Colorectal Cancer Singapore | Colon Cancer

Colorectal cancer is the most common cancer in Singapore for both males and females combined. Early detection requires regular screening as well as prompt medical consultation should symptoms occur.

Symptoms of colorectal cancer can be variable and non-specific, but most commonly include:

Change of bowel habits (e.g. increased diarrhoea or constipation, pencil-thin stools, increased urge to pass motion)
Blood in stools
Weight loss, reduced appetite
Abdominal pain
Feeling of lethargy, tiredness or getting breathless with activity may suggest anemia with blood loss that is not obvious to the eye

HOW IS COLORECTAL CANCER TREATED?

After detailed staging investigations are done, surgery is needed for a definitive cure. Colorectal cancer surgery will remove the affected part of the intestine, lymph nodes around the tumour, and possible surrounding organs if the cancer has invaded or involved these structures.

Dr Chew Min Hoe will tailor a colorectal cancer treatment plan based on the stage and severity of the disease. Surgery techniques can include open surgery or laparoscopic (minimally invasive) surgery. The aims of surgery will be to ensure complete cancer clearance, low complication rates, as well as good and enhanced recovery.

Chemotherapy and radiotherapy may be required as part of the treatment; and these will be coordinated with medical and radiation oncologists along with targeted treatment specific to your cancer, in order to achieve the best possible outcomes.

POST-SURGERY CARE FOR COLORECTAL CANCER

DIET

A comprehensive guide will be provided for patients and their caregivers during the recovery phase after colorectal cancer surgery. As an overall guide, patients are advised to consume small and frequent meals, monitor their weight closely, and avoid taking too many supplements at this stage. Do check with your doctor and nurse care coordinator.

EXERCISE AND ACTIVITY

You will be provided with adequate medical leave to rest from surgery. While resting is important, this should be balanced with some daily walks to improve muscle tone, digestion as well as improving mental well-being. Activity is also important to prevent problems such as blood clots in the legs (deep vein thrombosis) and physical deconditioning especially for the elderly which can lead to further complications.

We also advise not to commence high intensity activity too early after colorectal cancer surgery as these may lead to wound problems such as hernias. A good guide is to wait at least 4-6 weeks before commencing such exercises and do check with your doctor and nurse care coordinator.

WOUND CARE

Wound care advice will be provided upon discharge. There may also be a date provided to remove wound sutures or staples with your family physician or by our medical team. In the event of increasing wound pain, redness or some discharge that is unusual, please contact our team for a review.

STOMA CARE

A stoma is needed in some circumstances after surgery and will be advised. Stomas are usually temporary and are created to divert stools to allow healing of the anastomosis after removal of typically a rectal cancer. This stoma will be closed in a 2nd operation usually after a few months once you have fully recovered. If chemotherapy is required, the stoma is closed only after chemotherapy is completed in order to avoid any delays in your curative treatment.

If the cancer is a very low rectal cancer or involves the anus or anal canal muscles, surgery will require the removal of the anus, making the stoma a permanent one.

Stoma care will be advised and provided by our care teams along with supporting expert vendors. Stoma care will involve ensuring correct appliances are sized and the type advised based on each individual, and also guides on stoma skin care products.

There will be counselling on overall nutrition and hydration. It is important to regain normal activities of daily living as best even with a stoma and we can provide guidance on how to cope at studying or at work, and also with intimate moments for couples. We will also provide advise on activities such as sports, diving and travel.

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