The single most important risk factor in the development of colorectal cancer is age, with the risk increasing substantially after the age of 50. Although young patients can also develop colorectal cancer, approximately 75-80% of patients diagnosed are over the age of 55.
Individuals with a family history of colorectal cancer are also at increased risk,
particularly if there are multiple family members affected, the family members are
first degree relatives, or if one or more were less than 50 years old at diagnosis.
It is important to note, however, that more than 80% of patients have sporadic
colorectal cancer, which means that most patients with colorectal cancer do not have
a family history.
Early stage colorectal cancer usually does not manifest any symptoms. Hence by the time there are symptoms, it is likely that intermediate or late stage cancer may be diagnosed.
Some symptoms of colorectal cancer include:
Regardless of age, having these symptoms does not mean that you definitely have colorectal cancer. Rather, it means that you should consult a colorectal surgeon, so that tests can be performed to assess if you have cancer.
Yes! Colorectal cancer almost always develops from precancerous polyps. Hence regular screening with colonoscopy is the key to preventing colorectal cancer.
In Singapore, the Ministry of Health recommends screening for an average risk individual to begin at age 50. Individuals with a family history of colorectal cancer may need to start screening at an earlier age. For example, to start screening at age 40 or 10 years prior to the youngest case in the family (whichever is younger) if there is one 1st degree relative with colorectal cancer below the age of 60.
The American Cancer Society, in 2018, suggested to consider lowering the screening age to 45 years old. There is clear evidence of the benefit of this recommendation but this has not been adopted in Singapore likely because of the lack of cost effectiveness.
Faecal occult blood test (FOBT)
Yearly FOBT is a common population screening method. This detects the presence of blood in the stool. FOBT enables detection of cancers but is not meant to detect polyps as polyps, unless very large, do not usually bleed. Those with a positive FOBT will have to undergo a colonoscopy to rule out colorectal cancer.
Colonoscopy
During a Colonoscopy, the colorectal cancer surgeon will examine the inner lining of the colon and rectum. It is a more robust screening method as it allows detection and removal of polyps before they turn into cancer. Removal of these polyps during colonoscopy is a proven effective way of preventing the progression to cancer. If a cancer has already developed, it is also more likely to be discovered at an earlier stage on a screening colonoscopy, when treatment has a higher chance of cure.
However the evidence for the use of these 2 options for colorectal cancer screening is less strong, and a colonoscopy is still required to confirm any diagnosis if an abnormality is found on barium enema or CT colonography.
Colorectal cancer is a highly curable form of cancer, especially if detected in the early stages.
The mainstay of treatment is colorectal cancer surgery, by removing the segment of affected bowel. While this
appears daunting,
most patients are able to have their bowel continuity restored during the surgery, allowing them
to continue
to move their bowels through the anus, as they did prior to surgery. A small number of patients
may require a
stoma, but usually only temporarily.
In addition, most patients can undergo colorectal cancer surgery via minimally invasive techniques,
either
laparoscopically or robotically using the da Vinci robot.
Patients with more advanced disease may require treatment with radiotherapy and/or chemotherapy in addition to colorectal cancer surgery.
With better understanding of the disease, improved surgical techniques and better chemotherapy drugs, selected cases of Stage IV cancer or locally advanced cancers where the tumour has involved surrounding organs may also potentially be cured.
Before undergoing colorectal cancer surgery, you may need certain preparations, which may include:
After the surgery, you will be taken to a recovery room to rest, while your vital signs are being monitored. You may experience some pain and discomfort, but medications will be given to alleviate the pain. Additionally, your colorectal cancer doctor may prescribe antibiotics to prevent infection.
If bowel resection is performed, be prepared to stay in hospital for about 4 to 7 days. Once your doctor has determined it is safe for you to go home, you will be discharged with instructions on how to care for yourself. It’s important to follow these instructions carefully to ensure a smooth recovery.
After colorectal cancer surgery, properly caring for your wound and making necessary dietary and lifestyle changes are important. This includes drinking plenty of fluids, eating a healthy diet and exercising regularly (as advised by your physiotherapist). You should also watch for signs of infection or other complications, such as excessive abdominal pain, bleeding, or fever. If you experience any of these symptoms, contact your colorectal cancer doctor or head to the emergency department immediately.
Colon cancer is often very treatable and, in the early stages, curable. The earlier colorectal cancer is detected, the higher the chances of cure.
In Singapore, colorectal cancer is the most common cancer in men and the second most common cancer in women. More than 2000 people are diagnosed yearly with colorectal cancer in Singapore.
Eating a diet high in fiber, such as fresh fruits and vegetables, whole grains, beans and legumes, can help reduce your risk for colorectal cancer. Additionally, avoiding processed foods and limiting red meat intake can also help lower your risk. A higher Vitamin D intake has also been found to reduce the risk of colorectal cancer.
Both haemorrhoids and colon cancer can lead to blood in the stools, and it may be difficult to differentiate one from the other without seeing a doctor and/or going for appropriate tests.
The average life-time risk of contracting colorectal cancer is about 5% in Singapore. This risk increases by 3 to 5 times if you have a first-degree relative (e.g. a parent) who has had colorectal cancer. The risk is also further increased if the relative developed colorectal cancer at a young age (< 50 years old).
Colorectal cancer usually takes several years to develop from a benign polyp to cancer – all while potentially not displaying any symptoms through the early stages of cancer. The risk of developing cancer and polyps increases with age. This makes timely colonoscopies all the more important,as precancerous polyps can be removed before they have a chance of progressing to cancer.
Mount Elizabeth Medical Centre
#08-07, 3 Mount Elizabeth, Singapore 228510
Tel: 6454 0054
|
Fax: 6764 0054
|
Email: ask@surgicalassociates.sg
Gleneagles Medical Centre
#05-01, 6 Napier Road, Singapore 258499
Tel: 6471 0054
|
Fax: 6271 0054
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