Colon and Colorectal Cancer Treatment in Singapore
What Are Colon and Colorectal Cancers?
Colorectal cancer, encompassing both colon and rectal cancers, is a common malignancy that affects the large intestines – the final segment of the digestive tract. This form of cancer ranks among the most prevalent cancers globally and in Singapore. Although it is predominantly diagnosed in adults over 50, there is an alarming trend of increasing occurrences in younger adults worldwide.
The risk of developing colorectal cancer may be higher in individuals with a family history of the disease. Recognising the early signs and consulting a specialist, particularly a colorectal surgeon in Singapore, can likely enhance the treatment efficacy.
Are Colorectal Cancers Curable?
When detected early, colorectal cancers may be highly treatable and curable. The disease generally starts as benign polyps within the large intestines. Over time, these initially non-cancerous lumps can transform into cancerous cells, typically over several years. Early detection by colon and colorectal cancer specialists is advisable as it allows for the removal of these polyps before they turn malignant.
What Are the Signs and Symptoms of Colon Cancers?
The symptoms of colorectal cancer are often nonspecific, which can delay diagnosis until the cancer progresses to a more advanced stage. Knowing the signs and consulting a colorectal specialist or surgeon in Singapore may improve outcomes. Here are some common symptoms associated with this condition:
Persistent discomfort, such as pain or bloating in the abdomen, can be an early indicator of colorectal cancer.
Significant changes, including alternating patterns of diarrhoea and constipation, can suggest colorectal issues.
The presence of blood in the stools, which may appear bright red or dark, is a critical warning sign that may necessitate immediate attention.
Unexplained weight loss without changes in diet or exercise routines can indicate an underlying health issue, such as colorectal cancer.
Loss of bowel control is not only distressing but can also be a symptom of colorectal cancer affecting the nerve or muscle function in the pelvic region.
While often attributed to less severe conditions like haemorrhoids, pain around the anal area can also be related to cancerous growths.
Unfortunately, by the time these symptoms manifest, the cancer might already be in a severe stage.
Diagnosis of Colon or Rectal Cancer
Early diagnosis is paramount in managing colorectal cancer. This typically requires screening by colorectal specialists and surgeons in Singapore. Here are the potential diagnostic tools employed:
This non-invasive test checks for hidden blood in the stool, which can be an early indicator of colon and colorectal cancers. It is a simple screening tool that patients can perform at home.
Considered the gold standard for colorectal cancer diagnosis, this procedure involves inserting a flexible tube equipped with a camera into the rectum to examine the interior of the large intestines. If polyps or abnormalities are found, they may be removed during the procedure for further analysis.
This imaging technique provides a detailed, cross-sectional view of the colon and rectum without the need for a traditional scope. It is recommended for patients who may not be able to undergo a standard colonoscopy.
Discussing these options with a colorectal surgeon or specialist in Singapore is advisable to determine an optimal screening method based on individual risk factors and health status.
What Are the Treatments for Colon or Colorectal Cancers?
The treatment options for colorectal cancer depend on the stage of the cancer at diagnosis. The colorectal specialists and surgeons in Singapore may design treatment plans based on each patient’s specific needs and conditions, aiming for an optimal outcome. Here is an overview of the treatment approaches based on cancer stages:
Early detection often allows for the removal of polyps during a colonoscopy. At this stage, surgery is rarely required, as the polyps have not yet become cancerous.
Surgery is the primary treatment option and is usually minimally invasive, such as laparoscopic surgery. Some patients in Stage II may also require chemotherapy or radiation, depending on the specific characteristics of the cancer.
Surgery remains crucial and is generally minimally invasive. It is often followed by chemotherapy for colon cancer or both chemotherapy and radiation for rectal cancers.
At this advanced stage, the treatment becomes more complex and may include surgery, chemotherapy, targeted therapies, immunotherapy, and radiation. Each regimen is designed for optimal treatment efficacy and patient quality of life.
What to Expect During Colorectal Surgery?
Undergoing colorectal surgery can be a significant step in the treatment of colorectal cancer. The colorectal surgeon will ensure that every patient is informed and remains in optimal condition throughout the process. Here’s what to expect during surgery:
Before the surgery, you will undergo various tests to determine whether you fit the procedure. This may include blood tests, imaging, and possibly cardiac assessments. The surgeon will also discuss anaesthesia options with you to determine an optimal approach for your comfort and safety.
Colorectal surgery can vary depending on the location and stage of the cancer. Common procedures include:
- Polypectomy: Removal of polyps during a colonoscopy, typically for very early-stage cancers.
