According to the NATIONAL STRATEGIC PLAN National Strategic Plan for Colorectal Cancer (NSPCRC) 2021 – 2025, colorectal cancer (also known as colon cancer) is the second most common cancer and contributed to 13.5 per cent of all new cancer cases diagnosed in 2012-2016.
The incidence of colon cancer increases with age and is slightly higher in males. Colon cancer is known to be highly preventable and treatable through early detection. However, the 2012-2016 cancer report showed, around 70 per cent of colon cancer patients in Malaysia were diagnosed at stage III or IV. This is the stage where treatment is more complicated, and the outcome is poorer.
Understanding Colon Cancer
“Colon cancer occurs when there is an uncontrolled growth of abnormal cells in the colon or rectum. These abnormal cells can develop into polyps, which are small growths that protrude from the inner lining of the colon or rectum. While most polyps are not cancerous, some can develop into cancer over time,” explains Dr Zakry Onn Yahya, a Consultant General Surgeon of ParkCity Medical Centre.
The exact cause of colon cancer is still unknown, but there are several risk factors that increase the likelihood of developing the disease. These include a family history of colon cancer, a personal history of colon polyps or inflammatory bowel disease, a diet high in red and processed meats, obesity, smoking and a sedentary lifestyle.
Symptoms Of Colon Cancer
“In the early stages, colon cancer often does not produce any symptoms. As the cancer grows, however, it can cause several symptoms, including changes in bowel habits, such as diarrhoea or constipation, blood in the stool, abdominal pain or cramping, unexplained weight loss, fatigue and weakness. These symptoms are not specific to colon cancer and can be caused by other conditions, so it is important to consult a doctor if any of these symptoms persist,” reminds Dr Zakry.
Screening For Colon Cancer
Screening is the process of testing for a disease in individuals who do not show any symptoms. For colon cancer, there are several screening tests available, including Fecal Occult Blood Test (FOBT) which checks for blood in the stool and colonoscopy—a procedure that involves inserting a long, flexible tube with a camera on the end into the rectum to examine the colon and rectum. If polyps are found, they can be removed during the procedure. Meanwhile, the Stool DNA Test checks for DNA changes in the stool that may indicate the presence of colon cancer.
“The FOBT and colonoscopy is recommended for individuals over the age of 45, and those with a family history of colon cancer or polyps should start screening at an earlier age. Meanwhile the Stool DNA Test is recommended every 3 years for individuals over the age of 50. The choice of screening test depends on the individual’s risk factors, preferences and medical history. It is important to consult a doctor to determine the appropriate screening schedule,” stresses Dr Zakry.
Why Is Screening Important?
Screening for colon cancer is important for several reasons. Firstly, it can detect colon cancer at an early stage when it is most treatable. In fact, colon cancer is one of the most preventable cancers, as it can take 10 to 15 years for polyps to develop into cancer. If polyps are detected and removed during screening, the risk of developing colon cancer can be significantly reduced.
“Secondly, screening can also detect colon cancer before it causes symptoms. As mentioned earlier, colon cancer often does not produce any symptoms in the early stages. By the time symptoms appear, the cancer may have already spread to other parts of the body, making treatment much harder,” adds Dr Zakry.
Treating Colon Cancer
If colon cancer is detected in its early stages, the chances of successful treatment are much higher. Treatment for colon cancer often involves surgery to remove the cancerous tissue. Depending on the type and stage of the cancer, the surgery may involve removing a part of the colon or rectum, or even the entire colon or rectum. In some cases, a colostomy bag may be required temporarily or permanently.
While surgery is often necessary to treat colon cancer, it is not without risks. Patients may experience blood loss, infection or a prolonged stay in the hospital. Patients should be adequately prepared for surgery both physically and mentally and should be informed of the risks and benefits of the procedure.
“In addition to physical preparation, emotional support is also crucial for patients with colon cancer. Patients may experience anxiety, depression or denial when faced with a cancer diagnosis. It is important for doctors to provide adequate counselling and support to help patients cope with the emotional impact of the disease.
“Family support and participation in support groups can also be beneficial for patients with colon cancer. Support groups provide a safe space for patients to share their experiences and learn from others who have gone through similar experiences,” Dr Zakry advises.
Preventing Colon Cancer
“While there is no sure-fire way to prevent colon cancer, there are several steps that can be taken to reduce the risk of developing the disease. Some of these steps include eating a healthy diet that is high in fibre and low in fat, exercising regularly, maintaining a healthy weight, not smoking, limiting alcohol consumption, getting screened for colon cancer regularly and of course screening,” concludes Dr Zakry.
