Colorectal Cancer

Colorectal Cancer

My uncle has been having loose watery stools for a few weeks and also noticed some blood in it. He also has loss of appetite and feels very tired.

He is worried that he may have colon cancer.

What is colorectal cancer?

Colorectal cancer is a disease where there is uncontrolled growth of harmful cells in the large intestine (colon) or rectum.

What are the risk factors of colorectal cancer?

• Age (higher risk above age of 50) • Family history of cancer • Genetic disorders • Intestinal polyps • Inflammatory bowel diseases • Lifestyle: unhealthy diet, smoking and alcohol How do I know if I have this problem?

• Screening is recommended if you are above 40 years old as early cancers may not have symptoms.

• Symptoms that may be similar to haemorrhoids (piles) include: 1. Blood in stools (most common) 2. Change in bowel habit 3. Abdominal pain 4. Loss of appetite/ loss of weight 5. Lethargy 6. Emergency complications like perforation or intestinal obstruction

Why the need for surgery?

• Surgery is performed to prevent spread of cancer cells, and in some cases, manage complications such as obstruction, bleeding and perforation.

• Quality of life may be improved after surgery as unpleasant symptoms from the tumour may be reduced.

How is it diagnosed?

It is usually diagnosed during colonoscopy. A finger-sized scope with camera attached is inserted through the anus for direct visualization of the inner wall of the large intestine. Tissue will be taken for testing should there be any unusual growth inside the colon.

What is the treatment of choice?

• Surgery to remove diseased part of large intestine is treatment of choice in most cases.

• However, there may be situations where surgery may not be suitable.

• The surgeon will discuss further options with you after thorough assessment.

What method of surgery are there?

• Surgery can be performed through an open abdominal incision or laparoscopic (key hole) approach.

• Your doctor will discuss your treatment plans with you.

What are the pre-operative preparations?

• Various investigations including electrocardiogram (ECG), chest x-ray and blood tests will be done to assess fitness for surgery.

• You will be advised on fasting time before procedure.

• Your doctor may prescribe some preparations to consume on the eve and day of surgery.

• Some medications can be taken with sips of water. Blood thinning medications must be stopped temporarily prior to surgery.

Please consult your doctor about this.

What complications can occur?

Early complications: • Adverse reaction from anaesthetic agent • Bleeding • Wound infection • Anastomotic leak • Heart attack • Urinary tract infection • Stroke • Deep vein thrombosis • Chest infection

Exercise and early mobilization: • Continue or increase exercises to maintain/strengthen muscles before surgery.

• Be engaged in rehabilitation activities from first day after surgery to improve circulation and prevent muscle wasting.

• It also encourages early return of intestinal function and improves respiratory function.

• The ward staff will assist you in doing this.

Late stage complications: • Relapse of cancer • Adhesions

When to seek medical attention after discharge?

You should seek medical attention if any of the following symptoms are present: • Persistent fever • Bleeding or discharge from the wound • Pain not relieved by medication • Persistent nausea and vomiting • Inability to move bowels • Abdominal bloating or distension

What can I do to minimise risk of complications?

The estimated length of stay is approximately one week. Some measures to reduce risk of complications include: To prevent chest infection: • Stop smoking.

• Do prescribed deep breathing exercises before and after surgery.

• Try to sit out of bed/walk around as early as possible after surgery.

• Do not be afraid to cough.

A comfortable pillow on the abdomen may be helpful.

Please return to our Acute & Emergency Care Department immediately if any of the above occurs.

Yishun Health is a network of medical institutions and health facilities in the north of Singapore, under the National Healthcare Group.

Admiralty Medical Centre • (65) 6807 8000 • www.admiraltymedicalcentre.com.sg Khoo Teck Puat Hospital • (65) 6555 8000 • www.ktph.com.sg Yishun Community Hospital • (65) 6807 8800 • www.yishuncommunityhospital.com.sg The information is correct at the time of printing and subject to revision without further notice.

GS.PE.01.0422