विवरण
A Case-Based Approach to managing gastrointestinal (GI) malignancies involves applying a personalized, patient-centered strategy using specific case details to guide treatment decisions. It emphasizes a multidisciplinary team approach, where oncologists, surgeons, pathologists, and radiologists collaborate to determine the best course of action based on tumor type, stage, and patient factors. This method allows for tailored treatment plans, integrating surgery, chemotherapy, radiotherapy, and targeted therapies to optimize outcomes. By discussing individual cases, this approach also aids in identifying potential challenges and refining management protocols to improve patient care.
सारांश
- Colorectal cancer treatment can significantly impact pelvic floor function, leading to urinary, bowel, and sexual dysfunction. Cancer types in the pelvic area include bladder, cervix, anus/rectum, ovaries, uterus, testes, and prostate cancers. Treatment modalities include surgery, adjuvant treatment (surgery plus chemo-radio-auto therapy), and neoadjuvant treatment (chemo-radio-auto therapy before surgery).
- Surgery can cause nerve damage, impact fascia and ligaments, and result in scar tissue formation, leading to changes in bowel habits, anal incontinence, constipation, fecal urgency, erectile dysfunction, genital dryness, urinary issues, pelvic pain, decreased mobility, muscle weakness, and postural changes. Furthermore, emotional distress and reduced quality of life are common psychosocial impacts.
- Radiotherapy can lead to fibrosis in pelvic floor muscles, urinary and defecation changes, mucosal damage, pelvic pain, and menopausal symptoms. Chemotherapy side effects include cardio toxicity, anemia, cancer-related fatigue, and chemotherapy-induced neuropathies.
- Managing these patients requires a multidisciplinary approach involving collaborative care and tailored rehabilitation programs. Providing adequate support and education is essential. Tailored rehabilitation programs, dietary and medication modifications, and redo surgeries (when needed) are crucial for improving outcomes.
- Rehabilitation strategies include psychological counseling, nutritional interventions, surgical revision options, physiotherapy (strengthening pelvic floor muscles, managing stress), and lifestyle modifications. Pelvic floor exercises, trigger point massage, and scar massage are also beneficial. Long-term management focuses on addressing changes in bowel habits, sexual dysfunction, pelvic pain, and pelvic organ prolapse.
- Research advancements, including robotic-assisted surgery, telemedicine platforms, psychosocial support programs, and digital health applications, offer potential solutions for improving outcomes. Collaborative research and knowledge exchange are essential for advancing the understanding and management of pelvic floor issues after colorectal cancer surgery.
नमूना प्रमाण पत्र
वक्ताओं के बारे में
Dr. Özdal Ersoy
Consultant Gastroenterology, Acıbadem University School of Medicine, Atakent Acıbadem Hospital, Istanbul, Turkey
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