In other countries with the western way of life similar indicators of disease are observed. Meanwhile in different areas of the world the picture of disease of intestines cancer very widely varies, and in the countries of Asia and Africa this indicator much more low. Even in different areas of Europe essentially differing indicators are noted: in northern and western countries they above, than in southern and east. These facts obviously testify that the cancer of a thick gut is mainly illness of richer western countries and an essential role in their development play, possibly, sredovye factors, especially a food allowance. the reasons As it was already spoken, the diet is the important causal factor in cancer occurrence obodochnoj and a rectum; In particular, it concerns a diet abounding with meat products and animal fats and containing few rich kletchatkoj of products. The assumption was come out, that alcohol consumption can influence development of this disease. And on the contrary, there are some data, that the diet with the big maintenance of fruit, vegetables and rich kletchatkoj products and the low maintenance of fats and alcohol can provide some protection. Genetic factors also posess a certain role in occurrence of some kinds of a cancer obodochnoj and a rectum. As the weighty proof of it the rare hereditary status known as family adenomatoznyj of polyposes at which in mucous vystilke obodochnoj guts good-quality tumours (polyps) develop some can serve. Everyone at whom one of parents suffers this status, is subject to existing risk of occurrence of the same pathology at it, and people with the given status have very high probability of occurrence at them a cancer obodochnoj guts. Some families, most likely, have predisposition to a cancer obodochnoj guts, nesmotrja even on absence in the anamnesis family adenomatoznogo a polypose. If some members of one family are sick of this cancer, especially if that appears at rather young age, the risk of its occurrence at other members of a family raises. The people, suffering inflammatory diseases of intestines, ulcer kolitom and to a lesser degree illness the Crone, also have a high probability to be ill with intestines cancer. Meanwhile cancer kinds, assotsiiruemye with these risk factors, make only small share from the general number of cancer diseases of intestines, and in most cases illness develops spontaneously and though a diet, consumption of alcohol and others sredovye factors can play a part in its occurrence, for an establishment of more obvious communications between them scientific researches are still conducted. displays the Cancer obodochnoj and a rectum almost in 100 % of cases we will cure, if it manages to be revealed at early stages. Therefore at occurrence of any symptoms it is the extremely important to address as soon as possible to the doctor. The common symptom of a cancer of a thick gut is blood presence in a chair. At a bleeding after oporozhnenija intestines it is necessary to find out its reason. The most probable explanation - education gemorroidalnyh sites, but unique way to check up this possibility is medical research to exclude intestines cancer. Though similar researches can call some confusion the patient, they are rather important. If the doctor does not offer them, it is possible to take an interest at it about the reason. One more common symptom - change of character of intestinal departures. If someone has lock or a diarrhoeia or both these statuses follow one after another throughout more 2 ned, it is necessary to consult at the doctor. There are many other possible reasons of these symptoms, but in any case it is necessary to be surveyed to make sure of absence of a cancer of intestines at very early stage when it to treat most easier. Pains in a stomach or back pass as symptoms of a cancer of intestines are marked less often. Sometimes, if the tumour calls corking or impassability of intestines, there can be such symptoms, as a stomach swelling, shvatkoobraznye pains, a nausea, vomiting and a lock. If illness has extended on other parts of an organism, can arise and other obvious symptoms, for example a weight loss and a jaundice. Screening does not exist Now the general program of screening on intestines cancer. Unique practically realizable way to spend screening of the big groups of the population consists in statement of the test for the latent blood in the excrements, providing their research on the smallest quantities of blood which are not always visible with the naked eye. This research, however, is interfaced to some problems. It assumes regular checks of a chair and can be therefore unacceptable for people who do not have illness symptoms. It gives often lozhnopolozhitelnye results that calls strong alarm and as a result the further researches are required people. Research also is connected with big enough monetary expenses. Despite