Introduction
Colorectal cancer is the general term for colon and rectal cancer; it has poor prognosis and a high mortality rate. Cancers on the mucosa epithelium are collectively referred to as colorectal cancer and are the most common cancer of the gastrointestinal tract, second only to gastric cancer and esophageal cancer. The cancer originating from mesenchymal tissue is called sarcoma, accounting for 1% of the intestinal malignant lesions. The 5-year survival rate after surgical resection can reach 40%–60% on average. Early detection; early diagnosis; and early treatment, primarily standardized surgical treatment, are still the key for improving the curative effect of colorectal cancer.

Changes in defecation routines and properties of feces are often the earliest symptoms, such as increased number of defecations; diarrhea; constipation; and feces with mucus, pus, and blood. Abdominal pain is usually dull pain without clear position or abdominal discomfort, accompanied by flatulence, and so on. Weight loss, anemia, as well as acute and chronic intestinal obstruction appear in the medium-advanced stage. The mass, hard with unsmooth surface and less activity, is palpable in the abdomen of some patients. 

Treatments
1.Surgery
Radical resection can be applied to the majority of the primary cancers, and the objective is to remove the intestinal segment where the cancer is located (including the range of proximal 10 cm and distal 7 cm and the corresponding mesentery and its lymph nodes). The range for specific radical resection and its surgical mode are determined by the location of the cancer. If patients cannot receive radical surgery, palliative resection can still be applied to alleviate the symptoms and improve the patients’ quality of life. In recent years, many surgeons have applied resection under endoscopy for early colorectal cancer and have achieved better efficacy.

2.Radiotherapy
The main purposes of colorectal cancer radiotherapy and chemoradiotherapy are for adjuvant therapies and palliative treatments. The indications for adjuvant therapy are colorectal cancers at stages II and III; the indications for palliative treatment are tumor locoregional recurrence and/or distant metastasis. For some who cannot tolerate surgery or are adamant about anus preservation, radical radiotherapy or chemoradiotherapy can be tried. It is not recommended to apply radiotherapy for cancers of phase I. Radical surgery is recommended for the following cases: after local excision, when the postoperative pathological stage is T₂, when the maximum tumor diameter is greater than 4 cm, if the tumor-occupying perimeter of intestine is greater than one-third the size of intestine, if adenocarcinoma is poorly differentiated, if there is neural invasion, and if there is intravascular cancer embolus. If patients refuse surgery or are inoperable, it is recommended to apply postoperative radiotherapy. For rectal cancer clinically diagnosed as stage II or III, it is recommended to carry out preoperative radiotherapy or preoperative concurrent chemoradiotherapy. Patients who are pathologically diagnosed with rectal cancer at stage II or III after radical resection and without receiving preoperative chemoradiotherapy must receive postoperative concurrent chemoradiotherapy. Locally advanced unresectable rectal cancer (T₄) must first receive preoperative concurrent chemoradiotherapy and must be reevaluated after chemoradiotherapy to qualify for radical surgery. For local recurrence of rectal cancer, surgery is the first choice; if surgery is impossible, chemoradiotherapy is recommended. For initially treated rectal cancer of stage IV, it is recommended to carry out chemotherapy alone or chemotherapy combined with primary lesion radiotherapy. Reassess resectability after treatment. For metastases, if necessary, palliative reduction radiotherapy can be carried out. As far as recurrence and metastasis of colorectal cancer is concerned, and for patients with resectable local recurrence, it is recommended to have surgical resection first and then consider whether postoperative radiotherapy should be conducted. For unresectable patients with local recurrence, it is recommended to first have preoperative concurrent chemoradiotherapy and then seek surgical resection. For advanced rectal cancer cases, apply small doses of radiotherapy, which sometimes can have temporary effects of hemostasis and analgesia. 

