Colon Cancer Treatment in India

Colon Cancer initiates its growth either within the colon or the rectum. These types of Cancer are alternatively referred to as colorectal cancer or rectal cancer, depending on their point of origin. The development of cancer takes place when cells within the body begin an unregulated growth process.

The majority of colorectal cancers initiate as growths on the inner lining of either the colon or rectum, known as polyps. Some types of polyps have the potential to transform into cancer over time, typically spanning numerous years, although not all polyps follow this path to becoming cancerous. The likelihood of a polyp undergoing this transformation hinges on its specific type, with various categories existing, which are as follows:

• Adenomatous Polyps (Adenomas): These polyps occasionally progress into cancer, earning them the label of a precancerous condition. The three variations of adenomas are tubular, villous, and tubulovillous.
• Hyperplastic Polyps and Inflammatory Polyps: Although these polyps are more common, they generally do not carry a pre-cancerous attribute. However, individuals with larger hyperplastic polyps (exceeding 1 cm) might require more frequent colorectal cancer screenings through colonoscopy.
• Sessile Serrated Polyps (SSP) and Traditional Serrated Adenomas (TSA): These polyps are often managed similarly to adenomas due to their heightened risk of  leading to colorectal cancer.

If Cancer develops within a polyp, it has the potential to gradually extend into the wall of either the Colon or Rectum. The wall of these organs is composed of numerous layers. Colon Cancer originates within the innermost layer, known as the mucosa, and can progressively advance outward through one or multiple layers.

Once Cancer cells infiltrate the wall, they possess the capability to infiltrate blood vessels or lymph vessels, which are minute conduits responsible for transporting waste and fluid. Subsequently, they can migrate to neighbouring lymph nodes or even distant areas of the body. The stage or extent of spread of this cancer is determined by how deeply it penetrates the wall and whether it has disseminated beyond the confines of the colon or rectum.

Preliminary assessment for Colon Cancer involves several diagnostic measures aimed at detecting and evaluating the presence of this malignancy. Some of the essential pre-evaluation steps for this cancer include:

• Medical History Review: Your healthcare provider might inquire about your medical background, any instances of Cancer in your family, and potential symptoms you may be encountering. Factors such as your age, whether there's a history of colon cancer in your family, your own history of polyps or inflammatory bowel disease, and any genetic syndromes that could contribute to an elevated risk of developing this cancer.
• Fecal Occult Blood Testing (FOBT): Analysing three successive stool samples through FOBT has demonstrated efficacy in early, unnoticed Colon Cancer detection, potentially leading to a reduction in cancer-related deaths. To minimize false positives, patients should avoid consuming broccoli, turnips, radishes, cantaloupe, nonsteroidal anti-inflammatory drugs, and vitamin C for 48 hours before undergoing. FOBT is reported to possess a specificity ranging from 90% to 99% and a sensitivity of 30% to 92%.
• Flexible Sigmoidoscopy: Employed for direct visualization of the left colon, flexible sigmoidoscopy surpasses FOBT in sensitivity and specificity when detecting left-sided colon cancers. Its reported sensitivity is 91.7%, accompanied by a specificity of  85%.
• Double-Contrast Barium Enema (DCBE): Although not commonly used for routine colon cancer screening, DCBE is generally considered less effective than colonoscopy for identifying polyps and colon cancer. However, it might be a suitable screening option for individuals unable to undergo endoscopic evaluation.
• Colonoscopy: Recognized as the most effective screening technique for early colon cancer detection, colonoscopy enables a comprehensive view of the entire colon and permits the removal of polyps for pathological examination. Its sensitivity for detecting colon cancer stands at 95%.
• Complete Blood Count (CBC): Prior to surgery, a CBC should be conducted to assess the presence of anemia, which can be rectified before the surgical procedure.
• Carcinoembryonic Antigen (CEA): Measuring preoperative CEA levels is essential, as an elevated CEA (> 5 ng/mL) serves as an indicator of an unfavorable prognosis. Post-surgery, CEA levels should be retested to establish a new baseline for subsequent monitoring.
• CT Colonography: With advancements in radiological imaging, CT colonography, often referred to as virtual colonoscopy, has emerged as an option for colon evaluation. This method can be particularly useful for patients unable to undergo traditional colonoscopy or those with incomplete colonoscopies. For patients with rectal cancer, a preoperative CT scan is now standard practice, offering a detailed assessment for synchronous lesions, especially liver metastases, thereby enabling surgeons to adjust their operative strategies accordingly.
• Hydrocolonic Ultrasonography (HUS): This technique seems valuable for assessing the local staging of colon cancer prior to surgery.
• Sigmoidoscopy: It involves examining the rectum and the lower part of the colon (sigmoid colon) to detect polyps (small protruding tissue areas), anomalies, or    cancerous growths.
• Biopsy: It is the process of extracting cells or tissues to be examined by a pathologist under a microscope, aiming to identify indications of cancer.
• DNA Stool Test: is a procedure that assesses genetic alterations in stool cells, which could potentially indicate the presence of colorectal cancer.
• CT Scan (CAT scan): It is a process that captures a sequence of intricate images of  internal body regions, such as the abdomen, pelvis, or chest, by taking pictures from different angles.
• MRI (Magnetic Resonance Imaging): It is a technique that employs a magnet, radio waves, and a computer to create a series of detailed images of areas within the colon. 
• PET Scan (Positron Emission Tomography Scan): It is a procedure used to locate malignant tumour cells in the body.
• Lymph Node Biopsy: It involves extracting either a portion or the entirety of a lymph node. A pathologist examines the lymph node tissue under a microscope to identify any cancer cells.
• Chest Radiograph: A chest radiograph is part of the assessment process.

