Prof.
G R MOHAN
M B S (osm) M D (Hom) P G Dip (Env Stud)
Principal Devs Homoeopathic Medical college,
Colorectal cancer, commonly known as colon cancer or bowel cancer is a Cancer from uncontrolled cell
growth in the colon or rectum, or in the appendix. Genetic analysis shows that
colon and rectal tumours are essentially genetically the same cancer.1 Colorectal
cancer is the third most commonly diagnosed cancer in the world, but it is more
common in developed countries. Around 60% of cases were diagnosed in the
developed world. It is estimated that worldwide, in 2008, 1.23 million new
cases of colorectal cancer were clinically diagnosed, and that it killed 608,000
people 1.The
overall incidence of colorectal cancer increased until 1985 and then began
decreasing at an average rate of 1.6% per year. Deaths from colorectal
cancer rank third after lung and prostate cancer for men and third after lung
and breast cancer for women. Increased intake of
animal fats and calories and reduced intake of fibre, fruits and vegetables,
and micronutrients such as calcium, vitamin A, C and D, folic acid and selenium
are associated with an increased risk of developing CRC. Bile acids are also
implicated in colon carcinogenesis. Increased physical activity and use of aspirin
in higher doses are associated with reduced incidence of CRC.
There are wide
geographical differences in the incidence of colorectal cancer (CRC);
this is partly due to the differences in dietary habits. Westernisation of the
diet in Eastern countries like Japan and Singapore has lead to an increase in
the incidence of colorectal cancer. Even though the population-based
incidence of colorectal cancer in India is very low (< 5 per 100,000
men), it is an important cancer due to the large population affected. A
majority of Indian patients are diagnosed in an advanced stage, when the
chances of long-term cure are low 2
Colorectal
cancer is the second most common cause of cancer death in the UK. Each year
over 30 000 new cases are diagnosed in England and Wales (68% colon, 32% rectal
cancer) and it is registered as the underlying cause of death in about half
this number. The prevalence rate per 100 000 (all ages) is 53.5 for men and
36.7 for women. The incidence increases with age, the average age at diagnosis
being 60-65 years. The disease is much more common in westernized countries
than in Asia or Africa 3
The disease
occurs more often in upper socioeconomic populations who live in urban areas.
Mortality from colorectal cancer is directly correlated with per capita
consumption of calories, meat protein, and dietary fat and oil as well as
elevations in the serum cholesterol concentration and mortality from coronary
artery disease 4
Colon Cancer Symptoms
bleeding from rectum or blood mixed stools. Rectal bleeding
may be hidden and chronic and may show up as an Iron deficiency anemia ,
fatigue and pale skin. obstructive symptoms like
Abdominal distension:, pain abdomen , Unexplained, persistent nausea or vomiting, Unexplained weight loss , Change in frequency or character of stool , ribbon-like stools Sensation of incomplete evacuation after a
bowel movement and Rectal pain: Pain rarely occurs with colon cancer and
usually indicates a bulky tumor.5
A case of Carcinoma of Colon. Was reported
to me in my private clinic, all the investigations were pointing towards
Carcinoma of Colon,
Patient by name Mr B, aged 45 years,
broom stick cellar by occupation, came to me with many reports. Our friends in
conventional system gave poor prognosis by labelling the case as Carcinoma of
Colon.
PRESENTING
COMPLAINTS:
Passing semi liquid mucous stools, <
eating after, duration 18 months
Pain burning in anal area since duration
10 months
Pain in abdomen < eating after
duration 10 months
History of weight loss duration 6 months
PAST HISTORY:
met with small
injury at childhood .not able to
recollect tell about his health status
FAMILY HISTORY
*
Parents-died
cause old age
*
Sibilings -
Apparently healthy. No known diseases history.
*
Grand
parents-died , not able to tell about them .
*
*
*
PERSONAL HISTORY
*
*Appetite-
Good
*
*Diet- mixed.
*
*Thirst-2- 3 lits/ day.
*
*Desire- warm food
*
* Aversions/ intolerance- NS.
*
*Bowels- Regular.passing liquied,
mucus
*
*Urine- 5/6 times/day. No
special. Characteristics.
*
*Sweat- NS
*
*Sleep- disturbed.
*
Habits
and addictions: Alcohol
*
LIFE SPACE INVESTIGATION.
*
He
belongs to a lower middle class family of Hyderabad. His father was a manual
laborer . He was a fourth child of his
parents. Full term, normal delivery in house. never went to school. he was
married and started selling broom sticks by going on bicycle . couple never
conceived , when he was advised to go for semen analysis it was found he was
suffering with Azospermia. Various types of treatments were taken with out any
positive results. later couple adopted a child and leading a normal life.