3.Chemotherapy
Patients at stages II and III are required to have adjuvant chemotherapy, and if advanced patients are in good general condition palliative chemotherapy can be carried out. For colorectal cancer patients at stage II, confirm the presence or absence of the following risk factors: poor histological differentiation (grade III or IV), T₄, vascular lymphatic invasion, preoperative intestinal obstruction or intestinal perforation, and insufficiency of lymph nodes detected from specimens (less than 12 pieces). It is recommended to conduct follow-ups for patients without high risk factors or to conduct chemotherapy with single-agent thymidine phosphorylase. It is recommended to conduct adjuvant chemotherapy for patients with high risk factors. For rectal cancers at T_3-4 or N_1-2, less than or equal to 12 cm from the anal edge, it is recommended to carry out preoperative neoadjuvant chemotherapy. If preoperative neoadjuvant radiotherapy is not conducted, adjuvant chemoradiotherapy is  recommended. 

4.Hyperthermia
Hyperthermia heating technologies for colorectal cancer include intracavitary hyperthermia and out-of- body hyperthermia. According to pathological observations, preoperative thermoradiotherapy or thermochemoradiotherapy for killing cancer cells is significantly better than preoperative single radiotherapy alone. In recent years, in vitro heating intraperitoneal hyperthermic perfusion chemotherapy has been widely used clinically and has been commonly used for medium-advanced patients with good effects.

5.Chelation Detoxification Therapy
Chelation detoxification therapy can be applied before and after surgery, and its effectiveness is to help patients improve immunity, preoperatively inhibit tumor growth or metastasis, postoperatively inhibit or kill residual tumor cells, reduce the side effects of chemotherapy, and enhance chemosensitivity. Chelation detoxification therapy in clinical practice adopts intravenous infusion and effectively excludes heavy metals and other toxins from the body. Chelation detoxification can be used as the main treatment for advanced colorectal cancer and usually starts with the therapeutic dose.

6.Medical Ozone Therapy
Medical ozone can activate the body’s own immune function, directly kill the early cancer cells in blood or lymph that may produce metastasis or micrometastasis, increase oxygen supply, reduce the side effects of chemotherapy, and promote the healing of surgical wounds. EBOO is preferred. Patients in poor physical conditions can change to major autohemotherapy, minor autohemotherapy, venous medical ozone saline, medical ozone acupoint injection, and so on. Colorectal cancer patients can also be given concurrent rectal insufflation of medical ozone gas in addition to the aforementioned medical ozone therapies, which has direct effect on cancer or stump after surgery, can kill cancer cells, and inhibit cancer recurrence and metastasis. For medium-advanced patients, medical ozone therapy varies from person to person and venous medical ozone saline, EBOO, rectal insufflation of medical ozone gas and other modes can be selected.

7.Traditional Chinese Medicine
The syndrome of dampness invasion of lower energizer is commonly seen at the early stage and the prescription recommended is Huaihua Diyu Decoction or Qingchang Drink, or modified Windflower Decoction. For the obstruction of pathogenic factors, the prescription recommended is Wuwei Xiaodu Decoction or modified Huanglian Jiedu Decoction. For the syndrome of blood stasis obstruction in the interior, the prescription recommended is modified Xuefu Zhuyu Decoction. For advanced stage with the syndrome of yin deficiency of liver and kidney, the prescription recommended is modified Zhibai Dihuang Pill. For the syndrome of deficiency of spleen yang and kidney yang, the prescriptions recommended are Shenlingbaizhu Powder and modified Sishen Pill. For the syndrome of deficiency of both qi and blood, the prescriptions recommended are Guipi Decoction and modified Bazhen Decoction.

Medium-advanced colorectal cancer mainly exhibits syndromes of dampness heat, blood stasis, and toxins, as well as deficiency of spleen yang and kidney yang. The therapeutic principle should focus on invigorating spleen for eliminating dampness, removing toxins, eliminating stagnant blood, reinforcing spleen, and nourishing kidneys, as well as inducing astringency and relieving diarrhea.

8.Acupuncture
The syndrome of early colorectal cancer is mainly the stagnation of liver qi. The therapeutic principle should focus on regulating qi flow for activating stagnancy, as well as relieving Fu qi.

The main syndromes of medium-advanced colorectal cancer are dampness heat and stasis toxins and deficiency of spleen yang and kidney yang. The therapeutic principle should focus on invigorating spleen for eliminating dampness, removing toxins and eliminating stagnant blood, toning kidneys and spleen, as well as inducing astringency and relieving diarrhea.

