Symptoms that should not be ignored
Colon cancer often grows silently for years. When symptoms appear, the most common are a persistent change in bowel habit, blood or mucus in the stool, unexplained iron-deficiency anaemia, and unintentional weight loss. Any of these lasting more than a few weeks deserves a colonoscopy, not reassurance.
- Blood in or on the stool, or black tarry stools
- New constipation, diarrhoea or narrow-calibre stools lasting over 3 weeks
- Persistent lower abdominal pain, bloating or a feeling of incomplete emptying
- Unexplained fatigue, anaemia or weight loss
How colon cancer is diagnosed and staged
Diagnosis is made by colonoscopy with biopsy. Staging then uses a contrast CT of the chest, abdomen and pelvis, sometimes with CEA blood testing, to map the tumour and look for spread. Staging determines the order of treatment — surgery first for most colon cancers, with chemotherapy added for node-positive disease.
Surgical treatment: robotic complete mesocolic excision
The operation removes the diseased segment of colon together with its entire lymphatic envelope — the technique that most strongly influences long-term cure. Performed robotically, the dissection follows embryological planes with 10x magnified 3D vision, the join (anastomosis) is made inside the abdomen, and there is no long midline incision.
- Central vascular ligation with high lymph node yield
- Intracorporeal anastomosis through keyhole access
- Stoma avoided in the large majority of colon resections
- Enhanced recovery protocol — walking the same evening
Recovery and what happens after surgery
Most patients eat within a day, go home in two to four days, and return to ordinary activity in two to three weeks. The final pathology report is reviewed in a multidisciplinary tumour board to decide whether chemotherapy is needed. Surveillance colonoscopy and scans follow a structured five-year calendar.
Common questions
- Is blood in stool always colon cancer?
- No — piles and fissures are far more common causes. But bleeding should never be assumed to be piles, especially after age 40 or with a change in bowel habit. A single colonoscopy settles the question.
- Will I need a permanent stoma after colon cancer surgery?
- Permanent stomas are uncommon in colon (as opposed to rectal) cancer. Most robotic colectomies restore bowel continuity in the same operation.
- Do I need chemotherapy after colon cancer surgery?
- Stage I cancers usually need nothing further. Stage III (node-positive) cancers benefit from adjuvant chemotherapy. Stage II is individualised. The decision is made in a tumour board once final pathology is available.
This page is general education, reviewed by Dr. Ishaan Allahabadi, MCh Surgical Oncology (Edge Hill, UK) · MS Surgery · MBBS (Accredited by the Royal College of Surgeons of England). It is not a substitute for individual medical advice. Treatment decisions are made after reviewing your imaging and pathology, in a multidisciplinary tumour board.