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Colorectal Surgery - Know Procedures Involved!

FACRSI (Colo-Rectal Surgery), Fellowship in Minimal Access Surgery(FMAS) & Reproductive Medicine, FAIS, FICS, FIAGES-Advanced Laparoscopy, MBA (Hospital & Healthcare Management), MS - General Surgery
General Surgeon, Bikaner
Colorectal Surgery - Know Procedures Involved!
Colorectal surgery is the broad term for surgical procedures performed on the colon, the rectum and the anus. There are various different surgical procedures which fall under colorectal surgery and these are used to treat a vast array of disorders, such as:

1. Anal cancer
2. Colorectal cancer
3. Severe complications related to constipation
4. Anal injuries
5. Inflammatory conditions of the gastro-intestinal tract
6. Congenital defects


The surgeries under colorectal surgery are performed after diagnostic tests such as proctoscopy, sigmoidoscopy and defecating proctography. The most common diagnostic test is colonoscopy. These help to identify the origin and nature of the problem and decide which surgical procedure is to be followed. The procedures under colorectal surgery are as follows:

1. Colectomy
This procedure involves removal of a section of the large intestine. This is known as partial colectomy. In extreme cases, such as advanced cancer or severe gastrointestinal infection, the entire colon is removed and this is called total colectomy. Sometimes, the rectum is also taken out along with the colon and this is called proctocolectomy.

2. Colonic polypectomy
An abnormal growth of tissues of the inner lining of an organ is known as a polyp. Colonic polypectomy is done to eliminate polyps from the colon and rectum before they become malignant. This can be done endoscopically. Surgery is required in case of large polyps.

3. Strictureplasty
Chronic or repeated bowel inflammation causes scar tissue to accumulate in the large intestine. This results in the narrowing of the colon. Stricturoplasty removes the scar tissue so that proper flow of digestive contents is resumed.

4. Colostomy or Ileostomy
A damaged section of the colon is removed and the shortened intestine is then attached to another opening (stoma) in the anterior wall of the abdomen.

5. Hemorrhoidectomy
This surgical process is used for swollen hemorrhoids or blood vessels which form in the anal canal. Hemorrhoidectomy is extremely effective in removing hemorrhoids but the surgery also involves a number of complications.

6. Anoplasty
Anoplasty or imperforate anus correction is done to correct birth defects in the rectum and the anus. The structural flaw does not allow the stool to pass properly from the rectum and so it is repaired using surgery.

Know The Signs And Symptoms Of Colorectal Cancer!

DNB - Medical Oncology, MD - Medicine, MBBS
Oncologist, Chandigarh
Know The Signs And Symptoms Of Colorectal Cancer!
The lower part of the digestive system is known as the large intestine (colon), and colon cancer is the name given to the type of cancer that affects it. The rectal cancer is the cancer that affects the last few inches of the colon. Collectively they are known as colorectal cancers. In most of the cases, small, noncancerous (benign) clumps of cells called adenomatous polyps are formed in the intestine. They are not harmful on their own, but over a period, they enlarge to become colon cancers. Let us have a look at the early symptoms.

Polyps and the symptoms
Polyps are very small and do not display symptoms on their own. Doctors advise regular screening test to find polyps and destroy them before they can aggravate to colon cancer. In most of the cases, the symptoms start to appear only in the advanced levels. These include:

Changes in the bowel movement: There can be severe diarrhea or constipation. There can also be changes in the consistency of the stool.
Blood clots in the stool: There can be a persistent bleeding when passing out the stools. In some cases, there can be a general discomfort and pain while passing the stool.
Severe abdominal discomforts: Abdominal cramps and gas can be a regular occurrence. They would not respond to any digestive medications.
Weakness or fatigue: The body tends to get weak and fatigued easily. Even performing essential activities can be a daunting task.
Unexplained weight loss: Even after a proper diet, the body tends to lose weight. Weight loss can be categorized as one of the advanced stages of the disease.
The symptoms vary drastically depending on the size of cancer and the location in the large intestine. It is advisable to consult an oncologist if the symptoms mentioned above persist and it is also mandatory to have regularized screening after the age of 50.

