Colorectal (Colon) Cancer Treatment Treatment Cost in India

The reasons for colorectal cancer are not known exactly but medical science describes that when healthy cells in the colon suffer errors in the genetic blueprint that is in the DNA.

Healthy cells are expected to divide naturally in an arranged fashion to replace old cells and function normally. But when the DNA of a cell gets damaged, the cells continue to divide even when new cells are not required, and these cells eventually collect to form a tumor. At a later stage these grow to invade and kill normal tissues around. They travel to other parts of the body for the deposit formation or metastasis.

To an extent, inheritance of gene mutation can also increase the colon cancer risk and this can be passed on from one generation to another.

Some of the most common forms of colon cancer syndromes  are:

• Hereditary nonpolyposis colorectal cancer,which occurs at an age above 50
• Familial adenomatous polyposis can happen at lower age groups and forms hundreds of polyps in the colon
• Even diet has a huge role to play in increasing or developing the potential of colorectal cancer. Some of the risk factors include:
• Old age
• African- American race
• Personal history of colorectal cancer or polyps
• Inflammatory intestinal conditions
• Inherited syndromes that can increase the risk of colon cancer
• Family history of colon cancer
• High fat and low fiber diet
• Sedentary lifestyle
• Diabetes
• Alcohol consumption and smoking
• Obesity
• Radiation therapy for cancer 

Some of the signs and symptoms of colon cancer are:

• Change in the bowel habits like diarrhea or constipation or change in stool’s consistency that has a lasting effect
• Blood in stool
• Abdominal discomfort or cramps and gas and pain
• A feeling that bowel is still there
• Fatigue
• Loss in weight 

There are many people who have colon cancer and experience little or no symptoms in the early stages of the ailment. The symptoms vary largely depending on the size of the cancer and its exact positioning.

Above age 50, usually, colorectal cancers should be screened regularly for safety, and when discomfort is tremendous, patients are advised to undergo biopsy where a small amount of tissue will be observed for any cancerous growth. A colonoscopy can also be used for diagnosing as well as treating the problem. Apart from that, blood tests are also conducted to check for a substance in the blood called CEA or carcinoembryonic antigen.

Depending upon the stage of cancer, the doctor will recommend treatments. The treatment options for colorectal cancer can be broadly categorized under surgery, chemotherapy and radiation.

Surgery treatment option for early-stage colon cancer: If the colon cancer is very small, then a minimally invasive surgery can be recommended by the doctor including the following interventions

Removing polyps during colonoscopy:  This treatment is an option when the cancer is highly localized and small and in its early stage contained in a polyp, doctors can remove it in this kind of surgery.

Endoscopic mucosal resection: When the doctor needs to remove larger polyps they may require to take a small amount of the lining of the rectum or the colon in a procedure which is called an endoscopic mucosal resection.

Minimally invasive surgery:  These are the kinds of polyps that cannot be removed during a colonoscopy and can be removed only by using a laparoscopic surgery. In this kind of procedure, the surgeon must perform the operation through many small incisions made in the abdominal wall by inserting instruments that have cameras attached and can display the colon on the video monitor. The surgeon may also take a few samples from the lymph nodes in the region where the cancer is located.

Surgery for invasive colon cancer: If cancer or polyps have growth into or through the colon then the surgeon may recommend the following:

Partial colectomy: The surgeon extracts the area of the colon that has the cancer cells along with a small volume of residual normal tissue on either side of the cancer cells. Mostly, the surgeon must connect the healthy portion of the colon with the rectum. Commonly, the procedure can be combined with a minimally invasive or laparoscopic approach.

Creation of a way for the waste material to leave the body: An ostomy is required to reconnect the healthy portions of thee colon and the rectum and this shall involve the creation of opening the wall of the abdomen from a region of the remaining bowel to ensure that the stool is ejected out in a bag that fits securely over the opening there. At time ostomy is found to be only temporary and allowing the time for colon and rectum to heal post-surgery. But then again in some cases the colostomy may be permanent.

Lymph node removal: the lymph nodes that are in close proximity to the colon cancer cells are removed and tested for cancer during colon cancer surgery.

Surgery for advanced cancer: If the cancer is found to be in quite an advanced stage and the overall health of the patient is really poor, then the surgeon may also recommend an operation to relieve a blockage of the colon or some other conditions to improve the symptoms. Bleeding and pain which are some of the signs and symptoms of the surgeries get cured with the help of this, but the cancer may not be eradicated from its roots.

In certain specific scenarios where the cancer is found to have only spread in the liver, but the overall health is good otherwise then the doctor may recommend surgery for the removal of the cancerous lesion from the patient’s liver. In such cases, chemotherapy may also be used before or after this kind of surgery. This approach is found to be free from cancer for a long period of time.

Chemotherapy:  This method makes use of drugs for the destruction of cancer cells. Chemotherapy for colon cancer is chosen to be applied after a surgery when the lymph nodes are also found to be affected. In this way the chemotherapy may help in the reduction of the risk of cancer recurrence and ultimately death from cancer. At times chemotherapy can also be used before the surgery where the goal is to shrink the size of the cancer before the surgery. In case of rectal cancer before surgery chemotherapy is more common compared to colon cancer.

Chemotherapy is also used for bringing about relief from the symptoms of colon cancer which now has spread to other regions of the body.

Radiation therapy: Powerful energy sources are used in radiation therapies like X-rays for killing the cancer cells or to shrink large sized tumors before an operation so that they can be removed with more ease or relieve the symptoms of colon and rectal cancer. Radiation therapy alone or if combined with chemotherapy is one of the standard treatment options for the initial management of rectal cancer which must be followed by a surgery.

Targeted drug therapy: people suffering from advanced colon cancer can also be given drugs that aim to target specific malfunctions that permit the growth of cancer cells. Some of the drugs used are

• Cetuximab (Erbitux)
• Bevacizumab (Avastin)
• Ramucirumab (Cyramza)
• Panitumumab (Vectibix)
• Ziv-aflibercept (Zaltrap)
• Regorafenib (Stivarga)

These drugs can be either given alone or with chemotherapy or typically reserved for patients suffering from advanced colon cancer.

There are some people who get helped with targeted drugs and there can be some who do not benefit. Researchers have found out the group of patients who will most likely benefit from targeted drug usage. But till everything is confirmed healthcare providers carefully weigh the options of benefits with the risks of the side effects and costs when deciding whether one should use these treatments or not.

Immunotherapy: There are groups of patients who have the chance to benefit from immunotherapy using antibodies like pembrolizumab (Keyrtruda) and nivolumab (Opdivo). Whether a colon cancer has the chance to respond to the immunotherapies can be later determined by a test on the tumor tissue.

Supportive palliative care:  Palliative care aims at reducing the pain and symptoms associated with some terminal disease. They work with the patient, their family and friends and their doctors to provide that extra layer of the support required for complementing the ongoing care.

When the above kind of treatment is combined with all the other treatment options discussed then it can make the patient feel better and work on improving longevity. The best cancer hospitals are found in India.

It is important to clean the colon just before the surgery and as a result, one should concentrate on how to get a proper fibrous diet to flush clean the colon and toxins from the digestive tract. Patients are usually advised to eat a lot of vegetables and fruits and absolutely no processed food for some time. Fried food and excessively sugary and meaty food should also be looked at to be avoided. Apart from this, patients must in detail discuss their medical history so that the doctor is able to advise on specific medications.