Colon Cancer Can Be Beaten With Effective Prevention and Treatment

• Colon cancer prevention is crucial. Early detection through regular colonoscopy drastically increases survival rates. Screening should start at 45, or earlier for people with family history of colon cancer.
• Some types of colonic polyps have the potential to develop into cancer after 3-5 years. If these polyps can be identified through screening, doctors can remove them before they become cancerous.
• Undergoing colonoscopy at age 45 and above, even when there are no symptoms reduces the mortality rate of colon cancer.
• There are currently various colon cancer screening techniques available, such as narrow band imaging (NBI) which shows flat polyps more clearly. Moreover, it allows for immediate polyp removal without the need for surgical incision.

Colon cancer is a disease that results from normal colon cells mutating. These cells divide until there are so many of them that the body cannot cope. In its early stages, the disease may occur as a tumor. However, if it is left untreated and not removed, it could lead to the onset of cancer.

Studies have found that undergoing colonoscopy can dramatically reduce the mortality rate that results from colon cancer. Doctors recommend colonoscopy from the age of 45 years and above, even when no symptoms are displayed. 

Conversely, those with a family history of colon cancer should subtract 10 years from the age at which their family member contracted the disease. This provides the age at which family members should carry out colon cancer screening. For instance, if a father contracted colon cancer at age 40, subtract 10. So his offspring and relatives should begin colonoscopy from the age of 30, regardless of whether symptoms are displayed. This is because the family is considered to be at a higher risk than the general population.

Samitivej Hospital now offers polyp screening which identifies up to 60% of polyps before they can develop into colon cancer. The international average is currently at just 25%*. The sooner doctors identify the polyp, the higher the chance of successful treatment thereafter.

Many individuals with colon cancer may not exhibit any symptoms, remaining unaware of their condition.

Symptoms Include:

• Changes in bowel habits 
• Alternating between bouts of diarrhea and constipation
• Sudden, unexpected weight loss
• Severe exhaustion
• Blood in stools
• Chronic stomach pain, particularly in the abdomen area

Symptoms of colon cancer can be misleading as they are common to other digestive system conditions. These symptoms may indicate colon cancer at stages 2-4. If you notice persistent digestive irregularities for over two weeks, it's important to consult a specialist.

The onset of colon cancer can be categorized in to the following four stages:

1. A lump or polyp located in the colon wall tissue
2. Then, the cancer begins to spread into the deeper tissue of the colon
3. After that the cancer spreads to the lymph nodes
4. At this stage, the cancer will have spread to other organs, such as the liver, lungs and brain

Samitivej Hospitals’ GI doctors use the latest techniques for screening colon cancer with Ai- assisted colonoscopy with the narrow band imaging (NBI). This Japanese technique uses green/blue light rays to identify the presence of polyps, providing doctors with a clearer view of the polyps. 

Furthermore, doctors use Endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD), which are forms of painless minimally invasive surgery (MIS). These techniques allow surgeons to remove large polyps from the colon and stomach without the need for an incision into the abdomen. Hence, it does not leave the patient with any long-lasting scarring that could become a constant source of anxiety. Moreover, risks associated with surgery are reduced and time is saved. As a result, patients can make a speedy recovery and return to their daily lives much more quickly. In comparison, undergoing invasive surgery has a longer recovery period and carries the risk of complications that may arise. 

Regular colonoscopy for colon cancer is the safest option. The American Cancer Society urges people to start regular colon cancer screening at age 45.

There are some interesting data available which reveal that 90% of colon cancer identification comes in the form of an adenomatous polyp in the colon. These polyps are considered precancerous lesions and have the potential to develop into cancer over the next 3-5 years. Therefore, in cases where doctors find a polyp measuring less than 1 cm in size, they recommend the patient to repeat screening every 3-5 years.  However, if during the screening the doctor identifies a 1 cm polyp, the time frame for screening is adjusted to every 1-3 years. On the other hand, if a polyp is not found, doctors advise subsequent screening one once every 5-10 years. 

Please note that for those with insulin resistance, it may be necessary to increase the frequency of screening. Ofcourse, this depends on the individual’s body state and other associated colon cancer risk factors.

Preparation for colonoscopy

• The first step is to clear the bowel. Patients will also need to abstain from eating and drinking for six hours prior to screening.
• When arriving at the hospital, the doctor will ask for the patent’s personal medical record, underlying health conditions and drug allergy record. This includes the regular medications that the patient takes.
• Then, the patient will receive laxative to clean the bowel until it is clear and ready to receive the colonoscopy. This may take around 2-3 hours.
• Next, the doctor will inject the patient with a sedative. This should allow the doctor to see the interior of the colon in detail. However, if the patient is elderly and has a chronic illness, he or she will be administered a weaker sedative in the form of an inhalant. One that is fast-acting but wears off quickly.
• Finally, screening is done. The process should take about 20-30 minutes, but may take up to 45-60 minutes if there are many polyps that require removal.

In total, the colonoscopy procedure will only take around half a day.

Colonoscopy helps provide an analysis of the issues present in the colon. If doctors are able to spot abnormality in its initial stages, they can treat the disease before it spreads. 

Although medical technologies have progressed significantly and we can treat colon cancer, preventing is always better than cure. Therefore, Samitivej partnered with Japan’s Sano Hospital – a highly experienced institution for endoscopic procedures – to bring NBI technology to Thailand. NBI can help improve accuracy in identifying polyps by up to double the average rates.