Colorectal Cancer

Dr. Sulaiman Bin Yusof

MbChB (Sheffield) M.Med (Surg) FRCSEd (Gen Surg)
蘇萊曼·尤索夫博士

What Is Colorectal Cancer?

Colorectal cancer is a type of cancer that develops in the colon (large intestine) or rectum, which are parts of the digestive system.

It typically starts as a polyp, a small, non-cancerous growth on the inner lining of these organs. If left undetected and untreated, some of these polyps can develop into cancer over time. Colorectal cancer can affect both men and women and is more prevalent in people over the age of 50.

Types of Colorectal Cancer

Colorectal cancer is classified into several types based on the specific cells involved and the location within the digestive system.

Adenocarcinoma

This is the most common type, making up about 95% of colorectal cancer cases. It originates in the mucus-producing glands in the lining of the colon or rectum.

Carcinoid Tumours

These are rare and develop in the hormone-producing cells of the intestines. They typically grow slower than other types of colorectal cancer.

Gastrointestinal Stromal Tumours

These rare tumours develop in the connective tissue cells of the colon or rectum and can be benign or malignant.

Lymphomas

Though typically found in the lymph nodes, lymphomas can also develop in the colon or rectum. They start in the lymphatic system, which is part of the body’s immune system.

Sarcomas

These rare cancers begin in the blood vessels, muscle layers, or connective tissues of the colon or rectum.

Symptoms of Colorectal Cancer

Colorectal cancer may not present noticeable symptoms in its early stages, necessitating regular screening. As the cancer progresses, it can lead to a range of symptoms, including:

Changes in Bowel Habits: As the tumour grows, it may partially block the passage of stool, leading to diarrhoea or constipation.

Rectal Bleeding: As the tumour grows, it may irritate or damage the lining of the colon or rectum, causing bleeding. Depending on where the tumour is located, blood from rectal bleeding can appear bright red or dark in the stool.

Abdominal Discomfort: The tumour may block the bowel, making it difficult for waste to pass. The colon exerts more effort to push stool around the tumour, causing cramps, gas, or a feeling of fullness.

Unexplained Weight Loss: Colorectal cancer can lead to unexplained weight loss as the tumour affects the body’s ability to absorb nutrients. Cancer may also increase the body’s energy expenditure and disrupt normal metabolic processes, contributing to weight loss.

Fatigue: Advanced stages of colorectal cancer can cause chronic fatigue due to the body’s increased effort to fight the disease. Fatigue can also occur if the cancer leads to anaemia.

Causes & Risk Factors

The exact cause of colorectal cancer is not always known, but several factors can increase the risk of developing it.

Age

The risk of colorectal cancer increases with age, particularly after age 50. This is due to the accumulation of cell divisions and environmental exposures over time that can lead to mutations and cancer development.

Family History

Having a close relative with colorectal cancer or polyps before age 60 can increase your risk.

Genetic Mutations

Certain inherited genetic conditions, such as familial adenomatous polyposis (FAP) and Lynch syndrome, significantly increase the risk of colorectal cancer.

Inflammatory Bowel Disease

Chronic inflammatory conditions of the colon, such as ulcerative colitis or Crohn’s disease, can increase the risk of colorectal cancer. Prolonged inflammation damages the colon lining, increasing cell turnover and the risk of cancer-causing mutations.

Type 2 Diabetes

People with type 2 diabetes face a higher risk of colorectal cancer, possibly due to shared risk factors such as obesity and insulin resistance, which can elevate insulin levels and promote cancer cell growth.

Diagnosis of Colorectal Cancer

Diagnosing colorectal cancer typically combines diagnostic procedures and screening tests.

Colonoscopy

The most thorough method for diagnosing colorectal cancer, where a doctor uses a flexible tube with a camera to inspect the entire colon and rectum. Abnormal areas can be biopsied or polyps removed for examination.

CT Colonography (Virtual Colonoscopy)

A non-invasive imaging test that uses a CT scanner to create detailed pictures of the colon and rectum. A follow-up colonoscopy is often needed if abnormalities are found.

Stool Tests

Tests like the faecal occult blood test and faecal immunochemical test detect hidden blood in the stool, which may indicate cancer. Positive results typically lead to further testing, such as a colonoscopy.

Biopsy

If cancer is suspected during a colonoscopy, a biopsy is taken from the abnormal area to confirm the presence of cancer cells under a microscope.

Surgical Treatment

Surgical treatment aims to remove the cancerous tissue while preserving as much of the healthy colon and rectum as possible.

Polypectomy and Local Excision

In early-stage colorectal cancer, the cancerous polyp or a small section of the colon or rectum can be removed during a colonoscopy. This minimally invasive procedure is typically used when the cancer is confined to a small area, has not spread and requires a shorter recovery.

Colectomy

The removal of part or all of the colon containing cancer, with the remaining sections reconnected. A partial or total colectomy may be required when the cancer has spread beyond a small area. This procedure reduces the risk of recurrence by removing the cancerous tissue.

Laparoscopic Surgery

This minimally invasive surgery uses small incisions and a camera to guide the surgeon in removing cancer. It offers a shorter recovery period and less pain compared to traditional open surgery.

Laparoscopic anterior resection, a specific procedure, is used to remove cancer in the rectum and lower colon, preserving healthy tissue and reducing the need for a colostomy while maintaining normal bowel function.

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Prevention of Colorectal Cancer

Colorectal cancer prevention involves lifestyle changes, regular screening, and awareness of risk factors. A diet rich in fruits, vegetables, and whole grains, and a reduced consumption of red and processed meats, can lower your risk. Regular physical activity, maintaining a healthy weight, avoiding smoking, and limiting alcohol consumption also contribute to prevention.

Regular screening is recommended, especially for people over 50 and those with a family history of colorectal cancer. Colonoscopies can detect and remove polyps before they become cancerous. Those with a genetic predisposition may require more frequent screenings and preventive measures, including medications or surgery. Following screening guidelines can significantly lower your risk.

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Dr. Sulaiman Bin Yusof

MbChB (Sheffield)

M.Med (Surgery)

FRCSEd (General Surgery)

蘇萊曼·尤索夫博士

Dr. Sulaiman Yusof is a distinguished Senior Consultant in colorectal and general surgery, boasting over 15 years of expertise. His passion lies in minimally invasive techniques, particularly robotic surgery, where he has achieved remarkable success using the Da Vinci Xi system. Dr. Sulaiman is dedicated to delivering high-quality, personalized, and empathetic care, always striving for the best outcomes for his patients.

Education & Specialist Training
  • MbChB(Sheffield)
  • M.Med(Surgery)
  • FRCSEd(General Surgery)

Dr. Sulaiman’s journey began at the University of Sheffield, where he graduated in 2002. He honed his skills during his house officer and basic surgical training in the UK before returning to Singapore. There, he completed his Advanced Surgical Training at Changi General Hospital and earned the Joint Speciality Fellowship in General Surgery in 2013.

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    Frequently Asked Questions

    How often should I be screened for colorectal cancer?

    Screening frequency depends on age, family history, and personal risk factors. In general, people over 50 should have a colonoscopy every 10 years, but those at higher risk may need more frequent screenings.

    Is colorectal cancer curable?

    Yes, colorectal cancer can usually be cured if detected and treated early. The likelihood of a cure decreases as the cancer progresses, highlighting the importance of early detection.

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