Colorectal cancer refers to cancer of the colon (the main part of the large intestine) or rectum (the final ~15 cm of the large intestine). Often, benign (non-cancerous) growths (polyps) may appear within the colon and rectum. Over time, these polyps can turn malignant and develop into cancer.
Most patients diagnosed with colorectal cancer are older than 50 years old. However, patients who were diagnosed at an early age (for example, at age 20-40) may have a hereditary form of colorectal cancer, such as familial adenomatous polyposis (FAP).
There are warning signs which the patient should look out for and seek medical advice early. They include:
Below is a summary of possible risk factors associated with colorectal cancer.
Regular screening is still the main key in detecting colorectal polyps or cancer early. In Singapore, the recommended age of screening is 50 years old for individuals with no symptoms. Patients with a strong family history of colorectal cancer are advised to start screening earlier than the recommended age. Screening tools currently available include:
The mainstay of treatment for colorectal cancer is surgery. This aims to remove the tumour as well as the surrounding lymph nodes. Most of the time, the two ends of the cut section can be joined together to restore continuity of the colon and rectum. In recent years, keyhole (laparoscopic) surgery can be performed which avoids long scars after surgery.
A full detailed microscopic examination of the tumour is performed to determine the stage of the cancer. Depending on the stage, chemotherapy with or without radiotherapy may be required.
Locally, the mortality (death) rate of colorectal cancer has seen a slight decline over the past decade. This is likely due to the progress in treatment Main treatment for colorectal cancer is surgery. of colorectal cancer, as well as increased awareness for screening. As a result, more patients are treated at an early stage of the disease with a 5-year survival rate of as high as 95% in Stage 1 colorectal cancer. Therefore regular screening is important and early medical advice should be sought before it is too late.
If you have any of the abovementioned symptoms or signs, it is advisable to consult a general practitioner (GP) first. A referral to a specialist center for further investigation is warranted should there be no resolution of symptoms despite initial treatment by the GP. It is also advisable to be seen by a specialist should you have risk factors or if there is suspicion of colorectal cancer.
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