Risk Factors
There are also certain important factors that have to be looked that may increase the risk of colon cancer. These include:

Old age: It usually affects people more than the age of 50. Chances of it occurring in young people are very minimal.
Inflammation of the intestine: Chronic inflammatory diseases of the intestine such as ulcerative colitis and Crohn's disease can increase the risk of colon cancer.
Genetics: Chances are that the genes could be passed on through the generation and family; thereby enhancing the likelihood of colorectal cancer.
Diet: Fatty foods and foods that are low in fiber content can be one of the causes of colon cancer. People who are overweight and obese also increase their risk drastically.
Smoking and alcohol: Smoking and drinking in excess levels increase the chances of getting colon cancer.

Hello sir stage 3 colon cancer is curable or not. Six chemotherapy have been completed. I think the patient is a little better than before. Sir I just want to know stage 3 colon cancer is curable or not? Plez sir help me. Because I'm very worried.

MBBS, M.S. General Surgery, M.R.C.S. England, M.Ch. Surgical Oncology, DNB Surgical Oncology, FEBS Surgical Oncology, DNB General Surgery, MNAMS, FMAS, FIAGES, FAIS, FICS, FEBS Breast Surgery, FACS, Fellowship IFHNOS & MSKCC USA, Fellowship in breast and oncplastic Surgery
Oncologist, Mumbai
Yes. If proper treatment has been given. I would be able to opine better if you send me the detailed reports Feel free to contact me directly if you want to discuss this further.
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Colorectal Cancer - How Surgery Can Be Of Help?

DNB - General Surgery, MBBS, Fellowship of Association of Colon & Rectal Surgeons of India(FACRSI), Fellowship Advanced Colorectal, Fellowship Laparoscopic Colorectal Surgery
Proctologist, Mumbai
Colorectal Cancer - How Surgery Can Be Of Help?
If you have colorectal cancer, your healthcare team will develop a treatment plan just for you. It will be based on your needs and could include the combination of different treatments. When your healthcare team decides what treatments to offer you for colorectal cancer, it takes the following into consideration:

The location of the tumor or where the cancer has reappeared (recurrence)
The stage of cancer
Your general state of health
Your personal preferences
You may be offered one or more of the following treatments for colorectal cancer.
Surgery is the main treatment for most colorectal cancers. Depending on the stage and location of the tumor, you may have one of the following types of surgery.
The local excision, resection, or local, serve primarily to remove polyps or early stage tumor which is the surface coating of colon or rectum (superficial tumor). The surgeon uses special equipment, usually an endoscope, to remove the polyp or tumor and a margin of healthy tissue all around. Local excision is also used to remove local recurrence of rectal cancer or to relieve symptoms such as pain (palliative surgery). Surgery is done to remove metastatic tumors when there is only one or a few in the liver or lungs.

Chemotherapy is a common treatment for colorectal cancer. It is often given after surgery for stage 2 or stage 3 colon cancer. Chemotherapy may be used as the primary treatment for stage 4 or recurrent colon or rectal cancer that cannot be removed by treatment.

Mostly, radiotherapy is used to treat rectal cancer. It is usually given before surgery and sometimes as part of a chemoradiotherapy (chemotherapy and radiotherapy given during the same period). It may be used after surgery for stage 3 colon cancer to help prevent the recurrence or recurrence of cancer.
Radiotherapy to the abdomen, pelvis, bones or brain can be used as a palliative treatment for advanced colorectal cancer that cannot be surgically removed. The external radiation is the type that is most commonly radiotherapy. Brachytherapy may be used in some cases.

Targeted treatment
Targeted treatment of colorectal cancer is used to treat stage 4 colorectal cancer that has spread to distant organs such as the liver or lungs. It is usually associated with chemotherapy, but can be administered alone.

Some colorectal cancer clinical trials are underway in this country and accept participants. Clinical trials aim to find new, better methods for cancer prevention, detection and treatment. Learn more about clinical trials.

Colon Cancer - How To Manage It At Different Stages? - Surgical Oncology
Oncologist, Hyderabad
Colon Cancer - How To Manage It At Different Stages?
Cancer is the biggest menace humans have to encounter at this point in time. It is an issue that afflicts thousands of people worldwide and to this day this is no particular cure for this epidemic affliction. It s an ugly disease that makes people suffer, drains every resource they own and puts a humongous strain not only on the patient, but also on everyone surrounding them, and interpersonal relationships. Cancer is a disease that progresses in stages and that is why it is important to get checked regularly. In case you are unfortunate enough to have been diagnosed with colorectal cancer, or colon cancer, as it is commonly known, here is a quick guide to the different stages and how to proceed.