these difficulties, tests for the latent blood in excrements allow to reveal a cancer obodochnoj guts at an early stage when the probability of treatment is especially high. The tests which purpose - to define are now conducted, whether gives the chance to rescue actually this research a life of people thanks to revealing considerably bolshego numbers of cases of a cancer at an early stage, than it is found out now, and whether there will be it practically vypolnimym and comprehensible to various strata of society. To people in which family anamnesis there is a sufficient number of cases of a cancer obodochnoj guts, it is necessary to think of possible advantage of regular inspections after achievement of age of 35-40 years providing the test for latent blood in excrements and, possibly, regular kolonoskopiju. Researches the First step for revealing of a cancer of intestines is rektalnoe inspection in which course the doctor feels a finger back pass on presence of swellings or tumours. With the help rektoromanoskopa, representing the flexible tube entered into a rectum on distance to the bottom part obodochnoj of a gut, the doctor can see the bottom part of intestines in the extent of 20-25 sm where tumours more often are formed. If these tests do not allow to find out precisely the reason of symptoms, the doctor can survey all thick gut by means of the tool under the name kolonoskop. For this research it is necessary to empty completely intestines, therefore to the patient offer the scheme of its clearing 1 day prior to the inspection, providing reception of a depletive, plentiful drink and intestines washing before procedure. Kolonoskopija it is made after introduction to the patient of a sedative preparation, it is painless, though can call some discomfort. A long flexible tube enter through back pass to a thick gut. Advancing a tube on gut bends, the doctor by means of light examines an intestinal wall on presence of anomalies. Through a tube it is possible to make pictures and to take bioptaty for the further research. By means of baric klizmy radiological inspection of an internal surface of intestines can be made. This procedure demands the same preparation, as kolonoskopija, on-skolku intestines should be completely emptied. Into back pass enter a mix of barium with air and do a series of x-ray pictures. As barium becomes visible under the influence of X-rays, the doctor can track its passage on intestines on the screen of x-ray installation and find out any anomalies or tumours in an intestinal wall. Baric klizma - tiresome and unpleasant enough procedure which can call shvatkoobraznye pains. In process of deducing of barium from an organism within approximately 2 days the chair can be white colour. Throughout several days after procedure it is necessary to accept any depletive because barium sometimes calls a lock. To reveal illness distribution on other organism, other researches can be made. More often in such cases do ultrasonic scanning of a liver, Kt-scanning of a belly cavity and a liver and ren tgenografiju a thorax. TREATMENT: the Basic method of treatment of a cancer of a thick gut is surgical intervention. The purpose of the surgeon thus - removal of the tumour and a healthy fabric surrounding it. In most cases it is possible then to connect two opened ends of a gut. During this operation usually delete also nearby lymphatic glands as here sprout cancer cages. If for any of several reasons two ends of a gut to connect it is impossible, make kolostomiju. The open end of a gut deduce on a skin surface of a belly wall, i.e. impose stomu (an external fistula of a belly wall). To stome attach kalopriemnik. Sometimes kolostomija carries only a temporality, and in some months undertake one more operation for connection of the ends of a gut. If such operation is impossible, stoma remains constantly. Usually constant kolostomija it is necessary only when the operated site is located too low in obodochnoj to a gut, near to a rectum, and during operation it is impossible to avoid function infringement analnogo sfinktera, supervising intestinal departures. Achievements in the field of surgical technics have allowed to improve surgical methods of treatment of a cancer obodochnoj guts on many aspects. Now ever less patients require in kolostomii. Use of the sewing device instead of sewing together manually means, that operations on the bottom department obodochnoj can be carried out guts, not breaking function analnogo sfinktera. Laparoskopichesky surgical intervention represents a method allowing the surgeon to make operation through a small cut in a belly cavity instead of its full disclosing that provides faster recover. However this operation belongs to number of innovative methods and can be carried out only in the several specialised oncological centres. Some men after operation concerning a cancer on the lowermost