Many scientific studies and registries state that in the last 5 to 10 years we have witnessed drastic growth in cases of colon and rectal cancer. It is true that there is gross increase in the number of new cases of colorectal cancer Nationwide particularly in Kerala. It has been observed from a study among private hospitals in Kochi, Kerala that the number of patients siffering from clon and rectal cancer has increased 3-4 fold over last 2 decades. Similar high incidence is reported in North-Eastern states as well. It is difficult to estimate the actual increase in percentage due to lack of audited data. The incidence of colorectal cancer in Kerala is about 5.5/ 100,000 and recent PCBR data in 2015 (unpublished ) is 9.4%.

Signs and symptoms of colon & rectal cancer include:

  • A change in your bowel habits, including diarrhea or constipation or a change in the consistency of your stool, that lasts longer than four weeks
  • Rectal bleeding or blood in your stool often missed with mucus
  • Persistent abdominal discomfort, such as cramps, gas or pain
  • A feeling that your bowel doesn’t empty completely, thin stools
  • Weakness or fatigue
  • Unexplained weight loss


  1. What are the tests for colon malignancy before treatment?

Colonoscopy with biopsy is the test for confirmation. Colonic polyps can be removed with colonoscopy. A CT scan and or MRI scan and certain blood test are essential for planning surgery. A PET scan is done selectively.


  1. How do we treat colon cancer?

Once diagnosed and if it is confined to colon or operable, radical surgery is the treatment of choice. Hemicolectomy, transverse colectomy, extended colectomy of subtotal colectomy are the procedures done depending upon the site and nature of the cancer. Most often these procedures are done by laparoscopy or by robotic surgery. Tumour with all draining nodes are taken out. Most colon cancers can be treated with laparoscopy or key hole surgery. Benefits of laparoscopic colonic surgery are early recovery, less pain, less blood loss and early return of bowel function. It is well proven in many large studies that the results of laparoscopic surgery for colon cancer is equal to that of open surgery in short and long term. Robotic surgery is another excellent precise way to remove colon cancer very effectively. Aster Medcity is a referral center for forms of laparoscopic and robotic colon cancer surgery and has excellent results.

  1. What is the treatment for rectal cancer?

Rectal or rectosigmoid cancers are malignancy involving last portion of large intestine. They present with rectal bleed or altered bowel habits. If diagnosed sufficiently early, rectal and rectosigmoid cancer can be treated with laparoscopy or key hole surgery as well. In locally bulky or slightly advanced rectal cancers, chemoradiation therapy is given before surgery. For lower sigmoid or rectosigmoid cancer laparoscopic high anterior resection is offered. Laparoscopic low anterior resection surgery provides radical surgery for rectal cancer with total mesorectal excision. Few patients with low rectal cancer may require a temporary colostomy for few weeks along with laparoscopic low anterior resection. Robotic surgery for rectal cancer also is a very effective method for treatment of carcinoma rectum. With robotic surgery very low rectal cancers can be removed safely. If the lesion is involving anal canal or anal sphincters, laparoscopic abdominoperineal resection surgery (Lap APER) may be required. Laparoscopic rectal cancer surgery is now proven to have equivalent results compared to open surgery and offers advantage of early recovery.

  1. What are the results of surgery in colorectal cancer?


The long term results of colon or rectal cancer depends upon the stage of the disease. In general, colorectal cancer responds to treatment very well and good proportion of patients have favourable outome. Depending upon the stage of the disease patient may require postoperative chemotherapy or chemoradiation therapy. In general, the results of laparoscopic surgery for colon and rectal cancer is very good and a significant proportion of patients get long term cure.