- Local Excision: Removing small localised cancers that are on the surface of the colon or rectum.
- Resection: Removing a segment of the colon or rectum along with surrounding lymph nodes. This is often followed by reattaching the healthy parts of the colon or rectum.
- Minimally Invasive Surgery: Utilising methods such as laparoscopy, which involves smaller incisions and typically results in optimal recovery and pain management.
After the surgery, you will be closely monitored in the recovery area. The medical professionals will help manage pain and monitor for any signs of complications. The length of hospital stay can vary based on the extent of the surgery and your recovery rate.
Recovery at home involves managing pain, preventing infection, and gradually returning to normal activities. Follow-up appointments are crucial to monitor your healing and manage any long-term effects of the surgery.
What Happens After Colorectal Surgery?
The recovery process following colorectal surgery is a critical phase where careful management can impact the treatment. Here is what would happen after undergoing colorectal surgery:
Initially, you will be monitored in the postoperative recovery area. The colorectal specialist will help manage your pain and monitor for any signs of complications, such as infection or bleeding. You may have drains and catheters in place, which may be removed as you recover.
The length of your hospital stay will depend on the type of surgery performed and your individual recovery. During this time, the medical professionals will assist you with pain management and wound care, and gradually increase your activity levels to aid recovery.
Once discharged, you will receive detailed instructions for home care, including how to care for your surgical site, manage pain, and recognise signs of potential complications. It is advisable to follow a balanced diet and gradually reintroduce physical activity as recommended by your care team.
Regular follow-up appointments are recommended to help monitor your recovery and manage any long-term effects of the surgery. These visits may include blood tests, imaging studies, and consultations with your colorectal surgeon. The frequency of these visits will be tailored to your specific needs.
Recovery from colorectal surgery can be challenging, but feel free to seek professional assistance.
Colorectal Cancer Treatment: Radiation Therapy
Radiation therapy is often recommended in the treatment of colorectal cancer, particularly for rectal cancer. It can be utilised in various ways to enhance patient outcomes, depending on the stage and specifics of the tumour. Here’s how radiation therapy may be integrated into colorectal cancer treatment:
This approach involves using a machine called a linear accelerator to deliver high-energy X-rays to the tumour from outside the body. The radiation beams are carefully targeted to the cancerous area, aiming to destroy cancer cells while minimising damage to surrounding healthy tissues.
For some colorectal cancer patients, radioactive material, such as seeds or wires, is temporarily placed inside or near the tumour. These radioactive sources emit radiation directly to the cancer cells, delivering a concentrated dose of radiation while sparing healthy tissues.
Radiation therapy can be combined with other treatments, such as surgery and chemotherapy, to increase its effectiveness. It may be used before surgery (neoadjuvant therapy) to help shrink tumours or after surgery (adjuvant therapy) to target any remaining cancer cells.
In advanced cases or when colorectal cancer has spread, radiation therapy can be used to manage the symptoms, such as pain or bowel obstruction, and improve quality of life.
Each treatment plan is carefully recommended by a team of colorectal specialists and surgeons in Singapore, ensuring that every patient receives optimal and helpful therapy for their specific condition.
Side Effects from Colon & Colorectal Cancer Treatments
Treatment for colon and colorectal cancers, while recommended, can come with a range of side effects. However, they are generally dependent on the type of treatment. Having an in-depth discussion with the doctor may help you understand the extent of the disease better. Here’s an overview of the common side effects and ways to help manage them:
Treatments like chemotherapy and radiation may cause nausea, vomiting, diarrhoea, and constipation. The colorectal surgeon may prescribe medications to help manage these symptoms and offer dietary advice to help ease gastrointestinal distress.
A common side effect of cancer treatments is fatigue, which can potentially impact quality of life. It is advisable to have a balanced approach to activity and rest with the help of professional support through nutrition and rehabilitation programmes.
Some patients may experience nerve effects such as tingling, numbness, or pain, particularly in the hands and feet. The colorectal specialist may offer ways to help manage these symptoms and adjust treatment plans if necessary.
Treatments that affect the immune system can make patients more susceptible to infections. To help prevent infections, these individuals may be monitored and given specific guidelines.
Depending on the type and extent of treatment, some side effects may be long-lasting. Regular follow-ups allow the specialist to help address these issues and support ongoing health and wellness.
Though the exact cause of colorectal cancer remains unclear, studies suggest that certain lifestyle changes can help to reduce the risk of getting colon cancer. These include:
- Eating a well-balanced diet that includes a variety of fruits and vegetables. Cutting down on processed meats, like bacon, sausages, and ham, is also advisable.
