Colon Cancer Surgery in India

Overview

Colon cancer is the third most common cancer affecting both males and females in the United States. Annually, approximately 102,900 Americans are diagnosed with the disease. Approximately 80 percent of cases are localized to the bowel and regional lymph nodes at diagnosis .Colon cancer is a common type of malignancy (cancer) in which there is uncontrolled growth of the cells that line the inside of the colon or rectum. Colon cancer is also called colorectal cancer. With 655,000 deaths worldwide per year, it is the fourth most common form of cancer in the United States and the third leading cause of cancer-related death in the Western world. Colon cancers arise from adenomatous polyps in the colon.

What is Colon Cancer?

Colon Cancer also known as colorectal cancer or large bowel cancer includes cancerous growths in the colon, rectum and appendix. Screening for Colon cancer should begin at the age of 40 in healthy adults. 70 to 80 percent of colorectal cancer cases occur in adults without specific risk factors. Colon cancer may affect any racial or ethnic group; however, some studies suggest that Americans of northern European heritage have a higher-than-average risk of colon cancer.

Types of Colon Cancer

The Types of Colon Cancer are as under:

• Adenocarcinomas : These are the most common type of Colon Cancer and originate in glands. It account for about 90-95 percent of all colorectal Cancers and have two subtypes, Mucinous and signet ring cell. The Mucinous subtype comprises about 10-15 percent of Adenocarcinomas while the signet ring cell subtype comprises less than 0.1 percent of Adenocarcinomas.
• Leiomyosarcomas : This type of Colon Cancer occurs in the smooth muscle of the Colon. Leiomyosarcomas account for less than two percent of colorectal Cancers and have a fairly high chance of metastasizing.
• Lymphomas : These are the rare and are more likely to start in the rectum than in the Colon. However, lymphomas that start somewhere else in the body are more likely to spread to the Colon than to the rectum.
• Melanomas : This type of Colon cancer is rare. Usually, it results from a melanoma that started somewhere else and then spread to the Colon or rectum. Melanomas account for less than 2% of colorectal Cancers.
• Neuroendocrine Tumors : This tumor is divided into two main categories: aggressive and indolent.

Causes of Colon Cancer

There are several causes for colorectal cancer as well as factors that place certain individuals at increased risk for the disease. There are known genetic and environmental factors. The people at risk for colorectal cancer:

• The biggest risk factor is age. Colon cancer is rare in those under 40 years. The rate of colorectal cancer detection begins to increase after age 40. Most colorectal cancer is diagnosed in those over 60 years.
• Have a mother, father, sister, or brother who developed colorectal cancer or polyps. When more than one family member has had colorectal cancer, the risk to other members may be three-to-four times higher of developing the disease. This higher risk may be due to an inherited gene.
• Have history of benign growths, such as polyps, that have been surgically removed.
• Have a prior history of colon or rectal cancer.
• Have disease or condition linked with increased risk.
• Have a diet high in fat and low in fiber

Symptoms of Colon Cancer

Symptoms of colon cancer are numerous and nonspecific. They include fatigue, weakness, and shortness of breath, change in bowel habits, narrow stools, diarrhea or constipation, red or dark blood in stool, weight loss, abdominal pain, cramps, or bloating. Other conditions such as irritable bowel syndrome (spastic colon), ulcerative colitis, Crohn's disease, diverticulosis, and peptic ulcer disease can have symptoms that mimic colorectal cancer. Colon cancer can be present for several years before symptoms develop. Symptoms vary according to where in the large bowel the tumor is located. The right colon is spacious, and cancers of the right colon can grow to large sizes before they cause any abdominal symptoms.

Diagnosis for Colon Cancer

If people experience symptoms like those of colorectal cancer, they need to make an appointment with their family physician, a gastroenterologist, a physician specially trained in the management of digestive system disorders, or a colon and rectal surgeon, a specialist in treatment of diseases of the colon.

