ColoRectal Cancer
Colorectal cancer is a cancer of large intestine. Large intestine is last part of intestine where mainly water is absorbed.
Types
Right Sided Colon Cancer
Left Sided Colon Cancer
Colon Cancer
Symptoms
Right Sided Colon Cancer
- Stool is liquid here hence main symptom is weakness.
- Fatigue due to blood loss causing anemia.
- Sometimes lump in abdomen.
Left Sided Colon Cancer & Rectal Cancer
- Here symptoms are mainly obstructive due to constricting nature of tumor. They have change in bowel habit.
- Frequent alternate diarrhoea / constipation, with sensation of incomplete stool.
- Blood in stool.
- Pain in abdomen.
- Abdominal fullness / swelling.
- Advanced cases has jaundice, ascites, breathlessness.
How do I confirm colon / rectal cancer ?
All individuals with persistent above symptoms for more than 3 weeks must consult oncologist.
First and most important is clinical examination by finger (per rectal examination). Many can be easily confused with piles.
Diagnosis / Tests required
Colonoscopy and biopsy - endoscopic examination of large intestine and biopsy is done to assess tumor location, coexisting another tumor, precancerous lesions.
Ct scan of abdomen and chest for cancer staging.
Treatment Options
Colon Cancer
- Main and only curative treatment is surgery.
- Chemotherapy is used as supportive therapy for high risk stage 2 and all stage 3 colon cancer.
- Stage 4 cancer require only chemotherapy and sometimes diversion procedure for stool.
Rectal Cancer
- Except very early cancer, most require presurgery chemoradiotherapy (NACTRT).
- It decreases chances of cancer recurrence drastically.
- Also aid in preserving normal passage of stool, avoiding permanent bag (colostomy).
methods of surgery
Open Surgery
- Open Surgery is a conventional method.
- In complicated and obstructive cases, it is still preferred method.
- Its disadvantages are high wound infection rate, large scar, pain due to big scar.
Laproscopic Surgery
- It is really boon and has become gold standard.
- Due to magnified view, cancer clearence is better, chances of injury to nerves is less, blood loss minimal.
- Due to increase in reach, many cases where permanent colostomy was planned, can be converted to sphincter preserving surgery.
- Good training from good cancer institute is must to perform this surgery correctly.
Robotic Surgery
- Its principle and technique are same as laparoscopic surgery.
- Cost is almost double.
- Operating surgeon is more important as it is just a tool.
- FYI, robot is not performing surgery.