Colorectal Cancer (Colon Carcinoma): Therapy

General measures

  • Nicotine restriction (abstaining from tobacco use) – active smokers (before and after surgery) have a twofold increased mortality risk (risk of death)
  • Limited alcohol consumption (men: max. 25 g alcohol per day; women: max. 12 g alcohol per day).
  • Normal weight to strive for or maintain!Determination of BMI (body mass index, body mass index) or body composition using electrical impedance analysis.
    • BMI ≥ 25 → participation in a medically supervised weight loss program.
    • Falling below the BMI lower limit (from the age of 45: 22; from the age of 55: 23; from the age of 65: 24) → Participation in a medically supervised program for the underweight.

Conventional non-surgical therapy methods

  • Radiofrequency ablation (RFA); local-ablative (local, tumor-destructive) procedure in which tumor is destroyed by local (local) application of heat; indications: resectable liver metastases (daughter tumors in the liver that can be surgically removed) or the patient’s general condition does not permit resection, esp. after previous liver resection
  • Laser-induced interstitial thermotherapy (LITT); indication: liver metastases (only within clinical trials).

Vaccinations

The following vaccinations are advised:

  • Flu vaccination
  • Pneumococcal vaccination

Regular checkups

  • Regular follow-up examinations for early detection of recurrence (recurrence of the disease): every 3 months for the first 2 years, and every 6 months thereafter
    • UICC stage I: colonoscopy (colonoscopy; to detect metachronous neoplasms/neoplasms occurring at different times).
    • UICC stages II and III: medical history (history), abdominal ultrasonography (ultrasound of abdominal organs), and CEA determination (tumor marker) (every 6 years for the first 2 years, and every 12 months thereafter).

Nutritional medicine

  • Nutritional counseling based on nutritional analysis
  • Nutritional recommendations according to a mixed diet taking into account the disease at hand. This means:
    • Little red meat, i.e. muscle meat of pork, beef, lamb, veal, mutton, horse, sheep, goat – This is classified by the World Health Organization (WHO) as “probably carcinogenic to humans”, that is, carcinogenic. Meat and sausage products are classified as a so-called “definite group 1 carcinogen” and are thus comparable (qualitatively, but not quantitatively) to the carcinogenic (cancer-causing) effect of tobacco smoking. Meat products include products whose meat component has been preserved or improved in flavor by processing methods such as salting, curing, smoking, or fermenting: Sausages, cold cuts, ham, corned beef, jerky, air-dried beef, canned meat. Daily consumption of 50 g of processed meats (equivalent to two slices of sausage) increases the risk of colon cancer by 18%, and daily consumption of 100 g of red meat by 17%.
    • Reduce consumption of smoked and cured foods, because they contain nitrate or nitrite as a component of curing salt. Their preparation produces compounds (nitrosamines), which are risk factors for various tumor diseases.
    • Once or twice a week fresh sea fish, ie fatty marine fish (omega-3 fatty acids) such as salmon, herring, mackerel.
    • Daily total of 5 servings of fresh vegetables and fruits (≥ 400 g; 3 servings of vegetables and 2 servings of fruits).
    • Refrain from contaminated foods such as offal and wild mushrooms
    • Do not eat moldy food
    • Food, especially meat and fish, do not fry too hot. When heated (> 150 °C), heterocyclic aromatic amines (HAA) are formed. People who have a high intake of HAA have a 50 percent higher risk of developing polyps (adenomas) of the colon (large intestine), which are often precancerous (precursors) for colon carcinoma (colon cancer).
    • Consume only limited energy-rich foods.
    • Moderate total fat intake – keep intake of saturated fatty acids of animal origin and of the polyunsaturated fatty acid linoleic acid (omega-6 fatty acid), contained in safflower, sunflower and corn oil, low
    • Little animal protein (protein)
    • High fiber diet – 30 g per day: cereals, vegetable gums such as gum arabic, seed mucilage, vegetables, legumes, fruits.
      • Primary prevention: according to a meta-analysis of 25 prospective observational studies, colorectal cancer risk decreases by 10% for every 10 grams of dietary fiber.
      • In one study, all-cause mortality (all-cause death rate) decreased by 14% when daily fiber intake was increased by 5 grams.
    • Another observational study also showed that a diet rich in plant products and low in animal products and sugar increased colon cancer survival even when the diet was changed after diagnosis.
    • Diet rich in:
  • If necessary, special dietary recommendations due tomalassimilation (disturbance of pre-digestion in the stomach, the enzymatic breakdown of food components (exocrine pancreatic insufficiency / disease of the pancreas associated with insufficient production of enzymes), fat emulsification (eg, bile acid deficiency in cholestasis / biliary obstruction) and the absorption or removal of the absorbed food).
  • Selection of appropriate foods based on the nutritional analysis
  • See also under “Therapy with micronutrients (vital substances)” – if necessary, taking a suitable dietary supplement.
  • Detailed information on nutritional medicine you will receive from us.

Sports Medicine

  • Endurance training (cardio training) and strength training (muscle training).
    • In colon cancer, a significant reduction in incidence (frequency of new cases) of up to 50% was detected when practicing moderate endurance sports (primary prevention).
    • Regular exercise after cancer diagnosis reduces all-cause mortality (death rate) from colon cancer by a relative 38% (tertiary prevention).
    • In general, endurance training on a bicycle ergometer can be recommended, which is performed according to the principle of interval training. This means that load phases of 1 to 3 minutes duration alternate with rest phases of also 1 to 3 minutes duration. The training should be performed at about 80% of the maximum heart rate for a total of 30 minutes.
  • Preparation of a fitness or training plan with suitable sports disciplines based on a medical check (health check or athlete check).
  • Detailed information on sports medicine you will receive from us.

Psychotherapy