Colorectal Cancer

Colorectal Cancer

For most people, a tummy ache is just that. A simple tummy ache. Its something we tend to take very casually. But, on occasion, a stomach ache can be indicative of a far more serious problem - digestive track complications, colitis and even cancer. Tackling these conditions at an early stage ensures you a better chance of survival. In cases involving colonic cancer and colitis, timely intervention can save the lives of 70-80% of patients. So, make it a point to visit your doctor regularly for check-ups.

Colorectal cancer starts in the colon or the rectum. These cancers can also be named colon cancer or rectal cancer, depending on where they start.

Warning signs

  • Persistent constipation or diarrhoea
  • An urgency to move the bowels
  • Rectal cramping, or rectal bleeding
  • Dark patches of blood in or on stool; or long, thin, "pencil stools"
  • Abdominal discomfort or bloating
  • Unexplained fatigue, loss of appetite, and/or weight loss
  • Pelvic pain, which occurs at later stages of the disease

Risk factors

  • Older age (after 50)
  • Inflammatory bowel disease, Crohns disease, or ulcerative colitis
  • A personal or family history of colorectal cancer or colorectal polyps
  • Lack of regular physical activity
  • Low fruit and vegetable intake
  • A low-fibre and high-fat diet
  • Overweight and obesity
  • Alcohol consumption
  • Tobacco use


Stage I: Cancer has grown through the mucosa and has invaded the muscular layer of the colon or rectum.

Stage II: Cancer has grown through the wall of the colon or rectum

Stage III: Cancer has grown through the inner lining or into the muscle layers of the intestine and spread to one to three lymph nodes

Stage IV: Cancer has spread to different organ like lungs, bones, liver, lymph nodes, brain or spinal cord.


  • Primary diagnosis : Physical examination, blood tests
  • Advanced diagnosis : Colonoscopy (using a scope to examine the inside of your colon)

The incidence of colonic cancer and colitis in India is steadily on the rise. These diseases can have serious, if not fatal, consequences if not caught in time. Thus, regular check-ups are essential.

Regular check-ups help detect diseases early and the data acquired allows the doctor to make informed treatment decisions which may or may not include pouch surgery, laparoscopy surgery, advanced surgery or minimally invasive surgery. We have provided more information on the various treatment options below.

Kokilaben Hospitals Colorectal Unit believes in a multi-disciplinary approach to treat and manage colorectal complications. Our modern services include one-stop rectal bleeding clinic, family screening for bowel cancer, stoma clinics, IBD clinics for patients with inflammatory bowel disease, enhanced recovery programme.


Robotic + Laproscopy, Research performed routinely for Colorectal Cancer at Kokilaben hospital.


  • Bleeding from the rectum in patients above age 40
  • Altered bowel habits (> 6 weeks)
  • Weight loss or family history of cancer
  • Advantages of a Minimally Invasive Approach:

  • Concealed cosmetic scar
  • Minimal pain
  • Faster recovery and minimal post-op adhesions
  • Minimal blood loss as compared to normal surgery

Should you observe any of the following symptoms, please refer to a specialist immediately.


  • Bleeding from the rectum in patients above age 40
  • Altered bowel habits (> 6 weeks)
  • Weight loss or family history of cancer

Advantages of a Minimally Invasive Approach:

  • Concealed cosmetic scar
  • Minimal pain
  • Faster recovery and minimal post-op adhesions
  • Minimal blood loss as compared to normal surgery

Colitis affects young patients, making diagnosis quite difficult and, sometimes, this leads to a delayed diagnosis. As a result, patients may end up with a permanent stoma (bag for life).

Kokilaben Hospital offers:

  • A team approach to tackle this difficult problem
  • Keyhole technology
  • Pouch surgery - avoiding the need for a permanent stoma in most patients

Haemorrhoids (piles) are a very common problem which affects 1 in 3 people in India. Invasive surgery can be more painful than having piles. This is why we, at Kokilaben Hospital’s Colorectal Unit, offer minimally invasive treatment for piles, depending on the stage.

Treatment options for piles are:

  • Rubber band ligation
  • Infrared (laser) treatment
  • Stapled anopexy

Advantages of a Minimally Invasive Approach:

  • Day surgery
  • Minimal pain
  • Faster recovery and the ability to resume work sooner

Fissures and fistulas can be very painful. Traditional invasive surgery of these conditions carries the risk of incontinence. Kokilaben Hospital’s Colorectal Unit offers the latest treatment which uses botox in order to heal fissures faster. This unit also offers a new, innovative treatment option for fistulas which uses fistula plugs. Both these surgeries can be performed as day surgeries.

