It is only natural for individuals who are diagnosed with colon cancer to harbour fear and anxiety about the disease. Given the disease’s high incidence in Singapore, there are concerns about the chances of survival, the treatment that they have to go through, and if there is any risk of recurrence.
In this article, a brief discussion will be made on the diagnosis, treatment and prognosis of colon cancer.
Signs and Symptoms
The very first step to determining diagnosis is through the prompt detection and reporting of any colon cancer symptoms.
In its early stages, colon cancer may not present with any symptoms at all. However, as the disease progresses, the following warning signs and symptoms should be watched out for…
1) Presence of blood in the stools
2) Changes in bowel habits, such as persistent bouts of diarrhoea or constipation
3) Change in the frequency of stools
4) Abdominal discomfort or pain
5) Low red blood cell count (or anaemia)
6) Detection of a lump in the abdomen
Diagnosis of Colon Cancer
If the above symptoms were detected in the patient, the doctor will prescribe a number of procedures in order to confirm the diagnosis of colon cancer.
1) Colonoscopy = this procedure involves the insertion of a long scope into the colon. It allows for the examination of the entire length of the colon and rectum in order to find polyps and other traces of cancer. Colonoscopy can also be used to remove polyps and other abnormal tissues for biopsy.
2) Computerized Tomography Scan or CT Scan = this imaging procedure is effective in determining the actual location and extent of the cancer. It can also help in determining metastases or spread to nearby bowels or organs, and especially the liver.
3) Tumour Markers = Tumour markers are substances in the blood that increase with the presence of malignancies. In the case of colon cancer, tests are done to determine the levels of Carcino-Embryonic Antigen (CEA). High levels of CEA may be indicative of colon cancer.
4) Biopsy = This procedure allows for the definitive diagnosis of colon cancer and its stage so that treatment can be instituted.
Treatment of Colon Cancer
The gold standard of colon cancer treatment is surgery. The goal of the procedure is the total removal of the diseased sections of the colon (and/or rectum) together with surrounding tissues and lymph nodes. Once these sections are removed, the two ends of the cut section of the colon are connected together (also called “anastomosis”).
If the two ends cannot be joined together, a temporary or permanent artificial opening (called a colostomy) is created to allow for the elimination of faeces. In these cases, the patient has to wear a colostomy bag, which collects the faeces. Because of the threat of infection resulting from faeces, patients are also taught how to properly clean and care for their colostomy.
Other surgical procedures that may be performed include removal of cancerous lesions in the liver or intestinal bypass surgery (if the tumour is very large in size).
Laparascopic colon surgery is also being done by some doctors, especially with polyps and early stage tumours. However, for tumours in their later stage, it is not recommended because it is time-consuming and expensive, not to mention the fact that there is an increased risk of the cancer implanting in the skin.
If the patient is in Stages II, III or IV colon cancer, chemotherapy and radiotherapy need to be done in order to kill any cancer cells that may still be remaining inside the body or if there is evidence of cancer spread.
Prognosis of Colon Cancer
With the Singaporean government’s drive for early detection, colon cancer prognosis has significantly improved, with 36 to 66 percent and 23 to 66 percent increase in five-year survival rates in individuals with localised cancers (those cancers that are still within the bowels). All in all, patients in Stage 1 of the disease have a greater than 90 percent survival rate.
Patients who are diagnosed in Stage 3 have an average five-year survival rate of 40 to 60 percent while those in Stage 4 have a survival rate of 10 percent.
In other to improve one’s chances for survival, individuals should seek medical attention if they develop any signs and symptoms of colon cancer.