Understanding Colorectal Cancer

Colorectal cancer — cancer that begins in the colon (large intestine) or the rectum — is the third most commonly diagnosed cancer worldwide and a leading cause of cancer-related deaths. In India, incidence has been rising steadily, particularly in metropolitan cities, driven by dietary change, sedentary lifestyles, and an aging population. The reassuring news is that colorectal cancer is also one of the most preventable and, when caught early, most curable cancers. Five-year survival for localized disease exceeds 90%, yet too many Indian patients still present at Stage III or IV simply because symptoms were attributed to “piles,” irritable bowel, or dietary indiscretion for months or years before diagnosis.

At Dr. Abhishek Aggarwal’s clinic at BLK-Max, every colorectal cancer patient is offered a complete multidisciplinary workup, a personalized treatment plan, and access to the full spectrum of modern surgical options — including minimally invasive laparoscopic, robotic, and sphincter-saving procedures that preserve quality of life while delivering cure.

The Anatomy: Where Colorectal Cancer Starts

The colon is a roughly 1.5-metre-long tube divided into four segments — the ascending, transverse, descending, and sigmoid colon — that ends in the 15 cm rectum before opening at the anus. Most colorectal cancers begin as benign polyps (small growths on the inner lining of the bowel) that slowly transform into cancer over 5–10 years. This long precancerous window is exactly why screening colonoscopy is so powerful: detecting and removing polyps before they become malignant prevents the cancer from ever happening.

Approximately 95% of colorectal cancers are adenocarcinomas arising from the glandular lining of the bowel. Less common types include neuroendocrine tumours, gastrointestinal stromal tumours (GISTs), lymphomas, and squamous cell carcinomas of the anal canal. Each behaves differently and each requires a specific treatment approach — another reason a dedicated GI cancer specialist is so important.

Stages of Colorectal Cancer

Cancer staging determines how far the disease has progressed, and it is the single most important factor guiding treatment decisions and predicting outcomes. The TNM system (Tumour, Node, Metastasis) is used worldwide.

Symptoms: Warning Signs You Should Never Ignore

Colorectal cancer is notorious for mimicking benign conditions. The most common symptoms include persistent change in bowel habit (new constipation, diarrhoea, or alternating pattern) lasting more than three weeks, rectal bleeding or blood in the stool, unexplained iron-deficiency anaemia, unintentional weight loss, persistent abdominal pain or cramping, a feeling of incomplete evacuation, narrowing of stool calibre, and profound fatigue. Any of these symptoms persisting beyond a few weeks — especially in anyone over 40 — warrants a specialist consultation and, in most cases, a colonoscopy. Bleeding should never be dismissed as “just piles” without a proper examination.

Risk Factors

• Age: Risk rises sharply after 50, though incidence in patients under 45 is increasing rapidly in India.
• Family history: A first-degree relative with colorectal cancer doubles personal risk.
• Inherited syndromes: Lynch syndrome and familial adenomatous polyposis (FAP) carry very high lifetime risk.
• Diet: High consumption of red and processed meat, low fibre, and low vegetable intake.
• Lifestyle: Obesity, physical inactivity, smoking, and heavy alcohol use.
• Inflammatory bowel disease: Long-standing ulcerative colitis or Crohn’s disease.
• Type 2 diabetes: Independently associated with increased risk.

How Colorectal Cancer Is Diagnosed

Accurate staging is the foundation of good treatment. Dr. Abhishek’s protocol includes:

• Colonoscopy with biopsy — the gold standard. A flexible scope examines the entire colon and suspicious areas are sampled for tissue diagnosis.
• Contrast-enhanced CT of chest, abdomen and pelvis — to assess local spread and rule out distant metastases.
• MRI pelvis — mandatory for rectal cancers to plan surgery and decide on preoperative radiation.
• CEA tumour marker — baseline level used to monitor response and detect recurrence.
• PET-CT — in selected cases, especially suspected metastatic disease.
• Molecular testing — KRAS, NRAS, BRAF, MSI/MMR, HER2 — to personalize chemotherapy and identify candidates for immunotherapy.

Treatment Options — Tailored to Every Stage

Recovery & Outcomes

With minimally invasive surgery, most patients begin walking the same evening, resume liquids within 24 hours, and are discharged on days 4–6 after colon resections and days 6–8 after rectal resections. Return to office work typically takes 3–4 weeks. Adjuvant chemotherapy, where indicated, usually begins 6–8 weeks after surgery. Long-term outcomes depend on stage at diagnosis, completeness of resection, and adherence to follow-up. For localized disease treated in a high-volume specialist centre, cure is the expectation — not the exception.

Why Choose Dr. Abhishek Aggarwal

Dr. Abhishek has performed over 500 GI cancer surgeries with published outcomes comparable to the best international centres. His practice is built on four principles: careful patient selection, meticulous oncological surgery, honest communication, and rigorous long-term follow-up. Every patient gets his direct phone number, personalized attention, and a treatment plan that respects both their disease and their life.