Symptoms of Colon Cancer

Colon Cancer may not exhibit symptoms right away. In fact, many of the indications associated with this cancer can also arise due to other illnesses like infections, hemorrhoids, irritable bowel syndrome, or inflammatory bowel disease. Following are the symptoms associated with this cancer: 

• Alteration in bowel patterns (such as Persistent Diarrhea, Constipation, or Stool Narrowing) lasting beyond a few days
• Urge to pass stool that persists even after doing so
• Rectal bleeding with bright red blood
• Presence of blood in the stool, potentially leading to dark brown or black appearance
• Abdominal pain or cramping.
• Fatigue and Weakness
• Unintentional weight loss

Frequently, Colon Cancer remains asymptomatic until it advances or spreads. Early detection through screening can facilitate easier treatment. Additionally, screening has the potential to prevent certain colon cancers by identifying and removing precancerous growths called polyps.

Causes of Colon Cancer

Medical experts are not entirely sure about the exact causes of the majority of Colon Cancers. Nonetheless, there are factors that could potentially elevate the likelihood of developing this Cancer:

• Advanced Age: Such cancers can manifest at any age, but it is predominantly observed in individuals over 50. However, there has been a growing number of cases of colon cancer among those under 50, although the reasons for this trend are not yet understood
• Ethnicity: In the United States, Black individuals face a higher risk of colon cancer compared to people from other racial backgrounds
• Personal History: A previous occurrence of colorectal cancer or polyps increases the vulnerability to this cancer
• Inflammatory Bowel Diseases: Inflammatory bowel conditions, which result in intestinal inflammation and discomfort, such as ulcerative colitis and Crohn's disease, can escalate the likelihood of colon cancer
• Hereditary Predisposition: Certain genetic mutations that raise the risk of this cancer can be hereditary. The prevalent syndromes linked to this increased risk are familial adenomatous polyposis and Lynch syndrome
• Family History: Having a blood relative with colon or rectal cancer elevates the personal risk. The risk further heightens when more than one family member is affected
• Diet: A diet commonly associated with Western cultures, low in fiber and high in fat and calories, might be associated with colon and rectal cancer. The red and processed meats may also increase the risk
• Sedentary Lifestyle: Insufficient physical activity is correlated with a higher likelihood of developing colon cancer. Regular exercise could potentially lower this risk
• Diabetes: People with diabetes or insulin resistance are at an elevated risk of colorectal cancer
• Obesity: Obesity is linked to an increased susceptibility to this cancer, and it also enhances the risk of fatal outcomes
• Smoking: Smoking tobacco is associated with an increased risk of this cancer
• Alcohol Consumption: Excessive alcohol consumption also heightens such risks
• Previous Radiation Therapy: Abdominal radiation therapy administered for prior cancer treatment can raise the risk of subsequent Colon Cancer

Like any medical procedure, there's a chance of complications, although they are infrequent.
Potential complications linked to the Colorectal Cancer encompass:

• Leakage between the connected colon segments
• Intestinal perforation or bleeding
• Opening of the incision (dehiscence)
• Infection
• Harm to the Bladder, Ureters, or Blood Vessels
• Intestines protruding through the incision into the abdomen (incisional hernia)
• Formation of scar tissue causing an intestinal blockage (stricture)
• Visceral Injury
• Intraoperative blood loss
• Fatigue, Nausea, Hair Loss, and changes in bowel habits due to chemotherapy and radiation

The care provided to individuals diagnosed with cancer doesn't conclude after active treatment concludes. Your healthcare team will persist in monitoring for any potential cancer recurrence, addressing side effects, and overseeing your overall well-being. This ongoing care is referred to as follow-up care.

