Diagnosis

Complete mesocolic excision (CME): Following the well-established principles of complete reception of the primary tumor and its draining lymphatics, the patient depending on the location of the tumor will undergo a right hemicolectomy, left hemicolectomy, transverse colectomy, sigmoid colectomy, subtotal colectomy or total proctocolectomy. Occasionally if metastasis to the liver or lungs is there they might also be resected. Spread to surrounding organs can be resected. Most of the colonic surgery can be performed by minimally Invasive techniques of Laparoscopy or Robotic surgery.

These techniques facilitate accurate dissection with minimal blood loss and quick post-operative recovery.

A total Mesorectal excision (TME) is the standard of acre followed across the globe for surgical removal of rectal cancer. This can be performed by Minimally invasive techniques of Laparoscopy or Robotic surgery. One of the important factors in rectal cancer surgery is anal sphincter preservation. High volume centers with experienced surgical teams can preserve sphincters in the majority of the patients with judicious use of preoperative radiation and chemotherapy strategies and advanced surgical techniques.

Newer techniques like TA TME and TEMS and TAMIS are very selectively used for the particular size and location of cancers in a handful of patients with good results.

• Colon Cancer –Radiation therapy and proton therapy have a limited role in Colonic carcinoma. In cases where colon cancer has spread to the liver or a few other sites only, high-dose radiation or proton therapy may be used to deliver high doses to these lesions and at the least control the disease.
• Rectal Cancer – Radiation therapy along with chemotherapy is used in locally advanced rectal cancers pre-operatively to reduce the chances of the tumour coming back in the operated site. In patients who have not radiation therapy before surgery, this may sometimes be required after the surgery. Proton therapy can reduce the side effects of the radiation both in the pre-operative as well as post-operative setting. Also in cases where the tumour does recur after initial treatment, proton therapy is very useful to offer re-irradiation and control the tumour locally.

• Prevention of colorectal cancer
• High fiber diet with fresh fruits and vegetables avoiding excessive intake of processed and red meat.
• Smoking cessation
• Weight reduction and obesity prevention
• Screening of high-risk groups and early polyps removal