Risk Factors And Symptoms
Who are
at Risk?
Less than 5% of the cancers are considered genetic cancers. These are conditions due to abnormalities in the genetic constitution of the patient.
In Singapore, the lifetime risk of colorectal cancer is about 2%. Most colon and rectal cancer occurs in patients over the age of 50 years, though this does not mean that people below that age will never get colorectal cancer.
The risks increases when one has close family members with colorectal cancer.
When there is a first degree relative (parents, siblings or children) with colorectal cancer, the risks increase 3 times to about 6%. If this relative is below the age of 50 at the time of diagnosis, the risk goes up to about 10%. If there are 2 first degree relative (for example, father and brother) with colorectal cancer, the risk is 17%. With 3 first degree relative, the risk is almost 50%.
If you have a history of polyps (adenoma type) or colorectal cancer, there is an increased risk of getting a cancer / 2nd cancer. The greater the number of polyps and the earlier the age of the first cancer, the higher the risk
Inflammatory bowel disease is a type of chronic inflammation of the intestines. This is more common in the Caucasian population than in Asia. The risk of colorectal cancer is increased with people with this condition and they require long term specialist care for treatment, surveillance and cancer prevention. In certain cases, they are recommended to have colorectal surgery to remove the entire colon and rectum to avoid developing cancer.
What are the Signs and Symptoms?
As such, tumour in the right side of the colon do not usually cause much symptoms as the semi-solid stools can flow past most tumours quite easily. The cancer may bleed silently as it is mixed in the stools and cannot be seen with the naked eye. Patients with tumours here usually present late with symptoms of anemia (low blood levels). Symptoms of anemia include tiredness, feeling breathless when walking the same distance or climbing stairs, frequent giddiness.
At the left side of the colon, the stools are more solid. Therefore, any narrowing of the colon lumen results in the following disturbance of the bowel habit:
- The stools might seem to be narrower in size.
- Patients might also feel constipated as it is more difficult for the stools to squeeze through a narrower passageway. This might also alternate with diarrhea or loose stools as this type of stools can pass through the narrowed passageway more easily.
- Patients might also notice blood coating the stools. As a general guide, the blood seen is usually dark red in colour.
Other less specific symptoms include feeling of bloating and mucus in the stools. Pain is usually not a feature of colon and rectum cancer until it is at an advanced stage. One complication of the tumour is intestinal obstruction. This means that the entire passageway is blocked and the stools (and even flatus) are not able to pass through. This results in abdominal pain, distension and at a later stage, vomiting. Intestinal obstruction is an emergency medical condition.
Physical examination usually does not yield much signs unless the cancer is in an advanced stage. A hard mass in the abdomen is usually a sign of a large tumour. An enlarged liver signifies spread of the cancer to the liver. In some rectal cancers, a digital rectal examination where your colorectal doctor inserts a finger up the anus may pick up earlier cancers. As such, if your colorectal doctor thinks that you warrant a rectal examination, please do not decline or refuse for fear of discomfort or embarrassment.
Surgeon
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Surgeon
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Colorectal Surgeon
Mount Elizabeth Medical Centre
#12-09, Singapore 228510
| Tel | : (+65) 6737 2778 |
| Fax | : (+65) 6737 2389 |
| : hokoksuncolorectal@gmail.com |
| Mon - Fri | : 9am - 1pm, 2pm - 5pm |
| Sat | : 9am - 1pm |
| Closed | : Sunday, Public Holiday |