The doctor performs a thorough clinical evaluation that includes:

• A complete medical, family, and drug history
• A physical examination, including a digital rectal examination

Tests that may be performed include:

• Sigmoidoscopy
• Colonoscopy
• Double contrast barium enema (also called barium meal and enema)

Colon Cancer Staging

Colon cancer is "staged" according to the pathological findings (results from biopsy) after surgery. Staging is a method to describe how advanced a cancer is. Staging for colorectal cancer takes into account the depth of invasion into the colon wall, and spread to lymph nodes and other organs:

• Stage 0 (Carcinoma in Situ) : Stage 0 cancer is also called carcinoma in situ. This is a precancerous condition, usually found in a polyp.
• Stage I : The cancer has spread through the innermost lining of the colon to the second and third layers of the colon wall. It has not spread outside the colon.
• Stage II : The cancer has spread outside the colon to nearby tissues.
• Stage III : Cancer has spread to nearby lymph nodes, but not to other parts of the body.
• Stage IV : Cancer has spread to other parts of the body, such as the liver or lungs.

Preparing for Colon Cancer Surgery

It is vitally important to enter into Colon Cancer Surgery with a positive attitude. While the extent of involvement, type of tumor and surgical skill all play a role in the surgical outcome, going into the procedure with a sense of well being will help prepare your body to respond more effectively. Prepare yourself for a lengthy and possibly arduous recovery process, and expect good results.

• Do not eat or drink anything after midnight the night before your surgery; this includes water.
• Continue to take medication as prescribed, but with only a sip of water. Do not take ibuprofen, aspirin or any medication containing aspirin for one week before your surgery.
• Do not smoke after midnight the night before your surgery.
• Do not wear any make-up, especially eye make-up, lotions, or powders.
• Do not bring large sums of money, jewelry, or credit cards.
• If you wear contact lenses, bring the case to remove them before going into surgery.
• Do not wear artificial nails or nail polish. Your nails are monitored during surgery to identify oxygen and blood circulation.
• Bring a list with you of all your medications and their dosages.
• Bring your insurance identification cards, a copy of Advance Directives, etc.

Colon Cancer Surgery Procedures

The goal of Colon Cancer Surgery is to eliminate the cancer or, in the case of advanced disease, relieve symptoms. Leave an area around the cancerous site that is free of cancer cells. Therefore, no cancer cells are present in the tissue surrounding the surgery site and finally to remove nearby lymph nodes. The following are the major types of Colon Cancer Surgery:

