Colon & Rectal Cancer

There are a lot of overlapping points in colon and rectal cancers, for example risk factors, screening and a large part of treatment is also similar.

 

Question.  You mentioned on another page that screening is useful in 5 cancers, out of which one was colon .Can you elaborate on it? 

Answer. Colon cancer is the third most common cancer, but on the bright side, the impact of screening is highest in colorectal Cancer.

Five types of tests are available: 

-Fecal occult blood test

-Sigmoidoscopy 

-Colonoscopy

-Some centres are equipped with virtual Colonoscopy based on CT findings

-DNA stool test. 

DNA stool test does not get affected with the food intake or iron intake and is more sensitive. Previous concept of digital rectal examination is now obsolete, as it does not prevent number of deaths.

 

Question.  I have understood from your other web pages that Staging and typing is most important for cancer management. Is the colon cancer Staging also similar?

Answer.  Partially yes,  Staging of colon cancer also requires a CT scan or PET CT scan with biopsy. Biopsy can be done from colonoscopic procedure or any distant lymph nodes. Routine blood tests for colon cancer also include CEA also known as carcinoembryonic antigen.

 

Question.  Is there a way I can reduce the amount of chemotherapy to be taken?

Answer.  For stage two cancer we have certain clinical & surgical essays which can determine if it is low risk or high risk. As per latest recommendations, for low risk stage 2 colon cancers, four months of postoperative chemotherapy is considered enough.  Earlier 6 months was considered compulsory.

 

Question. What are the risk factors for colorectal cancer?

Answer.  Important risk factors for colorectal cancers are

-Inflammatory bowel disease like chronic ulcerative colitis or crohn's disease 

-Obesity  

-Other genetic syndromes like lynch syndrome is common among colon and rectal cancer

 

Question.  Are the signs of rectal cancer different from colon cancer?

Answer.  Usually in rectal Cancer if blood comes in the stool it is of red colour and patient develops constipation more than diarrhoea with the feeling of incomplete passage of stools. Stools might be of unusual shape or narrower at one end. 

 

Question.  Is the Staging workup same as colon cancer?

Answer.   Yes, Staging workup is more or less similar. We need Colonoscopy  biopsy with whole body CT scan or whole body PET CT scan.

 

Question.   How is the treatment of colon cancer different from rectal cancer?

Answer.  In rectal cancer the role of radiation is very important, while In colon cancer we do not offer radiation.