March is colorectal cancer awareness month and is a great time to ask about this topic. Colorectal cancer, sometimes it is called colon cancer, bowel cancer, or rectal cancer for short. It occurs when the cells that line the colon or the rectum become abnormal and grow out of control. In Malaysia, colorectal cancer is the most common cancer in males, second most common cancer in females and third most common cause of cancer death. Over 60% individuals with colorectal cancer are detected at a late stage (3rd or 4th stage) and researchers have indicated that this may partly be due to low cancer awareness and misbeliefs about cancer.
Myth: Colorectal cancer is fatal. There is no cure.
Fact: Colorectal cancer is highly treatable and often curable disease when localised to the bowel. Over 90% patients with localised colorectal cancer are alive 5 years after diagnosis. Sadly, only one third of them are diagnosed at this early stage. Most people visit the doctor when the disease has spread beyond the walls of the colon or rectum or remote parts of the body, reducing the chance of successful colorectal cancer cure.
Myth: There is nothing I can do about getting colorectal cancer.
Fact: There are many ways you can do to help lower the risk of getting colorectal cancer including:
- Getting screened
- Eating lots of vegetables, fruits and whole grain
- Taking care the balance of gut flora (Learn more)
- Get regular exercise
- Quit smoking
- Limit alcohol consumption
Myth: Screening is only necessary for those who have symptoms.
Fact: Since early colorectal cancer usually has no symptoms, it is important to obtain recommended screenings to detect these cancers. In fact, over 60% of deaths from colorectal cancer could be avoided with screening. Prevention is better than cure. Screening for colorectal cancer should be a part of routine care for all adults aged 50 years and above, especially those with family history of colorectal cancer. If you’re at higher risk, you may need to start regular screening at an earlier age and be screened more often. You should talk to your doctor about when you should begin screening and what is the best screening option for you.
High risk colorectal cancer checklist:
- aged 50 and above
- has family histories of colorectal cancer or polyps
- has personal histories of inflammatory bowel disease
- has a personal or family history of ovarian, endometrial or breast cancer
- overweight or obese, especially those who carry fat around their waists
- not physically active
- drinks alcohol in excess, especially men
- eats a lot of red meat or processed meat
- smoker
Myth: There are no effective test to screen for colorectal cancer.
Fact: There are various of test used for screening for colorectal cancer and they are 100% reliable.
- Barium Enema
- X-ray exam of your colon
- Colonoscopy
- scopes that look inside entire of the colon
- Digital Rectal Exam
- internal examination of the rectum done by your doctor
- Sigmoidoscopy
- scopes that look at lower part of the colon (i.e. sigmoid colon and rectum)
- Stool Test
- checks for blood, infections and nutrient absorptions
- Virtual Colonoscopy
- examination of your colon using computed tomography
All of these helps detect cancer or pre-cancer before you notice any warning signs. Your doctor can recommend whether one or more screening tests is right for you.
References:
https://fascrs.org/
https://www.cancer.gov/
Schliemann, D., Paramasivam, D., Dahlui, M. et al. Change in public awareness of colorectal cancer symptoms following the Be Cancer Alert Campaign in the multi-ethnic population of Malaysia. BMC Cancer 20, 252 (2020). https://doi.org/10.1186/s12885-020-06742-3
