Colorectal Cancer: Expert Insights from Professor Lim Seok-byeong
By Kwon Dae-ik, Medical Reporter
Lim Seok-byung, professor of colorectal surgery at Asan Medical Center (Director of Colon and Rectal Cancer Center). [Image provided by Asan Medical Center]
Colorectal cancer, which affects the large intestine and is responsible for the final stages of digestion, predominantly affects the elderly. As the elderly population in Korea continues to grow, the number of colorectal cancer cases is also rising significantly. According to the latest data from the National Cancer Registry, colorectal cancer ranked as the third most common cancer in Korea in 2020. To gain insights into this pressing issue, I had the privilege of interviewing Professor Lim Seok-byeong, a renowned expert in colorectal surgery at Asan Medical Center and Director of the Colon and Rectal Cancer Centre.
Professor Lim emphasizes the importance of adopting a healthy lifestyle to reduce the risk of colorectal cancer. This includes moderating food intake, quitting smoking, and avoiding extreme vegetarianism. Surprisingly, extreme vegetarianism, which completely eliminates meat from the diet, has been linked to an increased risk of colon and rectal cancer. On the other hand, consuming red meat, such as pork and beef, in moderation can also contribute to this risk.
Symptoms and Detection
When it comes to detecting colorectal cancer, it’s crucial to differentiate between common symptoms and indicators of advanced stages. Symptoms like diarrhea and bloody stools, which often cause alarm, are usually not indicative of colorectal cancer. Most cases of colon and rectal cancer present with no specific symptoms, making it harder to identify at early stages.
However, Professor Lim highlights some signs that may warrant further investigation. Advanced colorectal cancer can lead to sudden changes in bowel habits, such as difficulty passing stools, changes in stool frequency, or the sensation of incomplete evacuation. Bright red or dark red bloody stools, thinning of stools, and unexplained weight loss may also be observed. Nonetheless, routine examinations play a vital role in detecting colorectal cancer, and regular check-ups are crucial.
Choosing the Right Surgical Approach
Patients often question which surgical method is best for treating colorectal cancer. Professor Lim explains that there is no definitive answer as each approach has its own advantages and disadvantages. Open surgery involves making a sizable incision in the abdomen, allowing the surgeon direct access to the large intestine. Laparoscopic surgery and robotic surgery are less invasive alternatives, involving smaller incisions and the use of specialized instruments.
It’s important to note that there is no significant difference in treatment outcomes between these approaches. Factors such as tumor size, progression, and invasion dictate the choice of surgery. Therefore, the decision lies with the patient and their physician after considering individual circumstances.
In recent years, endoscopic procedures, such as Endoscopic Submucosal Dissection (ESD), have gained prominence for early-stage colorectal cancer. However, surgery remains the primary treatment option. Even if successful endoscopic removal of the tumor occurs, colon resection surgery may still be necessary if there is uncertainty about residual cancer cells or risk factors.
The Impact of Diet and Lifestyle
Contrary to popular belief, completely avoiding red meat is not the sole solution for preventing colorectal cancer. While excessive red meat consumption raises the risk, studies have demonstrated that a diet solely consisting of fiber and vegetables can also increase the chance of developing colorectal cancer.
Professor Lim advocates for a balanced diet to reduce these risks. It’s crucial to consume the right amount of food rather than strictly focusing on individual ingredients. Although the exact relationship between dietary factors and colorectal cancer is yet to be fully understood, it is known that refined carbohydrates, processed meats, alcohol, and sugar contribute to the risk. Conversely, dietary fiber from fresh fruits, vegetables, citrus fruits, dark green vegetables, and dried beans can help prevent colon cancer.
Additionally, smoking cessation is crucial as smoking significantly increases the risk of colorectal cancer. Smoking, a known risk factor for various types of cancer, is often overlooked in its association with colorectal cancer.
As the incidence of colorectal cancer continues to rise, it is essential to combine medical advances, healthy lifestyle choices, and regular screenings to combat this disease. By staying informed and adopting a well-rounded approach to prevention, we can make strides towards reducing the burden of colorectal cancer.
