Dr Mayank M Madan
New Delhi: Cancer in all its forms is rising worldwide, including in India. Though the prevalence of colorectal cancer in India is lower than the western countries, it is still the seventh leading cause of mortality. As per the recent data provided by the Globacan India 2018, over 27000 new cases were registered last year with a mortality of around 20000 patients. It is also estimated that the number of patients living with this condition is over 50000 people.
Colon and rectum which constitute the lower part of the digestive system, are parts of lower intestines, that aid in absorbing water from the stools and storing the stools until bowel movement respectively. Development of precancerous polyps originating from the colon or rectum (that usually have the common symptoms) leads to the development of colorectal cancer. Until now, colon cancer used to be a disease that affected people in their 50’s. But in the recent decade, there is a sharp increase in the number of cases among the younger population. It is surprising to see that almost 35% of the patients suffering from colon or rectal cancer or colorectal cancer are diagnosed under the age of 40 years.
Timely diagnosis is highly important in deciding the due course of the treatment. Many cancers, like, cancer of the colon and rectum have been extensively researched, and therefore, these can be treated well if diagnosed on time. In fact, cancer of colon is considered to be the third most common cancer diagnosed both in men and women. Ideally, screening for colon cancer should begin at the age of 40 in healthy adults, but due to poor lifestyle habits among the youngsters, it is quite likely to strike early. With extensive surveillance, early detection and prompt treatment coupled with a few lifestyle changes like, maintaining ideal body weight and consuming high fiber content, the incidence of colon cancer can be controlled.
Symptoms like fatigue, weakness, change in bowel habits, diarrhea or constipation, blood stains in stool, sudden weight loss accompanied by abdominal cramps and bloating should never be ignored. Though the symptoms may be an indication of other digestive disorders, it is advisable to rule out the possibilities of colon cancer at the earliest.
Major Risk Factors
What are the major risk factors for developing colorectal cancer?
Apart from being genetic (which may only have 15-20% chances of affecting the next generation), poor lifestyle habits are the major contributing factors that increase the risk of developing colon cancer up to three times higher.
Poor Diet: Many studies are suggestive of the fact that regular consumption of diet low in fiber and high in fat are attributing to the rise in colon cancer cases. With the growing western influence, Indian corporate and young professionals, eat diet which is low in fiber and high in fat and calories. Also, the risk doubles in people who eat diets high in red meat and processed meat.
Physical Inactivity: Everyone is advised to devote at least 5-6 hours a week for exercise, or any kind of physical activities. Lack of exercise is a big risk factor for developing colon cancer. A poor, inactive and a sedentary lifestyle makes you highly vulnerable to colon cancer.
Lifestyle Disorders: Obesity and diabetes not only raise the chances of developing colon cancer but in comparison to person with normal weight, patients with higher BMI or being insulin resistance also have increased risk of mortality due to colon cancer.
Smoking and Binge Drinking: Alcoholics and chain smokers have an elevated risk of colon cancer. Most of the Indian youth in the age bracket of 25-35 years of age, are addicted to smoking or alcoholism. Smoking cessation and restricting alcohol intake reduce the chances of colon cancer greatly.
How is it Treated?
Early detection is very important to cure colon cancer. Because of modern targeted management including judiciously planned surgery and Chemo and radiotherapy the outlook for such cancers have changed significantly,
Surgical Intervention – Different types of treatment are available for patients with colon cancer depending on the stage of the cancer, whether cancer has recurred and patient’s health and age, etc. Surgery is the most common treatment for all stages of colon cancer. In ideal situations, where the cancer is found at a very early stage, a doctor can remove the tumor with a colonoscope. Most of the time however, colon surgery is required. Also, depending on age and health of a patient, a laparoscopic colectomy can be done to eliminate the colon cancer. It surely avoids a big incision on the abdomen and allows early recovery from operation and an early return to work for young patients.
The colon is so frequently taken for granted that it is causing problems to untold number of people, especially the younger generations. Lifestyle and diet definitely play an important role. Like heart, liver and kidney, colon deserves a lot more attention than it gets in our modern day world.
(Dr Mayank M Madan, GI & Bariatric Surgeon, CK Birla Hospital for Women, Gurugram)