In recent times, cancer has been one of the leading causes of death worldwide. In Thailand, colorectal cancer is the most common cancer in men at 12.2% and ranks third in women at 9.6%. However, despite the misfortune, there is good news that colorectal cancer can now be prevented and cured.
Unhealthy lifestyle.. the silent killer
Did you know that living an unhealthy lifestyle, such as eating an unbalanced diet with only red meat and no fruits or vegetables, drinking little water, lack of exercise, allowing constipation, heavy drinking, and smoking, can lead you to a dangerous disease?
From the knowledge about the mechanism of colorectal cancer, it is found that the disease results from abnormal growth of the colon lining cells, from normal colon tissue to polyps, and eventually developing into cancer.
Therefore, if we can detect these abnormalities early, or at the polyp stage and remove them in time, it will destroy the chance of cancer developing. Theoretical data shows that a 1 cm polyp takes up to 10 years to become cancerous.
Meanwhile, another fact is that patients with polyps or early-stage colorectal cancer usually have no symptoms and often show symptoms only when the cancer has advanced significantly. Therefore, colorectal cancer screening should be done regularly every 3-5 years.
Screening for precancerous polyps or early-stage cancer can be done by
- Colonoscopy
- High-speed computed tomography (CT-Colonography)
Colonoscopy
This procedure involves inserting a scope to directly examine the entire colon, with a video camera attached at the tip to view images inside the colon and rectum. This method can remove polyps that may become cancerous in the future and is a highly accurate screening method.
High-speed computed tomography (CT-Colonography)
The high-speed CT scanner can create 2D and 3D images of the colon, allowing internal views similar to colonoscopy. It is highly effective, detecting polyps sized 6-8 mm with 85-90% accuracy and those 8 mm or larger with 95-100% accuracy. This method can also complement colonoscopy in cases where cancer causes obstruction preventing the scope from passing through. Additionally, it can examine the colon wall and internal abdominal organs that cannot be seen by colonoscopy. The procedure is quick, taking about 15-20 minutes.
Warning signs.. colorectal cancer
- No symptoms
- Changes in bowel habits, alternating diarrhea and constipation, narrower stools
- Bleeding from the rectum or blood mixed with stool
- Abdominal discomfort, pain, bloating, cramping-like sensations
- Symptoms of bowel obstruction such as fever, inability to pass stool or gas, bloating
- Paleness, unexplained anemia
- Loss of appetite, unusual fatigue
- Weight loss without dieting
- Palpable mass in the abdomen
Treatment can be divided according to the stage of the disease
- Stage 0 Cancer cells remain as polyps, detected by colonoscopy. Polyps can be removed through the scope before or nearly before becoming cancerous, with a 100% chance of cure.
- Stage 1 Cancer cells grow and invade the wall layers of the colon and rectum but have not spread to nearby tissues or lymph nodes. Treatment involves surgery called Curative resection, which removes 10-15 cm of the colon and at least 12 lymph nodes, then reconnects the healthy colon parts. For cancers near the rectum in the pelvic area, modern surgical techniques can preserve the anal sphincter, with a 95% chance of cure.
- Stage 2 Cancer cells spread through the colon or rectal wall to nearby tissues but not to lymph nodes. Curative resection surgery is the main treatment, similar to stage 1, with an 80% chance of cure.
- Stage 3 Cancer cells spread to 1-3 or more lymph nodes but have not invaded other nearby organs. Curative resection surgery remains the main treatment, similar to stages 1 and 2, with a 60% chance of cure. The cure rate can be improved with adjuvant chemotherapy after surgery, which can be oral or injectable.
- Stage 4 Cancer has spread to other organs such as the liver and lungs. If complete surgical removal is not possible, survival is only 1-2 years.