department of a basin find out damage of the nerves regulating function of genitals. New sparing nerves the surgical methods allowing whenever possible to avoid of such damage are developed. If it nevertheless occurs, the man can lose ability to erektsii or to its preservation and it can have problems with ejakuljatsiej. Such problems meet very seldom and can disappear in due course, but sometimes it does not occur. In such cases for minimising of sexual problems as a result of surgical operation concerning a cancer it is possible to resort to treatment by means of injections papaverina, stimulating erektsiju, or implantations in an artificial limb penis (which can be polurigidnym, providing a constant erektsiju or to be resulted in a status erektsii at will of the patient). the Life after kolostomii Though now necessity in kolostomii concerning a cancer obodochnoj guts arises all less often, it is that aspect of treatment of a cancer of intestines which calls fear many people. But to adapt to a normal life after this operation it is uneasy and on it some time it is required, many consider, that renewal of habitual activity after operation is quite possible. In the majority of hospitals there are the medical sisters, had training special preparation on rendering assistance by the patient by which it has been made kolostomija as in practical aspect, i.e. Training in their skills of care stomoj and usings kalopriemnikom, and in the emotional plan, helping to get used to the changed body. Many patients consider also useful to themselves conversations with people which have transferred the same operation and can share personal experience how it is better to adapt to the further life. Besides, there are the groups of the support specially created for rendering assistance transferred kolostomiju. Before operation the surgeon carefully selects an imposing place stomy that kalopriemnik constantly was in this place at performance of all kinds of activity. The medical sister specialising on care by patients with stomoj, after operation gives recommendations concerning various types kalopriemnikov and ways of their installation. It is possible not to carry constantly kalopriemnik if daily to wash out a fistula or to wash away from it allocation. After kolostomii there can be a necessity for diet regulation as at consumption of some foodstuff the chair becomes liquid and the quantity vydeleny increases. However after a while these phenomena stop. If problems remain, it is useful to consult at the hospital dietician. Adjuvantnaja therapy After surgical removal of a tumour the pathologist makes its research and any local lymphatic glands which also have been removed. During microscopic research on character of a tumour it is possible to establish, cancer relapse is how much probable. For an estimation of such probability it is the most important to define, whether there was a germination of cancer cages through a belly wall and, that is even more essential, whether local lymphatic glands are involved in pathological process. Even if a tumour and glands are completely removed, but glands have been involved in pathological process, in other parts of an organism the smallest metastasises already could be formed, which are too small to see them on skanogramme, but, developing during some time, will lead to cancer relapse. It is known, that the chemotherapy is more effective at a stage when metastasises are insignificant. Therefore in the situations characterised by high risk of relapse, spend the treatment aimed at prevention of relapse. Such treatment has received the name adjuvantnoj therapies. The researches carried out recently have shown, that adjuvantnaja the chemotherapy 5-ftoruratsilom (5-FAUGH) leads to considerable decrease in probability of relapse and increase of chances of a survival. There are some various schemes and methods of application of this preparation. Sometimes it accept in a combination with levamizolom which, probably, raises levels of natural immunity of an organism, or with folinovoj the acid raising efficiency 5-FAUGH. These preparations usually inetsirujut intravenously during 6 mes-1 year. Last scientific researches are devoted an estimation of effect of introduction of a preparation directly in a vein supplying with blood a liver. When the tumour develops in a rectum (the bottom department of intestines), especially if there was its germination through a wall of intestines or lymphatic glands are mentioned, there is a high risk of relapse in tazovyh bodies, and also in other parts of an organism. In such cases, besides adjuvantnoj chemotherapy, spend adjuvantnuju radiotheraphy (to radiotheraphy resort after operation even then when in an organism does not remain cancer cages). Relapse At relapse of a cancer or its distribution on other sites of an organism even at statement of the diagnosis preference usually give