COLORECTAL Cancer Awareness Month is an annual observance in March. It aims to raise awareness about colorectal cancer and encouraging people to take steps to prevent and detect this disease.
According to Malaysia National Cancer Registry (MNCR) 2012-2016, colorectal cancer is the second most common cancer among the general population in Malaysia. It is the most common cancer among males and the second most common cancer among females in Malaysia.
Colorectal cancer is a type of cancer that affects the colon or rectum, which are part of the digestive system. It is one of the most common types of cancer, and typically occurs in older adults. However, in recent years, there has been a rise in the younger age group.
Consultant colorectal surgeon from Prince Court Medical Centre, Dr Lim Hiong Chin notes, “The incidence of cancer increases with age and peaks at age 70.
"The older we get, the higher the risk but we see a rise of colorectal cancer in the younger age group. For males, we see a rise between the ages of 50 and 64 years, and in females, the rise is between the ages of 35 and 64.”
Several factors may contribute to this trend. One possible explanation is the dietary habits and lifestyle choices of Malaysians.
Dr Lim points out that dietary habits which include processed food, high in red meat, and low in fibre such as fresh vegetables and fruits are part of the problem.
He also blames the preference of the urban generation today who prefer eating out which may mean having little control over the way their food is prepared, as food that involves deep-frying and barbecuing with charred meat potentially contributes to the increase in colorectal cancer incidences.
“These factors have a big impact on the development of colorectal cancer. Other factors like lack of physical activity, obesity and smoking have also been linked to an increased risk of colorectal cancer,” he adds.
Another factor that may contribute to the increase in colorectal cancer incidence in younger patients is the lack of awareness and screening.
Colorectal cancer screening is recommended for adults over the age of 50, but younger individuals may not be aware of the importance of screening or may not have access to it.
Dr Lim stresses, “Screening is recommended at 50 years old, however with the trend suggesting an earlier onset of cancer, I recommend that screening should start as early as age 45.”
Early detection and treatment are crucial for improving colorectal cancer outcomes. The most effective way to detect colorectal cancer early is through screening tests, such as colonoscopy, the gold standard when it comes to detecting colorectal cancer.
“Colonoscopy is a procedure where a fibre optic camera is passed into the colon through the anus. The patient must prepare themselves a day before by taking laxatives to cleanse their bowel.
"The patient is sedated before the procedure, and the fibre optic camera is passed through to view the inner lining of the colon. If any abnormalities such as a tumour or polyp are detected, they can be removed at the same setting.
"For straightforward, non-complicated cases, it will usually take only about 20 minutes as a daycare procedure,” Dr Lim explains.
“Apart from colonoscopy, there other screening methods such as a stool test, where a test is done to determine the presence of blood in stools or evidence of bleeding, or a CT colonography CT colonography, where a CT scan is done to capture detailed images of the colon and rectum,” he adds.
Signs and symptoms
“The tricky part about colorectal cancer is the lack of clear signs, and they usually appear at the advanced stage. As such, there is a need to educate the public about the common signs and symptoms to look out for.
“Some of the signs are blood in your stools or mucus in the stools, and recent change in bowel habits such as constipation or diarrhoea which persists for a long time despite treatment with no obvious explanation.
"Other signs which are more indicative of the later stage of the disease include unexplained and non-specific abdominal pain, sudden weight loss without explanation and sudden appetite loss,” he reveals.
Treatment and prognosis
“There are in general three modalities of treatment for colorectal cancer. It comes in the form of surgery, radiotherapy, and systemic therapy.
"And lately we have been hearing about targeted therapy and immunotherapy. However, for early cancer, surgery may be the only treatment needed.
"For advanced cancer in Stage 3 and 4, it usually requires a combination of surgery and chemotherapy. With the right treatment, most people will be able to carry on with their lives, with many patients surpassing the five years survival rate,” says Dr Lim.
Colorectal cancer is a growing concern in Malaysia, with an increasing number of younger patients being diagnosed.
This trend is likely due to a combination of factors, including changing dietary habits and lifestyle choices, as well as a lack of awareness and screening.
To address this issue, there is a need for increased education and awareness about colorectal cancer, as well as efforts to promote healthy lifestyle choices and improve access to screening.
By taking these steps, we can reduce the burden of colorectal cancer in Malaysia and improve patient outcomes. – The Vibes, March 30, 2023
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