Good Morning everyone, my name is Dr Ninad Katdare I am a cancer surgeon and I specialise in gastrointestinal cancers and gynae cancer and peritoneal cancers. I am available at H.N. Hospital, Charni Road, Global Hospital, Parel, Raheja hospital, Mahim, BSES Hospital, Andheri and HCG Oncologist Hospital at Borivali. Today we will be speaking about Colorectal Cancer, this is one of the fastest growing cancer in India and more and more younger patients we are seeing with colorectal cancers. So I will take you through a short video showing the various treatment options and the various stages of colorectal cancers. So basically colorectal cancer is stage using something called as AJCC system which you can see in the next slide and I won’t go to the detail of it, you can just go through the details for it, this gives us just an idea ki on which stage is the cancer. So based on the stage of the cancer there very good treatment modalities available which does not sometimes necessitate even surgery and sometimes whenever we need surgery. It can be in the form of minimally invasive surgery. So I will go through all the aspects of that, so stage one cancer, these are not very common these are usually seen when you have gone through a health check or sometimes on routine screening colonoscopy you have found a colorectal cancer. In this stage one cancer’s almost 80 to 90% of the cancers can be removed by what is called as endoscopy resection. In this you don't need to undergo any surgery through the endoscope which is put through rectum and through special instrument pass through the score you can do the surgery and the tumour can be removed from inside the intestine itself and the patient is up and above and can be discharge in a day also so with this kind of treatment you don't need any surgery at all but this is limited only for stage one and those also early stage one cancers anything which is late stage 1 or beyond you cannot do the this procedure for these procedures which is a late stage 1, stage 2 and stage 3. Nowadays an open surgery is very rarely done. It has been shown that laparoscopic surgery can remove whole of your cancer without causing any increases of cancer. At the same time using laparoscopic surgery you have very small 1 cm cuts on your abdomen so that your recovery from the surgery is very fast so these are some photos showing how the laparoscopic surgery is done and laparoscopic colostomy and laparoscopy rectal surgeries now routinely available at our hospitals. In addition for stage 3 most of the time chemotherapy will be required to the patient, even first stage two and three another new technologies is available which is called as robotic surgery. In certain cases where the patient is very obese or if the cancer is very deep down into the pelvis these are the cases where robotic surgery has the best advantage and the recovery is very fast from the surgery. With robotic surgery here you can see that there is a robot which is why the patient side and there is one console, on which the surgeon sits and does the surgery. Usually after robotic surgery and laparoscopic surgery the patient can be sins sitting and on his bed in 6 hours and by next day he is walking around in the hospital. The recovery is very fast with these two procedures. One more thing which stage 2 and stage 3 cancers, especially in rectal Cancers, if they are very down in the rectum very close to what is called sprinters. Initially we used to do something called as a abdominal perineal resection, where in, for your whole life you use to requires a colostomy on the abdominal wall that means the stool use to pass from your abdominal wall now with the advent of new technology called as Pinto Preserving surgery, we are able to save with the sprinkles. So even if for a very low rectal cancer we are able to save the sprinkles and the colostomy is not required. In this image you can see the various technologies where we can do the springto preserving surgery. For stage 4 cancer also, in Colorectal Cancer specially there are many new technologies available so initially what we used to fear that this is a last stage of Cancer is not true anymore in colorectal Cancer. So for cancers which has spread to the liver and the lungs, we can do surgery with or without something called as ablation therapy which you can see on the right side and for something the peritoneal metastasis of colorectal Cancer we can do what is called the Hipec which you can see on the left side also along with all this treatment modality obviously chemotherapy is required at stage 4. But this should be noted that even for stage 4 cancer good selected patients you can get survival for even more than 5 years which was not possible 5 years back. So for colorectal cancer from stage 1 to stage for various technologies are available these are available at all the hospital where I work and for all this stage is the success rate are very good. Thank you, for any further questions you can contact me through lybrate.Com, thank you.