*
General physical examination
*
Patient was short stature 58.9 KGs weight, no pallor, cyanosis, oedema, clubbing or
lymphadenopathy.
*
Systemic examination
*
GIT System: abdomen was soft, liver palpable, spleen
not enlarged
*
CNS System: Nothing abnormal detected
*
CVS System: Nothing abnormal detected
*
Respiratory System: Nothing abnormal detected
*
Locomoto System: Nothing abnormal detected
*
Investigations:
*
09-09-09 CT scan of abdomen (with oral
and rectal I V contrast): focal cirumferantial mucosal thichening of asending
colon s/o CA colon
*
11-09-09
Diagnosis at MNJ Cancer institute : is CA colon
*
15-09-09—colonoscope report :3x3 cm
grouth hepatic flexer CA colon
*
15-09-09 histopathlogical report : granulation
tissue, no atypical cells identified
*
10-09-09
surgical pathology report : granulomatus inflamatary cells CA colon
*
02-10-09 Biopsy report :impression : in
favour of acute inflammatory lesion
*
010909: Barium enema : on USG
correlation intussusceptions of hepathic flexur of colon visulalised, on enema
abrupting ending of barium colon.
*
Clinical diagnosis: CA colon
*
Clinical classification
*
Dynamic chronic fully developed miasmatic disease.
*
Miasmatic diagnosis
*
Psoro-Sycotic and Syphilitic.
*
Susceptibility: moderate
*
*
Totality of symptoms :
*
Sadness about health
*
Weakness
*
Weakness after diarrhoea
*
Desire for warm Food
*
Family history of alcoholism
*
Azoospermia
*
Diarrhoea eating after
*
Pain burning anal area stool after
*
Pain burning abdomen eating after
*
*
Repertorisation (See below)
*
Ars alb covered six symptoms out of
nine, five symptoms are grade one, followed by Bryonia with 5/9,Lycopodium 4/9,
as most of generals covered and mental general covered by Ars Alb, Ars alb It
was selected.
*
9/10/09 ie before total case was taken ,on
the day one Thuja30C, Five doses were given every 12 th hourly, along with
Placebo 5 days .
*
Patient came on 02-11-09 instead 27th
Oct 09(case was taken and reprtorisation was done)
*
Weight 59.6 kgs; there were no new
symptoms,
*
Ars alb 200C, five doses were given as it was
selected on the basis of
Repertorisation,
each dose was asked to take every 12 hourly, followed by placebo for ten days.
*
16-11-09 weight was 60kgs, G C was good
*
18-11-09 he had sore throat. cough after
taking cold drinks
*
Hepar Sulp 6c was given 5 doses
*
02-12-09 weight was 59.9 kgs., general
health was satisfactory, all the symptoms were persisting , according the
patient intensity was less, but weight was reduced , in spite of good diet, Tuberculinum 200c one dose was given.
Rubrum for 10 days were given.
*
11-1-10 weight was 60.7 kgs general
health was satisfactory
*
Rubrum was given
*
31-1-10 general health was satisfactory,
out of nine symptoms which were taken as totality ,eight were relived
*
On 22/02/10 patient came to me with
slight pain in abdomen, with passing of offensive liquid stools
*
Weight was 62.2 kgs, Ars alb 200C, five
doses were given, and each dose was asked to take every 12 hourly, followed by
placebo for ten days.
*
25-03-10 he gained weight to 63.8 kgs,
there was general wellbeing was seen , weight gain was there , he was asked to
go for investigations or to consult earlier gastroenterologists
,but patient was already milked out by other system health care personals ,he
was not financially sound ,he escaped by saying now I am keeping good health
what was the necessary for costly investigations
*
Tuberculinum 1M, One dose was given,
Rubrum was given
*
08-04-10, weight was 63.8 kgs, general
health was satisfactory ,One month Rubrum was given
Discussion :
In
the above case all investigations were done , all investigations were pointing
towards Cancer colon, only biopsy was differed, clinical correlation was tilted
towards Cancer colon, at this point, I would like to emphasis that how
important is the role of investigations in nosological diagnosis of a case, if
investigations were not there we could have diagnosed the case as Chronic
Dysentary which is common in lower socio economical group of people, Patient
was followed up to 18 months diarrhoea
was controlled, general wellbeing maintained, what ever may be
diagnosis, mental agony was relived by our system of medicine and established
general wellbeing.