- Drinking alcohol in moderation.
- Stop smoking.
- Exercising regularly. If you have been inactive for a while, start slow and build up along the way.
- Maintaining a healthy weight.
Who are the Colon Cancer Specialists in Singapore?
Looking for an oncologist specialising in colon and colorectal cancers in Singapore? Our team of cancer doctors can help diagnose and manage all stages of the disease. With a focus on personalised care, the specialists will work with each patient to recommend a treatment plan that meets their needs.
Senior Consultant, Medical Oncologist
MBBS (Delhi) – American Board Certified (Int Med) – American Board Certified (Hematology) – American Board Certified (Med Oncology)
Before joining OncoCare Cancer Centre at Mount Elizabeth Hospital, Singapore, Dr Akhil Chopra was a Senior Consultant in Medical Oncology at Johns Hopkins Singapore, Tan Tock Seng Hospital and Adjunct Associate Professor at Lee Kong Chian School of Medicine.
Dr Chopra has experience treating multiple cancer types including breast cancer, lung cancer, cancers of stomach, colon, rectum, liver, prostate, kidney, testicular and bladder, gynaecological cancers such as ovarian and uterine/cervical cancers; as well as Sarcomas and chronic leukaemia’s/multiple myeloma. Besides his clinical and research work, he has been involved in teaching medical students from the Lee Kong Chian School of Medicine as well as medical residents and students from Johns Hopkins University, Baltimore in USA.
- Graduated from Delhi in 2001
- American Board Certified, Internal Medicine
- American Board Certified, Medical Oncology
- American Board Certified, Hematology
- Fellowship Training at Hahnemann University Hospital/Drexel University College of Medicine in Philadelphia, USA
Cancer Specialities: breast cancer, lung cancer, cancers of stomach, colon, rectum, liver, prostate, kidney, testicular and bladder, gynaecological cancers such as ovarian and uterine/cervical cancers
Senior Consultant, Medical Oncologist
MBBCH, BAO (Ireland) – MRCP (United Kingdom) – FRCP (Edinburgh) – FRCP (Medical Oncology)
Dr Benjamin Chuah graduated in medicine from Trinity College Dublin in 1998 where he was awarded the Professor Prize in Physic (Surgery) and the Arthur Ball Prize (2nd Place). Dr Chuah returned to Singapore and obtained his Membership of the Royal College of Physicians of the United Kingdom in 2002.
Dr Ben Chuah’s subspecialty interest is in Gastrointestinal Cancers including oesophageal, gastric, biliary tract, pancreatic, liver (hepatocellular carcinoma), neuroendocrine cancers and colorectal cancers. He has published research about screening colorectal cancer and he was involved in a randomized, phase 2 study of ganitumab or conatumumab in combination with FOLFIRI (5-FU, leucovorin, irinotecan) for second-line treatment of mutant KRAS metastatic colorectal cancer.
- Graduated from Trinity College, University of Dublin, Ireland in 1998.
- MRCP (UK), Royal Colleges of Physicians of the United Kingdom, 2002.
- Awarded the Professor’s Prize in Physic (Surgery) 1998, Arthur Ball Prize (2nd place) 1998, NUH Innovative Grant 2007, the Kobayashi Foundation Award 2010 and NUH Postgraduate Teaching Excellence Award 2011.
- He was the Director of Post Graduate Medical Education (Medical Oncology) and Core Faculty for the Residency Program (internal Medicine) at National University Hospital.
Senior Consultant, Medical Oncologist
MBBS (Singapore) – MRCP (United Kingdom)
Dr Thomas Soh graduated from National University of Singapore in 2003 and received his Membership of the Royal College of Physician (United Kingdom) in 2007. He completed his advanced specialist training in Medical Oncology in 2012. Throughout his career, Dr Soh has been actively involved in both research and education in cancer medicine. His research publication in colorectal cancer involves working with cell free DNA, chemotherapy drugs Regorafenib, and FOLFIRI regimen (irinotecan, 5-fluorouracil and folinic acid).
Dr Soh believes in the delivery of quality healthcare, and was the lead and co-lead in several healthcare improvement projects. He has received multiple awards for his involvement in the Clinical Practice Improvement Programmes that he had implemented in NUH. From 2013-2015, he contributed a leading role being the Honorary Secretary of the Executive Committee, Singapore Society of Oncology.
