All you wanted to know about Colorectal Cancer

Dr. Manish Joshi is a Consultant Surgical Gastroenterologist, GI Oncologist and Advanced Laparoscopic Surgeon at the BGS Global Hospitals, Bangalore. He had earlier served as Head of Surgical Gastroenterology services at St. John’s Medical College Hospital, Bangalore for almost 3 years. 

What is Colorectal Cancer?

Colorectal cancer is a cancer that starts in the colon or the rectum. These cancers can also be named colon cancer or rectal cancer, depending on where they start. Colon cancer and rectal cancer are often grouped together because they have many features in common. 

Symptoms of Colorectal Cancer

Colorectal cancer is often a silent disease, developing with no symptoms at all. When symptoms do occur they may include the following

Blood in or on the stool

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Change in bowel habits

Rectal bleeding

General Stomach Discomfort

Vomiting

Frequent Gas Pains

If you have any of these symptoms for more than two weeks, see your doctor or health professional immediately.  While not everyone who has these symptoms will have colon cancer, persistance of these is not normal and requires additional investigation to determine the underlying cause.

How does Colorectal Cancer start?

Polyps in the colon or rectum: Most colorectal cancers start as a growthon the inner lining of the colon or rectum. These growths are calledpolyps. 

Some types of polyps can change into cancer over time (usually many years), but not all polyps become cancer. The chance of a polyp changing into cancer depends on the type of polyp it is. The 2 main types of polyps are: 

  • Adenomatous polyps (adenomas):These polyps sometimes change into cancer. Because of this, adenomas are called apre-cancerous condition. 
  • Hyperplastic polyps and inflammatory polyps:These polyps are more common, but in general they are not pre-cancerous. 

How Colorectal Cancer spreads?

If cancer forms in a polyp, it can grow into the wall of the colon or rectum over time. The wall of the colon and rectum is made up of many layers. Colorectal cancer starts in the innermost layer (the mucosa) and can grow outward through some or all of the other layers. When cancer cells are in the wall, they can then grow into blood vessels or lymph vessels (tiny channels that carry away waste and fluid). From there, they can travel to nearby lymph nodes or to distant parts of the body. 

Surgery for Colon Cancer

Polypectomy and local excision 

Some early colon cancers (stage 0 and some early stage I tumors) and most polyps can be removed during a colonoscopy. This is a procedure that uses a long flexible tube with a small video camera on the end that’s put into the person’s rectum and threaded into the colon. These surgeries can be done during a colonoscopy:  

  • For apolypectomy, the cancer is removed as part of the polyp, which is cut at its stalk (the part that looks like the stem of a mushroom). This is usually done by passing a wire loop through the colonoscope to cut the polyp off the wall of the colon with an electric current. 
  • Alocal excisionis a slightly more involved procedure. Tools are used through the colonoscope to remove small cancers on the inside lining of the colon along with a small amount of surrounding healthy tissue on the wall of colon. 

Colectomy

A colectomy is surgery to remove all or part of the colon. Nearby lymph nodesare also removed. 

  • If only part of the colon is removed, it’s called ahemicolectomy, partial colectomy, orsegmental resection. The surgeon takes out the part of the colon with the cancer and a small segment of normal colon on either side. Usually, about one-fourth to one-third of the colon is removed, depending on the size and location of the cancer. The remaining sections of colon are then reattached. At least 12 nearby lymph nodes are also removed so they can be checked for cancer. 
  • If all of the colon is removed, it’s called atotal colectomy. Total colectomy isn’t often needed to treat colon cancer. It’s mostly used only if there’s another problem in the part of the colon without cancer, such as hundreds of polyps (in someone withfamilial adenomatous polyposis) or, sometimes, inflammatory bowel disease. 

Colostomy & Ileostomy

When cancer blocks the colon, it usually happens slowly and the person can become very sick over time. In cases like this, a stent may be placed before surgery is done. Astent is a hollow metal or plastic tube that the doctor can put inside the colon and through the blockage using a colonoscope. This tube to keeps the colon open and relieves the blockage to help you prepare for surgery. 

If a stent can’t be placed in a blocked colon or if the tumor has caused a hole in the colon, surgery may be needed right away. This usually is the same type of colectomy that’s done to remove the cancer, but instead of reconnecting the ends of the colon, the top end of the colon is attached to an opening (called a stoma) made in the skin of the abdomen. Stool then comes out this opening. This is called acolostomyand is usually only needed for a short time. Sometimes the end of the small intestine (the ileum) instead of the colon is connected to a stoma in the skin. This is called anileostomy. Either way, a bag sticks to the skin around the stoma to hold the waste. 

Once the patient is healthier, another operation (known as acolostomy reversal or ileostomy reversal) can be done to put the ends of the colon back together or to attach the ileum to the colon. Rarely, if a tumor can’t be removed or a stent placed, the colostomy or ileostomy may need to be permanent. 

Colorectal Cancer FAQ's

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Ask the Doctor

PreOp-Instructions

  • ON THE DAY BEFORE SURGERY
    Proceed with normal activities, normal diet & Shower
  • AFTER MIDNIGHT BEFORE THE DAY OF SURGERY
    Do not eat or drink anything, including water, candy, gum, mints, Brushing teeth is okay
  • ON THE DAY OF SURGERY
    Do not eat or drink anything Brushing teeth is okay Shower if you did not shower the night before
  • These are typical instructions. Your instructions by your surgeon or doctor may vary.

These are typical instructions. Your instructions by your surgeon or doctor may vary.

PostOp-Instructions

  • ON THE DAY BEFORE SURGERY
    Proceed with normal activities, normal diet & Shower
  • AFTER MIDNIGHT BEFORE THE DAY OF SURGERY
    Do not eat or drink anything, including water, candy, gum, mints, Brushing teeth is okay
  • ON THE DAY OF SURGERY
    Do not eat or drink anything Brushing teeth is okay Shower if you did not shower the night before
  • These are typical instructions. Your instructions by your surgeon or doctor may vary.

These are typical instructions. Your instructions by your surgeon or doctor may vary.

Key Benefits of Laparoscopic / Robotics Surgery

Key Hole Surgery

No Bigger Cuts

Shorter Hospital Stay

Safe & Stress Free Surgery

Short Stay Surgery

Dedicated Doctors

Best-in-Class Process for Best-in-Class Patient Experience

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Consulting

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Surgery

Post-Surgery Counselling

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Dr. Manish Joshi is the Best Gastrointestinal surgeon in Bangalore & India. He is an expert in Advanced Laparoscopic & Robotic Surgical Techniques. His motto is ‘Patient comes first” View Profile.

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Dr Manish Joshi conducts consultation at below locations

BGS Gleneagles Global Hospitals

Apollo Clinic

  • Consulting : 06:00 PM – 07:00 PM (Tues/Thur/Sat)
  • 673/A, Opp. Shriram Samruddhi , Varthur Road, Kundalahalli gate signal, Bengaluru, Karnataka 560066
  • www.apolloclinic.com

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