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Much can be done to prevent, detect and treat Singapore’s No.1 killer cancer, experts explained at a recent seminar.

When 53-year-old credit manager Ms Catherine Wong suffered severe abdominal pain and constipation days on end, she was quickly referred to a gastroenterologist who recommended a colonoscopy.

She braved the procedure three years ago and never regretted it.

The early intervention meant that the cancerous polyps in Ms Wong’s colon were removed early. But more so, the experience was a wake-up call.

“I was living a precarious lifestyle. I had a lot of work stress and had a bad diet. I even forgo running as an exercise which I loved to do before.”

Ms Wong, like many others who recently attended the ‘Digesting the essentials on gut health’ seminar organised by Channel NewsAsia, emerged as a strong advocate for a healthier lifestyle in preventing cancer.

The health seminar was packed, with a ballroom of eager participants who got first-hand information from a panel of cancer doctors who discussed about gut health, cancers associated with the digestive system and new medical treatments to treat the world’s leading cancer killers.

Dr Patricia Kho, Senior Consultant of medical oncology at Parkway Cancer Centre, kicked off the session with a talk about the commonest cancer killer among  Singapore men and women – colorectal cancer.

Colorectal cancer is three times higher in developed countries but Dr Kho said that not all hope is lost as colorectal cancer is definitely preventable.

“Over a period of five to 10 years, normal colon cells may undergo a hyper proliferative mode and will become a benign tumour called an adenoma,” she said. “If this adenoma is not removed, after genetic changes, it will become a malignant colon cancer tumour.”

It is this five to 10-year period that most people are unaware of and that they do have a choice to undergo a colonoscopy even if they do not have symptoms such as a change in bowel habits, abdominal pain, unexplained weight loss or blood in stools.

“Screening should be done when you are well in order to prevent you from being unwell,” Dr Kho concluded.

For Ms Wong, who has had a close shave with the cancer, resounded with Dr Kho’s message.

“Had I not gone for colonoscopy at 50, I would not have realised that there was actually cancer growing inside me,” said Ms Wong who also confided that she had no symptoms of blood in her stools.

According to Dr Kho, Singaporeans between the age of 45 and 50 carry an average risk of colorectal cancer which explains the need for people in this age group to undergo colonoscopy.

For those with a family history of colorectal cancer, symptoms or a personal history of inflammatory bowel disease or colonic polyps, screening at an earlier age is highly recommended.

“We all love our bak kwa, hamburgers and satay but we must do more to keep colorectal cancer at bay. Limit your intake of processed meats as they do increase the risk of colorectal cancer, stop smoking as it contains the cancer-causing carcinogenic substance, exercise to maintain a lower end of your body mass index (BMI) and eat more fruits and vegetables.

“More importantly, go for regular screening,” advised Dr Kho.

Fortunately, the advancement in personalised medicine, targeted treatment and surgery today has boosted the survival rate of colorectal cancer patients to 52 per cent. Colorectal cancer is now one of the top five survival cancers in Singapore.

With targeted therapy, new drugs like Cetuximab and Panitumumab cleverly block colorectal cancer cells from further growth. These drugs work well for advanced-stage individuals who carry the non-mutated (wild-type) KRAS and NRAS gene.

Another targeted drug, Bevacizumab can also be used to stop new formation of blood vessels on cancer tumours thus ‘starving’ the tumour and preventing them from proliferating further.

The latest and most promising form of cancer treatment is immunotherapy which marshals the body’s own immune defences against cancer.

Homemaker Madam Rahima Noor who was impressed with these discoveries believed they would give a renewed sense of hope to individuals battling cancer.

The 58-year-old who learnt more about the five-colour diet from Dr Tan Yu-Meng, Consultant Surgeon at FeM Surgery when he presented on liver cancer, said she was keen to introduce foods inclusive of an array of fruits and vegetables from the blue or purple, green, white, yellow or orange and red groups.

Dr Tan explained that lifestyle choices of a fatty diet, smoking and overconsumption of alcohol have resulted in more people developing liver cancer today.

Vaccinations against Hepatitis B or Hepatitis C may have kept some people from developing cirrhosis, a hardening and scarring condition of the liver, which can lead to liver cancer.

However, with the trend of over-consumption of toxic foods high in fat and alcohol, “doctors today are seeing more patients with liver cancer as a result of their bad lifestyle choices,” explained Dr Tan.

For Madam Rahima, she has set a goal to make family meals more nutritious and healthy.
“Singapore is a food haven and Singaporeans certainly love to eat but the last thing you would want is trouble with your health!” Madam Rahima said.

Written By Nuraisha Teng

How to fight colorectal cancer

• Limit your intake of processed meats.
• Eat more fruits and vegetables.
• Stop smoking.
• Exercise to maintain a lower BMI.
• Go for regular screening.
   

Other seminar highlights

Medical advances: Dr Dean Koh, Senior Consultant and General Surgeon of Colorectal Clinic Associates shows how medical advancements, particularly in surgery, have also improved patients’ chances of survival.  

Laparoscopy, a technique that allows surgeons to perform colon procedures through small incisions instead of a single long abdominal incision in a conventional open surgery and robotics surgery which increases surgical precision that ensures less complications and speedier recoveries.

Probiotics: Professor Lee Yuan Kun of the Department of Microbiology at the National University of Singapore explained that good bacteria such Lactobacillus and Bifidobacterium aid in the treatment of common gut problems like infectious diarrhoea. 

Pancreatic cancer: Dr Liau Kui Hin, Medical Director and Senior Consultant Surgeon at Nexus Surgical Associates explained how medical technology advancements have improved treatment in stomach and pancreatic cancers. They include the testing of the body’s Chromogranin A protein gene as an indicator for neuroendocrine cancer in the presence of suspicion of such tumours (not for screening), high-definition scans for clearer views of tumours, improved surgical techniques, molecular therapy and immunotherapy.