- Graduated from the National University of Singapore in 2003
- Obtained Membership of the Royal College of Physician (United Kingdom) in 2007
- Awarded Teaching Excellence Award in 2014, NCIS
- Awarded NUH UMC Undergraduate Teaching Best Tutor Award in 2015
- Research funding from the National Medical Research Council (NMRC), Singapore, being awarded the Clinical Investigator Salary Support Program (CISSP) award 3 times
- Research work was published in more than 10 publications relating to hepatocellular carcinoma, colorectal cancer, pancreatic cancer and other gastrointestinal cancers.
- Sub-specialty oncology interest in gastrointestinal (oesophageal, stomach, colon and rectal cancers) and hepatobiliary cancers (liver, pancreas, bile duct and gallbladder cancers).
Senior Consultant, Medical Oncologist
MBBS (Singapore) – M.Med (Singapore) – MRCP (United Kingdom) – FAMS (Medical Oncology) – MHsc (Duke, USA)
Dr Wong Nan Soon is a Senior Consultant Medical Oncologist with more than 15 years of experience in the diagnosis and management of a wide range of cancers.
His subspecialty interests are in the field of breast cancer and gastrointestinal cancers (which include colon cancer, rectal cancer, anal cancer, biliary cancer, pancreatic cancer, liver cancer, GI stromal cancers (GIST) and neuroendocrine cancers.
In addition, he is also well versed in the treatment of a wide variety of cancers which include lung cancers, kidney cancers, uterine, cervical and ovarian cancers.
He graduated from the Faculty of Medicine, National University of Singapore in 1994 and obtained the degrees of Master’s in Internal Medicine and Membership of the Royal College of Physicians of the United Kingdom in 2000.
In 2003, he completed advanced specialty training in general medical oncology.
This was followed by a 1 year clinical fellowship sub-specializing in breast medical oncology in Sunnybrook and Women’s Health Science Centre, Toronto, Canada where he trained under world renowned breast oncologists including Professor Kathleen Pritchard.
He was promoted to the position of consultant in 2006 and subsequently rose to the position of senior consultant and chief of breast team in the department of medical oncology, National Cancer Centre Singapore in 2009.
In 2009, he was awarded the prestigious Singapore National Medical Research Council overseas research fellowship to develop expertise in phase I clinical trials at Duke University, North Carolina, USA. During this year, he broadened his subspecialty interest to encompass gastrointestinal cancers, training under Professor Herbert Hurwitz. He also underwent further training in biostatistics and clinical research methodology, graduating with a master’s degree in health science research.
With this knowledge and experience in novel drug combinations, he is able to offer cutting edge medical treatment for both early stage cancers and also drug resistant difficult to treat advanced cancers.
- Novartis Oncology Young Canadian Investigator Award 2005
- Canadian Association of Medical Oncology Annual Meeting Best Poster Award 2005
- Chairperson, Medical Treatment Fund Committee, Singapore Cancer Society 2007
- Clinical teacher, Yong Loo Lin School of Medicine, National University of Singapore from 2006-2011
- Adjunct Associate Professor in the Department of Clinical Sciences, Duke-National University of Singapore, 2011-2013
- Visiting Senior Consultant, KK Women’s & Children’s Hospital, Singapore 2010-2011
- Senior Consultant, Dept of Medical Oncology, National Cancer Centre Singapore 2009-2011
- Visiting Consultant, Dept of Medical Oncology, National Cancer Centre Singapore 2012-2014
- Committee member, Specialist Training Committee (Medical oncology), Ministry of Health from 2009 to 2012
- Invited lecturer at Nanyang Polytechnic School of Health Sciences
- Director of Public and Patient Education, National Cancer Centre Singapore 2008-2011
- Deputy Director in the Division of Community Outreach and Philanthropy, National Cancer Centre Singapore
- Vice President, Singapore Society of Oncology 2011-2012
- Board Member, Chapter of Medical Oncologists of Singapore 2009-2012
- Honorary Secretary, Chapter of Medical Oncologists, College of Physicians, Academy of Medicine, Singapore 2007-2008
- Member, Clinical Trials Steering Committee, National Cancer Centre Singapore, 2008-2011
- Member, Singapore Society of Oncology
- Member, American Society of Clinical Oncology
- Member, HepatoPancreatoBiliary Association of Singapore.
- Chairman, Singapore Cancer Network Breast Cancer Workgroup since 2014
- Involvement in more than 30 local and international pharmaceutical and investigator initiated clinical trials
- Awardee of multiple institutional and national level research grants.
- More than 60 abstracts and papers in both local and international oncology journals, including Journal of Clinical Oncology, Clinical Cancer Research and Annals of Oncology.
- Faculty and lecturer at numerous national and international oncology conferences
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