Colorectal Cancer

Article Sections Introduction Causes Symptoms Treatment Prevention

Contributed by Singapore General Hospital


Introduction

Colorectal cancer is the second most common cancer in Singapore and the incidence is increasing very rapidly with about 1000 new cases diagnosed annually. This increase is expected to continue with 2,000 new cases being diagnosed in the early years of the next millennium. This will make colorectal cancer the most common cancer in the next millennium in Singapore. Currently more than half of those affected will die from this disease. This is a tragedy because most cases of colorectal cancer are curable if they were diagnosed in the early stage.


Causes and Risks

Though colorectal cancer may occur at any age, about 90 percent of the patients are over age 40. Other risk factors include a family history of colorectal cancer, a personal history of ulcerative colitis , or colon polyps or cancer, and cancers of other organs, especially the breast or uterus. 
 
Benign polyps

Nearly all colon and rectal cancer begins as benign polyps. These growths occur on the bowel wall and may eventually increase in size and become cancerous. Removal of benign polyps will treat the 'cancer' even before it is cancerous. 


Symptoms

The most common symptoms are rectal bleeding and change in bowel habits, such as constipation or diarrhoea. [These symptoms are also common in other diseases such as piles , so it is important you receive a thorough examination should you experience them]. Abdominal pain and weight loss are usually late symptoms indicating possible extensive disease.

Unfortunately, many polyps and early cancers fail to produce symptoms. Also, there are patients who have symptom such as bleeding and attribute the bleeding to piles, and so delay seeking treatment until the cancer is advanced.

 
Treatment

Colorectal cancer requires surgery in nearly all cases for complete cure. In the hands of a trained specialist, less than 10 percent of patients require a stoma (artificial opening in the abdomen). Radiation and chemotherapy are sometimes used in addition to surgery. Between 80 to 90 percent of colorectal cancer patients are restored to health if the cancer is detected and treated in its earliest stages. The cure rates however drops to 50 percent or less when diagnosed in the later stages.  


Prevention

One way of reducing the risk of contracting the disease is to have benign polyps removed by colonoscopy. In addition to removing the polyps, the long flexible tubular instruments used in this procedure provides a more through bowel examination.

Finally, you must be aware of changes in your bowel habits and make sure of bowel examinations are carried out once you fall under the "high-risk" category.




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