not to surgical treatment, and chemotherapy. To treatment of far come disease apply preparations on a basis 5-ftoruratsila, usually in a combination with folinovoj acid. The purpose of such treatment - to reduce volume of defeat and as it is possible to contain its growth longer. By-effects observed thus are insignificant, the cores from them are the stomatitis, a diarrhoeia and sometimes a nausea. As a rule, they manage to be constrained easily by means of medical products or completely to prevent. Loss of hair which at all patients grow after the treatment termination is sometimes observed. Researches on studying of the most effective ways of introduction 5-FAUGH and to search of other preparations which could be applied in a combination with 5-FAUGH to increase of its efficiency now proceed. If the new tumour is formed only in the field of a basin, for its reduction and growth restraint it is possible to resort also to radioterapii. Within several weeks after treatment the by-effects which are switching on a nausea, a diarrhoeia, frequent mocheispuskanie and sensation of burning arising thus can be observed. If relapse is limited by very small site: for example, when it represents individual defeat in one lung or in one share of a liver, sometimes spend surgical removal of the amazed site if the patient is young enough and can transfer operation. the forecast As it was already mentioned, in case of diagnosing of a cancer of a thick gut at an early stage the probability of its treatment is very high. However approximately for half of its patients diagnose at later stages. As a whole by means of surgical intervention in a combination with adjuvantnoj himio - and radiotheraphy it is possible to cure about half of all patients, thus treatment indicators continue to raise. Nevertheless the greatest effect in respect of increase of these indicators can be, certainly, will reach thanks to early diagnostics. Among patients who did not have a tumour germination through intestines wall, the treatment indicator exceeds 80 %. If germination takes place, but is not observed distributions of cancer cages on other bodies and lymphatic glands are not mentioned, this indicator makes about 70 %. At distribution of defeat and involving of local lymphatic glands it fluctuates from 30 to 50 %. At such patients the probability of essentially more favorable outcome raises at adjuvantnoj therapies. To patients with far come disease the chemotherapy is spent with a view of reduction of a tumour for simplification of symptoms, by improvements of quality of a life and sometimes its prolongation. The cited statistical data testify to great value of the sanitary education, necessary to raise awareness on symptoms of a cancer of intestines, to underline importance of the attentive relation to such symptoms and to help people to overcome indecision and confusion which they test when inform the doctor on occurrence of symptoms or there pass inspections. RARE TUMOURS of INTESTINES: the Cancer of a thin gut Tumours of a thin gut (as a rule, adenokartsinomy) meet very seldom and to a bowl of all amaze a duodenal gut entering into its structure. They call often impassability of the thin gut which characteristic symptoms in many cases happen first signs of cancer disease. Them usually treat surgical methods though good results have been received and in a number of experimental researches according to chemotherapy. Limfomy a thin gut This kind of a cancer is shown by symptoms, characteristic for impassability of intestines, including a nausea, vomiting and, probably, a diarrhoeia. It meets at the persons, suffering illness the Crone (intestines inflammation) is more often. The standard treatment consisting in surgical removal of a tumour with the subsequent chemotherapy, yields good results. Kartsinoidnye tumours These tumours develop in an appendix and a thin gut though can be formed and in lungs or a pancreas and in rare instances in other bodies more often. If kartsinoidnaja the tumour is formed in an appendix, it seldom calls any serious problems, and the probability of germination of cancer cages is very insignificant (90 % of tumours never give metastasises). In many cases such tumours find out only at carrying out of researches concerning other problems. Kartsinoidnye tumours outside of an appendix can metastazirovat, especially in a liver. They allocate chemical substance serotonin which can call rushes of blood and a diarrhoeia. These symptoms can be constrained easily by means of recently created preparation somatostatina. At metastasises primary treatment consists at a distance a primary tumour surgical by. In the big number of cases illness gives in to treatment by preparations on a basis 5-ftoruratsila, capable to lead to reduction of a tumour and restraint of its growth, but not to treatment. It is useful to apply interferon to disease restraint also.