• Bowel Diversion Surgery : Bowel diversion surgery allows stool to safely leave the body when—because of disease or injury—the large intestine is removed or needs time to heal. Bowel is a general term for any part of the small or large intestine. Some bowel diversion surgeries—those called ostomy surgery—divert the bowel to an opening in the abdomen where a stoma is created. A surgeon forms a stoma by rolling the bowel’s end back on itself, like a shirt cuff, and stitching it to the abdominal wall. An ostomy pouch is attached to the stoma and worn outside the body to collect stool. Other bowel diversion surgeries reconfigure the intestines after damaged portions are removed. For example, after removing the colon, a surgeon can create a colon like pouch out of the last part of the small intestine, avoiding the need for an ostomy pouch. Cancer, trauma, inflammatory bowel disease (IBD), bowel obstruction, and diverticulitis are all possible reasons for bowel diversion surgery. Several surgical options exist for bowel diversion.
  • Ileostomy: diverts the ileum to a stoma. Semisolid waste flows out of the stoma and collects in an ostomy pouch, which must be emptied several times a day. An ileostomy bypasses the colon, rectum, and anus and has the fewest complications.
  • Colostomy: is similar to an ileostomy, but the colon—not the ileum—is diverted to a stoma. As with an ileostomy, stool collects in an ostomy pouch.
  • Ileoanal reservoir surgery: is an option when the large intestine is removed but the anus remains intact and disease-free. The surgeon creates a colon like pouch, called an ileoanal reservoir, from the last several inches of the ileum. The Ileoanal reservoir is also called a pelvic pouch or J-pouch.
  • Continent Ileostomy: is an option for people who are not good candidates for ileoanal reservoir surgery because of damage to the rectum or anus but do not want to wear an ostomy pouch. As with ileoanal reservoir surgery, the large intestine is removed and a colon-like pouch, called a Koch pouch, is made from the end of the ileum.
• Radiofrequency Ablation : Radiofrequency ablation is a type of colon cancer surgery that uses a special probe with tiny electrodes that kill cancer cells. Sometimes the probe is inserted directly through the skin and only local anesthesia is needed. In other cases, the probe is inserted through an incision in the abdomen (stomach). This is done in the hospital with general anesthesia. Radiofrequency ablation helps the surgeons and radiologists at Cancer Treatment Centers of America eliminate small liver tumors, often without the risks and discomfort associated with traditional surgery. Radiofrequency ablation is also less invasive and less painful. To perform this innovative procedure, our surgeons or radiologists use ultrasound guidance to place a thin, needle-like device into the center of a liver tumor. The tip of the device then emits the radiofrequency waves (i.e., electrical energy), directing the heated energy at the tumor to destroy cancer cells. Radiofrequency ablation can be applied during a surgical procedure, or through the skin. It may be an appropriate treatment for colorectal cancer patients who have multiple tumors, or who have been previously treated with surgery.
• Cryosurgery : Cryosurgery is a treatment that uses an instrument to freeze and destroy abnormal tissue, such as carcinoma in situ. This type of surgery is also called cryotherapy. Cryosurgery can be used to treat men who have early-stage prostate cancer that is confined to the prostate gland. It is less well established than standard prostatectomy and various types of radiation therapy. Long-term outcomes are not known. Because it is effective only in small areas, cryosurgery is not used to treat prostate cancer that has spread outside the gland, or to distant parts of the body. Some advantages of cryosurgery are that the procedure can be repeated, and it can be used to treat men who cannot have surgery or radiation therapy because of their age or other medical problems. Cryosurgery for the prostate gland can cause side effects. These side effects may occur more often in men who have had radiation to the prostate. Cryosurgery offers advantages over other methods of cancer treatment. It is less invasive than surgery, involving only a small incision or insertion of the Cryoprobes through the skin. Consequently, pain, bleeding, and other complications of surgery are minimized. Cryosurgery is less expensive than other treatments and requires shorter recovery time and a shorter hospital stay, or no hospital stay at all. Sometimes cryosurgery can be done using only local anesthesia.
• Polypectomy : A polypectomy may be sufficient in cases involving Duke's Stage A and B cancers. The procedure is performed during a colonoscopy. During the procedure, the polyp is encircled with a wire snare and then an electro cauterizing current is passed through the endoscopic tube, and the polyp is removed. The procedure is then followed by a biopsy and periodic monitoring to check the colon for additional polyps, as well as to monitor for blood in the stool, and for tumor marker levels. There is the risk with a polypectomy that not all of the cancer has been removed. Thus, many surgeons advise a surgical resection to remove not only the part of the colon that contains the cancer, but also a margin of colon on either side of the tumor so as to avoid missing the presence of microscopic cancerous cells that would later spread. If a patient and his or her medical team do opt for a polypectomy, it is important for the patient to be highly motivated to follow up with monitoring procedures, as there is an increased risk of recurrence.
• Laparoscopic Colectomy : A laparoscopic colectomy procedure helps to eliminate the colon cancer. It is able to do this more easily than other procedures such as conventional open surgery, because this procedure places considerably less stress upon the body compared to that of conventional open surgery. Depending on your age and medical condition you may be required to undergo preoperative testing. This may include blood work, x-rays, and an electrocardiogram. The office will arrange this and give you instructions when you schedule your surgery. Patients will also be given a prescription for pain medication. It is recommended that you fill this prescription prior to the day of surgery. The colon is an enormous organ in size, and for the body to continue to be healthy, thrive, and to survive, the colon must be functioning at a reasonably normal state. Unfortunately, it is so common nowadays for us humans to do great damage by abusing its life sustaining properties. The colon is so frequently taken for granted that it is causing problems to untold numbers of people. It is truly a shame and disservice that in this time of our history, the importance of the heart and the importance of avoiding heart disease is so well known, but knowledge of the importance of the colon is so lacking among the general population. The colon deserves a lot more attention that it gets in our modern day world.

