Nagpur: Colorectal cancer is the cancer affecting the large intestine of the body, which is part of the digestive system. The incidence of colorectal cancer is rapidly increasing in India and it is now the fifth most important cause of cancer related deaths in India. The main reason for the increasing incidence of this cancer is the increasing westernisation of the Indian diet. High intake of processed meat, red meat and high fat diet are some of the dietary factors which are known to be related to the occurrence of colorectal cancer. Smoking, obesity and alcohol intake are other important contributing factors for this dreaded disease. High fibre diet with plenty of fruits and vegetables is the sure shot way to prevent colorectal cancer.
Change in bowel habits (either constipation or diarrhoea), bleeding while passing stools and passage of black stools are some of the symptoms of this disease. Unfortunately, many of these symptoms are often mistaken for piles or other benign ano-rectal disease, thus delaying the diagnosis of cancer. So it is important to consult an oncologist if these symptoms are not resolved with treatment.
Colonoscopy is the test that is used for diagnosis of colorectal cancer. Colonoscopy is basically the endoscopic examination of the large intestine. It helps in diagnosis of the cancer and it indicates the exact location of the disease in the intestine. MRI and/or CT scan of the abdomen is then done to know spread of the cancer within the body.
Like any other cancer, treatment of colorectal cancer is a multimodal treatment. Multimodal treatment means that treatment is done by the team of the specialists comprising of anonco-surgeon, medical oncologist and radiation oncologist. Depending upon the stage of the cancer, the cancer care team will recommend the sequence of therapy. In early stage colorectal cancer, surgery alone is curative and the patient can be spared the side effects of chemotherapy and radiotherapy.
In olden days, Abdomino-perineal resection was the standard treatment for low rectal cancer, which would result in creation of the permanent faecal stoma. Stoma is the artificial opening made on the anterior abdominal wall through
Dr Suraj Agrawal
MBBS, MS, M.Ch (Onco Surgery)
Consultant – Surgical Oncology
which faeces are passed. Nowadays with advances in surgical techniques and availability of modern stapling devices, surgeons are able to avoid stoma in the majority of cases and only few patients require stoma. Most of the stomas made now a days are temporary and are closed surgically after few weeks. Only in small minority, permanent stoma is required.
Colorectal cancer is curable if detected early. It is very important to maintain a low threshold for colonoscopy if any of the symptoms suggestive of colorectal disease are there especially in persons above 50 years of age, as risk of colon cancer increases with age. Apart from early detection, people may be able to lower the risk of colon cancer by adopting a more active life-style and healthy diet. It is recommended to avoid high fat foods, processed foods, and red meat and abstain from smoking and alcohol. One should consume high fibre diet with plenty of fruits and vegetables as these are known to reduce the risk of colon cancer. Remember, prevention is always better than cure, more so for cancer.