What is the average colorectal cancer diagnosis rate in India?  

In India, every year more than 51,000 new cases of Colorectal cancerare diagnosed every year (GLOBOCAN statistics). Colorectal cancerdeaths comprise about 5% of all cancer related deaths in the country.

What are the typical signs and symptoms that can lead to the early diagnosis of colorectal cancer?

Blood tinged stools, alteration in the frequency of stools (either decreased or increased), constipation, weight loss, feeling of delayed digestion, bloating of the abdomen and a palpable abdominalmass are some of the commonest symptoms. These symptoms are usually ignored by patients initially and often leads to a delayed diagnosis.Though many of these symptoms seem quite commonplace , it is essential that any symptom which has been persisting for more than 2-3 weeks is a “red flag” and patients need to consult a doctor for evaluation. Many of these cancers are detected on routine evaluation for anemia.

Who are at risk of developing colorectal cancer?

Obese individuals, smokers, heavy alcoholics and physically inactive persons are prone to develop CRC. All these factors are under the control of the individual and these are hence called “ Modifiable risk factors”. Old age, presence of colonic polyps, family history of colorectal cancer are other common risk factors.

What are the barriers regarding a timely diagnosis of colorectal cancer in India?

Ignorance and lack of access to good primary health care are the reasons for delayed diagnosis in India. Colonoscopy which is mandatory for early diagnosis is not very easily accessible at primary health centres .

What will be your suggestions regarding an increasing diagnosis of colorectal cancer?

Increasing awareness among general public is most important. Simple screening programmes for “at-risk” individuals as mentioned above will certainly improve diagnosis rates in early stages and the chances of complete cure are better. Improved availability of endoscopic equipment in rural areas and primary health centres will definitely help and the government needs to look in this direction.

Any key advise to prevent colorectal cancer?

Avoid fast food. Increase fiber content in your diet. This is the most important way to prevent colorectal cancer.

What interesting trends do you foresee with respect to colorectal cancer diagnosis and treatment?

There have been excellent advances in screening for CRC in the form of Fecal immuno chemical tests, fecal occult blood test, stool DNA test which can be done on the stool sample. If any of these tests are positive , then individuals are advised can undergo tests like“Virtual Colonoscopy” which is a specialised CT scan.  A traditional ‘colonoscopy” is the gold standard test.

For early stage cancers, surgery is the mainstay of treatment.

Infact, the five-year relative survival rate for localized colorectal cancer is 90.6 percent, according to the National Cancer Institute’s Surveillance,Epidemiology, and End Results (SEER) Program– that means 90 % of patients will get cured if they are detected in early stage.

Developments in Minimally invasive surgery in the form of Robotic and Laparoscopic surgery have helped patients to recover from their surgeries and get back to their normal daily activities quickly.

As far as advanced colorectal cancers are concerned, survival rate shave drastically increased in recent years due to the emergence of targeted drugs like Bevacizumab , Cetuximab and Pembrolizumab. Incomparison to traditional chemotherapeutic drugs, these medicines are more cancer specific and are generally more tolerable.

In advanced cancers, the onus is on quality of life. “ Adding life to the years is more important than adding years to the life”

“It is essential to know one’s gut habits. Any subtle change in these habits is the first warning sign”  (tagline/shighlight)

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