Skip to main contentShah's Gastro, Cancer & Robotic Surgery Centre · Ahmedabad & Gandhinagar
Last updated: 14-Oct-2026
Colon cancer · Gota OPD, Gota, Ahmedabad · Apollo Hospital, Bhat, Gandhinagar
Colon cancer treatment is planned in a fixed order. First the whole colon is checked, then the stage is set, then the tumour board agrees the plan.
Many patients need only an operation. Some need chemotherapy afterwards. When the cancer has spread, medicines usually come first and surgery is chosen with care.
A blocked or burst bowel changes everything. It needs emergency care, and the plan is then made in a different order.
The colon runs from the caecum, low on the right, to the sigmoid, low on the left. Where the cancer sits decides which part is removed.
Shah’s Gastro, Cancer & Robotic Surgery Centre. Two higher degrees in surgery of the digestive system, and 18 years of experience in GI and cancer surgery. Colonoscopy, CT and MRI reading, the tumour board with cancer physicians, emergency surgery, the stoma nurse, the dietitian and intensive care all work in one pathway.
Dr Harsh Shah
MS, MCh (Surgical Gastroenterology), DrNB (Surgical Gastroenterology)
Registered with Gujarat Medical Council, Reg. No. G-38738
Colon Cancer Surgeon · Apollo Hospital, Bhat, Gandhinagar · Gota OPD, Ahmedabad
Every colon cancer seen here goes to the tumour board before treatment. Dr Harsh Shah performs the operation himself.
| Where the cancer sits | Usual operation | Read more |
|---|---|---|
| Caecum or ascending colon, on the right. | Right hemicolectomy. | Right colon cancer. |
| Hepatic flexure or the near part of the transverse colon. | Extended right hemicolectomy. | Transverse colon cancer. |
| Far part of the transverse colon, or the splenic flexure. | Extended right or extended left hemicolectomy. | Transverse colon cancer. |
| Descending colon, on the left. | Left hemicolectomy. | Left colon cancer. |
| Sigmoid colon. | Sigmoid colectomy or anterior resection. | Sigmoid colon cancer. |
A cancer within the last part of the bowel, close to the anus, is a rectal cancer. It follows a different plan, often with treatment before surgery. This page covers the colon only.
Colon cancer often starts quietly. These signs are a reason to have a colonoscopy, even if they seem mild or come and go.
Bleeding, anaemia and bowel change have many causes. Only a colonoscopy with a biopsy shows whether it is colon cancer, and what kind.
Not every growth in the large bowel is the common colon cancer. Some look alike on a scan but need a different plan. The biopsy and the exact site sort this out before any operation is planned.
| What the tests show | What it means for the plan |
|---|---|
| A common colon cancer, from the caecum to the sigmoid. | This page applies. |
| A cancer close to the anus. | It is a rectal cancer. MRI of the pelvis and treatment before surgery are often needed. |
| A growth of the appendix. | It follows its own plan, sometimes with the abdominal lining in mind. |
| A GIST, lymphoma or neuroendocrine tumour. | Each has its own plan. Lymphoma is mostly treated with medicines. |
| A cancer of the anal canal. | A separate plan, often without a first operation. |
| A cancer in a family with many bowel cancers. | The cancer is treated here, and the family is checked for an inherited cause. |
The whole colon is checked before any plan is made. A second cancer elsewhere in the colon is not rare, so it must be looked for.
A PET-CT scan is not a routine test for colon cancer. It is kept for a suspected return of the cancer, or before removing a spread to the liver or lungs.
A strong patient recovers better. Weight loss, poor eating and low fitness are found early, so they can be improved before treatment starts.
| Any one of these | What follows |
|---|---|
| Losing more than a tenth of your weight in six months. | A dietitian plans extra feeding before surgery. |
| A very low body weight for your height. | The same. |
| A low albumin level in the blood. | The same. |
| Eating less than half of what you need for over a week. | The same. |
Doctors also grade how active you are in daily life. Fully active patients can be offered every step. Patients who rest for part of the day may get a gentler plan. Patients who are mostly in bed are offered comfort care first.
The stage is known for certain only after the operation, from the report on the removed bowel. The stage then decides whether chemotherapy is needed.
| Stage, in plain words | Usual treatment |
|---|---|
| Stage I. The cancer is in the bowel wall only. | An operation alone. |
| Stage II, with no warning signs in the report. | An operation, then regular checks. |
| Stage II, when the gene test shows MSI-high. | An operation, then checks. Chemotherapy with a single drug is not given. |
| Stage II, with warning signs in the report. | An operation. Chemotherapy is discussed with you. |
| Stage III, with a few nodes involved. | An operation, then about three months of chemotherapy. |
| Stage III, with many nodes or a deep tumour. | An operation, then about six months of chemotherapy. |
| Stage IV. The cancer has spread. | Medicines first in most cases. Spread to the liver or lungs may be removed in selected patients. |
Warning signs in the report include a tumour that has grown through the wall, a burst or blocked bowel, fewer than twelve nodes examined, or cancer cells in small vessels or nerves. These raise the chance of the cancer coming back.
