Who's at risk for colon cancer? - Amit H. Sachdev and Frank G. Gress

Prevoditelj: Ivan Stamenković Recezent: Senzos Osijek

If you were to lay your digestive tract out in a straight line,

Ako biste razvukli vaš probavni trakt u ravnoj crti,

it would form a tube spanning nearly ten meters.

to bi bila cijev duga otprilike 10 metara.

The last 1.5 meters of that are called the colon, or large intestine.

Zadnjih 1.5 metara toga zove se debelo crijevo.

Cells in this organ's lining constantly renew themselves,

Stanice u opni ovog organa stalno se obnavljaju,

but the genes that moderate this process occasionally go awry,

ali geni koji moderiraju ovaj proces ponekad zastrane,

leading to the excessive growth of new cells.

što vodi do ekscesivnog rasta novih stanica.

That results in small growths or abnormal clumps of cells called polyps.

To rezultira malim izraslinama abnormalnih nakupina stanica nazvanih polipi.

The majority of these polyps won't do any harm,

Većina tih polipa neće prouzrokovati nikakvu štetu,

but some can become cancerous when their cells begin to grow

ali neki mogu postati kancerogeni kada njihove stanice počnu rasti

and divide rapidly,

i brzo se dijeliti,

projecting further into the colon.

šireći se dalje u debelo crijevo.

At that point, they can transform into colon cancer,

U tom trenutku mogu postati rak debelog crijeva,

one of the most prevalent and preventable forms of cancer in the world.

jedan od najčešćih i sprječivih oblika raka u svijetu.

That's a slow process:

To je spor proces:

though growth times vary,

iako rast može varirati,

it often takes around ten years for a small polyp

najčešće treba deset godina da mali polip

to grow and develop into a cancerous one.

izraste i postane kancerogen.

We don't know exactly what causes

Ne znamo što točno uzrokuje

the majority of colon polyps and colon cancers.

većinu polipa i raka debelog crijeva.

We do know in general that colon cancer involves the activation

Znamo da generalno rak debelog crijeva uključuje aktivaciju

of what's called oncogenes in the polyp,

onoga što se zove onkogen u polipu,

and/or the loss of tumor-suppressor genes that usually keep cancer cells in check.

i/ili gubitak gena za potiskivanje tumora koji najčešće kontroliraju stanice raka.

Most cells have proto-oncogenes that help them grow.

Većina stanica ima proto-onkogene koje im pomažu da rastu.

When a proto-oncogene mutates, or there are two many copies of it,

Kada proto-onkogen mutira ili ima previše njegovih kopija,

it can become a permanently active oncogene

on može postati trajno aktivan onkogen

with cells that grow out of control.

sa stanicama koje rastu bez kontrole.

While we don't yet know exactly what underlying factors cause these changes,

Iako ne znamo koji su faktori koji uzrokuju ove promjene,

experts suspect a combination of both environmental

stručnjaci sumnjaju na kombinaciju okoliša

and inherited genetic factors.

i naslijeđenih genetskih faktora.

In the worst cases, when cells within polyps divide and spread unchecked,

U najgorim slučajevima, kada se stanice unutar polipa podijele i šire nekontrolirano,

they eventually break through the lining of the colon.

eventualno probiju kroz opnu debelog crijeva.

Lymph and blood vessels carry those cells all over the body,

Limfa i krvne žile nose te stanice kroz tijelo,

and they can go on to form tumors.

i one mogu formirati tumore.

Despite these challenges, there's a solution.

Unatoč svim izazovima, postoji rješenje.

We've become extremely good at detecting and removing offending polyps

Postali smo ekstremno dobri u detektiranju i uklanjanju loših polipa

before they can cause cancer.

prije nego uzrokuju rak.

This happens through a process called screening,

Ovo se događa kroz proces pregledavanja,

and when we do it regularly, we can prevent many cases of colon cancer.

i kada to radimo redovno, možemo spriječiti mnoge slučajeve raka.

So, who's at risk?

Pa, tko je riskantna skupina?

Most cases occur in people aged 50 years or older.

Većina slučajeva javlja se kod ljudi koji su 50 godina ili stariji.

This group is considered at average risk for colon cancer or colon polyps.

Ova grupa ima prosječan rizik za rak debelog crijeva ili polipe.

There's also a higher risk group that includes people with personal

Također postoji grupa visokog rizika koja uključuje ljude sa osobnom

or family histories of colon polyps or cancer,

ili obiteljskom povijesti polipa ili raka,

and those who suffer from inherited genetic syndromes,

i onih koji pate od nasljednjih genetskih sindroma,

or inflammatory diseases,

ili upalnih bolesti,

like Crohn’s disease and ulcerative colitis.

kao što je Chronova bolest i čirevi.

So the best age to initiate screening varies from person to person.

Tako da najbolja dob za preglede varira od osobe do osobe.

If you have access to healthcare,

Ako imate pristup zdravstvu,

it's best to consult a doctor to find out when you should begin.

najbolje je konzultirati sa liječnikom kako bi otkrili gdje početi.

Screening can be done with various tests.

Pregledi se mogu raditi sa raznim testovima.

Colonoscopy involves a long, thin, flexible tube

Kolonoskopija uključuje tanku fleksibilnu cijev

that's fitted with a video camera and light at the end

sa video kamerom i svjetlom na kraju

and placed internally to examine the colon for polyps.

i postavljenom iznutra kako bi se debelo crijevo pregledalo za polipe.

If polyps are found, a doctor can do a polypectomy,

Ako su polipi pronađeni, liječnik može napraviti polipektomiju,

a procedure that removes polyps from the colonic wall.

postupak koji uklanja polipe sa zida debelog crijeva.

Doctors can also then test the polyp for cancerous cells.

Liječnici također mogu testirati polip za stanice raka.

Colonoscopy is the only test that can be used to both find and remove polyps.

Kolonoskopija je test koji se koristi za pronalazak i uklanjanje polipa.

There are, however, other useful screening tests,

No postoje i drugi korisni testovi

including imaging

uključujući slikanje

and at-home tests that can allow patients

i testove koje pacijenti mogu napraviti kod kuće

to examine their stool for small amounts of blood.

kako bi pregledali stolicu za male tragove krvi.

Occasionally, polyps are too large to be removed during a colonoscopy,

Ponekad, polipi su preveliki da bi ih se uklonilo kolonoskopijom,

in which case, the next step is surgery.

u kojem slučaju je sljedeći korak operacija.

If blood and imaging tests then reveal

Ako krvna slika i testovi otkriju

that cancerous cells have spread outside the colon,

da su se stanice raka proširile izvan slijepog crijeva,

then a special treatment, like chemotherapy,

onda se poseban tretman poput kemoterapije

may also be required to stop the cancer from escalating.

može primjenjivati kako bi se rak zaustavio u širenju.

We can also take on certain habits

Možemo također usvojiti određene navike

to reduce our likelihood of developing colon cancer in the first place.

kako bi smanjili izglednost razvoja raka debelog crijeva.

There's evidence that maintaining a healthy weight,

Postoji dokaz da zdrava tjelesna težina,

not smoking,

nepušenje

and being physically active can help.

i fizička aktivnost mogu pomoći.

But most importantly, access to healthcare

Ali najvažnije, pristup zdravstvenim uslugama

and regular screenings at crucial times in life

i redovni pregledi u ključnim točkama života

are the best ways to prevent colon cancer.

najbolji su načini za prevenciju raka debelog crijeva.