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Colorectal Cancer

Colorectal Cancer

General Surgery

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Colorectal cancer develops in the large intestine. The colon occupies most of the abdomen, moving from the right lower side upward, across, and then down toward the left. The rectum is the last 12–15 cm segment just before the anus. This distinction is important. Tumours in the rectum, especially within 5–6 cm of the anal opening, may need a different treatment approach compared to those higher up in the colon.

Who Is at Risk

  • There is rarely a single cause; risk usually builds from multiple factors over time
  • Diet patterns matter, frequent intake of red meat, processed foods, and low-fibre diets
  • Sedentary lifestyle and increasing abdominal obesity contribute significantly
  • Smoking adds to long-term risk
  • Pre-existing conditions, such as ulcerative colitis or multiple colon polyps, increase susceptibility
  • Family history of colorectal cancer

Early Signs Patients Often Ignore

  • Symptoms are often mild or intermittent in the early stages
  • Blood in stool is common, may appear as bright red streaks or darker mixed stool
  • Often mistaken for piles, leading to delayed medical consultation
  • Persistent change in bowel habits, constipation alternating with loose motions
  • Sensation of incomplete bowel evacuation, even after passing stool
  • Unexplained weight loss without changes in diet or activity
  • Fatigue or gradually decreasing haemoglobin levels on routine tests

Symptoms lasting more than 2 to 3 weeks should not be ignored and need evaluation

Screening and Prevention

Screening is still not routine in many Indian families. Ideally, individuals above 45 years should undergo a colonoscopy. If there is a family history, screening may begin earlier. The procedure itself is short and usually done under sedation. The preparation, bowel cleansing the night before, is often the most uncomfortable part, but it is essential for accuracy. Detecting and removing polyps early can actually prevent cancer from developing.

Once there is suspicion, evaluation is fairly direct. Colonoscopy allows us to visualize the inner lining and take a biopsy. This confirms whether the growth is cancerous. Imaging, CT scan, or MRI - helps determine how far the disease has spread. We look at the depth of invasion, nearby lymph nodes, and occasionally other organs like the liver. This staging decides the treatment plan.

Treatment Approach

  • Surgery remains the primary and most effective treatment in most colorectal cancer cases
  • For colon tumours, the affected segment is removed along with nearby lymph nodes (colectomy).
  • For rectal cancers (especially in the upper rectum), a low anterior resection is performed to remove the tumour while preserving normal bowel function.
  • Tumours located very close to the anal sphincter may require the creation of a permanent stoma.
  • The need for a stoma is often a major concern, but with proper counselling and support, most patients adjust well over time.
  • Minimally invasive approaches (laparoscopic or robotic surgery) are preferred whenever feasible.
  • These involve small incisions (around 0.5 to 1 cm), leading to less pain and faster recovery.
  • Open surgery may be required in advanced or technically complex cases.
  • Chemotherapy and/or radiation therapy may be given before or after surgery, depending on the stage and location of the cancer.

Life After Surgery

Recovery is gradual, not immediate. Patients usually start with liquids, then move to a soft diet over a few days. High-fibre foods, raw salads, nuts, and corn are avoided initially. Walking early helps recovery. If a stoma is created, training becomes important. Patients and caregivers are taught how to manage the bag, maintain skin hygiene, and adjust diet. It sounds overwhelming at first, but it becomes routine over time. Regular follow-up is essential. Even after successful treatment, periodic scans and colonoscopies are needed.

At hospitals like UMC Navi Mumbai, colorectal cancer treatment is not handled by a single doctor alone. It is a coordinated effort. Surgeons, oncologists, radiologists, and nutrition teams work together to plan treatment. Minimally invasive techniques, structured recovery pathways, and consistent follow-up care help improve outcomes. Consult our team of specialists at our Department of General Surgery for advanced colorectal cancer treatment in Navi Mumbai.

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