Stage Zero: It is also called carcinoma in situ. This is the earliest stage where the cancerous cells have not spread beyond the inner lining of the rectum or colon.
What to do: Stage zero colon cancer means that it hasn t spread beyond the colon to other organs or areas so it only just requires surgery to remove the cancerous cells. This is called local excision performed using a colonoscope.

Stage One: This stage is where cancer has spread further into the lining of the colon but has not reached the outside walls of the colon or any other area for that matter.
What to do: If the cancer was removed at stage zero as a unit (the polyp) and nothing was left behind then nothing further needs doing. Although if the polyp is high grade then more surgery will be required, additionally if some get left behind after the first surgery then more will be required. Cancers that have developed otherwise require removing of a part of the colon, a partial colectomy. Colectomy can be done by conventional open surgery or by laparoscopic surgery.

Stage Two: The stage where cancer has advanced through the lining into growing over the walls of the colon but has not proceeded towards the lymph nodes.
What to do: Requires surgery, partial colectomy along with removing some of the surrounding lymph nodes. Chemotherapy post-surgery may be suggested by your doctor. Discuss before you agree to it. Colectomy can be done by conventional open surgery or by laparoscopic surgery.

Stage Three: Cancer has spread beyond the wall of the colon and reached the surrounding lymph nodes. It has not yet spread to other areas of the body or organs.
What to do: Partial colectomy including post-surgery chemotherapy but if the patient is not strong enough for surgery they are suggested chemotherapy or radiation therapy as an alternative. Surgery is the primary modality of treatment. However these patients will require additional treatment in the form of chemotherapy or radiation. Patients with rectal cancer may be advised Pre-operative chemotherapy & radiotherapy followed by surgery

Stage Four: Cancer has spread widely to several organs, to the liver, lungs, and even to the brain.
What to do: Surgery will not do much good, unless it can be used to remove the specific areas where the cancer is clustered. Mostly it is suggested to alleviate the pain but there is a chance that surgery might cure you too. Chemotherapy is absolutely required. Chemotherapy is the primary treatment. Patients with an obstructing tumor may need a colostomy or radiotherapy. Some patients with disease confined to the peritoneum may be offered curative surgery (Peritonectomy+ HIPEC)

In stages 2, 3 and 4 there is an emerging role of targeted therapies along with the traditional chemotherapy. The same are chosen on basis of biomarkers. In liver metastases, there is now a strong role for SBRT to liver lesions for high local control and potential cure in many. SBRT is a valuable alternative to liver surgery.

Cancers which have spread only to peritoneum have a chance of cure with peritonectomy with HIPEC or Hot chemotherapy wash. If the spread is limited to less than 3 nodules in liver, they can be removed by surgery following chemotherapy.
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Hi Sir, Mere husband ko colorectal ki problem hai unki age 26 years ki hai to please aap bataye ki ahmedabd me konse Doctor ko bataye. Please help me on it.

General Physician, Mumbai
Firstly we should meet a gastroenterologist nearby your locality for a diagnosis and follow up with reports.
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Colon Cancer - Ayurvedic Remedies That Can Help You Manage It!

B.A.M.S, M.D (Ayurveda)
Ayurveda, Nashik
Colon Cancer - Ayurvedic Remedies That Can Help You Manage It!
Colon cancer refers to the uncontrolled growth of cancer cells in the region of your large intestine. It is often associated with rectal cancer and is termed as colorectal cancer, since the process of metastasis (a process through which cancer cells pass rapidly to the other organs of your body) is very rapid for this particular medical condition. Colon cancer is prevalent among both men and women irrespective of their age, but is generally noticed in people above forty years of age. Though the causes of colon cancer cannot be specifically identified, there are certain factors that can increase your chance of developing colon cancer.

