COLORECTAL SURGERY SINGAPORE

Colon Cancer

What do I need to know about colorectal cancer in Singapore?

Colorectal cancer, or cancer of the colon and rectum, is the second most common cancer in Singapore for both men and women combined. The average person has a 5% lifetime risk of developing colorectal cancer while someone with a family history of colorectal cancer has an increased risk of up to 20%.

Some factors associated with an increased risk for colorectal cancer are:

  • Positive family history especially first degree relative
  • History of colorectal polyps
  • History of ovarian endometrial or breast cancer
  • History of inflammatory bowel disease
  • Smoking

Given the prevalence of colorectal cancer in Singapore and societal lifestyle changes, it is not uncommon that patients are being diagnosed at age 30s to 40s.

What are the symptoms of colorectal/colon cancer in Singapore?

Colorectal cancer is often a silent disease, developing without any symptoms. Symptoms, when they do occur, include the following:

  • Blood in the stool
  • Change in bowel habit
  • Stools becoming narrower in calibre
  • Abdominal distension or localized discomfort
  • Feeling of incomplete bowel evacuation
  • Significant weight loss

If any of these symptoms persist beyond a month, you should consult your doctor or a specialist immediately. While not everyone who has these symptoms will have colorectal cancer, persistence of these is not normal and should be investigated to determine the underlying cause.

Can colorectal/colon cancer be prevented?

Colorectal cancer is believed to develop from a benign polyp in its earliest stage. Hence it is important to detect these polyps and to remove them via colonoscopy before they become cancerous.

Other general lifestyle measures include observing a balanced diet that is high in fibre, low in animal-fat together with regular exercise.

How do I get screened for colorectal cancer in Singapore?

The risk for cancer increases with age and hence MOH recommends that anyone above the age of 50 years should undergo a colonoscopy as the most cost-effective screening method. Anyone with the above increased risks should be screened at an earlier age.

There are other methods of screening that are simpler to perform but less sensitive for colorectal cancer. Examples include faecal occult blood test, blood test for tumour marker as well as scans such as barium enema or CT colonography.

How is colorectal cancer treated in Singapore?

Like most solid cancers, colorectal cancer can effectively be cured by surgery particularly when detected at an early stage. It is important that the surgery is performed by a surgical oncologist (cancer surgeon) who is trained to systematically remove the cancer with all the accompanying diseased lymph nodes. Such a comprehensive resection provides the lowest probability of cancer recurrence and the best chance of cure.

Conventional surgery for colorectal cancer can be done by the following approaches:

  • Open colorectal surgery
  • Laparoscopic surgery (keyhole)
  • Robot-assisted surgery

The suitability for each approach will be discussed between the surgeon and you. While minimally invasive surgery (laparoscopic or robot-assisted) has its advantages in terms of faster recovery time, shorter length of stay in hospital and reduced post-operative pain, it is ultimately the completeness of the surgery that determines the curative outcome.

Colorectal Cancer Treatment

Your surgeon should also discuss the typical risks associated with a colorectal surgery, namely:

  • Leakage at the joined sections of the colon
  • Infection within the abdomen
  • Post-operative bleeding
  • Injury to the surrounding viscera such as the ureter, blood vessel and intestines

These complications can be minimized in the hands of an experienced surgeon.

Chemotherapy, and sometimes radiotherapy, play an important role in the treatment of colorectal cancer especially in the advanced stages. Your surgeon should discuss and outline the entire treatment sequence with you.

Cancer-fighting is not a journey that you take alone but one that is guided and supported by a team of doctors working alongside with you.

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