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

譯者: Ting-Yen Tsai 審譯者: Helen Chang

「預防勝於治療」──班傑明·富蘭克林

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

如果將你的消化道拉成一直線

it would form a tube spanning nearly ten meters.

它將會是一條長度近乎十公尺的管子

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

末端的一點五公尺被稱為結腸或大腸

Cells in this organ's lining constantly renew themselves,

這個器官裡的襯細胞 會不斷地進行自我更新替換

but the genes that moderate this process occasionally go awry,

但有時候負責緩和此程序的基因會失靈

leading to the excessive growth of new cells.

導致新細胞的過度成長

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

這會造成被我們稱為「息肉」的小腫塊 或是不正常的細胞結塊

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

大多數的息肉並不會對我們造成傷害

but some can become cancerous when their cells begin to grow

但是有些息肉在開始生長並快速分裂時

and divide rapidly,

會變成惡性腫瘤

projecting further into the colon.

繼續深入結腸內部

At that point, they can transform into colon cancer,

這個時候它們就變成了結腸癌──

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

世界上最盛行 也最可以預防的幾種癌症之一

That's a slow process:

這過程很慢

though growth times vary,

雖然成長的速度有快有慢

it often takes around ten years for a small polyp

通常需要十年左右的時間

才會使一個小息肉長成惡性腫瘤

to grow and develop into a cancerous one.

We don't know exactly what causes

我們不知道究竟是什麼

the majority of colon polyps and colon cancers.

造成大多數的結腸息肉或是結腸癌

We do know in general that colon cancer involves the activation

但我們確實知道通常結腸癌的發生

of what's called oncogenes in the polyp,

和激活息肉裡的「致癌基因」

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

還有／或是抑癌基因的消失有關

Most cells have proto-oncogenes that help them grow.

大多數的細胞具備「原致癌基因」 來幫助他們成長

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

一旦原致癌基因發生突變 或是有太多相同的複製基因

it can become a permanently active oncogene

它將會變成永久性活躍的致癌基因

with cells that grow out of control.

使細胞的成長速度失去控制

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

我們目前還不知道是哪些潛在因素 導致這些變化

experts suspect a combination of both environmental

不過專家們懷疑這是環境

and inherited genetic factors.

還有基因遺傳兩相結合起來的結果

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

在最糟糕的狀況下， 當息肉裡的細胞不受抑制的分裂並擴散

they eventually break through the lining of the colon.

他們最終會突破結腸的內襯

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

淋巴和血管會將這些細胞帶到全身

and they can go on to form tumors.

在各個身體部位產生腫瘤

Despite these challenges, there's a solution.

雖然有著這些困難， 我們這裡有一個解決辦法

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

我們已經對偵測日益猖獗的息肉

還有在它們導致癌症之前移除十分擅長

before they can cause cancer.

This happens through a process called screening,

這會透過被稱為「篩檢」的過程來實施

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

只要我們定期篩檢， 我們可以防止很多結腸癌的發生

So, who's at risk?

所以，誰是高危險群呢?

Most cases occur in people aged 50 years or older.

大部分的病例發生在五十歲以上的人身上

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

這族群罹患結腸息肉或結腸癌的風險 被認為高於平均

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

還有更高風險的族群，包括:

個人或家族有結腸息肉 或結腸癌病史的人

or family histories of colon polyps or cancer,

and those who suffer from inherited genetic syndromes,

以及患有遺傳症狀的人

or inflammatory diseases,

或是苦於發炎性疾病的人

like Crohn’s disease and ulcerative colitis.

例如克隆氏症和潰瘍性大腸炎

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

開始進行定期篩檢的合適年紀各不相同

If you have access to healthcare,

如果你有健康照護的管道

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

最好諮詢醫師你應該開始篩檢的時間

Screening can be done with various tests.

篩檢包含許多不同類型的測試

Colonoscopy involves a long, thin, flexible tube

「結腸鏡檢查」 是使用一根有彈性的細長管子

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

在末端裝上攝像頭和燈源

and placed internally to examine the colon for polyps.

深入內部檢查結腸中是否有長息肉

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

如果找到了息肉， 醫生就會進行「息肉切除術」──

a procedure that removes polyps from the colonic wall.

一個將息肉從結腸壁上移除的程序

Doctors can also then test the polyp for cancerous cells.

醫師之後還會測試息肉中 是否含有癌細胞

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

結腸鏡檢查是唯一可以同時找到 並移除息肉的方式

There are, however, other useful screening tests,

但是還有其他有用的篩檢測試

including imaging

包含影像掃描

and at-home tests that can allow patients

和「在家測試」──

請病人檢視他們的排泄物中是否含有血

to examine their stool for small amounts of blood.

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

偶爾會有過大的息肉 無法在結腸鏡檢查的程序中被移除

in which case, the next step is surgery.

在這種情況下，下一步便是手術了

If blood and imaging tests then reveal

如果血液測試還有影像顯示

that cancerous cells have spread outside the colon,

癌細胞已經擴散到結腸以外的地方

then a special treatment, like chemotherapy,

那麼特殊治療法──像是「化療」

may also be required to stop the cancer from escalating.

就是防止癌症惡化的必要措施

We can also take on certain habits

我們也可以先培養一些特定習慣

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

來降低我們得到結腸癌的可能性

There's evidence that maintaining a healthy weight,

有證據顯示維持適當的體重、

not smoking,

不吸菸、

and being physically active can help.

還有保持運動習慣是有幫助的

But most importantly, access to healthcare

但最重要的是， 擁有尋求醫療協助的管道

and regular screenings at crucial times in life

還有在關鍵時期的定期篩檢

are the best ways to prevent colon cancer.

是避免得到結腸癌的最好方式

感謝 PATRON 社群的財務支持， 讓我們能夠完成這影片

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