Colorectal Cancer

Dr Calvin Ong

MBBS M.MED (SURGERY) MRCS FRCS

What is Colorectal Cancer?

Colorectal cancer is a type of cancer that starts in the colon (large intestine) or rectum. It usually begins as small growths called polyps on the inner lining of the colon. While most polyps are harmless, some can turn into cancer over time. Colorectal cancer is one of the more common cancers, but it can often be successfully treated if found early through regular screenings like colonoscopies, especially for people over 50.

Causes & Risk Factors of Colorectal Cancer

Colorectal cancer develops when cells in the colon or rectum begin to grow abnormally. Several factors can increase this risk:

Age

As we age, our cells undergo more divisions, increasing the chances of mutations that can lead to cancer. This is why colorectal cancer is more common after age 50.

Family History

If someone in your family has had colorectal cancer, you may inherit genetic mutations that make your colon cells more likely to grow abnormally and form cancer.

Inflammatory Bowel Disease

Conditions like Crohn’s disease and ulcerative colitis cause chronic inflammation in the colon, which can damage the lining and increase the risk of cancer. Over time, the constant repair of inflamed tissues can lead to mutations and cancer.

Diet and Lifestyle

Eating large amounts of red and processed meats is linked to a higher risk of colorectal cancer. These foods may produce chemicals that damage cells in the colon. A lack of fibre in the diet can also slow digestion, causing waste to stay in the colon longer, and increasing exposure to cancer-causing substances. Smoking, alcohol consumption, obesity and a lack of physical activity further contribute to increased cancer risk.

Diagnosis of Colorectal Cancer

To accurately diagnose colorectal cancer, several tests are used to confirm the presence of cancer and determine its stage:

Colonoscopy

A colonoscopy allows the doctor to see inside the colon using a small camera to look for growths like polyps or tumours. If anything unusual is found, it can be removed or sampled (biopsy) for further testing.

Biopsy

During a biopsy, a small sample of tissue is taken from a suspicious area and examined under a microscope. This is necessary to confirm whether the cells are cancerous or benign.

Imaging Tests

CT or MRI scans provide detailed images of the body and are used to see if the cancer has spread to other organs or tissues. This helps in staging the cancer, which is important for deciding the best treatment plan.

Blood Tests

Blood tests look for specific markers, like CEA (carcinoembryonic antigen), which are substances that can be elevated when cancer is present. While not a standalone diagnostic tool, these tests help monitor cancer progression or recurrence after treatment.

Surgical Treatment Options

Surgery is often required when the tumour is confined to one area and can be removed. In some cases, surgery is combined with other treatments like chemotherapy or radiation to reduce the tumour size or lower the risk of recurrence. In more advanced cases, surgery may be used to alleviate symptoms or remove as much of the cancerous tissue as possible.

Polypectomy

This procedure is performed during a colonoscopy to remove polyps that may become cancerous. It involves using a wire loop or tools to cut away the polyp from the colon lining, which prevents further cancer development.

Colectomy

A colectomy removes part or all of the colon affected by cancer. In a partial colectomy, only the cancerous section is removed, and the healthy parts of the colon are reconnected. For more extensive cancer, a total colectomy may be required, where a larger section or the entire colon is removed. This restores normal bowel function and helps prevent the spread of cancer.

Laparoscopic or Robotic Surgery

This is a minimally invasive procedure where small incisions are made in the abdomen, and a camera is inserted to guide the removal of cancerous tissue. Laparoscopic surgery is generally associated with faster recovery and reduced discomfort compared to open surgery.

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Reducing the Risk of Colorectal Cancer

Maintaining a healthy lifestyle can help reduce the risk of colorectal cancer. Eating a diet rich in fruits, vegetables, and whole grains while reducing red and processed meats can promote colon health. Regular exercise supports healthy digestion and helps maintain a healthy weight. Quitting smoking and limiting alcohol intake can further reduce the risk. For individuals over 50 or those with a family history of colorectal cancer, regular screenings such as colonoscopies are recommended for early detection and removal of polyps before they turn cancerous.

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Dr Calvin Ong Jianming

MBBS (S’pore)|

M.Med (Surgery)|

MRCS (Ireland)|

FRCS (Edin)|

王健名医生

Dr. Calvin Ong is a Senior Consultant with more than 15 years of surgical experience. He specializes in colorectal and general surgery, performing minimally invasive as well as advanced robotic surgeries for benign and malignant colorectal conditions, including inflammatory bowel disease, pelvic floor disorders, colorectal cancer, and hernia repair. He is dedicated to providing high-quality, personalised care for his patients.

Dr. Ong graduated with a Bachelor’s degree in medicine and surgery from the National University of Singapore in 2008 and completed his Masters of Medicine (Surgery) at the same institute. He finished his advanced specialist training in 2016 and became a fellow of the Royal College of Surgeons of Edinburgh.

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    Frequently Asked Questions

    How often should I get screened for colorectal cancer?

    Screening frequency depends on your age and risk factors. For most people, colonoscopies are recommended every 10 years starting at age 50. However, if you have a family history of colorectal cancer or other risk factors, your doctor may recommend starting earlier or screening more frequently.

    Can I prevent colorectal cancer with diet alone?

    While a healthy diet can reduce the risk, it cannot completely prevent colorectal cancer. Regular screenings and a combination of healthy lifestyle choices, such as avoiding smoking and staying active, are important for prevention.

    Does colorectal cancer always have symptoms?

    No, colorectal cancer can be asymptomatic, especially in its early stages. That’s why regular screening is essential to catch the disease before symptoms develop.

    Can colorectal cancer be cured?

    If detected early, colorectal cancer can often be effectively managed with surgery, and in some cases, additional treatments like chemotherapy or radiation. The chances of a cure decrease if the cancer has spread, but treatment can still manage symptoms and improve quality of life.

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