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Colorectal cancer develops when cells of the inner lining of the colon (mucosa) undergo genetic changes and transform into benign tumours (colorectal polyps) at first and finally cancer cells. The process of change from normal to cancer cells is called "carcinogenesis" and usually takes many years, even up to 15 years. This type of cancer is called adenocarcinoma (which account for > 90% of all colorectal cancers). The causes of genetic change may be inherited from your parents (inherited genetic defect), environmental (urbanization, pollution, stress, exercise level, etc), lifestyle (smoking, excessive alcohol consumption) or dietary. It is impossible for any doctor to pinpoint the factors that caused a patient’s cancer based on our understanding of these factors today.
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In the pre-cancerous polyp stage or early stages of colorectal cancer, there are rarely any symptoms. By the time symptoms appear, the cancer has usually reached the intermediate to late stage. Common symptoms associated with colorectal cancer include blood in the stools, abnormal bowel habit, sensation of incomplete bowel movement, intermittent diarrhoea and constipation, mucus in the stools, unexplained weight loss and unexplained pallor.
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The best and most accurate way of confirming colorectal cancer is by colonoscopy. Colonoscopy allows the doctor to take a biopsy of the tumour to confirm the diagnosis, ascertain the exact location of the cancer and whether there is more than 1 cancer (synchronous cancers of colon). During colonoscopy, the surgeon can also tattoo the location of the cancer to help identification of the cancer during surgery.
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Colorectal cancer is a highly curable cancer if detected in the earlier stages. Even for Stage IV cases, patients with cancer spread that is localized to a single area can potentially be cured. Surgery is the cornerstone of treatment for colorectal cancer. As colorectal cancers are not very sensitive to chemotherapy or radiotherapy, these modalities are only used to augment the result of surgery in certain cases.
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Surgery for colorectal cancer needs to be performed in a methodical and meticulous manner with the aim of removing all the cancer cells without allowing the cancer to spread inadvertently during surgery. Great improvements in techniques of surgery, such as laparoscopic or robotic surgery, have also shortened the recovery time for surgery as well as reduce the risks of complications from surgery. In fact, more than 95% of patients who undergo colorectal cancer surgery do not develop complications and recover well enough to perform daily activities independently within 3-4 days. Chemotherapy and radiotherapy have also improved significantly and side effects and complications have become rarer. If side effects or complications happen, treatments for these are also better.
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Therefore, when you or your loved one is diagnosed with colorectal cancer, it is important you seek an opinion from a surgeon experienced in colorectal cancer surgery and ensure that the surgeon has your best interests at heart.
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