Colorectal Cancer Surgery

WHAT IS COLORECTAL CANCER?

Colorectal cancer is a cancer of the colon and rectum and is most prevalent in people aged 50 and above. To put the scale of colorectal cancer in perspective, it is the most common cancer in Singapore – #1 among men and #2 among women.

Colorectal cancer is usually caused by a polyp in the colon turning malignant. As such, early detection and removal of polyps while they are still benign, is crucial. Consider making an appointment with a colorectal cancer surgeon for recommended screening tests.

WHAT ARE CAUSES & RISK FACTORS OF COLORECTAL CANCER?

• History of colorectal cancer in the family
• History of having any type of cancer in the past
• Age (>50)
• Alcohol and cigarette smoking
• Inflammatory bowel disease: ulcerative colitis, Crohn’s disease
• Sedentary lifestyle
• Poor diet choices which are low in fibre and high in processed meat

For patients with higher risk levels, it will be good to consult a Singapore colon surgeon to find out ways you can manage your risk levels and aid in early detection of the disease.

WHAT ARE COMMON SYMPTOMS OF COLORECTAL CANCER?

• Blood in faeces and rectal bleeding
• A persistent change in bowel habits, such as diarrhoea, constipation or a change in consistency/calibre of the stool
• Discomfort in the abdominal area such as cramps and feeling bloated
• Fatigue and unexplained weight loss

If you are experiencing any of these symptoms, visit a colorectal specialist in Singapore for a detailed evaluation.

HOW TO DIAGNOSE COLORECTAL CANCER?

Detection of colorectal cancer can sometimes be done through a rectal examination. This is done through the gentle insertion of a gloved, lubricated finger into the rectum. However, this can only detect cancer if it affects up to 5 to 8 cm of the rectum.

In most cases, a colonoscopy or faecal blood test can be used in the diagnosis of colorectal cancer. A colonoscopy is the most detailed test, allowing the Singapore colorectal surgeon to clearly visualise the entire length of the colon with the help of a thin flexible tube (with a small camera attached) being inserted through the anus and gently threaded through the colon.

WHAT ARE COMMON TYPES OF SURGERIES FOR COLORECTAL CANCER?

• Polypectomy

  – This involves the removal of polyps on the lining of the colon and rectum. Your colorectal surgeon can perform this during a colonoscopy.

• Local Excision

  – This procedure removes the cancerous tumour while preserving normal bowel function.

• Resection

  – This surgery removes a part of or the entire colon and other surrounding tissue that are diseased.

• Laparoscopic Surgery

  – This is a minimally invasive procedure that only requires small incisions in the skin. A colorectal surgeon uses a thin fibre-optic instrument called a laparoscope, which is built with a high-resolution camera. This reduces the need for a traditional open surgery that requires a large incision. That being said, sometimes an open surgery may be necessary.

• Colostomy

  – This is a procedure where the large intestine is directly attached to an opening made in the abdominal wall, called a stoma. The opening is made as a pathway for stool to come out of the body.

WHAT ARE OTHER TREATMENTS FOR COLORECTAL CANCER?

• Cryoablation – This uses cold to destroy cancer cells. This procedure uses cryophobes – hollow needles inserted into the skin – to facilitate a freezing process that kills the cancerous tissues.
• Chemotherapy – This is a procedure that uses drugs (either injected through the veins or taken orally) in order to kill cancer cells in the colon or rectum. In severe cases of colorectal cancer, palliative chemotherapy may be recommended. This type of chemotherapy is administered to help shrink the cancerous tumours in the colon or the rectum when surgery is no longer possible.
• Radiation Therapy – This method uses high-energy rays to destroy cancer cells. A colorectal surgeon may do this before the surgery to shrink the tumors so it can be removed more easily.

Colorectal cancer may be common, and reportedly has an increasing risk in younger adults, but it is actually extremely preventable and treatable in the early stages. Do not delay getting screened should you be in a higher-risk group; and if you are unsure, seek medical advice.

Singapore colorectal surgeon, Dr Chong Chee Keong, is dedicated to the prevention and treatment of colorectal cancer for two decades. For more information, please reach us at 6355 5285 today.