Did you know that the five-year survival rate for localized colorectal cancer exceeds 90% when detected early? This remarkable statistic highlights why timely colorectal cancer treatment can dramatically change outcomes. I am Dr Mathangi, Senior Consultant and In-charge of Radiation Oncology at Gleneagles Cancer Institute in Bangalore. With over two decades of experience treating more than twelve thousand patients, I am committed to guiding individuals through every step of colorectal cancer treatments — from diagnosis to recovery — using advanced technologies and personalized care.
What is colorectal cancer and why does treatment matter?
Colorectal cancer arises in the colon or rectum and is one of the most treatable cancers if managed early. Treatment choice greatly influences cure rates, recurrence risk, and long-term quality of life. Selecting the right combination of therapies — whether surgery, radiation therapy, chemoradiation, neoadjuvant therapy, adjuvant therapy, or targeted therapy — ensures the disease is addressed effectively and comprehensively.
How are treatment options chosen?
Every patient’s colorectal cancer journey is unique. At Gleneagles Cancer Institute, I use a multidisciplinary approach that considers:
- The stage and spread of the tumour
- Location of the disease (colon or rectum)
- Patient’s overall health, organ function, and age
- Tumour biology and molecular characteristics
- Personal preferences and lifestyle factors
By integrating these aspects, we can design a treatment plan that maximizes success while minimizing side effects.
What is surgery and why is it critical?
Short answer: Surgery remains the cornerstone of colorectal cancer treatment and offers the best chance for cure in early-stage disease.
For many patients, surgical removal of the tumour and nearby lymph nodes is the first line of treatment. The goal is complete resection with healthy margins. When performed meticulously, surgery can eliminate the disease entirely in localized stages. My team collaborates with expert colorectal surgeons to ensure optimal outcomes and faster recovery, with particular attention to nerve preservation and bowel function.
What is radiation therapy and how does it help?
Short answer: Radiation therapy uses high-energy beams to destroy cancer cells and reduce the risk of recurrence, especially in rectal cancers.
In my department, we use sophisticated techniques such as Stereotactic Ablative Body Radiotherapy (SBRT), Gated RapidArc, and Image-Guided Interstitial Brachytherapy. These technologies deliver precise radiation doses to the tumour while sparing surrounding healthy tissue. Radiation therapy may be given before surgery to shrink the tumour or after surgery to eliminate residual cells, improving long-term control.
What is neoadjuvant therapy and when is it used?
Short answer: Neoadjuvant therapy involves treatments given before surgery to shrink the tumour and improve surgical outcomes.
For locally advanced rectal cancers, neoadjuvant therapy typically combines radiation therapy with chemotherapy — known as chemoradiation. This approach can reduce tumour size, allow more conservative surgery, and lower recurrence risk. Patients who respond well to neoadjuvant therapy often experience better long-term survival and improved organ preservation.
What is adjuvant therapy and why is it important?
Short answer: Adjuvant therapy is treatment given after surgery to destroy microscopic cancer cells that might remain.
Adjuvant therapy can include chemotherapy, radiation therapy, or both, depending on the cancer’s stage and aggressiveness. For rectal cancers with high-risk features, adjuvant therapy strengthens the surgical outcome and lowers the likelihood of recurrence. At Gleneagles, each patient’s postoperative pathology report is reviewed carefully before deciding on adjuvant therapy to ensure personalized, evidence-based care.
What is chemoradiation and where does it fit?
Short answer: Chemoradiation combines chemotherapy with radiation therapy for a synergistic effect in locally advanced disease.
This combined approach enhances tumour response and local control. It’s frequently recommended before surgery for rectal cancer to shrink the tumour and improve the likelihood of complete removal. By integrating modern image-guided and gated radiotherapy, we minimize side effects while maintaining effectiveness. Chemoradiation remains a key component of multidisciplinary colorectal cancer treatment strategies worldwide.
What is targeted therapy and how is it used?
