By Dr. Parameshwara C.M
Every year, the cancer burden on India increases by approximately one million, almost 75% of which are detected in their advanced stage, thereby reducing the patient’s odds of survival!
In a report by WHO, China and the USA held the topmost positions in terms of the occurrence of new cancer cases, followed by India. However, quite alarmingly, in India, the rate of cancer-caused deaths was on the higher side. This is due to a lack of early detection and an inadequate understanding of various treatment options and cancer care. In India, the rate of incidence of colorectal cancer is almost 6 per 100,000, making it one of the fastest-growing cancers in the country.
Colorectal Carcinoma or cancer refers to the development of cancerous cells in the colon or rectum. They usually originate as polyps, which are benign pockets of cells in the inner lining of the rectum and colon, and then slowly develop into cancerous cells over a period of time. Due to its symptoms being identical to common ailments such as piles and stomach infections, it often remains undetected until the last stage.
Cancer has evolved to be one of the most common causes of mortality worldwide, however, early diagnosis helps in providing a better quality of life for most people diagnosed with the disease. It is of paramount importance to get ourselves screened at suitable intervals to arrest the disease at an early stage. In order to mitigate the challenge of the rising burden of cancer in India, increased focus should be given to prevention, early detection, and increasing awareness among the general public.
Early symptoms to watch out for:
One of the most common symptoms faced by individuals with colorectal cancer is a recent change in bowel movements, such as persistent diarrhoea or constipation. Other symptoms include bleeding from the rectum, abdominal discomfort such as pain or cramps, gas formation, and a persistent feeling of incomplete bowel passing. Colorectal cancer symptoms are quite similar to those of temporary lifestyle diseases such as fatigue, unexplained weight loss, appetite loss, bloating, and many more, which makes detection at an early stage very difficult. When the symptoms arise, the polyps might have already turned cancerous.
Early detection is the key
Colorectal cancer affects a much younger population in India than it does in the West. While mostly people in the age bracket of 40–46 get inflicted with this cancer, alarmingly, the survival rate from colorectal cancer in India is as low as 30% compared to other countries, which have around a 60–70% rate of survival. One of the most significant reasons for such a low survival rate in India is the lack of early detection. People often fear the worst outcome and are reluctant to get tested. There are other socio-economic factors present, too, which deter the incidence of early screening. Early detection can help in the removal of the polyps before they turn cancerous. This prevents the disease from turning into cancer and spreading. However, according to studies, colorectal cancer has the best prognosis among other digestive cancers due to the availability of multidisciplinary treatment plans. While it can be easily misunderstood as a passing discomfort, early diagnosis will give one the best chance to have the best clinical outcome with modern, improved treatment options. Detection methods usually comprise the following:
- Physical examinations such as digital rectal examination
- Blood tests like CBC, Liver and Kidney function tests, Carcinoembryonic Antigen (CEA) tests and many more as deemed fit by the physician
- Colonoscopy where a scope is inserted in the large intestine to image any polyp or other abnormality
- Biopsy to confirm the presence of cancerous cells
- A scan of the abdomen to see the extent of the disease
Risk factors to be aware of
The risk factors can be classified into two categories: genetic and environmental. Genetic factors usually include a family history of colorectal cancer, HNPCC (Lynch syndrome), familial adenomatous polyposis (FAP), and MYH-associated polyposis. Environmental factors such as an unhealthy lifestyle, alcohol consumption, obesity, cigarette smoking, and the presence of ulcerative colitis and diabetes mellitus affect the occurrence of colorectal cancer to a great extent.
Hence, making lifestyle changes such as switching to an active lifestyle from a sedentary lifestyle, quitting alcohol and smoking, and consuming a balanced, fibre-rich diet helps prevent the incidence of this digestive cancer.
If you have the genetic factors present and a history of colorectal cancer in the family, it is extremely important to go for regular screening that would aid in early discovery, thereby enabling doctors to choose the best course of treatment.
Treatment protocols to be followed
Treatment metrics are usually dependent on the stage at which the disease is detected. Early stages of the cancer enable the physician to explore myriad options in contrary to last-stage discovery. Stages 1 and 2 can be mitigated via surgery, whereas stages 3 and 4 would require extensive chemotherapy as well as surgery.
If colorectal cancer gets detected at an early stage, the doctors might consider local excision, which is the surgical removal of a small portion of the lining of the colon or rectal wall where the polyp is present. However, a colectomy or total meso-rectal excision is done if the cancer has spread to the area around the colon or rectum. Other forms of treatment include open, laparoscopic, or robotic-assisted colectomy, wherein affected portions of the colon are removed using the above methods.
Precautions you can take
While the disease can come knocking at your door unannounced, it is important to incorporate a few precautionary measures to mitigate the effects of cancer. While men have a higher rate of getting diagnosed with colorectal cancer, women get affected too. It has been deemed the 5th most common cancer in India, affecting a large number of the younger generation. Hence, a few lifestyle changes along with regular screening can not only help in early detection but also give you the best chance of survival. Please visit the nearest hospital at the earliest if you get the preliminary symptoms such as blood in the stool, bloating, a regular feeling of gas formation, and the rest.
(The author is a Honorary Professor of Surgery, Surgical Gastroenterologist, Chief Colorectal Surgeon, AYU Health Hospitals. The article is for informational purposes only. Please consult medical experts and health professionals before starting any therapy, medication and/or remedy. Views expressed are personal and do not reflect the official position or policy of the FinancialExpress.com.)