These and many more questions may pop into your head if you are suffering from this disease. What if I do not treat my disease? This is a common question many people ask – is it safe to buy and use peyronie’s device amazon. Unfortunately, there is nothing we can do about our genes or family history that will make it “rain” down from us.

There are several treatment options available. What are the most common treatments? Which ones have the highest success rates? What is the risk for treatment failure? Which treatments relieve symptoms better than others? When the infection first appears what are the best treatment options? What is the most effective cure? If you are suffering from Peyronie what are your treatment options? What are the side effects of each treatment option? Where do I start? These are just some of the common questions faced by most people. Unfortunately, the answer is not simple. But to help you decide, here are some of the treatments available.

Oral antibiotics are the most commonly prescribed treatment for early-stage infection. It is taken orally in either a pill form or tablets. If it is taken as a pill it is usually taken once per day with your meal. The pill form of Vitamin C needs to be taken on an empty stomach to maximize the absorption rate and speed up the action of the medication. Oral antibiotics like penicillin are available at most drug stores and supermarkets.

Topical corticosteroids are usually applied topically to the affected area or joints. They work by reducing inflammation and redness within hours of being applied. These treatments can be found at most drug stores and supermarkets as well as vitamin stores. The most common brand is prednisone, which is usually prescribed for short periods only.

Most conventional therapies start off with topical steroid creams or gels. These treatment options are usually only recommended for mild or moderate cases of the disease. However, for more severe cases oral steroids may be required. Also, for the acute phase, these treatments are usually only recommended.

For the acute phase of the disease, many doctors will recommend surgery. Depending on how advanced the disease is surgery might be required as part of the treatment plan. Surgical options will always be under serious consultation with your physician. However, with advanced and aggressive disease, you will probably be able to choose a different course of treatment such as hormonal therapy or microsurgery.

As mentioned before, some patients will need more than one type of treatment. So it is important to find out what sort of treatments are already available for your condition. In most cases, surgery or hormonal therapy is usually the first recommendation. However, in some situations such as those that occur during menopause women will require liposuction. And last but not least, it is important to follow your doctor’s advice and start treatment as soon as possible.

It is very important to keep in mind that every case of the disease is different. Some patients will respond to treatments quicker than others. For this reason, you must discuss with your doctor which treatment will be best for you. Remember, that at any stage of the disease you should always see your doctor. Your doctor will be able to advise you on the best treatment for Peyronie’ disease based on your unique circumstances and the severity of the disease.

One of the most common treatments for Peyronie’s disease is a nonsurgical treatment using a penile traction device. The traction device has been shown to be very effective in helping to reduce the pain associated with the condition. This nonsurgical treatment can usually be worn under clothing. If your doctor recommends a penile traction device then it is strongly recommended that you wear it only during the day. Penile traction devices have been known to cause some discomfort, so you should take care not to aggravate the discomfort by exercising or performing other activity during the day.

Other nonsurgical treatment options that your doctor may recommend include steroid tablets, which can help relieve inflammation and reduce pain associated with the condition. Also part of what is the best treatment for Peyronie’s disease is to use prescribed oral pain medication. In most cases your doctor will consider anti inflammatory medication as an option, but there are also several oral pain medications that are considered safe if taken as directed. One important thing to remember is that when taking any kind of medication to relieve your condition, you should always consult your doctor and follow his or her dosage recommendations.

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