9.Medicated Diet, Nutrition, and so on
Medicated diet is mainly given for the cancer at the early stage. Total parenteral nutrition is given 1 day before thermochemotherapy to ensure adequate nutritional intake and to prevent loss of appetite caused by gastrointestinal reactions after thermochemotherapy, which can result in immune system damage. For medium- and advanced-stage patients who have no obstruction and can eat, it is recommended to give medicated diet and increase oral amino acids for supplementing rational nutrition. For patients with obstruction, consider giving total parenteral nutrition in conjunction with other therapies to prolong survival time and improve quality of life. 

10.Others
Actively practice qigong and tai chi. Strongly recommend to patients to make the necessary psychological adjustments to overcome negative emotions and alleviate psychological pressures by themselves. If necessary, psychiatrist treatment is given to help the transition to a normal and healthy state of mind. 

Typical Case
A 53 year old male patient was diagnosed with colon cancer by colonoscopy two years ago. He underwent right colon palliative resection and colon polypectomy. Liver metastasis was noted during the surgery, the tumor, approximate 6cm×7cm, located in the upper segment of sigmoid to the side of mesocolon; most of it had grown outside the enteric cavity (inside the mesenterium). Surrounding tissues and organs were not affected. Two pedicled polyps were visible in the vicinity of the proximal and distal colon. Lesions in the colon segment as well as polyps were removed.

Postoperative pathology: moderately differentiated adenocarcinoma of ulcerative type of the sigmoid colon, invading the surrounding tissues of the intestinal wall. One of  two polyps were tubular adenomas, with one being cancerous. A postoperative program of 5-fluorouracil + calcium folinate + oxaliplatin for chemotherapy was given. Enhanced abdominal CT of the patient taken a year ago show increased and enlarged intrahepatic metastases compared with the previous scan. Interventional chemoembolization for hepatocellular carcinoma was given. Half a year ago, patient was reexamined with CT revealing intrahepatic metastases had continued to grow. Patient was admitted to Clifford Hospital for further treatment due to abdominal pain, poor mental state, and difficulty sleeping. His urine and stool were normal.

Diagnosis: Hepatic metastases after postoperative chemotherapy of colon cancer and interventional treatment. 

Integrative treatment prescription: When patient was admitted to hospital he had a comprehensive assessment and was prescribed a nontoxic integrative treatment. Local hyperthermia, chelation and detoxification therapy were simultaneously conducted. Hyperthermia was conducted in the abdomen and hepatic region twice a week. Chelation and detoxification therapy was conducted twice a week. Extracorporeal Blood Oxygenation and Ozonation (EBOO) were applied twice every week, alternating with chelation and detoxification therapy. TCM and acupuncture therapy were a constant part of the treatment program. TCM decoction was given one dose per day. Medicinal Ingredients: Shenling Baizhu Decoction combing with Scutellaria Barbata, Lobelia Chinensis, Cremastra Appendiculata, Rhizoma Sparganii and Rhizoma Curcumae. The healing properties were to strengthen the bodies’ resistance, eliminate pathogen, activate blood and resolve stasis. 

Treatment outcome: patient was diagnosed with hepatic metastasis of advanced colonic carcinoma when he was admitted. During the 3 months patient was hospitalized, he had no obvious discomfort during the course of nontoxic integrative treatments. After treatment, patient regained a positive mental state, right upper abdominal pain disappeared, appetite was normal, with no further insomia. A repeated Abdominal CT showed no significant change in intrahepatic metastasesand lesions; Tumor marker: CEA 156.5 ng/ml.

Patient returned as outpatient for two applications each of chelation and detoxification therapy, medical ozone, local hyperthermia, and acupuncture treatments every 20 days after discharge, in addition to taking herbal medicine. Abdominal CT for reexamination 3 months after discharge show intrahepatic metastases had decreased compared with the previous scans. The biggest was 1.5cm × 1.2cm in size, and no new lesions were found. Rechecked CEA, 76.3 ng/ml. Conducted follow-up for more than 2 years after discharge and the patient’s condition remained stable. Patient continued with outpatient treatments and reviews.





