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What is colorectal cancer?

Colorectal cancer is cancer that affects the large intestine (colon) and rectum (back passage).


It is the second leading cause of death from cancer in US and UK. But in India, colorectal cancer has been ranked 5th biggest killer. As compared to the western world although we are having a lower incidence of colorectal cancer, our patients are presents late with advanced disease.



WHAT ARE THE SYMPTOMS OF COLORECTAL CANCER?


Most of early stage colorectal cancer has no symptoms at all and are detected during routine screening examinations. The most common symptom of colorectal cancer is a change in bowel habits.


Other symptoms of colorectal cancer includes:

  • Having alternate diarrhea or constipation

  • Feeling that your bowel does not empty completely

  • Finding blood (either bright red or very dark) in your stool

  • Frequently having gas, pains or cramps, or feeling full or bloated

  • Losing weight with no known reason

  • Fatigue, generalized weakness and anemia

  • Presence of perianal pain and swelling.

Usually, early cancer does not cause pain. It is important not to wait to feel pain before seeing a doctor.



WHAT ARE THE RISK FACTORS FOR COLORECTAL CANCER?


Risk factors are


  • Familial History of colorectal cancer. First-degree relatives (parents, brothers, sisters, or children) of a person with a history of colorectal cancer are somewhat more risk to develop. If several close relatives have a history of colorectal cancer, the risk is even greater. This is because of genetic alteration.

  • Environmental factors such as diet and life style, mainly high fat morered and refined meat and low fibre. Increased sugar, Decreased Calcium, Decreased Garlic, Pulses and non-stachy Vegetables and long history of constipation.

  • Obesity - 50 to 80% more likely in obese people.

  • Older age more than 50years: More than 90% of people with this disease are diagnosed after age 50. But now day’s younger age also presenting with colorectal cancer developing more aggressive form.

  • Chronic smoking and alcohol consumption: increased risk of developing polyps and colorectal cancer.

  • Known case of ulcerative colitis and Chon’s disease



WHY ONE SHOULD BE SCREENED FOR COLORECTAL CANCER?


Early stage colorectal cancer presents without any symptoms. The good news about colorectal cancer is majority of cancer arises from pre-existing polyps, which are a non-cancerous. This polyp exists in the colon for many years before they turn to cancer. Thus if you develop colonic polyp and they are removed early, it decrease the risk for development of cancer. Even if polyp turns into cancer, if diagnosed in the early stage it is definitely curable through keyhole surgery.



HOW DO I GET CHECKED FOR COLORECTAL CANCER?


We would advise a normal person without risk to do colonoscopy starting at age of 50 and to repeat every 5 years. This will reduce risk. According to Dr. Jankar, gastroenterologist in Pune, "too high-risk person such as, familial cancer history or having IBD we recommend to do colonoscopy from the age of 40 years or ten years before they reach age of their family member who developed cancer." Unfortunately in India less than 5% of adults are screened for colorectal cancer.



Having colorectal cancer, what next?

Don’t worry in the present era, colorectal cancer is 100% treatable if managed properly. Colorectal cancer can be cured if it is removed from the body before it spreads to other organs;

  • Polyp can be cured with colonoscopy without any surgery.

  • Early stage cancer can be cured with keyhole surgery.

  • Metastatic disease with spread to the liver can be managed very well with newer drugs followed by keyhole surgery.

Thanks to advancement in medical technology. Keyhole surgery can be performed and stoma can be prevented 90% cases..

CAN COLORECTAL CANCER BE PREVENTED?


Yes! Colorectal cancer can be preventable. Having a healthy high fiber diet, doing regular exercise at least 45 min and regular screening for cancer whenever indicated can keep you away from colorecatal cancer. A few small changes can make a big difference:

To conclude we can say that sensible modification of diet and life style will decrease 70% risk of colorectal cancer. If you are 50 years or more call your doctor today to schedule a colonoscopy.

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