Datos de interés sobre el cáncer colorrectal

Información proporcionada por Mayo Clinic Rochester, Minnesota.

Anualmente en Estados Unidos se diagnostica cáncer colorrectal a aproximadamente 140 000 personas. Es el tercer cáncer más común y la segunda causa de muerte vinculada con el cáncer, tanto en hombres como en mujeres. La cirujana de cáncer colorrectal Dra. Heidi Nelson, directora de cirugía de Mayo Clinic, comparte los siguientes cinco puntos acerca del cáncer colorrectal:

1) Detección temprana

Es realmente importante detectar pronto mediante exámenes para aumentar la posibilidad de supervivencia. La tasa de supervivencia es de aproximadamente 90% cuando se detecta pronto, dice la Dra. Nelson. Ahora existen múltiples alternativas de detección, entre ellas las colonoscopías, un examen de ADN en heces llamado Cologuard (cuyo coinventor es el gastroenterólogo Dr. David Ahlquist de Mayo Clinic), la colonoscopía virtual que emplea la tomografía computarizada y otros más.

“Gracias a la cobertura del examen por parte del seguro de salud y de Medicare, así como a la disponibilidad de más alternativas de detección, ahora con más frecuencia se detecta antes el cáncer colorrectal”, comenta la Dra. Nelson.

2) Cirugía de cáncer de colon y cáncer colorectal

La mayoría de pacientes con cáncer colorrectal requerirá una operación para extirpar el tejido canceroso, pero existe una gran diferencia entre la cirugía del cáncer de colon y la del cáncer rectal.

“La cirugía del cáncer de colon normalmente es un procedimiento bastante directo y de invasión mínima en el que se extirpa básicamente 30 centímetros de colon y en esos casos, los pacientes suelen comer y defecar normalmente después de la cirugía. Las implicaciones de la cirugía para el cáncer del recto, en cambio, son muy diferentes», añade la Dra. Nelson.

La cirugía del cáncer rectal también puede hacerse mediante procedimientos de invasión mínima, pero a menudo hay cambios duraderos en la función intestinal que precisan considerarse.

Por ejemplo, algunos pacientes recuperarán la evacuación intestinal normal después de la cirugía para cáncer del recto, mientras que otros quizás requieran evacuar con mayor frecuencia o tengan menos control sobre la evacuación, y menos de 40% necesitará un estoma. El estoma es una abertura que se crea en el abdomen para permitir la salida de desperdicios del cuerpo y requiere de una bolsa externa para recoger las heces. Esto puede ser algo temporal o permanente.

“Una vez que los pacientes entienden la importancia de esto, la vasta mayoría de ellos se adapta y puede llevar una vida normal y de alta calidad. En Estados Unidos, alrededor de 3 millones de pacientes tienen un estoma”, explica la Dra. Nelson.

En Mayo Clinic, se recomienda a los pacientes que se levanten y empiecen a movilizarse y comer normalmente poco después de la cirugía, a fin de acelerar la recuperación. Es asimismo importante caminar más y dejar de fumar antes de la cirugía, opina la Dra. Nelson.

3) Edad

Una persona joven puede tener cáncer colorrectal. A pesar de que sea más común entre las personas de 60 años, también lo puede tener alguien más joven o incluso un niño, aunque sea raro. El cáncer colorrectal en las personas jóvenes tiende a ser hereditario, mientras que en las personas mayores, los factores ambientales y del estilo de vida suelen desempeñar alguna función.

4) Medicina de precisión

El biobanco de Mayo Clinic ayuda a los investigadores a estudiar los genes responsables del cáncer colorrectal hereditario, los mismos que pueden variar de una a otra familia, anota la Dra. Nelson.

“No es algo que se ajuste a todos, sino que los genes pueden ocasionar cáncer de varias maneras en una familia y, a su vez, en cada familia también puede haber diferentes maneras”, comenta la doctora.

El reconocimiento de esos genes puede ayudar a identificar a las personas que deben someterse a exámenes de detección para cáncer colorrectal a menor edad y quizás también llevar a nuevos objetivos de tratamiento.

5) Microbioma

Los científicos de Mayo Clinic actualmente estudian a los microbios intestinales para intentar determinar si crean metabolitos que conducen al cáncer colorrectal.

“Se sabe que el virus del papiloma humano y el Helicobácter pylori causan cáncer; entonces, ¿tiene el intestino bacterias o virus que realmente causarían cáncer? Creo que todavía queda mucho por saber al estudiar específicamente el ambiente intestinal”, apostilla la Dra. Nelson, directora del programa de microbioma del Centro para Medicina Personalizada de Mayo Clinic y Profesora “Fred C. Andersen” de la misma institución.


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