▶ Lim Seok-byeong, Professor, Department of Colorectal Surgery, Asan Medical Center
Lim Seok-byung, professor of colorectal surgery at Asan Medical Center (Director of Colon and Rectal Cancer Center). [서울아산병원 제공]
Colon and rectal cancer is cancer that occurs in the large intestine, which is responsible for the end of the digestive function in our body. Most patients are elderly. As the elderly population in Korea increases, the number of patients with colorectal cancer also increases significantly. According to the most recently released National Cancer Registry, colorectal cancer is the third most common cancer in Korea in 2020. I met Lim Seok-byeong, professor of colorectal surgery at Asan Medical Center (Director of Colon and Rectal Cancer Centre). Professor Lim said, “It is important to stop smoking and eat all foods in moderation, and you must stop smoking. However, ‘extreme vegetarianism’, which does not eat meat from absolutely, is linked to colon and rectal cancer and eating such red meat. as pork and beef can pay,” he said.
-Are diarrhea and bloody stool the main symptoms of colorectal cancer?
Most of the people who visit the hospital with symptoms such as diarrhea and bloody stools often do not have colorectal cancer. Colon and rectal cancer, like other cancers, usually has no specific symptoms. There are many times when you don’t have to worry too much.
When colorectal cancer is significantly advanced, there are sudden changes in bowel habits such as difficulty passing stools or frequency of stools, diarrhoea/constipation or a feeling of stool remaining after a bowel movement, bright red stools or dark red bloody, thinner stools. than before, and subjective symptoms such as weight loss. It can happen, but most often it is discovered during routine examinations. Regular check-ups are essential for the early detection and treatment of colorectal cancer, as well as cancer.
-Which is better for colorectal cancer surgery, laparoscopic or robotic surgery?
This is one of the most common questions asked by patients before surgery. There is no best surgical method. Open surgery, laparoscopic surgery, and robotic surgery have advantages and disadvantages.
Open surgery is a method where a relatively large incision is made in the patient’s abdomen and the surgeon directly touches the large intestine with his hands. Laparoscopic surgery is a method of surgery by making 4 to 5 small holes in the stomach and inserting laparoscopic surgical instruments and operating the instruments by the surgeon. During the operation, only a few small holes are made, so there is little scarring and pain. Robotic surgery is similar to laparoscopic surgery in that a few small holes are made in the patient’s abdomen and robotic surgical instruments are inserted, but the difference is that the surgeon controls the surgical instruments remotely.
So far, it is known that there is no difference between surgical methods in cancer treatment outcomes. Because each patient has a different tumor size, progress, and degree of invasion into the surrounding tissue, the patient and the attending physician decide on the surgical approach taking all factors into account. He cannot say absolutely which method is better.
In recent years, endoscopic procedures have been greatly developed, and when colorectal cancer is detected early, ‘Endoscopic Submucosal Dissection (ESD)’ is actively implemented, where colon and rectal cancer is cut with an endoscope with a special knife. However, surgery is the primary treatment. Even if the tumor is successfully removed by endoscopy, if the depth of the tumor has invaded to the bottom of the submucosa, or if it is difficult to confirm that there are no cancer cells in the border removed by endoscopy, and if some risk factors remain even slightly through biopsy, colon resection surgery may be required. .
-Don’t eat red meat to prevent colon and rectal cancer
Not so. Red meat, such as pork and beef, is known to be linked to colon and rectal cancer, so I know there are people who severely limit their intake. Of course, the higher the consumption of red meat, the higher the incidence of colorectal cancer. However, some studies have shown that eating only fiber and vegetables without eating red meat actually increases the risk of colorectal cancer.
Therefore, a balanced diet is of utmost importance. The right amount of food should be eaten. It is actually difficult to eat while checking every ingredient in everyday life. No one eats anything but what is known to be completely unhealthy. Therefore, the most important thing is to eat the right amount of food.
Although a definitive relationship between colorectal cancer and dietary factors has yet to be identified, in addition to red meat, consumption of refined carbohydrates such as animal fats, processed meats, alcohol, and sugar is known to , and obesity is the main cause of the colon and rectum. cancer
On the other hand, dietary fiber consumed through fresh fruits and vegetables plays a role in preventing colon cancer, and citrus fruits, dark green vegetables (dark green), and dried beans are also known to have a preventive effect , so it is good to eat them equally.
Also, if you smoke, it is very important to stop smoking. Smoking is a risk factor for all types of cancer. You may think that there is no relationship between colorectal cancer and smoking, but smoking is a very large risk factor for colorectal cancer.
Kwon Dae-ik, medical reporter >
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