Short answer: Targeted therapy employs drugs that act on specific molecular changes in cancer cells, improving precision and reducing collateral damage.
When colorectal cancer spreads beyond the original site, targeted therapy offers hope for extending survival and enhancing quality of life. Treatments are tailored based on genetic profiling — for example, testing for EGFR or KRAS mutations. These targeted drugs can slow tumour growth and work alongside chemotherapy, surgery, and radiation therapy for comprehensive management.
How do we choose among the various options?
Short answer: The right combination of surgery, radiation therapy, neoadjuvant therapy, adjuvant therapy, chemoradiation, and targeted therapy is decided through collaborative evaluation by specialists.
My team follows a structured process:
- Diagnose and stage the tumour using imaging and biopsy.
- Evaluate the patient’s health and medical history.
- Decide whether neoadjuvant therapy will improve operability.
- Perform surgery when appropriate and safe.
- Plan adjuvant therapy based on pathology results.
- Integrate targeted therapy for advanced or recurrent disease.
This step-wise approach ensures precision, safety, and consistency while maintaining patient comfort and clarity throughout the journey.
What are the benefits and risks of each treatment option?
| Treatment option | Benefits | Potential risks |
|---|---|---|
| Surgery | Can completely remove the tumour; curative in early stages | Recovery time, bowel or nerve complications |
| Radiation therapy | Improves local control; preserves organs | Bowel irritation, fatigue, tissue stiffness |
| Neoadjuvant therapy | Shrinks tumour before surgery; improves outcomes | Temporary side effects; may delay surgery |
| Adjuvant therapy | Eliminates residual cells; prevents recurrence | Fatigue, mild nausea, temporary blood count changes |
| Chemoradiation | Boosts tumour control; reduces relapse | Combined toxicity of radiation and chemotherapy |
| Targeted therapy | Precision treatment with fewer systemic effects | Cost; limited to specific genetic profiles |
Why choose Dr Mathangi and Gleneagles Cancer Institute?
Choosing your oncologist is one of the most important decisions you’ll make. At Gleneagles Cancer Institute, Bangalore, I bring over 20 years of expertise and international training from Germany and Denmark in advanced radiotherapy techniques. As the first in Asia Pacific to install the TrueBeam STx system, we provide unparalleled precision in radiation therapy. Our multidisciplinary team ensures that every aspect of colorectal cancer treatment — from surgery to targeted therapy — is integrated seamlessly under one roof. You deserve this level of care, and you shouldn’t settle for less when modern, evidence-based therapy is accessible right here in India.
What is the outlook after treatment?
When detected early and treated appropriately, colorectal cancer has excellent outcomes. Even in advanced stages, the combination of modern therapies and careful follow-up can extend survival and preserve quality of life. With ongoing research and technological innovation, the future for colorectal cancer treatments continues to improve every year. My focus is always on helping patients not just survive, but thrive after treatment.
How to get started
If you or a loved one has been diagnosed with colorectal cancer, the best step forward is to seek expert guidance. You can book an appointment with me through the contact form on my website. Once we receive your details, my team will schedule your consultation and guide you through every step of your care. Together, we’ll design a personalised, effective treatment plan tailored to your diagnosis and goals.
About Dr Mathangi
Dr Mathangi J is the Senior Consultant and In-charge of Radiation Oncology at Gleneagles Cancer Institute, Bangalore. With MBBS, DMRT, and DNB qualifications, she has over 20 years of experience and has successfully treated more than 12,000 patients. She trained in advanced radiation oncology techniques including SRS/SBRT in Germany, IGRT/RapidArc in Denmark, and IORT in Europe. She heads the Fellowship in Advanced Radiotherapy Techniques affiliated with RGUHS and is recognised for introducing Asia Pacific’s first TrueBeam STx system. Her areas of expertise include head and neck cancers, prostate cancers, brain tumours, lung cancers, and women’s cancers such as breast, cervical, and uterine malignancies.
