Colorectal cancer: epidemiology in India, symptoms, causes, importance of dietary fibres, screening & diagnostic tests

Introduction

Colorectal cancer (CRC) affects the colon and rectum of the small intestine. Globally, 1-2 million individuals are diagnosed with CRC each year. It is the third most common cancer among men (~10.0% of all cancer cases) and second most common cancer among women (~9.4% of all cancer cases). Developed countries account for 60% of all CRC cases. It is the fourth most common cause of death due to cancer, accounting for 8% of the same.In India, colon and rectal cancers rank 8th and 9th respectively among men. For women, colon cancer ranks 9th and rectal cancer does not figure in the top 10 cancers.
Sammparada, the best cancer hospital in Bangalore ,are specialized in screening, diagnosing and treating colorectal cancer in a holistic manner.
Let’s examine the typical signs and symptoms of colorectal cancers:One or more of the following symptoms are the  warning signals:

• alteration in bowel habits such as loose/restricted stools, diarrhoea or constipation
• stomach pain, cramping, bloating or gas; blood in the stool, which can cause faeces to appear dark brown or black; bright red bleeding from the rectum
• persistent impulses to defecate despite having passed the stools,
• iron deficiency anemia; exhaustion; unexplained weight loss; irritable bowel syndrome; and weakness.

The later phases of the disease typically present with weight loss and abdominal pain .
What causes colorectal cancer?
When cells in the colon or rectum experience DNA alterations that may impair their ability to regulate division and growth , colorectal cancer ensues. These mutant cells frequently perish or are attacked by the host’s immune system. However, a tumor in the colon or rectum can develop when certain altered cells get past the immune system and continue to grow unchecked. Additionally, those who have a family history of CRC or certain hereditary cancer syndromes are at an increased risk of developing the disease.
Risk factors for CRC:
Most instances of CRC are sporadic, however an increase in risk occurs due to genetic factors. The risk factors are thus divided into genetic and environmental/lifestyle-related factors: Among the genetic factors are Familial adenomatous polyposis, Lynch syndrome and their variants. Environmental factors include being elderly men, obesity, physical inactivity, consumption of fresh red meat and processed meat, smoking and/or alcohol consumption, and ulcerative colitis etc.Screening tests available for detecting colorectal cancer
Screening test is performed on beneficiaries who do not present any symptoms of CRC. Screening test is performed by assessing an individual’s risk depending on his risk factors, with relatives of patients with CRC considered as high risk. Incidentally during the course of such a test, the Physician might detect blood in the stools or polyps in the colon. This helps in detecting the cancerours lesion at an early stage. Such down-stage cancers are amenable to effective treatment and effective recovery.
. If you are looking for the best cancer care hospital, you can visit Sammprada onco+wellness Hospital..Options for screening include:

1. i) Fecal blood test: beneficiary provides a sample placed in a kit, which is examined in the lab, ii) Colonoscopy: a scope views the interior aspects of the colon and rectum

iii) Flexible sigmoidoscopy: to view the lower part of the colon and rectum.Dietary fibres and their role in colorectal cancerPlant based food items such as cereals, vegetables, legumes, soy and fruits are rich in dietary fibres. These fibres are fermented in the large intestine but undigested/ unabsorbed in the small intestine. It helps in normalizing the bowel movements, maintain the bowel health, lower cholesterol levels, control blood sugar levels, achieving healthy weight and enables living a long life.Apart from protecting against CRC, dietary fibres are also beneficial in preventing other ailments such as heart disease, type 2 diabetes and other digestive disorders. Therefore, it is vital to include fibres in Your routine diet, to the extent of 30-40 gms/day.Diagnostic tests for colorectal cancerThe diagnostic methodology is based on various clinical determinants including the signs and symptoms, general health, age, medical history and/or family history.In a digital rectal examination, >60% of the lesions could be out of reach of the palpating finger. Higher levels of biomarkers such as carcinoembryonic antigen (CEA) and carbohydrate antigen 19.9 (CA19.9). apart from other blood investigations, are useful markers for diagnosis and patient follow up. An increase in the level of these tumor markers will induce early imaging studies, which in-turn enables the staging of disease or its recurrence. Complete colonoscopy will entitle the detection of lesions or polyps. It is essential to confirm the histology of the primary neoplasm, before definitive therapy is initiated.PET-CT scan is desirable for diagnosis and staging of CRC, when resection is planned for a metastatic tumor or when recurrence is suspected. Alternatively, other radiological investigations indicated include x-ray of chest, ultrasound/CT scan of the abdomen and pelvis.Treatment at Sammprada onco+wellness hospital:For treating CRC, we adopt a multidisciplinary care approach. This team approach includes the expertise of medical, surgical and radiation oncologists, gastroenterologist, pathologist, radiologist, palliative care Physician and nurse Specialist.

Conclusion

Apart from screening of beneficiaries and high-rsik group (relatives of CRC patients), Sammprada cancer hospital implements best practices in the diagnosis and management of CRC. The team approach in our center plans the line of treatment through an informed decision process considering the stage and type of cancer, age of the patient and his/her overall preferences, presumed side-effects of the treatment and current health condition of the patient. Nutrition care and the family’s support system are also factored in this process.