Other advantages:

  • Faster healing and recovery
  • Minimal pain
  • Avoids the risk of major surgery

Incontinence, both faecal and urinary, is still a taboo subject in India. It is very common in ladies who have gone through difficult childbirth (labour) in the past. The results of surgery are poor and the risks are significant.

At Kokilaben Hospital, the Colorectal Unit offers highly specialised incontinence services. The team consists of a colorectal surgeon, physiotherapists and incontinence nurse specialists. This unit is equipped to handle both minor as well as severe incontinence problems.

We also offer laparoscopic rectopexy for rectal prolapse. This procedure has the lowest recurrence rates. It is less painful and has faster recovery rates.

We are the first unit in India to offer implantation of a pacemaker, like the one used in the heart, to treat different types of incontinence. This technology is very new and has received excellent results in the UK and USA.


Day surgery

  • Avoids debilitating surgery
  • Completely reversible
  • Very minimal risks
  • Laparoscopic small bowel resection
  • Laparoscopic stomal hernia repairs
  • Laparoscopic appendicectomies

Multi-disciplinary approach

Kokilaben Hospitals Colorectal Unit believes in a multi-disciplinary approach to treat and manage colorectal complications. The modern services we offer include:

  • One-stop rectal bleeding clinic - where camera examination and treatment can be done on the same day
  • Family screening for bowel cancer
  • Stoma clinics
  • IBD clinics for patients with inflammatory bowel disease
  • Enhanced recovery programme - so that patients can recover from surgery faster

Reported outcome

5 years survival rates

Stage I 95 per cent
Stage II 75 per cent
Stage III 60 per cent
Stage IV 30 per cent

Top tips

  • Getting regular screening tests for colon cancer is the single best way to prevent it.
  • If youve put on weight, your first goal should be to stop gaining weight, which has health benefits by itself.
  • Dont smoke at all. Its the best thing you can do for your health.
  • Any amount of physical activity is better than none, but its good to aim for around 30 minutes or more of moderate activity each day. Choose things you enjoy, like brisk walking, cycling, dancing or gardening.
  • Alcohol is heart-healthy in moderation but can increase the risk of colon and other cancers at even low levels. So drink moderately is you cannot stop. And if you dont drink at all, there is no reason to start.
  • Eating too much red meat – like steak, hamburger and pork – increases the risk of colon cancer.
  • Shoot for 1,000 to 1,200 milligrams per day of calcium and about 1,000 international units (IU) per day of vitamin D for healthy colon and rectum.
  • A daily multivitamin with folate is a good nutrition insurance policy that can also help protect against colon cancer.

Remarkable Case

Mumbais First Robotic Surgery for Cancer of the Rectum

Background and diagnosis : A 45-year-old male complained about bleeding from the rectum. We diagnosed him and found other symptoms bothering him like anaemia, fatigue, shortness of breath, dizziness and/or a fast heartbeat, bowel obstruction, small diameter stools and weight loss. Additional tests confirmed cancer of the rectum.

Treatment : At our hospital, laparoscopic colon and rectal cancer surgery is the standard of care. The recent addition of precision, ease and three-dimensional vision in state-of-the-art robotics helped us perform a successful surgery. We applied this technology for precise resection of a rectal tumour for the first time in Mumbai.

Outcome : The tumour was successfully removed and the patient had a normal postoperative recovery.

Dr. Mandar Nadkarni

Dr. Mandar Nadkarni



Cancer/Surgical Oncology


Breast Oncology & G I Oncology

Dr. Manoj Mulchandani

Dr. Manoj Mulchandani



Cancer, Robotic Surgery, General Surgery, Minimal Access Surgery


Laparoscopic/ Robotic Colorectal Resections for Cancer, inflammatory Bowel disease, Pelvic Floor Surgeries, All types of Surgeries for Haemorrhoids and Fistula

Dr. Rajendra Sonawane

Dr. Rajendra Sonawane

MS, MCh(Surgical Gastroenterology), SGPGIMS, Lucknow


Robotic Surgery, General Surgery, Minimal Access Surgery


Minimal Access Gastrointestinal /Colorectal cancer surgery, Pancreatic and biliary surgery, Restorative proctocolectomy with Ileal pouch, Minimal access Surgery for Reflux disease, Nissens fundoplication