Colorectal or bowel cancer is the third most common cancer in men and the second in women worldwide. Its incidence in Asia is on the rise with rapid ‘westernisation’ of diet. The established and suspected modifiable risk factors include obesity, physical inactivity, smoking, heavy alcohol consumption, a diet rich in red or processed meat and inadequate consumption of fruits and vegetables.
In the early stages, symptoms may not show up. Anaemia (low haemoglobin) may be one indicator. As the disease progresses, patients complain of rectal bleeding or blood in/on the stool, change in bowel habits (constipation or diarrhoea), stomach discomfort (bloating, fullness or cramps), a feeling that the bowel does not empty completely, anal pain or discomfort and weight loss for no apparent reason.
Those with any of the above symptoms are at risk of colorectal cancer. See a doctor who specialises in treating colorectal cancer, a Coloproctologist. He/she will recommend further investigations. The gold standard test for examining the colon and rectum is the colonoscopy. Other tests include blood tests, CT scans and sometimes MRI scans.
The best treatment for colorectal cancer is surgery. Removing the diseased segment of the colon or rectum and rejoining the healthy ends has been done traditionally with open surgery. In the last decade, minimally invasive surgery techniques — such as laparoscopic or keyhole surgery — were introduced. Surgeons are able to perform complex colorectal surgery with tiny cuts through the abdominal wall and achieve results similar to open surgery but with smaller scars, less pain, early recovery and return to work.
More recently Robotic Surgery has been introduced for colorectal surgery. The state-of-the-art Da Vinci Robotic system uses three-dimensional high-definition visualisation and special instruments to perform surgical manoeuvres that are limited for the human hand. This results in less blood loss, quicker return to normal bowel function and diet, shorter hospital stay, faster recovery time and excellent clinical outcomes for cancer control.
In the years to come, Robotic surgery may become the main surgical option for colorectal cancer.