The risk factors are mentioned below:
i. Family history of colon cancer
ii. Chronic diseases of the intestine(like inflammation of intestine)
iii. A regular diet with low fibers but high calories
iv. Diabetes
v. Obesity
vi. Consuming high amount of alcohol

If you are diagnosed with colon cancer, you may show the following symptoms:
a) Inconsistency of bowel movements. (diarrhea and constipation)
b) Passage of blood through stool
c) Pain in your abdominal region
d) Sudden weight loss
e) Body fatigue

Colon cancer can be fatal if not treated at an early stage. Ayurveda offers effective remedies for colon cancer. Some of the remedies are mentioned below:
1. Drinking green tea can be very effective. Green tea has epigallocatechin (a Polyphenol used in different dietary supplements) which can destroy the formation of cancer cells.
2. Consuming Aloe Vera is another useful technique. It cleans the digestive tract and colon region by removing harmful toxins and can thus help to cure cancer faster.
3. Turmeric is also very potent in fighting cancer. It contains curcumins which can destroy the cancer cells formed in the colon region.
4. Ashwagandha is known to have certain properties that can control the growth of cancer cells and is thus instrumental in treating colon cancer.
5. The juice of garlic has certain medicinal properties that can combat the growth of cancer cells in your colon region. Intake of garlic juice can thus be very helpful.

Since colon cancer has limited survival rates, it is highly recommended for you to seek advice from an Ayurveda practitioner if you wish to get healed naturally.
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Early Diagnoses & Treatment Of Colorectal Cancer!

DNB (Surgical gastroenterology, MS( General Surgery), MBBS, Fellowship in Minimal Access Surgery, Diploma in Minimal Access Surgery, Fellow of International College of Robotic Surgeons
Surgical Gastroenterologist, Delhi
Early Diagnoses & Treatment Of Colorectal Cancer!
The most common indicators of colorectal cancers are sudden change in bowel habits, blood in stools, anorexia, significant loss of weight ( > 10 kg in 6 months or > 5 kg in one month) without making an effort to do so, significant loosening of clothes, abdominal pain, family history of colorectal cancer, pre-existing inflammatory bowel disease, tenesmus( feeling of "need to defecate" without actually passing stools) etc. If you have any of these symptoms or condition you should consult a gastrointestinal surgeon. The medical community often suggests generally healthy people undergo the tests for colorectal cancer. An early detection helps to counter the condition better. An early screening also increases the odds of survival. While people with no family history of cancer should ideally undergo this tests at the age of 50, people with a greater risk of cancer should undertake the tests at 45 or before. Depending on the stage of cancer, the treatment plan is designed by the doctor.

Diagnosis of colorectal cancer in the early stages

Colonoscopy: This is a test that uses a long and slender tube that is inserted into the body through the rectum. It helps to have a clear view of the rectum and colon, through a video camera that is attached to the tube. A doctor might pass surgical tool to take a sample tissue so that it can be tested for cancer.
CT scan: A contrast-enhanced CT scan is used to accurately stage colorectal cancer. Staging is important with regard to decide on the modality of treatment and determine the prognosis. MRI Pelvis: In cases of the rectum, MRI of the pelvis is recommended to accurately stage the disease.
PET-CT Scan: Its used to rule out a distant spread of tumor beyond the large intestine eg into the lung and liver. If the Distant spread is present then treatment modality is different and the prognosis is worse. Blood tests: Serum CEA levels may be elevated in colorectal cancer but not in all cases.
Serum CEA may be monitored after curative surgery to look for recurrence of cancer. Other blood tests may be required to assess the general condition of the patient with regard to pre-anaesthetic checkup.

Stages of colon cancer:
Stage 1: In this stage, cancer grows through the superficial lining of the rectum or the colon.
Stage 2: This is the stage where cancer grows through the wall of the colon and the rectum.
Stage 3: In this stage, the cancer cells grows through the lymph nodes.
Stage 4: This is the worst form of colorectal cancer, where cancer spreads to other organs.

These stages of cancer are progressive stages on a continuum that means early diagnosis may catch cancer at an earlier stage and hence there are higher chances of cure and better prognosis. Later stages have lower chances of cure and poorer prognosis. Screening programs help us to catch colorectal cancer at an earlier stage. In India, due to lack of robust screening programs, colorectal cancer usually are a little more advanced as compared to Western countries and the Far East.

