Colorectal cancer is the second commonest cancer in Malaysia in 2020, affecting both the colon and the rectum. Beginning as small benign clumps of cells known as polyps, colorectal cancer impacts those 50-years-old and above the most, with 80% diagnosed at this age bracket.

Colorectal cancer was given much limelight in recent times following the death of actor Chadwick Boseman at the age of 43, due to colon cancer, which highlights the growing rate of this disease among younger adults.  

Statistically, in most cases of colorectal cancer, approximately 69% of patients are diagnosed at Stage Three and Stage Four of cancer, with only about 6% diagnosed at Stage One.

Early detection is key to curing colorectal cancer, and screening can help you begin your journey to colorectal cancer treatment as in most cases, symptoms are not obvious until cancer grows or spreads.

There are a few screening options that will detect colorectal cancer, such as:

• Colonoscopy
• Fecal occult blood testing

Begin screening at around the age of 50, then continue screening at regular intervals. When colon cancer is found in the early stages, the 5-year survival rate is at about 90%.

Talking to an expert like General and Colorectal Surgeon, Dr Ang Chin Wee, can help. When it comes to treating colorectal cancer, Dr Ang shares – “a lot of patients with advanced colorectal cancers or peritoneal cancers (cancers that have spread to the lining of the abdomen) in Malaysia have very poor survival outcome or quality of life after the cancer diagnosis”.

Fret not, because according to Dr Ang, surgical oncological treatment has advanced significantly over the years to include treatments such as:

• Intraoperative Radiotherapy (IORT) – A tool used for dosage escalation beyond EBRT tolerance level, targeting locally advanced cancer cells.
• Heated Intraperitoneal Chemotherapy (HIPEC) – A treatment where heated chemotherapy drugs are pumped into the abdomen.
• Aerosolized Intraperitoneal Chemotherapy (PIPAC) – A technique of delivering cytotoxic drugs into the abdominal cavity as an aerosol under pressure.

There is a significant difference between beginning early treatment and treatment at an advanced stage of cancer. “Patients with advanced colorectal cancers quite often do not have a lot of options for treatment.”

Dr Ang adds that “for straight forward or early-stage colorectal cancer” – minimally invasive laparoscopic surgery will provide the best result as it is less painful, has a quicker recovery time and shorter hospital stay.

“For patients with advanced cancers, I perform complex surgeries, which quite often involved removing several organs, while HIPEC and PIPAC can be used for cancers that have spread to the lining of the abdomen called the peritoneum.”