Medical Director
Senior Consultant, General & Colorectal Surgeon
MBBS (Singapore), MRCS (Edinburgh), MMed (Surgery), FRCS (Edinburgh)
An elderly patient being diagnosed with colorectal cancer is not uncommon as many countries, including ours, face a dramatic increase in the number and proportion of the elderly with vastly improved life expectancies.
- Elderly patients may have many concurrent illnesses such as diabetes, heart conditions, hypertension and other chronic illness
- The elderly often has a common geriatric syndrome known as "Frailty" whereby there is diminished strength, endurance and reduced physiological reserves. These may increase the risk of complications from surgery due to an inability to mount an adequate response to stressors from surgery.
- Furthermore, as many patients are very old, the benefit of surgery may not be clear-cut to the family members and even the surgeons, as the life span of the patient may not outlive the cancer.
Dr Chew Min Hoe has had extensive experience managing many elderly patients while in the public sector. He has also devoted considerable time to research and improvements in care plans for the elderly. In addition, he has led a Programme for Enhanced Elderly Recovery which has performed prehabilitation for 100 patients before surgery, thereby reducing post-operative problems as well as increasing the ability to be discharged home rather than to community care facilities. He has had a good understanding of the holistic care required and has demonstrated good results. He has also performed more than 20 surgeries for patients older than 90 years old.
Dr Chew's experience with elderly colorectal cancer patients ensures you or your loved ones receive comprehensive, compassionate care.
Schedule an appointment today.
There are considerable misconceptions that having medical conditions equates to frailty and disability. This is incorrect. Many patients with medical conditions are, in fact, able to maintain good health and fitness with good disease management. Furthermore, frailty is reversible and can improve over time.
Many elderly patients often remark "I am so old; I am not keen to subject myself to an operation as I am likely to pass away first." While it is hard to predict the actual duration of lifespan of any individual, we understand that in Singapore, many live well beyond 80 years old.
Many times, the diagnosis of the cancer is made as the symptoms have prompted the elderly patient to seek medical attention after a long time. It can often be after considerable delay as the patient did not wish to trouble his/her family members.
Left untreated, these symptoms can be distressing as they often wake the patient up from sleep, and can be relentless and progressive in intensity as the cancer grows. This often causes the family members to be highly anxious and affects the mental well-being of everyone caring for the patient at home.
Subsequently, after declining and observing over a period of time before finally seeking help for the cancer and requesting surgery, the surgeon often finds that the patient is just too unwell or too physically deconditioned that surgery is no longer safe and has limited success.
Surgery will be recommended once a careful assessment, individualised evaluation of treatment goals, and communication of realistic outcomes are done. Surgery may be performed once medical conditions are optimised and a possible short duration of prehabilitation of physiotherapy and nutritional improvement if needed.
- Multi-disciplinary team evaluation and discussions. This will be dependent on the chronic medical conditions that the patient has. An evaluation of fitness for general anaesthesia may also involve a cardiac screen, especially if no previous screen has been done before.
- Prehabilitation may be required if the patient is assessed to have some degree of frailty. This may include a series of activities and exercises, nutritional supplementation and a repeat assessment thereafter to ensure physical improvement.
- Once deemed suitable for discharge, physical activity and exercises as well as nutrition advice will be provided to avoid further deconditioning.
- Aids and home modifications may be advised to prevent problems such as falls while at home.
- Caregiver teaching and guidance will be provided by our medical team.
Dr Chew Min Hoe
Medical Director
Senior Consultant, General & Colorectal Surgeon
MBBS (Singapore), MRCS (Edinburgh), MMed (Surgery), FRCS (Edinburgh)
Dr Chew Min Hoe is an experienced colorectal surgeon with specialised interest in colorectal cancer and advanced pelvic tumours. Awarded the Public Administration Medal (Bronze), he is recognised for his compassionate approach to patient care and dedication to improving outcomes.
Dr Chew has held the position of President of the Society of Colorectal Surgeons, Singapore, and established the Department of Surgery at Sengkang General Hospital (SKH). His contributions to research and academia include authorship of over 100 peer-reviewed publications and guest speaking at international conferences.
Seow-En I, Tan WJ, Dorajoo SR, Soh SHL, Law YC, Park SY, Choi GS, Tan WS, Tang CL, Chew MH
Prediction of overall survival following colorectal cancer surgery in elderly patients
World J Gastrointest Surg 2019 May 27; 11(5):247-260. Doi:10.4240/wjgs.v11.i5.247
PMID: 31171956
Tan WS; Chew MH; Lim I AL; Ng KH; Tang CL; Eu KW
Evaluation of laparoscopic versus open colorectal surgery in elderly patients more than 70 years old: an evaluation of 727 patients.
International journal of colorectal disease 2012; 27(6):773-780 (Article; Published in Print)
Our Motto
Caring Hearts, Educated Minds, Skilled Hands
Orchard
3 Mount Elizabeth #16-09, Mount Elizabeth Medical Centre,Singapore 228510
Tel:+65 6518 4688
Fax:+65 6235 0897
Mon-Fri:8:30am - 5:30pm
Sat / PH Eve:8:30am - 12:00 noon
Sun & Public Holiday: Closed
Farrer Park
1 Farrer Park Station Road Connexion,#08-07 Farrer Park Medical Centre,Singapore 217562
Tel:+65 6518 4868
Fax:+65 6443 6616
Mon-Fri:8:30am - 5:30pm
Sat / PH Eve:8:30am - 12:00 noon
Sun & Public Holiday: Closed