Four facts in the pathology report drive the whole chemotherapy talk. If one is missing, the report is chased before any decision.
An operation helps when it can remove the cancer safely. In some situations, medicines, a stent or comfort care serve the patient better.
Saying no to an operation is a medical decision, not giving up. Medicines, a stent, nutrition and early palliative care are planned with the same care.
The aim is the same everywhere in the colon. The cancer comes out with its blood vessels and lymph nodes in one piece, with clear edges.
| Rule in our protocol | What it means for you |
|---|---|
| The feeding vessel is tied where it starts. | The lymph nodes along it come out too. |
| The fatty fan holding the nodes comes out whole. | This is called complete mesocolic excision. |
| At least five centimetres of healthy bowel on each side. | The cut ends are free of cancer. |
| Any organ stuck to the tumour is removed with it. | Peeling a tumour off can leave cancer behind. |
| The tumour is handled as little as possible. | Cancer cells are not spilled. |
Keyhole surgery is the tested standard for colon cancer. It gives the same cancer results as open surgery, with a faster recovery. Robotic surgery is a sound choice in experienced hands. Open surgery is chosen for a very bulky tumour, a tumour stuck to other organs, or a belly scarred by past operations. Choosing open surgery is a sound judgement, not a failure.
A blocked or burst bowel needs emergency care. The safe choice depends on the side of the colon and on how unwell you are.
| Emergency | Usual plan |
|---|---|
| A blocked right colon. | The tumour is removed and the bowel is usually joined in the same operation. |
| A blocked left colon, in a fit patient. | The tumour is removed. The bowel is joined, sometimes with a temporary stoma, or a stoma alone if you are very unwell. |
| A blocked left colon, in an unfit patient or with spread. | A metal stent opens the bowel. A planned operation can follow later. |
| A burst bowel. | The tumour is removed and the belly is washed out. A stoma is usually needed. |
A swollen, tender belly with a very wide colon on the scan is a sign the bowel may burst. Heavy bleeding from the tumour is also an emergency. Both need the consultant surgeon the same day.
Good preparation makes recovery faster. Most of it starts at the first visit, so the weeks before surgery are used well.
| Step | Why |
|---|---|
| Low blood count corrected, with iron through a drip if needed. | It lowers the need for blood transfusion. |
| Sugar control, and no smoking or alcohol for four weeks. | Wounds and lungs heal better. |
| Extra nutrition if you are underweight or not eating. | It builds strength for recovery. |
| Bowel preparation with antibiotic tablets. | Together they lower infection and leak at the join. |
| A carbohydrate drink the evening before and on the day. | It keeps you stronger during surgery. |
| No solid food for six hours, clear fluids up to two hours before. | It keeps you safe under anaesthesia. |
| Blood thinner injections for four weeks after surgery. | They prevent clots in the legs and lungs. |
| The stoma nurse marks a site if a stoma is possible. | A well-placed stoma is easier to care for. |
A structured exercise programme before surgery is offered to patients who are underweight or less active. It is not needed by everyone.
Recovery is planned day by day. Most patients sit out of bed on the day of surgery and eat a normal diet the next day.
| Day | What usually happens |
|---|---|
| Day of surgery. | Sitting out of bed. Clear fluids. Pain relief with few strong painkillers. |
| Day one. | Normal food as you feel able. Walking four times. The urine tube comes out. |
| Day two. | Full diet, more walking, pain tablets only. Wind usually passes. |
| Day three. | The bowel usually opens. Any drain comes out. |
| Days four to five. | Home after an uncomplicated keyhole operation. |
You go home when you are eating, passing wind or stool, walking on your own and free of fever. If you have a stoma, you or your family must be able to change the bag. A fast pulse, fever or new belly pain is checked the same day. A scan is done and the consultant surgeon is told at once.
Chemotherapy helps most when it starts within six to eight weeks of surgery. When the cancer has spread, gene tests on the tumour guide the choice.
| Situation | Usual medicine |
|---|---|
| After surgery, stage III with few nodes. | CAPOX for about three months: a drip every three weeks with tablets. |
| After surgery, higher-risk stage III. | CAPOX or FOLFOX for about six months. |
| Older or less fit patients. | Capecitabine tablets alone. |
| Spread, RAS normal, left-sided cancer. | Chemotherapy with an anti-EGFR medicine. |
| Spread, RAS changed, or right-sided cancer. | Chemotherapy with bevacizumab. |
| Spread, MSI-high type. | Immunotherapy first. |
| Spread, BRAF or HER2 change. | Targeted medicines in later steps. |
Before capecitabine or 5-FU, a DPYD blood test is done where it is available. A small number of people cannot break these drugs down safely. Every patient with spread disease also meets the palliative care and nutrition teams early.
