Dr Ng Chee Yung, a surgeon from the renowned Mount Elizabeth Hospitals in Singapore, was in town recently to share new information on colorectal cancer. Dr Ng graduated from the University of Western Australia and trained at the Royal North Shore Hospital in Australia, Yonsei Hospital in Korea and at the Singapore General Hospital. He is a specialist in minimally invasive surgery and complex procedures like laparoscopic and robotic colorectal surgery and transanal endoscopic microsurgery.
CanHope Manila and Manila Bulletin interviewed Dr Ng about colorectal cancer. Here are excerpts:
What is Colorectal Cancer and why is it a growing concern?
The Department of Health (DOH) ranks Colon cancer as 6th in the leading causes of death of Filipinos. Colon cancer is also the #1 cause of deaths from cancer in Singapore.
Colorectal cancer is a disease of the colon (the longest part of the large intestine) or rectum (the last several inches of the large intestine before the anus). There is no single cause of colorectal cancer. The cancer frequently begins as a polyp in the lining of the colon that may develop into a tumour over a period of five to ten years.
Polyps are growths common in people aged 50 and above. Some polyps (adenomas) can become cancer.
Who are likely to get the disease?
Smokers or people who frequently consume meats and fatty foods have a high risk of colorectal cancer. A study in Israel showed a strong correlation between patients who developed colorectal cancer in their 50’s who were obese in their teenage years.
Early colon cancer is hard to detect as it has no symptoms. When persons aged 50 years old and above complains of changes in bowel habits, minor abdominal pains, and unexplained weight loss and anemia, doctors immediately recommend them for screening.
According to the DOH, a major factor in the delayed detection of colon cancer is the incorrect diagnosis of amoebiasis and other forms of inflammatory bowel disease. Too many physicians prescribe vitamins and hematinics for unexplained weight loss and anemia without carefully looking for the cause of the weight loss.
What are the symptoms of colorectal cancer ?
- Change in bowel habits (diarrhea or constipation)
- Feeling that your bowel does not empty completely
- Finding blood (either bright red or very dark) in your stool
- Frequently having gas pains or cramps, or feeling full or bloated
- Losing weight and feeling tired all the time
- Having nausea or vomiting
If you are experiencing these symptoms, you must immediately see an internal medicine specialist who will recommend you for tests.
What happens next ?
If your tests or screening suggest colorectal cancer, your doctor will ask about your medical history and perform a physical examination or a colonoscopy. A colonoscopy is a painless procedure to examine the colon to check for colorectal cancer, and even prevent it. Studies have shown that a regular colonoscopy can prevent colon cancer by as much as 90 per cent.
What are the various treatment options?
Surgery via laparoscopy or open surgery involves the removal of tissues that contain the tumor. In a laparoscopy, the surgeon examines the colon through a keyhole incision. The abnormal tissue (polyps) can be removed during colonoscopy. A biopsy will be done on the polyps to check the presence of cancer.
In open surgery, the surgeon removes the polyps through a long abdominal incision.
In chemotherapy, anticancer drugs are given to shrink/kill cancer cells, especially those that have formed into a large tumor, before actual surgery to take it out.
TARGETED CANCER THERAPY
Targeted therapy is applied on patients with cancer that has spread. Drugs or other substances block the growth and spread of cancer by controlling specific molecules that trigger tumor growth.
Radiation therapy (also called radiotherapy) uses high-energy rays to kill cancer cells in affected parts of the body.
Fortunately, the advances in cancer treatments (especially in the early stages) have improved the success rate and recovery of patients. It is still advised that persons with a high risk of colorectal cancer go for early screening.
What is the most challenging part of your profession?
You always need to make quick decisions to save patients’ lives. A doctor must work closely with the family and other doctors to plan the treatment. We must study the patient’s case thoroughly to arrive at the best treatment.
What is the most fulfilling part of your profession?
Surgeons need experience to improve their craft. Helping sick people, in a way, makes us better surgeons. Thankfully, advancements in surgery have made our work more effective so we can give more patients a second chance.
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