Max Health Bulletin: Understanding Colorectal Cancer

Colorectal cancer, or Cancer affecting the large intestine, is the 3rd?most common cancer amongst men and 2nd?most common in women worldwide. It is amongst the ten commonest cancer in men and women in India.

What are the symptoms of colorectal cancer?

• Presence of blood in stools
• Weakness, lethargy due to slow, small amount unnoticed bleeding
• Abdominal pain
• Worsening constipation or feeling of incomplete passage of stools
• Inability to pass gas or stools resulting from the cancer causing intestinal obstruction

Can we prevent colorectal cancer?

Avoiding?obesity,?quit smoking, limit alcohol intake, reducing red meats in diet and screening colonoscopy for patients at high risk (inflammatory bowel disease?or a family history of colorectal cancer) can help prevent colorectal cancer. Colorectal cancers arise from small polyps, most of which can be removed at colonoscopy, thereby reducing the risk of subsequent development of cancer.

Early diagnosis: How and why?

Colonoscopy helps diagnose polyps as well as cancers. Patients in India present at a later stage, in which case further tests (CT scan, MRI, PET-CT) are usually needed. Such tumours also need more extensive treatment with some combination of surgery,?chemotherapy?and radiotherapy. Tumours diagnosed early, are easier to treat and?have better long-term outcomes with?colorectal cancer treatment in India.

What is the role of surgery in the treatment of colorectal cancer and what does it entail?

Surgery is the best?colon cancer treatment?unless the disease has spread in which case chemotherapy is given first. Early rectal cancers are treated with surgery, more advanced ones with some combination of chemotherapy and radiotherapy prior to surgery. Surgery entails removal of the tumour with a segment of normal large intestine with regional lymph nodes and mostly joining the two healthy ends of the intestine to each other for restoration of the digestive tract.

Why minimally invasive (laparoscopic or robotic) surgery for colorectal cancer?

Most abdominal cancers can now be managed with laparoscopic or even better with robotic techniques. There are a number of advantages of these techniques, namely a magnified view at surgery, smaller incisions and therefore, lesser postoperative pain, shorter hospital stay, and earlier return to normal activity.

How is the management of stage IV colorectal cancer changing?

Patients with stage IV cancer usually have hard time coping up with physical and mental health challenges. However, colorectal cancer is an exception. Selected patients with stage IV cancer (limited spread to lung, liver or even the abdominal cavity) are now treated with a combination of newer medications and techniques with good long-term survival. Patients with disease spread in peritoneal cavity can also be treated with chemotherapy followed by cytoreductive surgery and HIPEC, a technique in which heated chemotherapy medicines are circulated in abdomen of patient at surgery. Even if the disease is deemed incurable, treatment helps and?most?patients’ chances of survival are more than 2 years.

Vivek Mangla