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Introduction
Colorectal cancer is the general term for colon and rectal cancer; it has poor prognosis and a high mortality rate. Cancers on the mucosa epithelium are collectively referred to as colorectal cancer and are the most common cancer of the gastrointestinal tract, second only to gastric cancer and esophageal cancer. The cancer originating from mesenchymal tissue is called sarcoma, accounting for 1% of the intestinal malignant lesions. The 5-year survival rate after surgical resection can reach 40%–60% on average. Early detection; early diagnosis; and early treatment, primarily standardized surgical treatment, are still the key for improving the curative effect of colorectal cancer.

Changes in defecation routines and properties of feces are often the earliest symptoms, such as increased number of defecations; diarrhea; constipation; and feces with mucus, pus, and blood. Abdominal pain is usually dull pain without clear position or abdominal discomfort, accompanied by flatulence, and so on. Weight loss, anemia, as well as acute and chronic intestinal obstruction appear in the medium-advanced stage. The mass, hard with unsmooth surface and less activity, is palpable in the abdomen of some patients. 

Treatments
1.Surgery
Radical resection can be applied to the majority of the primary cancers, and the objective is to remove the intestinal segment where the cancer is located (including the range of proximal 10 cm and distal 7 cm and the corresponding mesentery and its lymph nodes). The range for specific radical resection and its surgical mode are determined by the location of the cancer. If patients cannot receive radical surgery, palliative resection can still be applied to alleviate the symptoms and improve the patients’ quality of life. In recent years, many surgeons have applied resection under endoscopy for early colorectal cancer and have achieved better efficacy.

2.Radiotherapy
The main purposes of colorectal cancer radiotherapy and chemoradiotherapy are for adjuvant therapies and palliative treatments. The indications for adjuvant therapy are colorectal cancers at stages II and III; the indications for palliative treatment are tumor locoregional recurrence and/or distant metastasis. For some who cannot tolerate surgery or are adamant about anus preservation, radical radiotherapy or chemoradiotherapy can be tried. It is not recommended to apply radiotherapy for cancers of phase I. Radical surgery is recommended for the following cases: after local excision, when the postoperative pathological stage is T₂, when the maximum tumor diameter is greater than 4 cm, if the tumor-occupying perimeter of intestine is greater than one-third the size of intestine, if adenocarcinoma is poorly differentiated, if there is neural invasion, and if there is intravascular cancer embolus. If patients refuse surgery or are inoperable, it is recommended to apply postoperative radiotherapy. For rectal cancer clinically diagnosed as stage II or III, it is recommended to carry out preoperative radiotherapy or preoperative concurrent chemoradiotherapy. Patients who are pathologically diagnosed with rectal cancer at stage II or III after radical resection and without receiving preoperative chemoradiotherapy must receive postoperative concurrent chemoradiotherapy. Locally advanced unresectable rectal cancer (T₄) must first receive preoperative concurrent chemoradiotherapy and must be reevaluated after chemoradiotherapy to qualify for radical surgery. For local recurrence of rectal cancer, surgery is the first choice; if surgery is impossible, chemoradiotherapy is recommended. For initially treated rectal cancer of stage IV, it is recommended to carry out chemotherapy alone or chemotherapy combined with primary lesion radiotherapy. Reassess resectability after treatment. For metastases, if necessary, palliative reduction radiotherapy can be carried out. As far as recurrence and metastasis of colorectal cancer is concerned, and for patients with resectable local recurrence, it is recommended to have surgical resection first and then consider whether postoperative radiotherapy should be conducted. For unresectable patients with local recurrence, it is recommended to first have preoperative concurrent chemoradiotherapy and then seek surgical resection. For advanced rectal cancer cases, apply small doses of radiotherapy, which sometimes can have temporary effects of hemostasis and analgesia. 

