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Digestive cancers · free patient guide
Colorectal cancer
Colon and rectal cancer, bowel cancer
GI & hepatobiliary clinic
What it is
Most colorectal cancers develop slowly from polyps, growths in the bowel lining that can be removed before they ever become cancer. That is what makes this one of the most preventable cancers there is.
Colon and rectal cancer are grouped together but treated differently, because the rectum sits in a tight pelvis surrounded by structures that change what surgery and radiation can do.
Colorectal cancer is rising in urban India and is appearing in younger adults more often than previously. Rectal bleeding is frequently attributed to piles for months before anyone looks properly.
Warning signs worth acting on
- Blood in the stool, or bleeding from the back passage, at any age, even if you have piles
- A persistent change in bowel habit lasting more than a few weeks
- Iron-deficiency anaemia without an obvious cause, particularly in men and post-menopausal women
- Unexplained weight loss with any bowel symptom
- Persistent abdominal pain or a feeling of incomplete emptying
- A family history of bowel cancer or polyps, especially at a young age
How it is diagnosed
- Colonoscopy, which both diagnoses and can remove polyps
- Biopsy of any abnormal area
- CT of chest, abdomen and pelvis for staging
- MRI of the pelvis for rectal disease specifically
- Mismatch-repair or microsatellite testing on the tumour
Mismatch-repair and microsatellite status are checked because they change treatment options and can also point to Lynch syndrome, an inherited condition affecting the whole family. Broader profiling informs targeted options in advanced disease. Residual-disease monitoring after curative surgery is assessed on a case-by-case basis.
Is it inherited?
Lynch syndrome and familial polyposis are real and identifiable. Finding one changes screening for every blood relative, often decades before anything would otherwise be found.
Genetic counselling & family risk →
Prevention & early detection
Colonoscopy can remove polyps before they become cancer, which is prevention rather than early detection. Screening age depends on family history, ask what applies to you rather than assuming a standard number.
Treatment options
What may form part of a plan
Which of these apply to you depends on your stage, your pathology, your other health and what you want from treatment. That decision belongs at a tumour board, not on a website.
Surgery
Operability assessment and planning here; the operation at the appropriate partner centre.
Chemotherapy
Drug treatment that acts on rapidly dividing cells throughout the body.
Radiotherapy
Targeted radiation to a defined area, planned in millimetres.
Targeted therapy
Medicines matched to a specific alteration found in your tumour.
Immunotherapy
Treatment that works on the immune system rather than directly on the tumour.
Clinical trials
Most Indian patients never learn a trial exists, because nobody is looking.
At KPCIRC
The pathway for this disease
- Mismatch-repair status driving the immunotherapy assessment
- Lynch syndrome triage, and cascade testing for the family where it is found
- Nutrition and stoma pathway, the two things that determine whether treatment is tolerable
- Residual-disease monitoring candidacy after curative resection
- Stoma education and troubleshooting, which almost nobody offers properly
Support that matters most here
Take this with you
Questions to ask your own doctor
These work wherever you are treated. Print the page or take a photograph of this list.
- Is this colon or rectal disease, and does that change the plan?
- Will I need a stoma, and if so is it temporary or permanent?
- What did the mismatch-repair test show?
- Should my family be screened, and from what age?
- What is the plan for monitoring after treatment?
This page is not an emergency service. Severe breathlessness, chest pain, uncontrolled bleeding, a high fever during chemotherapy, or a sudden change in alertness means going to your nearest emergency department now, not reading further.