Dr. Ranjan Kumar Mohapatra

Colorectal cancer is otherwise known as cancer of the colon or the rectum. This can affect both men and women with age being a major risk factor. Majority of such cancers are seen to occur after age of 50 years.

1. Type: Colorectal cancers can present as one of the following types: 

   1. Adenocarcinomas are the most common type of colorectal cancers. These cancers begin in the cells making mucous and other fluids. Certain colorectal cancers begin as adenomatous polyps (adenomas) that turn cancerous over a period of time. This is precisely why the adenomas are regarded as pre-cancerous or pre-malignant.

   2. Gastrointestinal (GI) carcinoid tumors, GI stromal tumors, primary colorectal lymphoma, leiomyosarcoma, melanoma & squamous cell carcinoma are certain other colorectal cancers

      • Carcinoid tumors: start in specialized cells that produce hormones, in the intestine.

      • GI Stromal tumors: start in the interstitial cells of Cajal (ICC), in the wall of the colon.

      • Lymphomas: start typically in the lymph nodes but they may also start in colon or rectum.

      • Sarcomas: can start in the muscle and the connective tissue in the walls of the colon and rectum.

2. Gender: It affects both male and female populace.

3. Etiology: Mostly, the factors that are associated with increased risk of colorectal cancer include the following –

   1. Age exceeding 50 years.

   2. Racial & ethnic background such as African Americans, in the USA, are known to have the highest incidence of colorectal cancer, and mortality rates.

   3. Low fibre and high fat diet. Excessive consumption of red meat (e.g. goat meat, beef, pork, lamb, or liver), processed meats, butter, refined grains, sweets, sugary drinks etc all can increase the risk of colorectal cancer.

   4. Personal history of inflammatory bowel diseases (IBD) (e.g. ulcerative colitis), Crohn’s disease, adenomatous colorectal polyps, colorectal cancer etc all.

   5. Family history of colorectal cancer or adenomatous polyps etc all.

   6. Inherited syndromes such as familial adenomatous polyposis (FAP) and Lynch syndrome (hereditary non-polyposis colon cancer or HNPCC).

   7. Sedentary lifestyle/ associated Obesity.

   8. Type 2 diabetes.

   9. Tobacco and alcohol abuse.

4. Features or symptoms can vary from person to person depending on the size and location of the tumour. Following are the signs & symptoms mainly -

   1. Changes in bowel habits, diarrhea or constipation or an alternating diarrhea and constipation.

   2. Occult/ blood in the stool, and 

   3. Problems related to blood loss (e.g. anemia, weakness, fatigue, intolerance to exercise, shortness of breath, increased heart rate, chest pain etc all),

   4. Abdominal discomfort (frequent gas/ flatulence, bloating, fullness, cramps, and pain), vomiting etc.

   5. Unexplained weight loss,

   6. Pain with bowel movement,

   7. Feeling that bowel does not empty completely,

   8. Stools are narrower than usual.

5. Diagnosis: Following are the diagnostics employed. Abnormal blood test results may be indicative of malignancy, but a follow-up imaging/ biopsy is always the gold standard for accurate diagnosis.
   1. Blood: fecal occult blood test, Carcinoembryonic Antigen (CEA) assay values are raised, Hb/ RBC counts may be low.
   2. Imaging: Colonoscopy, Endorectal Scan/ CT Scan followed by Biopsy clinches the diagnosis and the nature of the disease.
   3. Apart from the above-mentioned barium enema X-Ray, USG, Chest X-ray, PET CT scan etc all help detect metastasis, if any. An increase in level of the serum tumor marker ‘CEA’ is indicative of metastatic spread/ proliferation that can be ascertained through a PET CT scan.
6. Treatment: Conventional treatment includes surgery, radiation and chemotherapy as contextually appropriate. Simultaneously, an adjunctive/ integrative naturopathic treatment with suitable complementary & alternative medicines (CAM)/ therapies too can help improve clinical outcomes and facilitate recovery as feasible contextually.

7. Prognosis: Preventive measures, earlier diagnosis and right early treatment is key for better prognosis and efficient/ effective therapeutic management. Usually, the chances of cure for an early stage cancer are more. Above-mentioned apart, recovery chances are influenced by the grade, stage of cancer, recurrence and the patient’s general health & vitality etc all too.

8. Prevention: Rightly said, prevention is always a better choice. Although genetic risks are difficult to modify, still an adherence to a Mediterranean diet, maintaining an ideal body weight and an active lifestyle with due emphasis on regular exercising (for at least 30 minutes daily), de-stressing and relaxation is highly recommended for prevention or reducing the risks of colorectal cancer. A healthy eating plate comprises essentially a low fat diet, fibre rich foods including whole grain cereals, green leafy vegetables cooked using healthy vegetable oils, fresh fruits of all colours as seasonally available and healthy proteins/ fats including fresh fish, poultry, beans, nuts etc all. It is advisable to limit milk/ dairy, preferably of low fat content, to 1 to 2 servings max daily. Although alcohol is optional and is not for everyone, the consumption of the same, if any, has to be strictly in moderation, and is best avoided. Smoking is to be avoided as well. Again, red meat, butter, refined grains, sweets, sugary drinks including carbonated beverages and other high calorie foods etc all, if any, are to be taken sparingly or are best avoided too. Apart from the generic preventive measures as mentioned above, certain pre-malignant conditions, of which adenomas are the most common, can be successfully treated with complementary and alternative medicines too.