3.Chemotherapy
Patients at stages II and III are required to have adjuvant chemotherapy, and if advanced patients are in good general condition palliative chemotherapy can be carried out. For colorectal cancer patients at stage II, confirm the presence or absence of the following risk factors: poor histological differentiation (grade III or IV), T₄, vascular lymphatic invasion, preoperative intestinal obstruction or intestinal perforation, and insufficiency of lymph nodes detected from specimens (less than 12 pieces). It is recommended to conduct follow-ups for patients without high risk factors or to conduct chemotherapy with single-agent thymidine phosphorylase. It is recommended to conduct adjuvant chemotherapy for patients with high risk factors. For rectal cancers at T_3-4 or N_1-2, less than or equal to 12 cm from the anal edge, it is recommended to carry out preoperative neoadjuvant chemotherapy. If preoperative neoadjuvant radiotherapy is not conducted, adjuvant chemoradiotherapy is  recommended. 

4.Hyperthermia
Hyperthermia heating technologies for colorectal cancer include intracavitary hyperthermia and out-of- body hyperthermia. According to pathological observations, preoperative thermoradiotherapy or thermochemoradiotherapy for killing cancer cells is significantly better than preoperative single radiotherapy alone. In recent years, in vitro heating intraperitoneal hyperthermic perfusion chemotherapy has been widely used clinically and has been commonly used for medium-advanced patients with good effects.

5.Chelation Detoxification Therapy
Chelation detoxification therapy can be applied before and after surgery, and its effectiveness is to help patients improve immunity, preoperatively inhibit tumor growth or metastasis, postoperatively inhibit or kill residual tumor cells, reduce the side effects of chemotherapy, and enhance chemosensitivity. Chelation detoxification therapy in clinical practice adopts intravenous infusion and effectively excludes heavy metals and other toxins from the body. Chelation detoxification can be used as the main treatment for advanced colorectal cancer and usually starts with the therapeutic dose.

6.Medical Ozone Therapy
Medical ozone can activate the body’s own immune function, directly kill the early cancer cells in blood or lymph that may produce metastasis or micrometastasis, increase oxygen supply, reduce the side effects of chemotherapy, and promote the healing of surgical wounds. EBOO is preferred. Patients in poor physical conditions can change to major autohemotherapy, minor autohemotherapy, venous medical ozone saline, medical ozone acupoint injection, and so on. Colorectal cancer patients can also be given concurrent rectal insufflation of medical ozone gas in addition to the aforementioned medical ozone therapies, which has direct effect on cancer or stump after surgery, can kill cancer cells, and inhibit cancer recurrence and metastasis. For medium-advanced patients, medical ozone therapy varies from person to person and venous medical ozone saline, EBOO, rectal insufflation of medical ozone gas and other modes can be selected.

7.Traditional Chinese Medicine
The syndrome of dampness invasion of lower energizer is commonly seen at the early stage and the prescription recommended is Huaihua Diyu Decoction or Qingchang Drink, or modified Windflower Decoction. For the obstruction of pathogenic factors, the prescription recommended is Wuwei Xiaodu Decoction or modified Huanglian Jiedu Decoction. For the syndrome of blood stasis obstruction in the interior, the prescription recommended is modified Xuefu Zhuyu Decoction. For advanced stage with the syndrome of yin deficiency of liver and kidney, the prescription recommended is modified Zhibai Dihuang Pill. For the syndrome of deficiency of spleen yang and kidney yang, the prescriptions recommended are Shenlingbaizhu Powder and modified Sishen Pill. For the syndrome of deficiency of both qi and blood, the prescriptions recommended are Guipi Decoction and modified Bazhen Decoction.

Medium-advanced colorectal cancer mainly exhibits syndromes of dampness heat, blood stasis, and toxins, as well as deficiency of spleen yang and kidney yang. The therapeutic principle should focus on invigorating spleen for eliminating dampness, removing toxins, eliminating stagnant blood, reinforcing spleen, and nourishing kidneys, as well as inducing astringency and relieving diarrhea.

8.Acupuncture
The syndrome of early colorectal cancer is mainly the stagnation of liver qi. The therapeutic principle should focus on regulating qi flow for activating stagnancy, as well as relieving Fu qi.

The main syndromes of medium-advanced colorectal cancer are dampness heat and stasis toxins and deficiency of spleen yang and kidney yang. The therapeutic principle should focus on invigorating spleen for eliminating dampness, removing toxins and eliminating stagnant blood, toning kidneys and spleen, as well as inducing astringency and relieving diarrhea.