Treatment options for colorectal cancer

Early stage surgery to treat colorectal cancer:

Colonoscopy: This is a small medical procedure where the doctor removes the cancer cell or the polyp with a colonoscopy.
Mucosal resection: An endoscopic mucosal resection is a procedure that involves taking out polyps along with the lining of the rectum and the colon. Colonoscopic removal of polyp and Mucosal resection is usually only possible in very early cancers caught on screening colonoscopies which is usually not the scenario in India. Patient present for a colonoscopy only when symptomatic by which time these treatment options are not usually recommended.
Minimally invasive surgery: This is a procedure where the surgeon performs numerous incisions in the abdominal wall. Instruments are inserted along with cameras to view and do the surgery.
For invasive colorectal cancer:

Surgery for invasive colorectal cancer include Right hemicolectomy ( open or laparoscopic ), Left Hemicolectomy ( open or laparoscopic), Low anterior resection ( OPen or laparoscopic ) with total mesorectal excision, Total colectomy ( Open or Lap) and their variations. The affected bowel is resected along with adequate proximal and distal margin and all surrounding lymph node tissue to ensure adequate clearance of tumor mass. The surgeon may choose to restore the bowel continuity or perform an ostomy depending on multiple other factors and which is usually reversible later.

For advanced colorectal cancer:

In case of an advanced stage colorectal cancer, a surgeon might perform a procedure to remove the blockage from the rectum or the colon to relieve the symptoms. Chemotherapy is deployed after the procedure to destroy the cancer cells. Depending on the stage of cancer, a doctor might also suggest a radiation therapy to shrink the area of the cancer cells, so the procedure has better chances of becoming successful. Other methods such as targeted drug therapy and immunotherapy are also employed to keep the cancer growth under control.

For all stages of cancer surgical resection of all tumor mass provides the best chance of sure regardless of their response to chemo or radiotherapy. Hence it is essential that adequate removal of tumor mass with surrounding tissue is done in competent hands to ensure the best outcome.
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Can Ayurveda Help You Manage Colon Cancer?

Bachelor of Ayurveda, Medicine and Surgery (BAMS), MBA (Healthcare)
Ayurveda, Dehradun
Can Ayurveda Help You Manage Colon Cancer?
According to the American Cancer Society and Colon Cancer Alliance, colon cancer, which is also referred to as colorectal cancer is regarded as the third most commonly diagnosed cancer type as well as the second most important reason of cancer death in the U.S. affecting both men and women. But thankfully, colon cancer can be prevented by changing the food habits.

It is also important to get regular screenings through colonoscopy, which will help you to determine the early or precancerous stage that can be treated with the removal of cancerous cells. Colorectal cancer is deemed to be cancer-related to the food habits and it can be prevented by correcting the same. Here are the top ways through which you can help your condition naturally:

Reduce the amount of red meat consumption: Health studies reveal that people who eat red meat on a regular basis are more prone to developing colon cancer. This is because the chemicals required to digest this food damage the DNA material which in turn is the main reason behind the cause of cancer.
Increase the amount of garlic intake: By consuming more garlic, you can reduce the risk of developing different types of cancer, particularly those of the gastrointestinal tract. Garlic is rich in anti-bacterial properties that can block the pathways of cancer causing elements and boost the repair as well as reduce the proliferation of cells. It is also high in selenium and sodium content which are beneficial for the overall health.
Consume all types of plant antioxidants: The bright coloured fruits and vegetables, as well as herbs and spices, can greatly contribute to adding a wide array of antioxidants in your regular diet. Foods that are rich in anti-oxidants include carrots, pomegranates, cranberries, kale, broccoli, tomatoes, apples, cabbage, turmeric, sage, rosemary, saffron, purple and red grapes.
Cook foods in olive oil: Olive oil is rich in anti-cancer properties and it helps in reducing bile acid and increasing the enzymes that can regulate the growth of the cells on the intestine lining so that tissues can be renewed. Antioxidant compounds called phenolics are present in olive oil and have also proven to be a cancer protective anti-oxidant.
Increase the consumption of Omega-3 fatty acids: It has been reported by several types of research that a diet rich in Omega-3 fatty acids can reduce the occurrence of colon cancer and therefore you must eat a lot of salmon, cod, mackerel and sardines for decreasing the pro-inflammatory levels in your body.
These few alterations to your food habits can greatly help you in preventing colon cancer and you can consult your doctor for a detailed analysis and recommendation based on your individual health condition.
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Colorectal Cancers

Oncologist, Hyderabad
Do not avoid any change in your routine bowel movements that last for long. Anemia (hemoglobin going down, black coloured motions, tenesmus (repeated sensation to empty your bowels) associated with cramp like pain. Do not avoid all these symptoms. Simple test like per rectal examination and FOBT (fecal occult blood test) are often neglected.
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