In humans, the intestine forms the major part of the digestive tract. It is divided into small and large intestine, based on its appearance. Even though large intestine is considerably shorter in length compared to the small intestine, its represents the major site of intestinal malignancies.

Large intestine consists of the colon and the rectum. The colon which is an inverted U shaped structure located in the periphery of the abdomen is further divided into caecum, ascending colon, transverse colon, descending colon, sigmoid colon, terminating in the rectum. Cancers occurring in any of these sites is termed “Colorectal cancer”.

Here are some FAQs answered!

Some insight into the prevalence of colorectal cancer

Even though the prevalence of colorectal cancer is more in the western world, India has shown an alarming increase in the incidence, to become the third most common cause of cancer related deaths. There are a lot of variations in the presentation of colorectal cancers in India compared to the western world. We see an early age of presentation (mean age- 43 yrs, compared to 50-60 yrs in rest of the world) of significantly advanced cancers (stage 3 -4) with metastasis and worse prognosis. Ignorance, low socioeconomic status, hesitation and delay in seeking medical care for long term symptoms contribute to this. The importance of this comes with the fact that colorectal cancer is one of disorders that have adequate screening tools (colonoscopy and biopsy), capable of detecting cancer in the early stages and when timely utilized, aid in early diagnosis and treatment and thus can prevent a major share of the colorectal cancer deaths.

What are the causes of colorectal cancer?

Colorectal cancers can be due to a family history of inheritable genetic mutations or most commonly sporadic, that has occurred due to environmental or lifestyle changes of the individual. It is observed that adoption of a diet low in vitamins and fiber (fruits and vegetables), and high in fat and refined carbohydrate (maida based and red meat and alcohol) is closely associated with the occurrence of this disease. It is theorized that this reduces the bulk of the stools formed, deterring its easy passage and alters the intestinal bacteria(good bacteria), which in turn increases the synthesis of the toxic chemicals that can remain in contact with the colon for an extended duration of time that can result in carcinogenic changes. Compounding these changes are deficiencies in Vitamins A, C and E that are known antioxidants, neutralizing the free oxygen radicals.

What are the types of colorectal cancer?

Colorectal cancers can clinically be divided into two sets: Right sided (caecum and ascending colon and part of the transverse colon) and Left sided (descending and sigmoid colon along with the rectum). Right sided cancers mainly have fatigue, weakness and undiagnosed anemia as a presentation, whereas left sided cancers have changes in stool passage, bleeding associated with defecation, and pain abdomen. Unfortunately, these are undetected and undiagnosed for very long periods, by which time the cancer would have spread through the layers of the intestine, invaded lymphatics and blood vessels and reached distant organs, leading to metastasis.

How to treat colorectal cancer?

Colorectal cancers in the initial stages are confined to the first two layers of the intestine. Diagnosis at this time almost results in a complete cure of the patient with surgery usually being the only mode of treatment required. Once the tumor spreads across the intestinal layers and reaches the lymph nodes and adjacent organs, treatment involving chemo radiation is needed along with surgery to remove the cancer focus in the body. A thorough body workup to determine the actual stage of the cancer along with the biopsy of the cancerous tissue is essential.

  • 1st Prize: Paediatric Quiz – JJM, Davanagere, Karnataka.
  • 1st Prize: Surgery Quiz – JSS Medical College, Mysore.
  • 1st Rank Belgaum District, Karnataka PUC II year.
  • Received scholarship to attend workshop on research ethics at Harvard University Boston.
  • Selected as International travelling fellow from Colorectal Associations of India for a visit to Birmingham Heartland Hospital.
  • Received Travel Award at International Gastrointestinal Conference in Barcelona 2005.
  • Received Best Teachers Award in Karnataka state 2013.
  • “Pink Hope” a book written by Ms.Beena on Breast Cancer journey of her mother and my patient , Sara is dedicated to Dr. Nanda Rajaneesh.

Like most career women, Dr. Nanda balances her career and home with a formula that helps her to give her best to the two worlds that she is an integral part of. With unstinting support from her husband and his family, complemented with professional help at the domestic front, Dr. Nanda balances home and her career with enormous ease and composure that would be an envy to any working women or for that matter working men who have in more recent times making a serious attempt to balance career and home as responsible fathers. The constant quest and challenge in the career of Dr. Nanda is the ability to face medical complications that lead to the death of the patient. While she acknowledges that this may be few for a successful surgeon, but the number of surgeries performed during one’s career will not allow one to free themselves from this situation. She says that this challenge is a part of the profession. But to her, dealing with this challenge is a constant battle and she would want to find a way to come to terms with it. She says she does not want a medical complication, but when it comes it is hard to take it and one must learn to deal with it.

An extremely pleasing personality, her confidence, humility and human touch governed by medical ethics, this is what characterises Dr. Nanda, who is a unique combination of a surgeon with a lion’s heart and ladies finger.

Excellence has been a passion for Dr. Nanda, with which she undertook any activity. This passion for excellence has been the trait that has seen her through her years of successful professional life both as a surgeon, an administrator and as a leader in the profession. To her, only she is her closest competitor. Her goal in life is to get better in all spheres every day with her previous point as her reference. It is this unique ability that has been responsible for her to network with several doctors and consultants in her profession who are both younger and older in the profession.

Dr. Nanda Rajaneesh’s chief calling is that of a surgeon which provides her with a platform to serve people who are ill. Given the broad range of experience particularly with St. John’s hospital, where she served as an associate professor for a period of 4 years, Dr. Nanda has had the unique opportunity of interacting with patients coming from different socio-economic strata that binds her to her patients and their family in more ways than one.

A keen observer and a listener, she particularly understands the emotions and feelings related to an illness in the family and very often identifies herself with the relative of the patient. Empathy comes naturally to her. This has been particularly responsible in her building bridges with her patients with varying backgrounds, which in a way gives a personal touch to her interface with each individual patient.

As a keen learner, Dr. Nanda has used this opportunity to develop interpersonal skills that bind her to her patients and their family in more ways than one. She epitomises energy and happiness that is infectious. Her ability to make each of her clients feel special and important to her has been an asset which has helped her to broad base her clients by references through her patients and acquaintances.

According to her, patients and their families are her brand ambassadors and have stood by her at all times.