Cancer is characterized as the uncontrolled proliferation of cells that result in the growth of tumors; over time, the cancer cells may spread to other parts of the body. Cancer can start anywhere in the human body.
In a normal human body, human cells will grow and multiply to form new cells when the body needs them. As the cell becomes old or damaged, they will die, and new cells will be created to take its place. However, sometimes this process malfunctions, resulting in the growth or multiplication of cells when there shouldn’t be any. These cells may eventually form a lump of tissue known as a tumor, which can be either cancerous or non-cancerous.
According to the Singapore Cancer Society, colorectal cancer is the second most common cancer for both men and women, after prostate and breast cancer respectively.
We sit down with General Surgeon Dr. Lee Chinli to look at the signs and symptoms of colorectal cancer, what screenings are available to help detect the cancer early, what you could possibly do to lower your risk of developing this cancer, and more.
Colorectal cancer is one of the most common cancers in Singapore, accounting for 16% of all cancer cases in men and 13% of all cancer cases in women. It is the cancer of the colon (the main part of the large intestine) and rectum (the passageway connecting the colon to the anus), which usually begins as a non-cancerous polyp that may develop into cancer over time. Between 2017 and 2021, approximately 12,239 cases of colorectal cancer were diagnosed in Singapore. It is more common among people aged 50 years and above.
| Modifiable Risk Factors | Modifiable Risk Factors |
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Colorectal cancer may still happen in younger adults, but your risk of developing it increases as you age, with adults aged 50 years and above recommended going for regular screening for colorectal cancer. Men are also at a higher risk of developing colorectal cancer than women.
Despite older age being a risk factor, Dr. Lee Chinli shared that there is an increasing prevalence of young colorectal patients.
“No one knows the exact cause but it can be due to the lifestyle and dietary risks as mentioned. Some patients with young colorectal cancers are related to certain genetic syndromes such as Lynch and Familial Adematous Polyposis Syndrome,” he explained.
A diet that’s high in red meat and processed meats may also raise your risk of colorectal cancer, with studies suggesting limiting red and processed meat consumption for the prevention of colorectal cancer.
Colorectal cancer is the second most common cancer for men and women in Singapore, right after prostate and breast cancer, respectively. The majority of colorectal cancers happen from adenomatous polyps; hence, early detection of said polyps improves the likelihood of a cure. Most polyps can be removed during a colonoscopy, ruling out the need for surgery. This makes colonoscopy the gold standard in colonic screening.
Dr. Lee advises young patients under the age of 50 are encouraged to undergo colonoscopy as well. “If you are under 50 and have red flag symptoms such as unexplained weight loss or appetite loss, altered bowel habits, rectal bleeding or bloody stools, and change in stool forms, you are advised to have a colonoscopy done,” says Dr. Lee.
A Faecal Occult Blood Test (FOBT) detects human haemoglobin from partially digested blood in stool samples to screen for colorectal cancer or other digestive issues. If blood is detected, further tests further tests such as endoscopy will have to be conducted to find the source of bleeding, as not all cancers or polyps bleed.
Treatment options for colorectal cancer typically involve surgery to remove the cancer, as well as radiation therapy and chemotherapy.
According to Dr. Lee, “Rectal tumor may require neoadjuvant treatment such as chemotherapy and radiotherapy prior to surgery to ensure better outcomes.” He adds that the stage of the tumor will affect whether the surgery is performed upfront or after neoadjuvant treatment.
Neoadjuvant treatment refers to cancer treatment administered prior to a surgery with the goal of shrinking the tumor and increasing the chances of a successful surgery.