Every operation carries risk. Your own risk depends on age, fitness, the stage and whether it is planned or an emergency.
| Type of risk | Examples |
|---|---|
| General. | Bleeding, wound infection, clots in the legs or lungs, heart or breathing problems. |
| The join. | A leak from the join, or a narrowing of it later. |
| The bowel. | Slow return of bowel action, or a blockage from adhesions years later. |
| Nearby parts. | Injury to the urine tube, or a milky fluid leak after a right-sided operation. |
| A stoma. | A temporary or lasting stoma. This is discussed every time, even when unlikely. |
| Later. | A hernia at the scar. The cancer can return even after complete removal. |
Your own figures, including the risk to life, are explained in person before consent. Planned and emergency operations carry very different risks.
Follow-up runs for at least five years. It uses visits, the CEA blood test, CT scans and colonoscopy at set times.
| When | What is done |
|---|---|
| Two weeks after surgery. | Wound check, the report discussion, chemotherapy referral, diet and stoma review. |
| Every three months for three years. | Symptoms, weight, examination and CEA. |
| Every six months in years four and five. | The same checks. |
| Once a year for three to five years. | A CT scan of the chest, abdomen and pelvis. |
| One year after surgery. | Colonoscopy. If normal, again at three years, then every five years. |
| Any MSI-high result or a strong family history. | Referral for genetic counselling. |
★★★★★
“(Translated by Google) Dr. Harsh Shah's personality is very nice. He always talks in a good way. He has undergone surgery for colon cancer. Without any problem. Yours faithfully.🙏 (Original) ડૉ હર્ષ શાહ નો સ્વાભાવ ખૂબ જ સરસ છે.તેઓ હમેશા સારી રીત વાત કરે છે .મોટા આંતરડા ના કેન્સર ની સર્જરી એમને કરેલ લી છે. કોઈ પ્રકાર ની તકલીફ નાથી .આપનો અભર.🙏”
— Ismailbhai Shaikh, Google review
★★★★★
“Met with Dr. Harsh Shah for the consultation of one of my relative. Dr. Harsh Shah is an exceptional surgical oncologist in Ahmedabad. His expertise in treating complex GI cancers like liver, pancreas, and colon cancers is truly remarkable. He explains everything clearly and gives patients full confidence in their treatment. Highly recommended for anyone looking for a skilled and compassionate cancer specialist.”
— Nagesh Patidar, Google review
★★★★★
“My father has carcinoma of stomach ,Harsh sir did radical gastrectomy and he is recovering very nicely under Dr.Harsh's observation ,he listen each and every complain calmly and with patience and make patient very comfortable during treatment , during procedure and during stay at hospital. we are satisfied with the treatment and very confident about the fully recovery of disease as we are under treatment of Dr.Harsh & team.Thank you Dr.Harsh & his whole team and staff.”
— tina parmar, Google review
Reviews are shown exactly as written on Google. The first describes colon cancer surgery. The other two speak about his cancer care more widely.
A patient’s own account after a colon cancer operation by Dr Harsh Shah, shared with consent. Whether any treatment suits you is decided only after your own tests and the tumour board.
The cost depends on the step you need. A stent, an operation and a course of chemotherapy differ widely. You get a written estimate first.
Apollo Hospital, Bhat works with the major insurers and cashless schemes. Its office handles pre-authorisation. Please bring every scan and report, past treatment notes, your medicine list, your insurance card and an ID.
No. Stage I and many stage II cancers need surgery alone. The report on the removed bowel decides.
It guides chemotherapy and immunotherapy. It also shows whether the family should be checked for an inherited cause.
Yes, in most planned operations. Open surgery is chosen for very bulky tumours or emergencies.
Most planned colon operations do not need one. It is more likely in an emergency. It is always discussed before consent.
Medicines usually come first. Spread to the liver or lungs can sometimes be removed later.
At least five years of visits and scans, and colonoscopy for life at set times.
Shah’s Gastro, Cancer & Robotic Surgery Centre — Gota, Ahmedabad
Consultations, review of scans and reports, second opinions, follow-up after treatment.
Google: Dr Harsh Shah · 4.89 · 216 reviews
Directions to the Gota clinic · +91-63555-64601
Apollo Hospital — Bhat, Gandhinagar
Apollo Hospital International Limited, Plot No. 1 A, GIDC Bhat Industrial Estate, Bhat, Gandhinagar.
Colonoscopy, keyhole and open surgery, emergency care, intensive care and inpatient care.
Google: Dr Harsh Shah – Robotic GI Surgeon · 4.94 · 18 reviews
Directions to Apollo, Bhat · WhatsApp +91-63555-64601
Patients come to Ahmedabad from across Gujarat, southern Rajasthan and western Madhya Pradesh.
Bleeding, anaemia or a change in bowel habit, or a colonoscopy that found a growth? The colonoscopy and biopsy reports, the CT scan with its report and any blood tests can be sent ahead, so the consultation starts with them already read. Treatment is decided at the consultation, after examination and at the tumour board. Call +91-63555-64601 · Send the reports ahead on WhatsApp
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