9.Medicated Diet, Nutrition, and so on
Medicated diet is mainly given for the cancer at the early stage. Total parenteral nutrition is given 1 day before thermochemotherapy to ensure adequate nutritional intake and to prevent loss of appetite caused by gastrointestinal reactions after thermochemotherapy, which can result in immune system damage. For medium- and advanced-stage patients who have no obstruction and can eat, it is recommended to give medicated diet and increase oral amino acids for supplementing rational nutrition. For patients with obstruction, consider giving total parenteral nutrition in conjunction with other therapies to prolong survival time and improve quality of life. 

10.Others
Actively practice qigong and tai chi. Strongly recommend to patients to make the necessary psychological adjustments to overcome negative emotions and alleviate psychological pressures by themselves. If necessary, psychiatrist treatment is given to help the transition to a normal and healthy state of mind. 

Typical Case
A 53 year old male patient was diagnosed with colon cancer by colonoscopy two years ago. He underwent right colon palliative resection and colon polypectomy. Liver metastasis was noted during the surgery, the tumor, approximate 6cm×7cm, located in the upper segment of sigmoid to the side of mesocolon; most of it had grown outside the enteric cavity (inside the mesenterium). Surrounding tissues and organs were not affected. Two pedicled polyps were visible in the vicinity of the proximal and distal colon. Lesions in the colon segment as well as polyps were removed.

Postoperative pathology: moderately differentiated adenocarcinoma of ulcerative type of the sigmoid colon, invading the surrounding tissues of the intestinal wall. One of  two polyps were tubular adenomas, with one being cancerous. A postoperative program of 5-fluorouracil + calcium folinate + oxaliplatin for chemotherapy was given. Enhanced abdominal CT of the patient taken a year ago show increased and enlarged intrahepatic metastases compared with the previous scan. Interventional chemoembolization for hepatocellular carcinoma was given. Half a year ago, patient was reexamined with CT revealing intrahepatic metastases had continued to grow. Patient was admitted to Clifford Hospital for further treatment due to abdominal pain, poor mental state, and difficulty sleeping. His urine and stool were normal.

Diagnosis: Hepatic metastases after postoperative chemotherapy of colon cancer and interventional treatment. 

Integrative treatment prescription: When patient was admitted to hospital he had a comprehensive assessment and was prescribed a nontoxic integrative treatment. Local hyperthermia, chelation and detoxification therapy were simultaneously conducted. Hyperthermia was conducted in the abdomen and hepatic region twice a week. Chelation and detoxification therapy was conducted twice a week. Extracorporeal Blood Oxygenation and Ozonation (EBOO) were applied twice every week, alternating with chelation and detoxification therapy. TCM and acupuncture therapy were a constant part of the treatment program. TCM decoction was given one dose per day. Medicinal Ingredients: Shenling Baizhu Decoction combing with Scutellaria Barbata, Lobelia Chinensis, Cremastra Appendiculata, Rhizoma Sparganii and Rhizoma Curcumae. The healing properties were to strengthen the bodies’ resistance, eliminate pathogen, activate blood and resolve stasis. 

Treatment outcome: patient was diagnosed with hepatic metastasis of advanced colonic carcinoma when he was admitted. During the 3 months patient was hospitalized, he had no obvious discomfort during the course of nontoxic integrative treatments. After treatment, patient regained a positive mental state, right upper abdominal pain disappeared, appetite was normal, with no further insomia. A repeated Abdominal CT showed no significant change in intrahepatic metastasesand lesions; Tumor marker: CEA 156.5 ng/ml.

Patient returned as outpatient for two applications each of chelation and detoxification therapy, medical ozone, local hyperthermia, and acupuncture treatments every 20 days after discharge, in addition to taking herbal medicine. Abdominal CT for reexamination 3 months after discharge show intrahepatic metastases had decreased compared with the previous scans. The biggest was 1.5cm × 1.2cm in size, and no new lesions were found. Rechecked CEA, 76.3 ng/ml. Conducted follow-up for more than 2 years after discharge and the patient’s condition remained stable. Patient continued with outpatient treatments and reviews.