Author: Dr. Deepak George T
MBBS, MS, DNB (Surgical Gastroenterology). MRCS, FLT, FMAS, MNAMS : Senior Consultant Surgical Gastroenterology & Liver Transplant Surgeon

For the past two decades, the number of colon cancer has been increasing in Kerala. The reasons for this are changes in lifestyle and changes in genetic makeup. Like any other cancer, colon cancer is completely curable if detected and treated early. Not like pancreatic or liver cancer, even if it's a little late. It is worth mentioning that it is possible to survive this disease for a long time. 

How is colon cancer diagnosed?

Colonoscopy is the most important test to detect colon cancer. To know if there is blood in the stool Although there are many tests like FOBT (faecal occult blood test), serum CEA (tumor marker test) to CT scan, whole body PET scan etc., one hundred percent confirmation can be done only after colonoscopy and biopsy. After the age of 50, if you see blood and phlegm passing through the stool, it is safe to do a colonoscopy instead of thinking that it is due to piles. If someone in the family has colon cancer, other members of the family should undergo colonoscopy from the age of ten years younger than the age at which the cancer was diagnosed. 

Is it possible to completely remove colon cancer through keyhole?

Of course, colon cancer can be completely removed with keyhole surgery. A keyhole may not be possible if there is an intestinal obstruction due to cancer or if the cancer covers several other organs mm (multivisceral infiltration). While keyhole surgery involves small incisions outside the abdomen, an extensive operation is performed to remove all the diseased parts inside the abdomen. Thus, when operating through a small incision, not only the pain of the wound is less, but the wound heals quickly and the bowel takes less time to function again, so discharge can be achieved in two or three days. 

Does rectal cancer require permanent bowel removal?

In the past, a good number of people had to have their bowels out for the rest of their lives if they got cancer in the rectum, the last part of the large intestine. But cancer treatment has advanced technologically, including radiation and chemotherapyBecause of the increased resolution of keyhole cameras, rectal surgery is now rare. A keyhole operation is performed to shrink the cancer and remove the diseased part of the rectum, sometimes temporarily leaving the bowel out for two months, but then it is possible to live a normal life with the anus preserved. 

Is there an age limit for keyhole operation?

In fact, it is not the age of the patient but their health that determines whether the operation is feasible. A keyhole operation is definitely possible if the patient is fit for the operation after a thorough pre-operative examination, assessment of heart and lung function, and an anesthesiologist's examination. The keyhole operation is easier for the elderly to recover as there is less post-operative pain. Even people over 90 are undergoing keyhole surgery for colon cancer.  

What are the follow-ups after colon cancer surgery?

In the first hospital visit after the operation, the oncology doctor will have to see the biopsy report and decide if he needs to take drugs like chemotherapy to prevent the disease from coming back in the future. Because the wounds of the keyhole operation heal quickly, it is possible to start chemotherapy earlier than others. After that every three to four months (serum CEA) blood test and ultrasound scan will have to be done. A colonoscopy is also performed at one, three, and five years. Because the incision is smaller after a keyhole operation, a hernia is rarely seen in the postoperative incision on this follow-up examination.