COLORECTAL CANCER: EXPERTS INSIGHTS ON SCREENING, TREATMENT AND PREVENTION STRATEGIES

KUALA LUMPUR, March 28 (Bernama) -- Colorectal cancer remains a major global health concern, but breakthroughs in early screening, advanced treatment and cutting-edge surgical techniques offer renewed hope for patients.

Experts emphasised that timely detection and evolving medical technologies are revolutionising patient outcomes and transforming the fight against this deadly disease.

In an exclusive interview, consultant colorectal and general surgeon at Sunway Medical Centre Damansara (SMCD) Dr Siti Mayuha Rusli highlighted the crucial role of cancer staging and personalised treatment plans in improving patient outcomes.

“The first step is to gather basic demographic details of the patient, such as their age and any existing comorbidities. Next, reviewing the scope findings allows the medical team to determine the precise location of the tumour, whether it involves one or multiple areas and the extent of its spread.

“Once the tumour location is confirmed, we proceed with a Computer Tomography (CT) scan of the thorax, abdomen and pelvis. In some cases, we may require Magnetic Resonance Imaging (MRI) of the rectum. This helps us assess how far the tumour has spread to nearby organs or distant sites such as the liver or lungs - the most common organs affected in advanced stages of colorectal cancer,” she explained.

The staging of colorectal cancer directly influences treatment decisions. Early-stage cancers (Stage 1 and 2) are confined within the colon or rectum, while Stage 3 spreads to nearby lymph nodes.

By Stage 4, the disease reaches distant organs, significantly lowering survival rates and shifting treatment towards palliative care, although in about 20 per cent of cases, cure is still possible in Stage 4.

According to MyScan 2018 data, Malaysia’s overall five-year rate for colorectal cancer stands at approximately 51 per cent. However, survival chances vary widely by stage.

“Stage 1 colorectal cancer has a survival rate of 75-80 per cent. By Stage 2, it drops slightly to 70-75 per cent. Stage 3 survival rates fall further to 50-60 per cent, and Stage 4, where the disease has spread, survival chances are less than 20 per cent,” Dr Siti Mayuha noted.

Surgery remains the primary treatment for colorectal cancer, with procedures tailored to the tumour’s location. Right-sided tumours require the removal of the right colon, while left-sided tumours necessitate left colon removal.

Locally spread rectal cancer cases may even require complete rectum and nearby organs like bladder or uterus removal, sometimes leading to a permanent stoma, she said.

“Stoma formation, which involves creating an opening on the abdomen to allow waste removal, is often part of colorectal cancer surgery. It’s a difficult adjustment for many patients, but it is sometimes necessary for their survival,” Dr Siti Mayuha said.

She also highlighted the role of minimally invasive techniques, such as keyhole and robotic surgery, which have significantly improved patient recovery and reduced complications.

“In the past, surgeries left long scars that took weeks to heal. Today, with minimally invasive procedures, patients experience much smaller incisions, sometimes as small as five millimetres, leading to less pain, quicker recovery and fewer complications. Patients can often walk the next day and return to work much sooner than with traditional surgery,” she explained.

However, despite these advancements, post-surgical complications remain a concern, including bleeding, infections and leaks where the colon is reconnected.

“One of the most feared complications is leakage from the surgical connection. Minor cases can be treated with antibiotics, but severe cases may require additional surgery,” she said, adding that other potential complications include infections, pneumonia and deep vein thrombosis (DVT).

Meanwhile, SMCD consultant gastroenterologist, hepatologist and physician Dr Muhammad Ilham Abdul Hafidz stressed that prevention through screening and lifestyle changes can significantly reduce colorectal cancer risks.

“The two most common screening methods are the faecal occult blood test (FOBT) and colonoscopy. FOBT detects blood in stool and can be done at home, but a positive result only indicates the need for further assessment. However, colonoscopy, where a camera is used to examine the colon, helps identify polyps and abnormalities that could develop into cancer,” he explained.

He said that in Malaysia, the Ministry of Health recommends colorectal cancer screening from age 50, but with rising early-onset cases, countries like the U.S. and Australia have lowered the screening age to 45.

Individuals with a strong family history of colorectal cancer should begin screening even earlier, he said.

Dr Muhammad Ilham pointed out that warning signs include persistent bowel habit changes, rectal bleeding, unexplained weight loss, bloating and abdominal pain, urging those experiencing symptoms not to delay seeking medical advice.

“Lifestyle factors such as obesity, smoking, excessive alcohol intake and diets high in processed foods and red meats increase the risk of colorectal cancer. Maintaining a healthy lifestyle, weight and diet and reducing alcohol intake can significantly lower the risk,” he advised.

He also emphasised the importance of spreading awareness, especially to those with family histories of colorectal cancer, to undergo regular screening as early detection could save lives.

As medical technology advances, both experts believe that artificial intelligence (AI) will play a transformative role in the future of colorectal cancer care. AI-powered tools can enhance screening accuracy, personalise treatment plans and improve outcomes.

They stressed that colorectal cancer is preventable through early detection and advised the public to maintain a healthy lifestyle, undergo regular screenings and not hesitate to consult healthcare professionals if symptoms arise.

With early detection and timely intervention, colorectal cancer can be managed effectively, significantly improving survival rates and quality of life for patients.

For more information and inquiries, please contact Sunway Medical Centre Damansara at 03-8966 9191 or email smcd-ge@sunway.com.my. Visit https://www.sunwaymedicaldamansara.com.my/en/ and follow on Facebook: Sunway Medical Centre Damansara.

-- BERNAMA

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