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Dr. Indranil Ghosh

Colorectal cancer, as the name suggests, arises from the colon or rectum, which are parts of our large intestine. It is the 3rd most common cancer in the world, occurring in more than 1,700,000 people every year.

India is generally considered a low-incidence area for colorectal cancer. Close to 60,000 new cases occur every year in India. But, still, it is within the top 10 types of cancer in both males and females. The incidence is also increasing every year.

Some risk factors are being overweight and not having enough physical activity, smoking, moderate to high alcohol usage, a diet high in red meat or processed meat, having strong family history or genetic syndrome, and having ulcerative colitis or Crohn’s disease.

While risk factors such as being overweight and smoking are modifiable, genetics is non-modifiable. Therefore, we offer genetic screening or screening by colonoscopy for early detection of the disease. For others, symptoms such as a recent change in bowel habits, bleeding in stools, unexplained weight loss or anemia, and persistent abdominal pain should be investigated without delay.

A colonoscopy with biopsy is required to establish the diagnosis. Once the diagnosis is confirmed, staging investigations such as CT/PET-CT scans are done. Treatment is usually decided in multidisciplinary discussions.

Colorectal cancer in stage I-II is usually curable with surgery and sometimes with added chemotherapy. However, in stage III, the disease is more advanced and there is higher risk of it coming back. So, chemotherapy is usually administered after surgery. In locally advanced rectal cancer, radiotherapy is also an important tool. In stage IV, unfortunately, the disease is not curable. But survival has improved in recent times with chemotherapy and targeted therapy. Immunotherapy has also shown promise in a subset of these patients. Support from family members and friends is essential for the patient to go through the treatment journey successfully.

This article has been written by Dr.Indranil Ghosh, MD(AIIMS), DM Medical Oncology(AIIMS), Consultant at Department of Medical Oncology of Apollo Gleneagles Hospitals, Kolkata.