In Malaysia, colon cancer is the second most common cancer in males and the third most common in females. It has an overall incidence rate of 21.32 cases per 100,000 population in Malaysia but occurs 1.33 times higher among males more than females.
What is colon cancer?
Colon cancer or colorectal cancer is the growth of tumours along the cells of the lining of the colon or the large intestine.
It usually affects older adults but can happen at any age.
It typically begins in the large intestine, but can also affect the rectum, which is the passage connecting the colon to the anus. It may begin as benign lumps of cells known as polyps inside the colon. Over the time, these polyps can turn malignant, causing cancer.
Polyps may be detected at an early stage and removed at timely manner to avoid turning into cancer.
Colon cancer causes and risk factors
The development of colon cancer can be influenced by several factors, ranging from genetic, environmental, and lifestyle factors. The following can contribute to the risk of getting colon cancer:
- Family history of colon cancer, or inherited syndromes such as familial adenomatous polyposis (FAP) and Lynch syndrome
- Chronic inflammatory bowel illnesses such as ulcerative colitis and Crohn’s disease
- Low fibre and high-fat diet
- Sedentary lifestyle
- Excessive smoking and alcohol drinking
- Obesity
- High alcohol consumption
Colon cancer symptoms
The risk of catching colon cancer increases with age. Many people with colon cancer experience few to no symptoms at the early stages of the disease.
These symptoms vary depending on the size and location of the tumour in the colon. Symptoms of colon cancer include but are not limited to:
- Changes in bowel habits and consistency of stool
- Presence of blood in stool
- Diarrhoea, constipation, or a persistent feeling that your bowel is not empty
- Abdominal pain or discomfort that does not go away
- Weakness or fatigue
- Inexplicable weight loss.
It is important to get screened regularly if these symptoms of colon cancer are consistently occurring.
Colon cancer diagnosis
Your doctor may recommend the following diagnostic tests and procedures for colon cancer:
- Colonoscopy
- Blood tests to check for a chemical called carcinoembryonic antigen (CEA)
- Imaging procedures like CT scans.
Colon cancer stages
Doctors usually assign cancer stages based on T (tumour), N (node), M (metastasis) factors. Based on these, the following stages are identified:
| Stage | Description |
|---|---|
| 0 | Cancer is within the inner lining of the colon or rectum |
| 1 | Cancer has grown through mucosa and reached the muscular layers of the colon and rectum. However, tumour has not yet spread to the nearby lymph nodes |
| 2A | The cancer has grown outside the walls of colon but not reached the lymph nodes or surrounding tissues |
| 2B | The cancer reaches the abdominal lining (visceral peritoneum) but has not spread to the nearby lymph nodes or other body parts |
| 2C | The spreads to nearby structures |
| 3A | The cancer grows into the inner lining of the intestine and has infected 1-3 lymph nodes. It has not yet spread to other body parts |
| 3B | Cancer grows through bowel walls and surrounding organs. It also spreads to 1-3 lymph nodes |
| 3C | Cancer has spread to more than 4 lymph modes but not to distant body parts |
| 4A | Cancer has spread to one of the distant body parts like liver or lungs |
| 4B-C | Cancer has spread to distant body parts and to the peritoneum |
Colon cancer treatment
The following treatment options are available for colon cancer:
- Surgery
- Chemotherapy
- Radiotherapy
- Immunotherapy
Surgery or removal of the cancer tissues at early detection is the best curative treatment. Cancer may be removed during a colonoscopy if detected early enough.
But once the cancer is localised, complete surgical removal of the tumour may be necessary.
Colon cancer patients may also have chemotherapy in their treatment plan alongside surgery and radiation therapy.
Immunotherapy may also be used, which involves using drugs that help the patient’s immune system better recognise and destroy cancer cells. These drugs can be administered through the bloodstream.
Colon cancer prevention
The most effective way to lower the risk of colon cancer is to participate in routine colon cancer screening such as colonoscopy.
During a colonoscopy, a tube with a camera is inserted to assess the structure of the large intestine. Stool sample tests may also be used, wherein the faeces are analysed for cancer cells.
Almost all cases of colon cancer begin with precancerous polyps or abnormal growths that can go undetected for years before invasive cancer develops. Finding cancer early, especially when it is still small and has not spread widely, gives the patient more options for treatment.
Aside from preventative colonoscopy, medical experts also recommend a diet low in animal fats and high in fibre, fruits, and vegetables. An increase in physical activity and lowering of use of tobacco and alcohol can help as well.
Make an appointment at Gleneagles Hospital
If you or a loved one is experiencing any of the symptoms of colon cancer, get in touch with us for an appointment with the Oncology specialists at your nearest Gleneagles Hospital.
References
- Colorectal cancer in Malaysia, Available at: https://www.sciencedirect.com/science/article/pii/S1015958416301774#:~:text=In%20Malaysia%2C%20colorectal%20cancer%20is,trend%20in%20colorectal%20cancer%20incidence [Accessed at 26 February 2022]
- Colorectal cancer stages, Available at https://www.cancer.net/cancer-types/colorectal-cancer/stages [Accessed at 26 February 2022]
- Colon cancer diagnosis, Available at https://www.mayoclinic.org/diseases-conditions/colon-cancer/diagnosis-treatment/drc-20353674 [Accessed at 26 February 2022]
- Colon cancer, Available at https://www.medicalnewstoday.com/articles/150496 [Accessed at 26 February 2022]
- Signs and symptoms of colon cancer, Available at: https://www.healthline.com/health/colon-cancer [Accessed at 26 February 2022]
