6 Things You Need To Know About Colorectal Cancer

Colorectal cancer is the number 1 cancer in Singapore with more than 1,200 cases every year! It is the most common cancer among Singaporean men, and second only to breast cancer for Singaporean women. Here are 6 things you need to know about this disease:

1. What is colorectal cancer and how common is it?

Colorectal cancer, also known as colon or bowel cancer, is the most common cancer in Singapore among men, and the second most common cancer in women after breast cancer. Both men and women are equally at risk of colorectal cancer, but men are more likely to develop rectal cancer.

2. What are the risk factors for colorectal cancer?

Factors which may presdispose a person to colorectal cancer are: Diets rich in red meat, processed food, low-fibre diet, coupled with sedentary lifestyles, obesity and smoking.

Colon cancer may also be hereditary. The two most commonly inherited syndromes are hereditary nonpolyposis colorectal cancer (HNPCC) and familial adenomatous polyposis (FAP). Carriers of such genes usually develop colon cancer at a younger age. Women with HNPCC are also at risk of developing other cancers, such as ovarian and uterine cancer. The BRCA-1 gene, which puts carriers at risk for breast and ovarian cancer are also at an increased risk of colorectal cancer.

3. If I am in my 30s or 40s, should I be worried of developing colorectal cancer or does it affect older people only?

Whilst colon cancer is uncommon amongst adults aged 30s to 40s, it is also wrong to say that this cancer only affects older people. For hereditary colon cancers, such cancers tend to strike at a younger age.  Even for the sporadic cancer cases, it is estimated 7% of colon cancer patients are below 40 years of age at the point of diagnosis. For persons below 40 years old, they should be made aware of the symptoms of colon cancer and seek help early should they experience such symptoms.

4. Can colorectal cancer be prevented?

You can reduce your risk of colorectal cancer by practicing the following habits:

  • Reduce your intake of red and processed meats.
  • Increase your intake of vegetables and fruits.
  • Have an active lifestyle and exercise regularly.
  • Stop smoking.
  • Maintain a healthy weight.
  • If you’re 50 and above, schedule colonoscopy screening with a specialist.

5. How is colorectal cancer detected?

As the early stages of colorectal cancer have no symptoms, it is recommended that stools should be checked for occult blood once you reach 50 years old. This is done through test kits called the faecal occult blood test (FOBT) and faecal immunochemical test (FIT). Both kits test for the presence of blood not visible to the naked eye, which allows cancer to be detected.

Both kits are cheap and safe but are not very sensitive in detecting polyps, abnormal small growths on the inner lining of the large intestine. Most colorectal cancers start off as polyps. If such polyps are detected and removed before they turn cancerous, the cancer can be prevented.

This can be done through a colonoscopy, in which a long flexible tube is inserted into the colon. As it is able to detect and remove such polyps, colonoscopy procedures have been shown to reduce colon cancer by 80% to 90%.

By the time cancer symptoms appear, the cancer may already be at an advanced stage. Some symptoms include blood in stools, a change in bowel habits, and recurrent unexplained abdominal pain.

6. What are the treatment options for colorectal cancer?

Surgeons can use keyhole surgery to remove tumours that aren’t too big. This means less post-operative pain, an earlier hospital discharge, an earlier return to normal activities and better cosmetic outcomes.

The survival rate for patients with Stage IV colorectal cancer has increased over the past two decades. For colorectal cancer, the liver and the lung are two of the most common sites where the cancer cells can spread to.

If you are aged 50 and above, it is recommended to go for a FOBT or FIT annually accompanied by a colonoscopy every 10 years. For high-risk individuals, do consult your doctor for personalised treatment recommendations.

 

This article is written by Dr Ho Choon Kiat, Laparoscopic, Hepato-Pancreato-Biliary and General Surgeon at Thomson Surgical Centre. For more information, please contact Thomson Surgical Centre at 6846 6766 or email surgicalcentre@thomsonmedical.com.