What is the relief method for lynch syndrome

The symptoms of lynch syndrome are very diverse. There are many types of diseases, which are mainly divided into four types of patients. When it occurs, patients will feel very obvious symptoms in their bodies and often feel gastrointestinal pain. This is the most common phenomenon. As the disease worsens, the pain will become more severe. When this happens, patients can only achieve relief through some surgical treatments.

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Lynch syndrome patients encountered clinically can be divided into four categories: (1) patients with confirmed Lynch syndrome who have newly developed colorectal cancer or other related tumors. (2) The patient underwent surgery for colorectal cancer and was diagnosed with Lynch syndrome after surgery. (3) Lynch syndrome was diagnosed after surgery for gynecological or other organ-related cancers. (4) Simple MMR gene mutation carriers. The principles of treatment are different.

For patients with Lynch syndrome who have been diagnosed before surgery, most experts believe that if the cancer is located in the colon, lymph node dissection and total colectomy should be performed according to the location of the cancer, and ileorectal anastomosis should be performed. Regular colonoscopy should be performed after surgery to detect rectal cancer as early as possible. If the cancer is located in the rectum, total colectomy, regional lymph node dissection, and ileoanal anastomosis should be performed. This is especially true for patients with an early age of onset, because for patients with Lynch syndrome, after partial resection of the large intestine, the chance of cancer developing in the retained segment of the large intestine is very high.

Literature reports that for patients with Lynch syndrome who undergo segmental colon resection, the probability of recurrence of colon cancer within 10 years is 16%, the probability of recurrence of colon cancer within 20 years is 41%, and the probability of recurrence of colon cancer within 30 years is 62%. However, total colectomy, especially total large bowel resection, will inevitably lead to a decline in the patient's quality of life after surgery. Therefore, clinicians should fully explain the risks of surgery to patients and adopt personalized surgical plans based on the patient's specific circumstances. 5-FU-based adjuvant chemotherapy cannot be used for patients with Lynch syndrome colorectal cancer whose postoperative pathology indicates the need for adjuvant chemotherapy, because both laboratory and clinical studies have confirmed that colorectal cancer with MSI manifestations is ineffective for 5-Fu treatment.

For patients with Lynch syndrome diagnosed after surgery, experts recommend regular colonoscopy of the retained large intestine, and early radical surgery if adenoma is found to have a tendency to become cancerous, to prevent cancer from occurring. Patients with Lynch syndrome who have MMR gene mutations but have not yet developed the disease should be closely monitored. In 2010, the American Comprehensive Cancer Network recommended monitoring for Lynch syndrome patients: Start colonoscopy at the age of 20 to 25, or 10 years earlier than the youngest age of colorectal cancer in the family, and perform colonoscopy every 1 to 2 years. For other malignant tumors besides colorectal cancer, such as endometrial cancer and ovarian cancer, it is recommended that gynecological oncologists conduct monitoring and educate patients on the medical knowledge of endometrial cancer to improve their awareness and facilitate early medical treatment after symptoms appear.

Preventive hysterectomy and bilateral salpingo-oophorectomy for sterilized women can reduce the risk of endometrial cancer and ovarian cancer. In order to reduce the risk of gastric and duodenal cancer, it is recommended to undergo upper gastrointestinal endoscopy starting at the age of 25 to 30 years, and repeat it once every 1 to 3 years depending on the results. For urinary system testing, experts recommend a urinalysis once a year. For the nervous system, it is recommended to have a specialist physical examination once a year. There are no current guidelines for testing for other cancers. At present, there is no consensus in my country on monitoring measures for Lynch syndrome patients.