Why you should be wary of abdominal discomfort, altered bowel habits
Colorectal cancer (CRC) is the 3rd most common cancer worldwide after breast and lung cancer. It is 3rd most commonly diagnosed cancer in males and the 2nd most in females, with more than 1.4 million new cancer cases every year.
The geographical distribution patterns show that the incidence of CRC in India is subjacent compared to the rest of the world. It ranks as the 7th most common cancer in India and 4th most common cancer in males. However, the absolute number of cases is very high in view of the mountainous Indian population. Also, interestingly, the incidence of CRC is very high in the younger population (<40 years).
Five-year (long-term) survival of colorectal cancer in India is one of the lowest in the world at less than 40%. This may be a reflection of late stage at presentation, lack of awareness in patients about the symptoms, and inadequate resources to deal with this disease in many parts of the country, especially semi-urban and rural areas.
Colorectal cancers can have genetic predisposition; 3-4 % of all CRC have heredity to blame, while the rest can be associated with diet, inactive lifestyle, smoking, alcohol intake, increasing age (>45yrs), obesity, diabetes. Consumption of red meat cooked at very high temperatures is emerging as a very common cause, while diets rich in high fibres, fruits and vegetables may prove to be protective for CRC.
The most common symptoms of colorectal cancer are abdominal discomfort and altered bowel habits (constipation or diarrhoea), which, unfortunately, most of us tend to ignore. Over-the-counter medicines and inadequate community level medical services add to a delay in diagnosis. These factors lead to the diagnosis of CRC at advanced and incurable stage. Alarming symptoms in advanced stage could include excessive bleeding in stool, loss of weight and loss of appetite, cough and haemoptysis and jaundice.
Awareness about the risk factors and symptoms and the need to seek early medical help would drastically increase diagnosis of early-stage disease, which may be curable.
Once a patient is suspected of having CRC, he/she will have to undergo investigative procedures such as colonoscopies, CT scans or MRI scans, biopsy, occasionally PET-CT scans, tumor markers in the blood and routine blood tests. Based on the results, the diagnosis is confirmed and treatment plans are made.
The treatment options in CRC consist of surgery and chemotherapy. Traditionally, an advanced stage at presentation was a death knell. But with recent advances in surgical techniques and with the introduction of modern targeted therapies, even advanced-stage CRC are curable.
Know more about colorectal cancer here.
This article has been written by Dr. Udip Maheshwari, Consultant Medical Oncologist, Mumbai Oncocare Centre, Sion.