文/陈执中医生

某天为一个病人切除了肠癌。病人肠子阻塞，但却等到其腹部肿涨才来看医生。

根据我的判断，他的这个病情应该早在半年到一年前就已经出现了，那为什么等到肠道塞住了才就医呢？

其实腹部里的大部分器官是没有疼痛触觉细胞的。这些器官有胀痛的触觉细胞、胃酸的触觉细胞、绞痛的触觉细胞，但唯独没有疼痛的触觉细胞，所以患上癌症后病人是不会感觉到疼痛。奇怪的是，有时候肠子阻塞了90%的粪便却还是能够排除体外，且病人也没有出现什么病症，所以有些人等到排便困难，肠子开始绞痛时才来看医生。而上面提到的这位病人是直到肠道完全阻塞时才来，当然这样的情形癌症已是比较后期的了，手术也变得较为紧急，风险自然会增加，不过还好这个病人的手术在1小时半内就完成了。

肠癌是由肠子内部的息肉恶转变成癌症的，整个过程要经历五年到15年不等的时间。如果一个人照肠镜的时候发现了这些息肉，那就能够当场把它切除，这样就成功预防了肠癌的出现。现如今，肠癌已是男子癌症的头号杀手、女子的次号杀手，所以如果能够预防，那不是一件好事吗？所以我的建议是40岁开始就做例常的大肠镜筛检，每五年做一次，这样患上肠癌的机会能大大减少。

It is a very wrong concept that: no pain = no illness

I had removed a colon cancer from a patient. The patient presented with  intestinal obstruction and abdominal distension.

How long has this cancer exited? Probably about half a year to a year. Then why did the patient come so late?

Many of the abdominal organs have no pain sensation. These organs have nerves for distension, nerves for stomach acid, and nerves for spastic pain but no nerves fibre for pain. So having cancer doesn’t hurt. Will intestinal obstruction hurt? The strange thing is that often faeces can pass through the intestinal blockage until may be 90% narrowed. Therefore, some people only see a doctor when it is very difficult to defecate. Some patients like this one come in when they had complete blockage. Of course, in this case, the cancer is relatively advanced, and surgery has increased risks.  Fortunately, this patient's surgery was completed within an hour and a half .

We already know that colon  cancer develops from polyps inside the intestines. It takes 5 to 15 years for this polyp to turn into cancer. If a doctor finds these polyps during a colonoscopy, they can be removed on the spot and thus prevent colon cancer. Colon cancer is now the number one killer of cancer in man and the number two cancer killer in women. So, wouldn’t it be great if we could prevent colon  cancer by doing a simple colonoscopy (telescoping inside the colon)

So my suggestion is to have routine colonoscopy screening starting at the age of 40. Repeat it every five years. This will great reduces the chance of getting bowel cancer .

Clement Chen