What is Colorectal Cancer?

Cancers that start in the cells that line the inside of the colon (the longest part of the large intestine) and rectum (the last few inches of the large intestine before the anus) are called colorectal cancers. The colon and rectum form the large intestine (large bowel), which is the last portion of the digestive system. The digestive system, which is made up of the esophagus, stomach, and small and large intestines, extracts and processes nutrients (vitamins, minerals, carbohydrates, fats and proteins) from food and helps pass waste material out of the body. The important news about colorectal cancer is that it usually starts from a pre-cancerous growth called a polyp and grows slowly, usually in a predictable way. It therefore can be preventable with screening, and when diagnosed at an early stage, it is often curable.

Stages of Colorectal Cancer

Once a cancer diagnosis is made, the cancer will be described by a stage and grade. Colorectal cancer staging describes the size of the tumour, how far it has grown into the colon or rectum wall, and whether the cancer has spread to lymph nodes or other places in the body past the place where it began to grow. Colorectal cancer has fi ve stages:

Stage 0 – Cancer cells are located only in the inner lining of the colon or rectum. Typically, this is confi ned to the surface of a polyp (a growth that protrudes from a mucous membrane). It is also known as carcinoma in situ.

Stage 1 – Cancer cells have spread from the inner lining into the middle layers of the muscular wall of the colon or rectum.

Stage 2 – Cancer has spread to the outside surface of the colon or rectum, and may involve nearby tissues but not the lymph nodes.

Stage 3 – Cancer involves the nearby lymph nodes.

Stage 4 – Cancer has spread to other distant parts of the body, such as the liver or lungs.

In addition to the cancer stage, it is also useful to determine the grade of the cancer. To determine the grade of a tumour, a biopsy sample is examined under a microscope. Comparing the cancer cells look and behaviour to normal cells will enable a determination of the grade and help enable your doctor to estimate how quickly the cancer may be growing. Colorectal cancer has three grades:

Grade 1 or Low grade – typically means that cancer is slow growing, also known as well differentiated.

Grade 2 or Moderate grade – also known as intermediate differentiation.

Grade 3 or High grade – means that cancer is faster growing, also known as poorly differentiated.

What is the Colon cancer treatment in bangalore ?

Your treatment will depend on your general health as well as the type, stage and grade of the cancer. For colorectal cancer, your treatment may include a combination of surgery, radiation therapy, chemotherapy and biological therapy. Working together with your healthcare team, you will decide what treatments will be best for you. You may be invited to take part in a clinical trial to test newer treatment options or combinations. Treatment for colorectal cancer includes one or more of the following: Surgery Surgery is the main treatment for colorectal cancer. Surgery is used to cure the cancer in the early stages by completely removing the tumour and tissues affected by it. It’s occasionally possible that surgery may also be offered to people whose tumours have returned in the pelvis or spread to the liver or the lungs.Colon cancer treatment in bangalore For people with disease that cannot be removed in total, surgery may be offered to help relieve the symptoms of cancer. The size of the tumour and its location (where it is in the intestine) will determine which surgery is right for you. Different surgical procedures are used to remove tumours depending on their size, location, how far they have grown into the wall of the colon or rectum, and the amount of colon or rectum that needs to be removed. For removal of small early cancers such as cancerous polyps, a tube (or scope) is inserted through the rectum, while for larger tumours removal of the part of the intestine containing the cancer is usually necessary. If a part of the intestine is removed, the remaining healthy parts of the intestine are sewn together. If this can’t be done immediately, a temporary colostomy may be performed where an opening will be made in the abdomen and the colon will be pulled through this opening to the outside of the body. This will help the body pass the waste directly from the colon through the opening in the skin and into a bag, which can be emptied regularly. Because every patient is different,for some a colostomy may be permanent while for others it may only be needed until the operation site heals and after about 2-3 months the colostomy can be removed (or reversed). Your healthcare professional team will teach you how to manage a colostomy and allow you to continue to participate in everyday activities. For some patients with colorectal cancer that has spread only to the liver, specialized surgery may be an option to remove liver metastases if they are small or few in number.

Radiation therapy for rectal cancer (also called radiotherapy)

During radiation therapy, high doses of a special type of energy (radiation) are aimed at the area where the cancer is growing and destroys cells, making it impossible for them to grow and divide. Radiation therapy destroys cancer cells, which grow uncontrollably, but it also can damage healthy cells nearby. The good news is that healthy cells are able to repair themselves after the therapy is complete. There are two types of radiation therapy that can be used: external beam radiation therapy and occasionally brachytherapy. In external beam radiation, the beam of radiation is directed at the tumour. In brachytherapy, radioactive material is placed inside the tumour, making it possible to treat the cancer in a very focused manner. Radiation therapy is more commonly used to treat rectal cancer. It is rarely used for colon cancer because the colon is quite mobile and cancers, even when on the surface, tend to push away from nearby structures and the local risk of contamination by the cancer is low. The small intestine is also nearby and it further limits the sorts of radiation dosage that might be necessary. The opposite is however true for the rectum, where local spread can readily contaminate the side-wall of the pelvis and in addition the small intestine is at a safe distance. This means the radiation oncologist can deliver high doses of the cancerkilling radiation more safely for rectal cancers either before or after surgery. It is following the detailed pathology analysis of rectal cancers that a decision about the need for radiation is usually reached. Side effects that may be experienced after radiation are a feeling of being more tired than usual, occasionally diarrhea, and perhaps changes to the skin such as redness.Colon cancer treatment in bangalore.

Chemotherapy

Chemotherapy Commonly drugs are used to treat the different stages of colorectal cancer. Chemotherapy is the use of anti-cancer medicines (chemotherapy drugs) that are typically given by injection, or sometimes as pills, to destroy cancer cells. First, a word about how these drugs are named. When a drug’s name is shown beginning with an upper case letter (such as Eloxatin®) this is the name chosen by the manufacturer. Eloxatin is also known as oxaliplatin, spelled in lower case. This is known as the drug’s generic name, which is the version of the drug’s name that is, for example, more often used by doctors. Colon cancer treatment in bangalore.