Colorectal Cancer: Not Only Is It Preventable, It Is Highly Curable
Early intervention can save your life
Out of all the different types of cancer, colorectal cancer is the most common in Singapore. In fact, it's the most common type of cancer in men and the second most common in women. The death rates are also telling: according to National University Cancer Institute Singapore, it results in more than 1,865 case each year.
But the thing is, bowel cancer, as it is otherwise known, is very much preventable. Dr Tan Wah Siew, a colorectal and general surgeon at Mount Elizabeth Hospital tells us more about this condition and the things we can do to reduce our odds of contracting it.
First things first: Colorectal cancer is cancer of the large intestine, which comprises the colon and the rectum. It develops when mutations in the cells of the wall of the colon and rectum grow out of control.
Nearly all colorectal cancers start off as polyps, which are benign growths on the inner wall of the colon and rectum but that develop into cancer after several years. As such, this type of cancer can be prevented if these polyps are discovered and removed before they have a chance to become cancerous.
According to Dr Tan, some of the symptoms include blood in the stools, change in bowel habits, narrow calibre stools, mucus in the stools, abdominal pain, unexplained weight loss, loss of appetite, anaemia and a feeling that your bowels are not emptying completely. However, early-stage colorectal cancer and pre-cancerous polyps do not typically present any symptoms.
“As such, by the time the symptoms develop, the cancer is usually in the advanced stages. It is thus important to screen for colorectal cancer even when one does not have any symptoms,” she says.
The exact cause of colorectal cancer is not known, but what experts do know is that the risk of contracting colorectal cancer increases with age—more than 75 per cent of patients are aged 50 years or older.
Dr Tan explains that apart from age, some of the risk factors include obesity, lack of exercise, smoking, excessive alcohol intake, and a diet high in processed foods and red meat but and low in fruit and vegetables.
“The other factors are a personal history of colorectal polyps, a personal history of inflammatory bowel disease and a family history of colorectal cancer. That said, while family history increases a person’s risk of contracting colorectal cancer, the majority of patients do not have a family history.”
A diagnosis typically requires a colonoscopy, which allows small pieces of tissue from the tumour to be removed for biopsy. Once established, further tests like a CT scan, PET/CT scan or MRI scan may be needed to determine the extent of the cancer.
The good news is, colorectal cancer is highly curable, especially if detected in the early stages.
“The mainstay of treatment is surgery, which allows for the removal of the segment affected by the cancer. While this seems daunting, most patients are able to have their bowel continuity restored during the surgery, allowing them to continue to pass stools the way they did prior to surgery. A small number of patients may require a stoma, but usually only temporarily,” says Dr Tan.
She adds that minimally invasive surgery for colorectal cancer is now the standard of care, and that the advantages include less pain, faster recovery, shorter length of hospital stay and lower chance of developing long-term complications like adhesions and incisional hernia. Chemotherapy and/or radiotherapy may also be a part of the treatment plan if required.
Apart from regular screening—the Ministry of Health recommends screening to begin at age 50, but earlier if one has a family history—colorectal cancer can also be prevented if one reduces their risk by cutting down on smoking, limiting their intake of red meat and processed meat, and reducing or avoiding the consumption of alcohol.
“You should also maintain a healthy weight, exercise regularly and ensure that you get enough vitamin D. The optimal dose of vitamin D that has cancer preventive activity is not clear, but studies indicate that an intake of at least 300 international units per day decreases the risk of colorectal cancer in people below 50 years old by about 50 per cent,” urges Dr Tan.
Text by: Adora Wong/HerWorld