Colorectal Cancer Treatment in Delhi, India

Overview

Colorectal cancer (CRC) is a type of cancer that develops in the colon or rectum. Colon (large intestine) starts in the right side of the abdomen after the last part of the small intestine (ileum) and ends at the junction with the rectum. The rectum is the last part of the intestine, and it ends in the anal canal. Colorectal cancer is the 3rd most common cancer in men and 2nd most common cancer in women worldwide. It is also the 10th most common cancer in India.

Many patients either do not have specific symptoms until very late or have non-specific symptoms which they attribute to normal variation in lifestyle and keep ignoring them. However, the essential signs and symptoms are:

Bleeding from the rectum - the most common symptom found in 60% of patients. It is often mixed with mucous/stool.
Altered bowel habits - constipation and/or diarrhea
Feeling gas pains, bloating, fullness or abdominal cramps
Unexplained weight loss
Fatigue Lump in the abdomen
Change in bowel habits
Stool that is narrower than usual
Black stools

Emergency symptoms of severe abdominal pain, abdominal distension and constipation are seen in patients with obstruction or perforation of the intestine due to cancer. One must remember, however, that each of these symptoms may be found in benign conditions as well.

Development of colorectal cancer cannot be attributed to any single factor. There are certain risk factors which increase its chances of occurrence. These include:

Age: It is more common in older people (50 and above).
Sedentary lifestyle
Obesity
Previous history of colon polyps or cancer
Family History - Conditions like Familial Adenomatous Polyposis(FAP), Hereditary Nonpolyposis Colorectal Cancer (HNPCC), etc.
Personal history of colon, ovarian cancer, endometrium or breast cancer
History of ulcerative colitis for more than 8-10 years

However, patients may develop these cancers even without any of these risk factors being present.

Max Institute of Cancer Care (MICC) is one of the leading facilities in India, which offers the latest treatments under surgical oncology, radiation oncology, and medical oncology. It is one of the largest chain of Cancer Centres in North India, with presence in Saket, Patparganj, Shalimar Bagh, Vaishali, Mohali and Bathinda. The centres are highly efficient and offer specialized and dedicated daycare with all significant sub-specialities and privacy to cancer patients.

With over 100 oncologists, Max Institute of Cancer Care provides world-class treatment facilities and focused care to cure various types of oncological diseases. The doctors treat people with cancer of the colorectal as well as cancer of esophagus, small bowels, hepatobiliary system, pancreas, area, intrabdominal tumors and masses, and splenic and gastrointestinal cancer. The facility has the best colorectal cancer specialists.

Max Institute of Cancer Care has a DMG for colorectal cancer which consists of a team of gastroenterologists, surgical oncologists, colorectal surgeons, radiation oncologists and medical oncologists. This team specializes in treating the colorectal cancer with surgery, targeted therapy, chemotherapy, radiation therapy and immunotherapy. Our holistic cancer care includes the following:

Adherence to the latest international cancer treatment protocols
Superior cancer treatment technology: Max Institute of Cancer Care is the first facility in Northern India to acquire Novalis Tx for IMRT/IGRT, Radiosurgery, SRS/5RT. Other technologies at our disposal include Da Vinci XI Robotic System and Linear Accelerator (LINAC).
Complete cancer care: Right from cancer screening, early detection, multidisciplinary treatment to rehabilitation.
Dedicated daycare chemotherapy centres outside the hospital or in separate areas with chemo chairs-and-recliners, patient beds, a library, TV sets, and iPads are provided to take patients’ minds off from the treatment.
A wider range of medical resources to draw from, with our multi-super speciality backups.

There are different types of rectal cancer, depending on the type of cell/tissue from which the tumour is arising. Adenocarcinoma is the most common type. Gastrointestinal stromal tumours (GIST), lymphoma and leiomyoma are less common. We use the following tests and procedures to diagnose & provide colorectal cancer treatment in india:

Endoscopy
Blood tests
Biopsy
Imaging tests - Computerized Tomography Scan (CT Scan) and Magnetic Resonance Imaging (MRI Scan)
Endorectal ultrasound
Stool for occult blood
Carcinoembryonic antigen (CEA)

Tumor Board

Additionally, there is a constant cross chat between the various specialities at the respective Colorectal Disease Management Group (DMG) Tumour Board meeting. The main motive behind which is to make the best skills available to patients.

Meetings are held once a week to discuss the situation with patients and arrive at the best possible management for the patient. The surgical, medical and radiation specialists of the respective DMG along with the pathologists, radiologist and molecular oncologists attend these meetings. Discussion involves planning a procedure tailored to the patient according to the extent of the disease.

After completion of treatment, a patient is required to visit their respective oncologist every three months for the first two years, every six months for the next three years and yearly after that. At each visit, their doctor will perform a clinical examination and order specific blood tests (CEA, LFT - liver function tests), radiologic investigations (CT Scan, Ultrasound, PET Scan) and colonoscopy.

Max Institute of Cancer Care is equipped with cutting-edge technology with which our team of oncology experts offer holistic care to patients. When it comes to treating colorectal cancer, our treatment options include the following: These may be offered singly, sequentially or in combination, depending on the stage and type of the cancer.

Surgery (Open, Laparoscopic or Robot-Assisted)

Surgery is the most common modality employed in treating colorectal cancer. It is effective in curing the disease at an early stage. Surgical removal involves complete removal of the tumour along with a healthy margin of the intestine and surrounding lymph nodes.

For colon cancer: Surgery involves removal of the part of the colon (right colon, left colon, transverse colon or sigmoid colon).
For rectal cancer: Majority of rectal cancer patients receive radiotherapy and chemotherapy as the first treatment. Surgery is carried out after 6-8 weeks of radiation. Some patients with very early symptoms of the disease can undergo surgery initially. In patients where the cancer is at the last part of rectum and anus, a part of the intestine is brought out directly from the skin (stoma) and is removed temporarily (ileostomy) or permanently (colostomy).
For spread of cancer to liver or lung: In such cases, cancer can still be cured if the tumour can be removed from the liver or lung. These surgeries can be performed by traditional open method (laparotomy) or with laparoscopic surgery or robotic surgery (minimally invasive approach).

Patients may also require chemotherapy and radiation therapy depending upon the stage of tumour and the general health. Chemotherapy is an important consideration post-operatively in colonic cancer as well as in metastatic disease. It also should be considered in colorectal cancer, both pre-operatively and post-operatively.

Chemotherapy

Chemotherapy is treatment with anticancer drugs which can be given intravenously or in tablet form to kill the tumour cells in the body.

Radiotherapy

Radiotherapy aims to kill the tumour cells by high energy x-rays or gamma rays. Usually, it is used in combination with chemotherapy.

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Colorectal Cancer

Overview

Colorectal Cancer Symptoms

Causes of Colorectal Cancer

Expertise to Treat Colorectal Cancer

Positive Approach Towards Colorectal Cancer Treatment