Your follow-up care might involve regular physical check-ups, medical assessments, or both. Doctors aim to monitor your progress over the coming months and years.Typically, patients often have appointments with the doctor and undergo follow-up screenings every 3 to 6 months for a span of 5 years following their diagnosis. Follow-up care is particularly critical during the initial 5 years post-treatment for colon cancer, as this phase carries the highest risk of recurrence.

Cancer rehabilitation could also be advised, encompassing a broad spectrum of services such as Physical Therapy, Occupational Therapy, career guidance, Pain Management, dietary planning, and emotional counseling. The objective of rehabilitation is to aid individuals in regaining control over various aspects of their lives and maintaining as much independence as feasible.

Many individuals anticipate experiencing side effects during treatment. However, survivors are often taken aback by the possibility that certain side effects might persist beyond the treatment duration. These are termed as long-term side effects. Additionally, there are late effects that can emerge months or even years after treatment completion. These effects can encompass both physical and emotional changes.

It's advisable to have a conversation with your doctor about the potential for encountering such side effects, based on your diagnosis, personalized treatment plan, and overall health. If you underwent treatment associated with specific late effects, you might need particular physical examinations, scans, or blood tests to detect and manage them effectively.

The survival rates for Colon Cancer differ based on multiple factors. These factors encompass the cancer's stage, an individual's age and overall health, as well as the effectiveness of the treatment plan. The overall 5-year relative survival rate is 63% for Colon Cancer. If the cancer is identified at a localized stage, the survival rate reaches 91%. This stage accounts for around 37% of diagnoses. In cases where the Cancer has spread to nearby tissues or organs and/or the regional lymph nodes, the 5-year relative survival rate is 72%. Approximately 36% of patients receive a diagnosis at this regional stage. If colon cancer has metastasized to distant body parts, the 5-year relative survival rate is 13%. Roughly 22% of patients are diagnosed at this advanced stage. 

The cost of Colon Cancer Treatment in India ranges from $2,993 to $7,832.This cost discrepancy is attributed to the diversity of treatment choices and the extent of treatment required. As previously mentioned, there are several treatment alternatives for colon cancer.The average estimate of cost of colon cancer treatment based on the various available treatment choices:

The average estimate of cost of Colon Cancer Treatment based on the location of the facility providing treatment:

However, the expenses associated with Colon Cancer Treatment in India can vary based on the following key factors:

• The scope of health insurance coverage
• Out-of-pocket costs
• Admission fees
• Compensation for the oncologist's services
• Patient's age
• Severity of the tumour or extent of metastasis
• Patient's overall medical condition
• Type of Colon Cancer treatment chosen
• Complications arising after the procedure
• Classification of the hospital
• Preferred room category for admission
• Supplementary laboratory or diagnostic tests such as X-rays, ECGs, and similar assessments

The costs linked to the diagnosis of colon cancer may involve multiple initial tests and evaluations conducted before the main treatment. These additional expenses encompass diagnostic processes such as X-rays, CT (computed tomography) scans, MRI (magnetic resonance imaging) scans, PET (positron emission tomography) scans, biopsies, and other diagnostic assessments. The total expenses for these examinations can vary between INR 40,000 and INR 50,000.

MedFlick, your trusted healthcare companion, is dedicated to ensuring that your medical journey goes as smoothly and successfully as possible.

•  Individualized Guidance: Personalized guidance throughout your medical journey.
•  Access to a broad network of prominent hospitals, top doctors, and skilled surgeons.
•  Transparent and Competitive Pricing: A full breakdown of treatment costs that eliminates surprises and offers you cost-effective solutions.
•  MedFlick provides everything from travel arrangements to hotel and visa help to lodging.
•  Multilingual Support: Breaking down language barriers to allow patients and medical professionals to communicate more effectively.

The road to a successful Colon Cancer treatment is long and winding, full of hope, resilience, and the promise of a brighter future. With MedFlick as your guide, navigating this life-changing adventure becomes simple and liberating