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Dr. Mohit Agarwal

Colorectal cancer is the third most common cancer in the world and sixth most in India. It is more common in developed countries. The risk factors include physical inactivity, a poor diet, and smoking or drinking. Although colorectal cancer generally occurs in people older than 50 years, it can affect young people too.

Symptoms

  1. A change in bowel habits lasting for more than 4 weeks
  2. Blood in stool
  3. Persistent abdominal cramps
  4. Weakness or fatigue
  5. Unexplained weight loss

Diagnosis

Specific tests for diagnosis involve:

  1. CEA (Carcinoembryonic Antigen), a tumour marker secreted by colorectal cancer. However, this cannot alone be used for diagnosis, as it might be normal in patients while maybe raised non-specifically in non-cancerous conditions.
  2. Proctoscopy/colonoscopy- looking inside the lumen of rectum or large intestine through scope.
  3. Biopsy- obtaining a tissue for diagnosis is necessary to prove cancer. It additionally helps us to do some molecular tests to see if the cancer is genetic in case of the patient.
  4. Imaging tests like CT scan, PET scan, and X-ray are required for staging.

Treatment

In early stages, the tumour is removed through surgery. Sometimes, if the tumour cannot be resected up front, chemotherapy is given to downsize the tumour, followed by surgery. In addition, radiotherapy is generally used along with chemotherapy in treatment of rectal cancer. Patient in both early and advanced stages can be cured of the disease by using these modalities.

Contrary to the popular belief that chemotherapy makes a patient bed-ridden, it actually helps improve his quality of life. Also, now we have options of targeted and immunotherapy for such patients as per the molecular profile. Targeted therapy identifies cancer cells and specifically kills them. Immunotherapy modulates the body’s own immunity to kill cancer cells. These drugs are exciting new treatment options.

Prevention

  1. Exercise regularly
  2. Avoid alcohol
  3. Limit intake of red and processed meats
  4. Eat more vegetables and fruits
  5. Avoid smoking
  6. Screening

People between ages 45 and 50 should be screened for colorectal cancer. This can be done either through a stool-based test or colonoscopy.

This article has been authored by Dr. Mohit Agarwal, Consultant & Unit Head, Medical Oncology, Fortis Hospital, Shalimar Bagh, Delhi.