Life After Colon Cancer Surgery

After colon cancer surgery, you will be hospitalized for five to seven days. Intestinal ileus, a condition that interferes with your intestines' proper functioning, can occur and cause nausea and poor appetite. You will receive IV fluids during this time to prevent dehydration. The first day after surgery, your doctor will recommend getting out of bed and walking around. You will start a liquid diet one to two days after surgery and gradually work your way up to normal food. Change your diet to a low-fiber diet for the next five to six months to reduce the amount of bulk in your colon. A small amount of pain is expected after surgery, and your doctor will administer pain medication to you intravenously, orally or intramuscularly.

Recovering After Colon Cancer Surgery

The amount of time that people are hospitalized after colon surgery varies. Most people stay in the hospital several days after surgery. During the recovery period, patients should follow the following tips for proper recovery:

• Avoid lifting heavy objects. Such strain may cause a herniation or a rip in the weakened muscles lining the abdominal wall. A gradually progressive exercise program, prescribed by your doctor, helps strengthen abdominal muscles.
• Follow a high-fiber diet.
• If excessive gas, diarrhea, or constipation becomes a problem, eliminate the suspected offending food from the diet. It may be possible to reintroduce this food later.
• If diarrhea is a problem, eat applesauce, bananas, or rice.
• Take laxatives or anti-diarrhea medications only when prescribed by the doctor.
• If surgery included a colostomy, instructions on care of the colostomy will be given by specialized nurses called enterostomal therapists.

Alternatives to Colon Cancer Surgery

With every passing day, we are learning about complementary and alternative medicine therapies for Colon Cancer treatments, but there is still more to learn. Consumers may use the terms "natural," "holistic," "home remedy," or "Eastern medicine" to refer to complementary and alternative medicine. However, experts recommend the following alternatives for Colon Cancer Surgery:

• Mind-Body Medicines
• Biologically Based Practices
• Manipulative and Body-Based Practices
• Energy Medicine
• Whole Medical Systems

Colon Cancer Surgery in India

India has been recognized as a new emerging global medical destination for Colon Cancer Surgery. A sea of foreign patients from all across the world come to India for medical treatments and surgeries of high quality delivered as practiced in the developed nations like the US, UK or any part of the western world and that too at the most affordable costs.

The Cancer Hospitals in India are well equipped with the most advanced medical treatment and techniques. They have the most extensive diagnostic and imaging facilities including Asia’s most advanced MRI and CT technology. These Hospitals offers you a almost all the medical services and treatment maintaining the international benchmarks.

The Indian Oncologists performing different procedures of Colon Cancer Surgery in India are highly qualified, skilled with many years of experience and are affiliated with many renowned medical organizations. India provides the services of the most leading doctors and Colon Cancer Surgery professionals at reasonable cost budget in the following cities:

Cost of Colon Cancer Surgery in India

Cost of Colon Cancer Surgery in India India offers outstanding Colon Cancer Surgery at 60-80% less than prevailing USA or UK rates. Even with travel expenses taken into account, the comprehensive medical tourism packages still provide a savings measured in the thousands of dollars for major procedures. A cost comparison of various medical treatments can give you the exact idea about the difference:

Some of the common countries from which patients travel to India for surgery are:

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