Dr Deepak Varma Gastro Surgeon Cochin

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Large Intestine And Rectal Cancer

Large intestine cancer is also known as colon cancer. It is one of the most common gastrointestinal cancers. Surgery is the only treatment for potential cure available for colon cancer. It is caused due to multiple factors such as genetics, inappropriate diet, and inflammation of the digestive tract. HNPCC and Lynch’s syndrome are also known to cause large intestine cancer. A diet high in animal fat and red meat, low intake of fruits and fibre all predispose to large intestine cancer. Obesity and lifestyle choices play a significant role in the risk and development of the disease. Alcohol consumption, cigarette smoking and sedentary life habits are all contributing factors to colon cancer.

treatment for rectal cancer.

  • Diagnosis of colon cancer is made by doing a colonoscopy. Biopsies also can be taken to prove malignancy. Once cancer is proven, further staging is done by CT scan and PET CT (in selected cases). CEA levels are determined to aid for follow up of the patient.
  • All non-metastatic colon cancer patients should undergo surgical removal of the affected portion of the colon. Even if the disease has spread to other parts of the body, palliative surgery may be required in certain special situations like bleeding and obstruction.
  • Depending on the site of cancer, right or left colectomies are done. Most of the colectomies are done through laparoscopy (keyhole surgery). This gives better results compared to open surgery in terms of postoperative recovery without compromising long-term results. In certain patients who suffer from familial colon cancer, it may become necessary to remove the entire colon. This is called total colectomy, which can also be done through keyhole surgery.

Rectal Cancer

Cancer forms in the tissues of the rectum leading to rectal cancer. The signs and symptoms of rectal cancer include:

  • Bleeding
  • Incomplete stool evacuation or tenesmus
  • Changes in calibre of stool
  • Change in bowel habits
  • Back pain due to the invasion of tumour or compression of nerve trunks

Patients suspected of rectal cancer should also undergo colonoscopy to detect any other synchronous tumors in the rest of the large intestine. After proving the disease with biopsies, the further treatment depends on the stage of the disease. CT scan of the abdomen and pelvis is mandatory to stage the disease. In special cases, MRI scan is done to stage the disease.

If the tumor is large, the patient might require radiation therapy to cause shrinkage of tumor. Later, after completion of radiation therapy, surgical removal is done after 6 to 8 weeks. Rectal surgeries are nowadays done through keyhole surgery with a very high success rate. By this, the part of the rectum affected by the disease is removed and the remaining part is joined to the large intestine using special staplers.

In certain situations, the patient might need to undergo postoperative chemotherapy, depending on the stage of the disease. However, surgical removal is the only curative option for rectal cancers.

We give high considerations to intent and aim of surgery and its functional outcome. With a vast experience in keyhole surgery, he has successfully treated colorectal cancer patients in great numbers with minimal morbidity to the patient.

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

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