Colorectal Cancer Treatment in Singapore

Screening frequency depends on your age, family history, and personal risk factors. For most people at average risk, a colonoscopy is recommended every 10 years starting at age 50. However, if you have a family history of colorectal cancer or polyps, screening should begin earlier — typically at age 40, or 10 years before the age at which your relative was diagnosed, whichever comes first. Those with inflammatory bowel disease or known genetic conditions such as Lynch syndrome may require even more frequent monitoring. Dr. Sulaiman will advise on the most appropriate schedule for your individual circumstances.

Yes, colorectal cancer is often curable when detected early. At Stage I, the five-year survival rate exceeds 90%. Even Stage III disease carries a reasonable chance of cure with a combination of surgery and chemotherapy. The likelihood of a successful outcome decreases as the cancer advances, which is why early detection through regular screening is so important. If you have any concerns about your symptoms or risk factors, it is always better to seek assessment sooner rather than later.

Both types arise from the same inner lining of the large bowel, but their location within the body affects how they are managed. Colon cancer is located in the longer upper portion of the large intestine, while rectal cancer occurs in the final 15–20 cm before the anus. Rectal cancers often require a more complex treatment approach, which may include radiotherapy and chemotherapy before or after surgery. The surgical techniques also differ — rectal cancer surgery demands greater precision to preserve the nerves controlling bladder and sexual function, which is an area where robotic-assisted surgery offers a significant advantage.

There are several options available depending on your preference and risk profile:

• Colonoscopy is the most thorough and effective method. It allows direct visualisation of the entire colon and rectum, and any polyps found can be removed immediately during the same procedure.
• Faecal Immunochemical Test (FIT) is a stool-based test that detects hidden blood and is a practical first-line option. A positive result will require follow-up with a colonoscopy.
• CT Colonography (Virtual Colonoscopy) is a non-invasive imaging alternative for those who are unable or unwilling to undergo a standard colonoscopy. Any abnormalities found will still require a conventional colonoscopy for biopsy or removal.

For most patients, a colonoscopy remains the gold standard as it combines diagnosis and treatment in a single procedure.

There is currently no blood test that can reliably diagnose colorectal cancer on its own. Tumour markers such as CEA (carcinoembryonic antigen) and CA 19-9 can be elevated in colorectal cancer but are not specific enough for screening — they may also be raised in benign conditions such as smoking, infection, or liver disease. These markers are more useful for monitoring treatment response and detecting recurrence after a diagnosis has already been made. A colonoscopy remains the most reliable method for diagnosis.

Robotic-assisted surgery uses the da Vinci Xi surgical system to perform precise, minimally invasive removal of the tumour through small keyhole incisions. Dr. Sulaiman is experienced in robotic colectomy and anterior resection for colorectal cancer. Compared to open surgery, the robotic approach typically offers reduced blood loss, lower risk of complications, a shorter hospital stay, and a faster return to normal activity. For rectal cancer in particular, the enhanced three-dimensional visualisation and precision of robotic instruments makes it easier to work in the narrow confines of the pelvis while protecting the nerves responsible for bladder and sexual function.

Most patients do not require a permanent colostomy. With modern surgical techniques, the majority of colorectal cancers can be treated with bowel-preserving surgery, where the healthy ends of the bowel are reconnected after the tumour is removed. In some cases — particularly for low rectal cancers or emergency situations — a temporary stoma may be needed to allow the bowel to heal, but this is usually reversed in a subsequent procedure. Whether a stoma is required depends on the location and stage of the tumour, as well as your overall health. Dr. Sulaiman will discuss all possibilities with you before any operation.

Yes. First-degree relatives — parents, siblings, and children — of someone diagnosed with colorectal cancer have approximately two to three times the average risk of developing the condition themselves. It is recommended that they begin screening at age 40, or 10 years before the age at which you were diagnosed, whichever is earlier. Informing your family members of your diagnosis gives them the opportunity to take preventive action. Dr. Sulaiman’s team is happy to advise family members on appropriate screening options.

Yes. Colorectal cancer is the most common cancer among men in Singapore and the second most common cancer overall. Singapore also reflects a global trend of rising incidence among younger adults — cases in people under 50 are increasing, which has led to growing calls for earlier screening in those with risk factors. If you are experiencing symptoms such as rectal bleeding, changes in bowel habits, or unexplained weight loss — regardless of your age — it is important to seek a prompt evaluation.

This depends on the stage and characteristics of your cancer. For early-stage disease, surgery alone may be curative. For Stage III cancers — where lymph nodes are involved — adjuvant chemotherapy is usually recommended after surgery to reduce the risk of recurrence. For rectal cancer, neoadjuvant (pre-operative) chemoradiation may be used to shrink the tumour before surgery, improving the chances of complete removal and bowel preservation. Your treatment plan will be developed in a multidisciplinary setting, and Dr. Sulaiman will coordinate your care with oncologists and radiation specialists as needed.