SHARES
Debbie was an employee of a multinational company. Her job was stressful and involved travelling frequently. Lately, she noticed a change in her bowel habits and is easily tired, feeling breathless upon exertion but decided to ignore it, thinking it was only temporary. After a few months, she noticed that her stools were black, felt pain in abdomen and experienced loss of weight and energy. Worried, she decided to consult a doctor. After some preliminary tests and a colonoscopy, the doctor confirmed that Debbie had Stage 3 colorectal cancer. If Debbie had gone for a screening early, she could have detected the cancer in earlier stages.
As the name suggests, colorectal cancer affects the colon and rectum of the digestive system. The colon is the organ that absorbs water and nutrients from food matter after it passes through the small intestine while the rectum stores undigested waste matter until it is expelled from the anus.
According to Dr. Melvin Look from Pan Asia Surgery Group – “Colon polyps form due to genetic mutations. These genetic accidents become more frequent as our cells age and can occur to anyone. The majority of colorectal cancers happen in people who have no family history of cancer so you are still at risk even if no one in your family has ever had it. In fact, only 10 to 20 percent of people that have colorectal cancer have a family member with colorectal cancer.”
The causes of colorectal cancer remain unknown, but you can reduce risk by acting on certain identifiable risk factors, which include:
- Family history
- Old age
- Smoking
- Excessive alcohol consumption
- Sedentary lifestyle
- Obesity
Take note of these signs and symptoms of colorectal cancer:
- Blood in stools/Black stools
- Change in bowel habits (Change in consistency, frequency and calibre of stools)
- Abdominal pain or discomfort
- Anaemia (tiredness, breathlessness)
- Loss of energy
- Rapid heart rate
- Pale skin
- Leg cramps
- Presence of a lump in the abdomen
Most cases of colon cancer begin as small, noncancerous (benign) clumps of cell called adenomatous polyps. Over time some of these polyps can become colon cancer. Colorectal cancers are malignant tumors where cure is possible if it is detected and treated at an early stage.
Screening for cancer at an early stage, even when the patient shows no symptoms, can help to detect pre–malignant stages (polyp) of the cancer.
According to Dr. Melvin Look, a Gastrointestinal and Endoscopic Surgeon, “The vast majority of colorectal cancers start off as little fleshy growths called polyps which take a good 5 to 10 years to grow before they undergo cancer change. They start to form when we hit our forties, so a good recommendation is to do your first colon screening by the age of 50 or so.”
These are some common screening procedures in screening for colorectal tumors:
- Barium enema
Barium solution, a type of contrast dye, is injected into the bowel of the patient to highlight the affected part of the colon tissue via X-ray images. It is not as accurate as colonoscopy as small cancer- causing polyps are most likely missed with Barium enema
- Blood stool test(or fecal occult blood test)
This test checks for occult blood or hidden blood in the stool of the patient. The test can be done using a kit at the doctor’s clinic or at home. This method is not 100% accurate as blood may be present in the stool due to other conditions, such as hemorrhoids, peptic ulcers, anal fissures etc. Although not accurate, it is useful to detect early signs of colorectal cancer.
- Colonoscopy
According to Dr. Look, “By far the best way to screen for colon cancers is by a simple endoscopic procedure called colonoscopy.”
Colonoscopy helps to visualize the inner linings of the large intestine with a fibre-optic endoscope to detect any abnormal structures (polyp) or growth. It is a 20 minute procedure done under sedation. Bowel preparation is needed before the examination i.e. removing all the faeces from the colon and rectum.
- Computed Tomography (CT) Scan
A CT scan is a commonly performed procedure. The CT scan machine takes three-dimensional, high resolution images of the colon. It is a noninvasive, painless procedure which allows doctor to evaluate spread of the cancer. This procedure also needs bowel preparation.
- Fecal DNA testing
This non- invasive test detects DNA markers (altered DNA) and blood in the stool, which are shed by the colorectal cancer cells. Presence of these markers indicates the presence of cancer-causing polyps in the colon. Colonoscopy is done to confirm the abnormality present in the colon
Make lifestyle changes to help reduce the risk of getting colorectal cancer:
- Going for regular screenings– Those above 50 or have a family history of cancer are encouraged to attend regular screenings and check-ups.
- Keeping a healthy diet– Following a balanced diet of fruits, vegetables and good quality carbohydrates and fats like nuts, avocado, olive oil etc. helps to keep the body fit.
- Exercise Regularly– Along with a proper diet, regular exercise helps to keep the body fit.
- Losing excess weight– Since obesity increases the risk of colorectal cancer, losing excess weight by exercising and eating healthy reduces the risk of colorectal cancer.
Acknowledgment
This article is written drawn from information at a health talk by Dr Melvin Look, Gastrointestinal and Endoscopic Surgeon from The Pan Asia Surgery Group.
Read another related topic, Common Myths about Colorectal Cancer Screening by Dr Melvin Look
To read more about pros and cons of the screening tests of colorectal cancer. Click here
References-
- Internet-www.cancer.org
- Internet-www.singaporecancersociety.org
- Research paper- Fecal DNA testing
- Article- Quotes by Dr. Melvin Look
If you would like to make an appointment with a colorectal surgeon
Find a colorectal surgeon in Singapore on GetDoc
Find a colorectal surgeon in Malaysia on GetDoc
by Aditi Upadhyay
View all articles by Aditi Upadhyay.
