Cancer arising in the large intestine and rectum are called colorectal cancers. Incidence of these cancers is increasing because of certain risk factors.
What are the risk factors?
Familial incidence is around 20%, your consultant will ask details about your family, vitamin D deficiency, past history of inflammatory bowel disease, smoking, alcohol consumption, high consumption of red and processed meat, diabetes mellitus and low level of physical activity.
These risk factors can be modified and colorectal cancers can be prevented in certain patients. You have to be aware of these risk factors and discuss with the consultant how to prevent the occurrence of colorectal cancer.
These patients present with bleeding per rectum, altered bowel habit, black colored stools, spurious diarrhea, persistent abdominal discomfort and sometimes fatigue.
If you have these symptoms, your doctor will advise colonoscopy to identify any growth, its location and appearance and during this procedure he will take a biopsy. This will say whether cancer is there or not. If cancer is confirmed in the colon, he will get a CECT scan of the abdomen and pelvis done for staging. For a Rectal cancer MRI pelvis with contrast.
Based on the site of the growth, your doctor will explain the surgery and if surgery is not feasible, what are the other treatment options available.
Surgeries that are routinely done are colectomy, anterior resection and abdominoperineal resection. Most of the time stoma (intestine placed outside your skin) is avoided.
These procedures are done in three approaches, open laparoscopic and Robotic. Laparoscopy & Robotics, the recovery time is less and you can resume your work as early as possible. Less blood loss, no ICU stay, less hospital stay are some of the advantages.
Awareness about the advantages with Robotics is needed and request your doctor. Better magnification, stable platform, less dependency on the assistant, ergonomics, more precise work in a limited space and less conversion to open surgery even in obese patients.
After surgery, you have to collect your specimen report and it will be analysed in detail. If a stoma reversal is being planned, your doctor will explain to you the timing. Options of chemotherapy and radiation will be explained.
Certain complications like suture leak, sepsis are described after surgery, these are manageable.
Regarding stoma, most of the time not done, if done also it will be temporary. In abdominoperineal resection it’s permanent. For stoma care exclusive stoma care therapists will be available. Apprehension about the stoma can be discussed with your doctor.
Chemotherapy will be given by a medical oncologist, he will explain to you what regimen is being planned, duration, advantages and side effects. No need for any fear of chemotherapy. Counselling about chemotherapy will help you to overcome it.In rectal cancer you may be advised about radiation according to the stage of your disease. It will be given by a radiation oncologist. With the recent advances like Rapid arc, the side effects have come down enhancing the compliance and recovery of the patients.
Comprehensive cancer care with Surgical, Medical, Radiation oncologists help you give the best results for your disease.
How to prevent colorectal cancer?
Habits like smoking, alcoholism, and sedentary lifestyle can be modified. Food habits modification like consumption of a more vegetarian diet, fruits and less consumption of red and processed meat. Undergoing prophylactic surgery in screened individuals with polyps will prevent cancer in future.
Better awareness, early diagnosis and appropriate treatment will give you the best results.
Dr. Madhu Devarasetty
Consultant Surgical Oncology
KIMS Hospitals, Secunderabad.