Colorectal cancer is the leading cancer in Singapore. Worldwide, 655,000 people die from colorectal cancer each year. Many colorectal cancers are thought to arise from adenomatous polyps in the colon. These mushroom-like growths are usually benign, but some may develop into cancer over time. Diagnosis of colon cancer is currently done through a combination of blood test, stool test and colonoscopy.

“It is important to diagnose colon cancer early,” said Dr Ng Chin, General Surgeon of Raffles Surgery Centre, “as up to 95% of early cancers can be cured with an operation. Early diagnosis can also halt the progression of cancer.”

Treatment of colorectal cancer is stagedependent. Early-stage colorectal cancer is potentially curable. When colorectal cancer has spread to other organs, the cancer is less likely to be curable. Surgery is the mainstay of treatment. Chemotherapy and radiotherapy may be required, depending on the staging.

“The aim of curative surgery,” explained Dr Wong Kutt Sing, General Sungeon, Raffles Surgery Centre, “is to completely remove the cancer-bearing segment of the bowel with adequate margins and radical en-bloc resection of its mesentery and lymph nodes.”

Laparoscopic colectomy is a minimally invasive (keyhole) surgical technique to treat colorectal cancer. Potential benefits of this technique include smaller incisions, less postoperative pain, earlier return of bowel function, earlier resumption of oral intake, shorter hospital stay and earlier return to normal activities. The main disadvantage of laparoscopic colectomy is increased operating time.

Long-term studies comparing laparoscopic and open colectomy have demonstrated equivalent survival rates between the 2 techniques. One study from Spain showed better survival in Stage 3 colon cancer in patients who have undergone laparoscopic colectomy.

Although it may be hidden in the depths of your bowels, colorectal cancer can be prevented through regular screening and the removal of polyps.

“Early diagnosis means a better chance of successful treatment,” advised Dr Wong. “Screening should begin at age 50 for all average risk individuals or sooner if you have a family history of colorectal cancer, symptoms, or a personal history of inflammatory bowel disease.”

Risk Factors for Colorectal Cancer

• Polyps
• Age
• Inflammatory bowel disease (IBD)
• Diet high in saturated fats, such as
• red meat
• Personal or family history of cancer
• Obesity
• Smoking
• Race
• Other

Colorectal Cancer Symptoms

• Change in bowel habits: diarrhoea, constipation, or a feeling that the bowel does not empty completely
• Bright red or dark blood in stool
• Stools appear narrower or thinner than usual
• Discomfort in the abdomen, including frequent gas pains, bloating, fullness, and cramps Unexplained weight loss, constant tiredness, or unexplained anaemia

Screening Tests

• Colonoscopy
• Virtual colonography
• Sigmoidoscopy
• Fecal occult blood test
• Double contrast barium enema
• Stool DNA test