Dr Deepak Varma Gastro Surgeon Cochin

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Colorectal Cancer

The colon and the rectum constitute the lower parts of the digestive system. Colorectal cancer starts either in the colon or in the rectum. As food passes through the small intestine into the large intestine or colon, it absorbs water and releases waste matter or stool into the rectum. The beginning of the growth of colorectal cancer is usually in the form of a polyp. Starting benign, they turn cancerous over a period of time. Generally, colorectal cancers develop in mucosal cells of the colon and the rectum and are known as adenocarcinomas.

 treatment for colorectal cancer

Causes and risk factors

  • FAP or familial adenomatous polyposis

  • HNPCC or hereditary non-polyposis colon cancer

  • Previous incidences of colorectal cancer

  • Already existing polyps

  • History of ulcerative colitis

  • Crohn s disease

  • Family history or genetics

  • Diets containing red meat and processed meat

  • Cooking at a high flame like frying, deep frying, boiling etc generate harmful chemicals that increase the risk of colon cancer

  • Lack of physical activity and exercise

  • Alcohol abuse

  • Smoking

Signs and symptoms

  • Early stages of the disease show no symptoms.

  • Diarrhea

  • Constipation

  • Rectal bleeding or bloody stools

  • Abdominal discomforts cramps, gas formations, pain etc.

  • Fatigue

  • Unexplained weight loss and anemia

  • Recent change in bowel habits


  • Screening tests:

    • Sigmoidoscopy: To check for polyps and cancer

    • Colonoscopy: a flexible tube inserted into the body to examine the entire colon and rectum

    • CT colonography: Also known as virtual colonoscopy to scan the colon and rectum (done in special situations)

  • Both tests are done to check stool for any signs of blood indicating the presence of cancer or polyp

    • FOBT or faecal occult blood test

    • FIT or faecal immunochemical test


Surgery is the only mode of treatment for colorectal cancer. The different types of surgery performed are colectomy, low anterior resection, proctectomy and segmental resection. A colostomy is performed for cancers growing through the rectal wall and involves the muscles which control the passage of stool. Key hole surgery for colon and rectal cancer has advantages in the form of early recovery, early return to work, less pain and cosmesis, without affecting long-term results on cancer survival.

We recommend earlier screenings if risk factors are high and perform keyhole surgery for colon and rectal cancer to give a comprehensive care to the patients.

Authored by Dr. Deepak Varma, MBBS, MS (General Surgery)

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