Doctors at Fortis Hospital Shalimar Bagh took care of a 60-year-old diabetic patient with advanced colon cancer. Arun Kumar who hailed from Bodhgaya, Bihar was admitted with a bleeding rectum, however after a complete medical evaluation under Dr. Pradeep Jain, Director, GI Cancer and his team, he was diagnosed with advanced colon cancer. The patient was presented with gall stones, low Contraction power of heart – 30% against the average of 60%, infection, fever, breathlessness and swelling in the lungs. Patient had to be kept in the ICU for over 40 days before the treatment for colon cancer could commence.
Dr. Pradeep Jain, Director, GI Cancer, Fortis Hospital, Shalimar Bagh said, “This case was extremely challenging as patient was diagnosed with multiple morbidities. He was brought to the hospital in an extremely critical state and was kept in the ICU for over 40 days. He had to be stabilised so that we could proceed with the laparoscopic surgery for colon cancer. These complications in surgery could have been avoided if the disease had been diagnosed at an early stage. Therefore, it is essential for everyone to get screened periodically and regularly. If any symptoms such as change in bowel habits (diarrhoea, constipation or stool consistency), rectal bleeding, blood in stool, abdominal pain, cramps, bloating, discomfort, unexplained weight loss, unexplained anaemia, it should not be ignored but immediately evaluated medically.”
Mahipal Singh Bhanot, Facility Director said, “This was one of the most challenging cases as patient suffered from multiple life-threatening complications. Stabilising the patient was the main focus for the doctors. However, this was successfully achieved due to the diligence with which the case was handled. This case was a unique example of smooth coordination and team work between the various teams.”
Colorectal Cancer has the lowest incidence in India as compared to Western Countries. However, it has seen an increase in numbers with the increasing urbanization in India. According to a report by the Indian Council of Medical Research (ICMR), colorectal cancer is the third most common cancer in men and the second most common in women. In India, the annual incidence for colon cancer in men is 4.4 per 100000 and 3.9 per 100000 in women.
Arun underwent chemotherapy and radiation therapy, after which he was discharged from the hospital. However, within 15 days, he had to be re-admitted as he was suffering from fever, chills and breathlessness. A cardio assessment revealed that he had a very low rate of pumping heart power – 30% against the average rate of 60%. His oxygen supply was also very low and he had to be put onto ventilator support. Mr. Arun’s kidney function test also showed irregularities and the ultrasound report revealed presence of fluids, swelling in the lungs and an increase in the size of the liver.
Additionally, Arun had an active infection and stones in the gall bladder and bile duct. The stones were removed through an endoscopic procedure, post which stenting was done. Once the infection had been controlled and the patient stabilised, he underwent a laparoscopic cancer surgery. However due to the extremely low rate of heart power – the surgery proved to be immensely challenging. His blood pressure, pulse rate, oxygen saturation and CO2 levels had to be constantly monitored, maintained and kept in check during the surgery.
Dr. Pradeep Jain and Dr. Umesh Deshmukh, Head of Department, Anesthesia, Fortis Hospital, Shalimar Bagh successfully conducted the laparoscopic surgery. No complications arose during the post-operative period and he was discharged within a week. Considering the complications that had arisen before the surgery, Mr. Arun had recovered well and in good time.