Colonic/rectal cancer is one of the commonest cancers seen all over the world. The incidence is on the rise in India. It is one of the few malignancies where long-term survival is possible even in an advanced stage of detection. Hence it is very important for all the patients with this disease to understand various aspects of this disease. There is no specific cause for colorectal cancer except for de novo genetic changes leading to cancer, polyposis syndromes (cancerous change in a benign polyp) that are again associated with mutation, and inflammatory bowel disease (malignant change in the chronically inflamed lining of the large intestine). Polyposis syndromes are due to genetic mutations which are inherited or sporadic. Hence multiple family members of various generations are seen affected. Continuous inflammation in IBD / UC leads to cellular changes/overgrowth and finally cancer. Colorectal cancer can be due to genetic changes that lead to cancer in multiple organs like the large intestine, and uterus. Breast, stomach, pancreas etcetera (Lynch syndrome) and is a familial occurrence/hereditary. Important to note that all genetic changes are not inherited, actually majority are de novo (in that patient). Hence the majority of colorectal cancers are sporadic/isolated in occurrence. Few are part of polyposis syndromes, Lynch syndrome. For recurrence at the local site (intestine/pelvis), a combination of chemotherapy, surgery, and selective radiotherapy is used. If surgery is possible a major resectional procedure involving multiple organs like bowel, urinary bladder, uterus & vagina, and part of the sacral bone is needed which has a significant risk of complications (anastomotic leak, bleeding, infections, need to live with a stoma, urinary and sexual dysfunction) and risk to life. DR SUBHASHISH DAS Many more questions can come to the mind of a patient or relatives depending on the situation and the DR SUBHASHISH DAS would be in the best position to answer them.
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