Cancer, or the big C, is always in the news. Use any keyword related to cancer, and there is definitely information overload. Also, with more people surviving cancer, there are too many tales to tell. All this leads to misconceptions and myths, leaving people, who are looking for genuine information, completely confused. The following are some common misconceptions.

1. Cancer is a new-age disease: There is reference to cancer in ancient Egyptian and Greek stories, so cancer is definitely not new. However, it is true that the incidence has increased tremendously with the modern lifestyle habits.
2. Food items prevent cancer: There are claims that food items like kale, blueberries, green tea, broccoli, etc., can prevent cancer. It is not true. They do have antioxidant and anti-inflammatory properties, but are not helpful in preventing cancer.
3. Acidic diet causes cancer: The body’s pH is not determined by the food products that we consume. Neither acidic nor alkaline environment is healthy, and further, the body has its own mechanism to regulate pH; so go ahead and eat what you like.
4. Sugars cause cancer: Sugar, believed to be the main energy source, is required for growth. Since cancer is linked to uncontrolled growth, it is believed that more sugar leads to more cancer. This again is a false notion, as there is no connection between the two.
5. Screening is only for breast cancer: Agreed, breast cancer is easy to screen for, but any person with predisposition can go for periodic screening to help in early identification and intervention.
6. Cancer medicines kill more than they cure: Whether it is chemotherapy or radiation, they do not pick only the cancer cells. When directed at a body part, the radiation affects the entire area. Chemotherapy targets and controls growth of a lot of normal processes, thereby affecting normal life.
7. There is no cure for cancer: It is not a simple process. Curing cancer involves multiple facets – some of which may not be known or unearthed. While there are some stories, which talk about how they conquered cancer completely, there are a greater number of failures. Do not conclude on either side. Each person and each type of cancer is treated differently.
8. Tight undergarments are not connected to cancer: As popularly advertised, tight underwear and underwired bras do not cause testicular or breast cancer.
9. Biopsies spread cancer: This is a misconception. Most people are scared to get a biopsy as they perceive that it may spread the cancerous cells to normal areas.

This is just a short list, and there are far too many false notions. Check with your doctor to validate the information before using it to take any decision. If you wish to discuss about any specific problem, you can consult an Oncologist.
 

Renal cancer is also known as hypernephroma, renal cell carcinoma (RCC), kidney cancer or renal adenocarcinoma. The kidneys are organs in your body that dispose off waste, while additionally regulating fluid balance. There are small tubes in the kidneys called tubules. These filter the blood, help in discharging waste, and make urine. RCC happens when cancer cells start to grow out of control in the lining of the tubules of the kidney. Renal cancer is a progressive disease that spreads to the lungs and the organs around it.

Medical experts do not know the exact cause behind renal cancer. It is most commonly found in men between the ages of 50 and 70. There are some risk factors and signs that indicate one’s possibility of having renal cancer and these are as follows:

1. Family history of renal cancer
2. Dialysis treatment
3. Hypertension or high blood pressure
4. Obesity
5. Smoking cigarettes
6. Polycystic kidney disease (a condition that causes cyst formation in the kidneys)

At a point when renal cancer is in its initial stages, patients might not see any symptoms. The symptoms are mainly seen in the later stages. Some of the most common symptoms are as follows:

1. Blood in urine: Blood in urine is called hematuria. As indicated by the Renal Cancer Association, hematuria is the most widely recognized indication of kidney cancer. In case you have blood in your urine, you may see pink, rust or even a red staining.
2. Lower back pain: The vast majority does not encounter pain until cancer is in later stages. Pain from renal cancer is felt on one side of the flank, the region over the pelvis, and beneath the ribs in the abdomen. This pain can go from a dull yearn to a sharp wound, frequently leaving the area blue. In case you have any sudden pain that continues for more than a couple of days, you need to see a specialist.
3. A mass or lump: A mass or protuberance in the abdomen can be an indication of renal cancer. Kidney knots might be hard to feel since they are somewhere down in the abdomen. Once a bump is found, your specialist may arrange symptomatic tests such as an ultrasound or a CT scan. These tests may diagnose what your knot might be.
4. Iron deficiency and fatigue: Weakness and a fall in your iron levels are the most common symptoms of any type of cancer. Cancer exhaustion is not quite the same as simply feeling tired.
5. Weight reduction, loss of appetite and fever: Another normal side effect of cancer is sudden and startling weight reduction. This happens quickly without any excessive workouts or dieting. A person diagnosed with cancer can also face a loss of appetite. In fact, even their most loved food items can get to be unappealing. Frequent fever is yet another common symptoms among most cancer patients.

In case your specialist suspects that you may have renal cancer, they will take some information about your and family’s medical history. They will then do a physical exam. Discoveries that can show renal cancer include swelling or irregularities in the stomach area. In case of men, augmented veins in the scrotal sac (varicocele) may be found. If you wish to discuss about any specific problem, you can consult a Nephrologist.