Colorectal cancer (CC), or cancer of the large intestine, has risen to become the most common type of cancer in most developed countries, including Singapore. Like most cancers, the best chance of treatment and cure is where the cancer is detected early and has not invaded or spread to other organs. Unfortunately, the patient with CC may not feel anything is wrong until the cancer is more advanced.
This is where screening comes in. Screening can detect cancer, and even pre-cancerous lesions called polyps, at an early stage. Some very early and small cancers can even be treated during colonoscopy without needing to resort to major surgery.
Colonoscopy is the most accurate tool available today to screen for and diagnose CC. Colonoscopy is the examination of the colon and rectum using a fibreoptic endoscope.
Colonoscopy is recommended for anyone with persistent symptoms relating to their large intestine, like:
- Irregular bowel movements – especially a recent change in bowel habit. E.g. if a person normally has one or two bowel movements per day has recently (meaning over past few weeks or months) changed the habit to less frequent (e.g. once every few days) or more frequent (like 4 – 5 times per day) for no reason.
- Passing blood or mucous in the stools. This is an important and significant symptom
- Persistent abdominal pain or bloatedness.
Due to the rising incidence of CC, and the fact that during the early stages, the patient may not even be aware of it being there, it is now recommended that all persons above the age of 50 years should have a colonoscopy done at least once to exclude the presence of CC, even if they are totally well.
It is quite understandable that most people are nervous about having a long tube inserted into their rectum. However, it is not all that bad. Not everyone with symptoms mentioned above has colorectal cancer. In fact, the more common causes of these symptoms are benign. Colonoscopy can help to relieve that anxiety by excluding cancer conclusively.
Before colonoscopy can be done, the large intestine has to be totally cleared of all residual fecal matter. This process is called ‘bowel prep’ and usually involves taking a strong laxative the night before and on the morning of the procedure. Colonoscopy is usually done as a day-case procedure. It takes about 30 to 45 minutes to do. The use of short-acting intravenous sedatives and pain-relieving drugs ensures comfort for the patient. Most patients do not feel anything at all and some do not even recall having gone into the procedure. There is usually no pain or other side-effects after the procedure although some patients may experience temporary bloatedness due to the air that was pumped into the intestine during the procedure. Patients usually need to take the day off from work but should be able to resume normal activities the next day. Colonoscopy is claimable under Medisave and is covered by most medical insurance.
If you are over the age of 50 years of age, or may be experiencing some of the symptoms mentioned earlier, make colorectal screening a part of your routine healthcare. |
