Colorectal cancer: Everything you need to know


With COVID-19 grabbing the full attention of healthcare professionals, treatment of many fatal diseases has taken a hit – cancer being one of them, say experts. The second leading cause of death globally, cancer was responsible for an estimated 9.6 million deaths in 2018. Out of the 9.6 million cancer deaths, colorectal cancer – the most common cancer — contributed to 1.80 million deaths, mentioned Dr Deep Goel, Senior Director, consultant robotic surgeon, Department of Surgical Gastroenterology, Bariatric & Minimal Access Surgery, BLK Super Specialty Hospital, New Delhi.

What is colorectal cancer?

Colorectal Cancer (CRC) is a cancer that starts in the colon (large intestine) or rectum. Both these organs are in the lower portion of the digestive system. The rectum is at the end of the colon. Usually, CRC attacks older adults when they are in their seventies or above. However, it can happen at any age.

Elaborating on the incidence and fatality of CRC, Dr Goel said, “This is the third most common cancer and the fourth most common cause of cancer death worldwide. Predictions of the future burden of the disease is to inform health planners and raise awareness of the need for cancer control action. Colorectal cancer may not present with any symptoms, especially in the early stages. However, any chronic conditions like constipation, diarrhoea, changes in stool colour, blood in the stool, bleeding from the rectum, excessive gas, abdominal cramps and abdominal pain could be indicators.”

colon cancer The treatment of colorectal cancer depends on a variety of factors. (Source: Thinkstock Images)

What are the causes?

“There are so many factors of cancer to develop. It may be caused by genetic mutations, either inherited or acquired. These mutations don’t guarantee that it will cause the development of colorectal cancer, but they do increase the chances. Some mutations may cause abnormal cells to accumulate in the lining of the colon, forming polyps. There’s an array of risk factors that act alone or in combination to increase a person’s chances of developing colorectal cancer. Lifestyle-related risk factors such as dietary factors including red meats (such as beef, pork, lamb, or liver) increase the risk. Likewise, cooking meats at very high temperatures (frying, boiling, or grilling) creates chemicals that increase risk. However, diets high in vegetables, fruits, and whole grains along with increased physical activity have been linked with a decreased risk,” he added.

Diagnosis and treatment

The intensity of diagnosis followed by treatments determines the degree of cure of any disease. Thus in such conditions, early is better; the delay is fatal. Usually, the diagnostic methods such as colonoscopy and biopsy — the most accurate, CT/MRI/PET scan, and tumour marker (CEA) are employed. Similarly, popular screening methodologies employed are colonoscopy/sigmoidoscopy, and FOBT (Fecal occult blood testing).

As far as the treatment of colorectal cancer is concerned, it depends on a variety of factors. The state of your overall health and the stage of your colorectal cancer will help your doctor create a treatment plan. In the earliest stages of colorectal cancer, it might be possible for your surgeon to remove cancerous polyps through surgery. If the polyp hasn’t attached to the wall of the bowels, you’ll likely have an excellent outlook. Besides, radiation therapy and chemotherapy therapy are also used for treatment.

In addition to the conventional treatment modality of colorectal cancer, newer technologies such as Liquid Biopsy, Minimal Invasive (Keyhole), Robotic, Personalised Chemotherapy, Targeted chemotherapy, and Gene editing have been in use widely, said Dr Goel.

As all the modalities have their respective significance, laparoscopic/robotic surgery has certain advantages. “This modality decreases pain, helps the return of bowel function, reduces the length of hospital stay post-surgery, reduces wound-related problems, renders less disability and finally gives a better cosmetic result,” he said.

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