Colorectal cancer is one of the three most common cancers in Singapore, regardless of gender and ethnicity. It is important to know the facts about colorectal cancer, and address common myths.
1 – Colorectal cancer cannot be prevented
False; colorectal cancer can be prevented. Growths known as polyps are commonly found in the colon. They form on the inner lining of the colon and rectum. Some of these polyps can grow and develop into cancer. Colorectal polyps may be detected by tests such as the Faecal Immunochemical Test (FIT), a screening test that detects presence of small amounts of blood in the faeces. Polyps may also be seen during colonoscopy, and removal of these polyps prevents development into cancer.
2 – I don’t have colorectal cancer if I don’t manifest symptoms
False; colorectal cancer might not cause symptoms immediately. In many cases, colorectal cancer does not cause symptoms until it is advanced. This is why screening is important – to be tested for colorectal cancer before any symptoms appear. In addition, cancers detected through screening tests are usually in the early stages and therefore have better outcomes after treatment.
3 – Screenings for colorectal cancer are not necessary until I am above 50 years old
False; the age for screening for colorectal cancer varies, depending on the risk factors. Screening should begin at the age of 50 for those at low risk of developing colorectal cancer. For individuals with increased risk, screening must begin earlier (before age 50).
4 – There is no cure for colorectal cancer
False; there are three main treatment options for colorectal cancer in Singapore: surgery, chemotherapy, and radiation. Depending on the cancer stage, these options may be used alone or in combination. Colorectal surgery involves removing part of your colon that contains cancer cells. Chemotherapy is used to destroy cancer cells, control the growth of tumours, or relieve symptoms. Radiation therapy uses radiation to kill cancer cells that might remain after surgery, shrink large tumours before an operation, or relieve symptoms.
5 – Having a polyp means I need to undergo surgery
False; most polyps can be removed during colonoscopy. Small polyps are snipped, while slightly larger polyps are removed using a wire loop that burns them using an electrical current. Surgery is indicated if polyps cannot be safely removed at colonoscopy.
6 – You only get colorectal cancer if you have a family history of the disease
False; there are numerous risk factors of colorectal cancer aside from a family history of the disease. These include:
- Inflammatory bowel diseases
- Ulcerative colitis
- Crohn’s disease
- Rare inherited conditions
- Lynch syndrome
- Familial adenomatous polyposis
- Lifestyle factors
- Physical inactivity
- Low-fibre, high-fat diet
- Being overweight or obese
- Alcohol and tobacco use
7 – Colorectal cancer can be inherited
True; inherited colorectal cancers are less common (about 5 to 10 percent) and occur when genetic mutations or changes are passed from one generation to the next. However, most colorectal cancers are considered sporadic, meaning the genetic changes develop after a person is born.
8 – The risk factors of colorectal cancer are mostly uncontrollable
False; the only uncontrollable risk factors are age, inflammatory bowel diseases, family history, and rare inherited conditions. You can reduce your risk by regular exercise, maintaining a healthy weight, consuming a high-fibre diet, cutting down on processed meats, and avoiding alcohol and tobacco.
9 – Colorectal cancer is fatal
False; it only becomes fatal when cancer is advanced. This is why screening tests are recommended. Many people seek treatment only when they have some symptoms of colorectal cancer. At that stage, the cancer might have spread beyond the wall of the colon or rectum, to distant parts of the body. This decreases the chance of being successfully cured of colorectal cancer.
10 – Colorectal cancer surgery always results in a stoma
False; most operations for colorectal cancer do not lead to the creation of a stoma. The formation of a stoma depends on the location and stage of the disease. Most patients will not need a stoma, and for those who have one created, most of these are temporary and the stoma can be reversed.
Colorectal cancer is the most common cancer in men and the second most common in women. It is therefore important to have essential information – such as risk factors, screening tests, and rectal/colon cancer treatment options, so that necessary steps can be taken, like seeking professional advice or getting screened for colorectal cancer.