Letter to the editor

Comment to the article: Patients´ description operated on mechanical bowel occlusion surgery due to colorectal and anal cancer

0000-0002-8701-9075Belkis Alvarez Escobar^{1  *}  , 0000-0002-9159-6887Juan Carlos Mirabal Requena¹ 

¹Universidad de Ciencias Médicas de Sancti Spíritus, Cuba.

Dear director:

After performing a comprehensive analysis of the article "Patients´ description operated on mechanical bowel occlusion surgery due to colorectal and anal cancer", ¹ we agree with authors that colorectal cancer is diagnosed in late stages, due to the fact that patients come to secondary health care with symptoms and signs suggestive of complication, likewise it is adults over 60 years of age who frequently present this disease.

According to some studies published by the United Nations, the percentage of the population aged 65 years and over will triple by the middle of this century in Latin America and by the year 2050 there will be as many people reaching this age each year as new births. ² Cuba is today the third most aged country in Latin America, so in the next 50 years it will be the most aged country in the Third World; the province of Villa Clara, together with the city of Havana and Sancti Spíritus, have the highest number of elderly people. ³

Colorectal cancer is a health problem in the older adult population in Cuba, it constitutes the third cause of death. The probability of developing it during life is 4 to 6 %. 8 % of the cases are infrequent, but 20 % have a genetic influence. In more than 90 % this cancer occurs with a peak incidence between 60 and 75 years of age. ⁴ When analyzing the incidence of this disease in this age group, it is necessary to intensify the work at the primary health care level in terms of early detection; for this it is vital to achieve an adequate dispensation and early diagnosis of the disease.

The Ministry of Public Health, together with the Immunoassay Center, has made available a rapid test to detect occult blood in feces, available in all health areas with the aim of improving actions for the early diagnosis of diseases that cause bleeding in the digestive tract, including colorectal cancer. The importance of this issue is evident in order to achieve a diagnosis in curable stages with better life quality. ⁵

Survival or subsistence, that is the time that elapses from the moment of diagnosis until the death of these patients, is clearly conditioned by the stage or extension of the disease at diagnosis. As it is achieved at a lower stage of the disease, the prognosis of survival at five years will be greater. In general, colon tumors are declared when they bleed, perforate or occlude the intestine; many of the patients have already advanced disease at the time of diagnosis. ⁶

Self-care of the elderly is considered a consistent element in the treatment of the aforementioned disease. This perspective helps the patient to become aware of his or her own condition by improving his or her information and skills to perform appropriate self-care actions. The physician should induce changes in lifestyle, as well as in hygienic and dietary habits that lead to a decrease in the risk factors associated with the onset of the disease.

New health care and research challenges are posed for the primary health care level from the Cuban public health paradigm, due to the role played by medical personnel within the basic health care team, as there is a greater need to support community health practices focused on self-care for individuals, in order to ensure those people getting older then enjoy healthy aging. Self-care strategies accomplish significant changes at knowledge and health status of elderly dimensions with colorectal cancer, leading to modifications of health-generating behaviors. ⁷

Diagnosis at the secondary health care level is a failure of the chronic disease and cancer control program. ⁽⁸ Adequate control of patients with clinical characteristics that may suggest the presence of this type of disease is essential to reduce the number of years of life lost due to preventable causes. Raising the level of knowledge in the population about the forms of presentation and symptomatology suggestive of colorectal cancer is one of the most effective ways to diagnose the disease in its early stages.

It is necessary to reframe the elderly self-care diagnosed with this disease, specifically in relation to their behavior in concrete life situations, during this reframing, the physician trains the patient to learn and achieve a full development and functioning for the benefit of their life, health and well-being. The aim is to relieve pain, prolong survival and improve the state of health, through activities of a coherent and systemic nature, which will form part of the community's work system. For this, community actions and activities should be performed in the short, medium and long term to the transformation of the process direction, in order to favorably impact the health status of the elderly. These actions should begin early in life to prevent the onset of colorectal cancer.

It is necessary to delve into the main aspects related to this disease; to achieve this, Cuban health has basic work teams, family doctors and nurses at the primary care level, where the diagnosis of this disease should be detected sooner, using the clinical method and diagnostic tests available at this level thus, with this premise of improving the life quality of those who suffer from this ill-fated disease.

REFERENCIAS BIBLIOGRÁFICAS

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Received: February 23, 2022; Accepted: May 20, 2022

^*Autor para la correspondencia. Correo electrónico: [e-mail]

Los autores declaran no tener conflicto de interés en esta investigación.