Cancer of the large intestine, called colorectal cancer, is on the rise in India and although there has been a decline in the death rate, experts stress on early screening, especially of those aged 45 and above, and a healthy lifestyle to prevent fatalities.?Colorectal cancer is an umbrella term for colon, anus or rectum cancer.?

According to experts, while it is common to think that having a family history makes it difficult for one to keep cancer at bay, the disease is quite often lifestyle driven and even in hereditary cases, prevention and early diagnosis can improve outcomes.

"Cancer is being caused by multiple factors. Genes do play a role, but only 1-2 per cent cases are genetic. The rest are lifestyle driven. It takes just a faulty inner or outer environment to switch the bad genes on," Dr Vivek Mangla, a Gastro-intestinal, Hepato-Pancreatico-Biliary and Colorectal surgeon, said.?

"As the saying goes prevention is better than cure, it is advisable that people seek preventive screening for colorectal cancer. Any person aged above 45 years should go for it," he added, more so if there is a family history of cancer. According to doctors, one of the common symptoms of polyps as well as colorectal cancer is a change in the person's toilet frequency.?

If someone finds himself frequenting the toilet, maybe four to five times, as opposed to once daily in the past and if the individual does not feel relieved even after that, it may be a sign of worry. The other common symptoms include stomachache, anaemia, and rectal bleeding.

"The polyps can be mostly removed endoscopically, sometimes requiring surgery which can be done laparoscopically, or by robotic surgery. These are minimally invasive procedures which shorten the length of a patient's stay in the hospital."However, if the polyp turns cancerous, one might need to have those removed surgically mostly laparoscopically, or by robotic surgery," Dr Mangla said.

According to him, there is no need for one to be worried or overwhelmed following a colorectal cancer diagnosis. Stage I and II colorectal cancer can be cured in more than 90 per cent of cases and stage III in about 70-75 per cent. About 40 per cent of patients with Stage IV but resectable colorectal cancer can be cured despite the disease having advanced to stage four, the doctor said.

"In early stages of rectal tumours, we usually avoid attaching stoma (a tool to help passage of stools). For advanced cases also, most patients receiving radiation and chemotherapy would need a temporary stoma which would be closed once the postoperative treatment is over.

"Using special laparoscopic and surgical techniques, we can preserve a person's ability to pass stool normally albeit with an increase in stool frequency which usually settles over time. In a significant proportion of patients, even those with distal rectal cancer, we try to avoid permanent colostomy," Dr Mangla said.?

Studies suggest that a sedentary lifestyle and faulty food habits are making this variant of cancer common, even among the young, Dr M D Ray, Professor at the department of Surgical Oncology at AIIMS, Delhi said. Over the last five years, the disease has doubled to four out of one lakh people from 2-3 in 1 lakh people, he stated.

Although this number may seem insignificant, because of the huge population of India, which has become the most populous country in the world, it adds up to a huge disease burden. No wonder that colorectal cancer, which was the seventh most common cancer to affect Indians, has shot up to third place.

"If a member of your family had this cancer before turning 40 or 50, the risk of this disease for you is high. You should get a colonoscopy done around 20 years of age. After that, undergoing colonoscopy every 1 to 3 year, depending on the molecular variety of the cancer, is advisable under the guidance of the concerned expert," Dr Ray stated. He also added that 80 per cent of cancer is preventable and even curable if detected early.
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