COLORECTAL CANCER

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1. OVERVIEW

What is colorectal cancer?

Colorectal cancer is cancer of the colon and rectum. The colon and rectum are segments of the large
intestine that play an important role in the body's ability to digest food and pass waste. Colorectal
cancer is also known as colon cancer or bowel cancer.

Risk Factors

-Colorectal Cancer: Who's at Risk?

Age: More than 90 per cent of the colorectal cancer cases in Malaysia occur in people over the age of
40.

Polyps: Most colorectal cancer begins in polyps. This non-cancerous growth occurs in the lining of
the large intestine. Certain types of polyps can develop into cancer.

Family history: People whose family members have colorectal cancer especially at a young age,
have a higher risk of developing this disease.

Personal history of cancer: Women who have had cancer of the ovary, uterus or breast are more
likely to develop colorectal cancer.

Diet: A diet high in fat and low in fibre is linked to the development of the disease.
Tobacco: Smoking increases the risk of polyp formation.

Body weight and physical activity: People with sedentary lifestyles and who are overweight or
obese increase their risk of colorectal cancer.

Nonsteroidal anti-inflammatory drugs (NSAIDS): Some studies suggest that taking aspirin and
other NSAIDS may reduce the risk of developing polyps.
Symptoms

Common signs and symptoms of colorectal cancer include:

A change in bowel habits

Diarrhoea, constipation or feeling that the bowel does not empty completely
Blood (either bright red or very dark) in the stool
Stools that are narrower than usual

General abdominal discomfort (frequent gas pains, bloating, fullness, and/or cramps)
Weight loss with no known reason
Constant tiredness
Vomiting

These symptoms may be caused by colorectal cancer or by other conditions. It is important to

check with a doctor.

Stages

Knowing the stage of the disease help the doctor plan treatment. The following stages are used
for colorectal cancer:

Adapted from National Cancer Institute

Stage 0. The cancer is very early. It is found only in the innermost lining of the colon or rectum.

Stage I. The cancer involves more of the inner wall of the colon or rectum.
Stage II. The cancer has spread outside the colon or rectum to nearby tissue but not to the lymph
nodes. (Lymph nodes are small, bean-shaped structures that are part of the body's immune
system.)

Stage III. The cancer has spread to nearby lymph nodes but not to other parts of the body.

Stage IV. The cancer has spread to other parts of the body. Colorectal cancer tends to spread to
the liver and/or lungs.

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2. SCREENING

Tests that examine the rectum, rectal tissue and blood are used to detect (find) and diagnose
colorectal cancer.

The following tests and procedures may be used:

Physical exam and history: An exam of the body to check general signs of health, including checking
for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health
habits and past illnesses and treatments will also be taken.

Digital rectal exam: An exam of the rectum. The doctor or nurse inserts a lubricated gloved finger into
the rectum to feel for lumps or anything else that seems unusual

Faecal occult blood test: A test to check stool (solid waste) for blood that can only be seen with a
microscope. Small samples of stool are placed on special cards and returned to the doctor or
laboratory for testing.

Faecal Occult Blood Test (FOBT) kit to check for blood in stool.

Barium enema: A series of x-rays of the lower gastrointestinal tract. A liquid that contains barium
(a silver-white metallic compound) is put into the rectum. The barium coats the lower
gastrointestinal tract and x-rays are taken. This procedure is also called a lower GI series.
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