Day 017 - 25 Jul 94 - Page 09
1 In other words, it is a controllable getting rid of waste
products.
2
Q. A waste disposal unit?
3 A. Yes, a sort of waste disposal unit. The first part of
the large bowel is called the ascending colon simply
4 because where the small intestine enters the large bowel
it is deep down in the right-hand side of our abdomen. It
5 travels up in an ascending fashion. Then it goes across
the upper part of the abdomen, that is called the
6 transverse colon; then it goes down the left-hand side
which is called the descending colon. Finally, it enters
7 the rectum, which is the last part of the bowel before the
anus.
8
Obviously, the contents within the bowel are different as
9 they enter the ascending colon because they are more fluid
at that particular point than they are when they are in
10 the descending colon, when they are much more solid. So
it is likely the influences on the lining of the bowel are
11 different in these different places.
12 Q. Does one find cancers in both the left and right-hand
sides?
13 A. Yes, the majority of cancers arise in the descending
colon just before it becomes the rectum. The next
14 commonest site is the rectum itself. The transverse colon
is relatively spared from the development of cancers,
15 although they can occur, and the ascending colon forms a
sort of intermediate position. But it is interesting. It
16 seems that we may be seeing a slight increase in the
numbers of cancers in the ascending colon developing and a
17 slight decrease in the incidence of cancers of the left
side of the colon.
18
Q. Let me see I have understood it correctly: The
19 environmental or physiological conditions of the ascending
colon are different from those of the descending colon?
20 A. That is absolutely right.
21 MR. JUSTICE BELL: Where in your report you refer to the right
colon and the left colon, are they the ascending and
22 descending colons respectively?
A. Yes, they are.
23
MR. RAMPTON: When, therefore, we are considering the aetiology
24 of cancer of the colon and rectum, must we take account of
the different environmental conditions obtaining in the
25 different places?
A. I think we should be, yes, though that is not easy.
26 I think we should.
27 Q. I am not suggesting any of it is easy, Dr. Arnott. I want
to ask you about the different methods which exist for
28 collecting evidence about the aetiology of these cancers.
This is a very obvious question, forgive me: Is it, from
29 the point of view of the person like yourself, who is
concerned to improve the health of humankind, to
30 understand as far as possible how these conditions are
caused?
