How Advanced Treatments Are Improving Colorectal Cancer Outcomes in India by Dr. Vivek Mangla – GI, HPB & Colorectal Cancer Surgeon

24 Nov, 2025

Learn how modern colorectal cancer treatments—minimally invasive surgery, robotic techniques, precision therapies, and advanced neoadjuvant protocols—are improving survival and quality of life in India.

Colorectal cancer is rising steadily in India, but the encouraging news is that outcomes have never been better. Over the last decade, advances in diagnosis, staging, systemic therapy, technology, and surgical techniques have transformed the way we treat this disease.

In my practice, I have seen patients who once had limited options now achieve excellent recoveries, organ preservation, and long-term survival because their treatment plans could be tailored using these modern tools.

As a colorectal cancer specialist who has dedicated over 20 years to GI & HPB cancer surgery, I want patients and families to understand how these new treatment pathways are working—and why choosing the right centre and team matters for the best results.

More accurate diagnosis is changing the prognosis

Today, high-resolution CT scans, MRI pelvis for rectal cancer, and PET-CT help us stage cancers with far greater precision. Combined with colonoscopy and advanced biopsy techniques, we are identifying cancers earlier and planning treatment with clarity.

In my own patients, accurate early staging has allowed us to offer organ-preserving treatments, minimally invasive resections, and shorter recovery times—especially in rectal cancers, where tailoring treatment to stage is critical.

Total Neoadjuvant Therapy (TNT) is improving cure rates in rectal cancer

One of the biggest breakthroughs in recent years is Total Neoadjuvant Therapy—a protocol where patients receive both Chemotherapy and Chemo radiation before surgery. TNT offers three major benefits:

• Higher tumour shrinkage
• Better chances of sphincter preservation
• Lower risk of local recurrence

In my practice, I have seen several patients achieve near-complete or complete tumour response with TNT, allowing for safer surgery and better long-term control.

For low rectal tumours—traditionally difficult to treat—these results are particularly meaningful.

Precision medicine: Immunotherapy & targeted therapy are extending survival

Today, colorectal cancer is no longer treated with one-size-fits-all chemotherapy.

Testing tumours for MSI status, RAS/BRAF mutations, and other markers helps us identify patients who benefit from:

• Immunotherapy (for MSI-high/dMMR cancers)
• Targeted drugs such as anti-VEGF and anti-EGFR therapies
• Personalised combinations to maximise tumour response

International studies and results in Indian centres have shown impressive outcomes with these therapies. In select molecular subgroups, immunotherapy can produce prolonged disease control—and in some cases, near-complete responses.

I routinely recommend molecular profiling for all my colorectal cancer patients. It allows us to plan treatment with greater accuracy and helps achieve the best possible prognosis.

Minimally invasive & robotic surgery: faster recovery, equal oncologic results

One of the most transformative changes in colorectal cancer management is the shift to laparoscopic and robotic surgery. These methods allow us to perform complete cancer resection with:

• Smaller incisions
• Less pain
• Quicker return to normal activity
• Lower complication rates
• Excellent lymph node retrieval
• Precise pelvic dissection (especially with robotics)

We routinely perform laparoscopic and robotic colectomies/rectal cancer surgeries, even for complex cases.

For many patients, this approach has meant shorter hospital stays and better long-term functional results—without compromising cancer clearance.

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Advanced surgery for complex & locally advanced tumours

A significant number of patients in India present with advanced-stage tumours that involve nearby organs. With modern imaging, careful planning, and multidisciplinary collaboration, we can safely offer:

• Multivisceral resections
• Cytoreductive surgery
• Synchronous liver metastasis treatment

Over the years, I have successfully treated many such cases who were initially told their tumours were “inoperable.” With meticulous surgical technique and coordinated care, we have achieved clear margins and meaningful long-term survival in many of these patients.

Better outcomes through multidisciplinary cancer care (MDT)

No single doctor treats colorectal cancer anymore. The best results come from integrated care, where surgeons, medical oncologists, radiation oncologists, radiologists and pathologists work together.

At Max Institute of Cancer Care, this is how every colorectal cancer case is approached.

This coordinated planning ensures:

• Correct sequencing of chemotherapy/radiation
• Personalised surgery timing
• Optimal use of targeted and immunotherapies
• Comprehensive follow-up and survivorship care

This model of MDT-based care has significantly improved outcomes for my patients over the years.

What outcomes we are seeing in practice?

While individual results vary based on stage and tumour biology, I can confidently say that:

• Patients receiving TNT for rectal cancer are achieving higher tumour response and better sphincter preservation.
• Minimally invasive and robotic approaches have led to faster recovery and fewer complications compared to open surgery.
• Selected patients with advanced disease are living longer because of personalised systemic therapy.
• Earlier-stage patients treated with multidisciplinary protocols are achieving outcomes comparable to top international centres.

Most importantly, many of my patients return to normal life far sooner than was possible a decade ago.

Why these advances matter for patients in India

India faces unique challenges—late presentation, lack of awareness, and variable healthcare access. Yet, with modern treatment pathways now available at leading centres, we can offer international-grade outcomes without patients needing to travel abroad.

When treated early and correctly, colorectal cancer is one of the most curable cancers.

My message to patients is simple:

Early diagnosis and the right treatment strategy can change everything.

Conclusion: The future of colorectal cancer treatment in India is promising

With the combination of better diagnostics, precision medicine, advanced neoadjuvant protocols, robotic surgery, and stronger multidisciplinary care, the survival and quality-of-life outcomes for colorectal cancer in India are improving dramatically.

I am committed to ensuring that every patient who walks into my clinic receives clear guidance, evidence-based treatment, and compassionate care—using the most advanced techniques we have today.

If you or a loved one is dealing with colorectal symptoms or a recent diagnosis, early consultation can make a life-changing difference.