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Healthxchange > Forums > Ask the Specialists > Ask the specialist > Colon Cancer

 Ask Specialists  
 Colon Cancer
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 May 2nd - 31st 2012 
 
 

A change in your bowel habits, such as diarrhoea or constipation, could be harmless, or it could signify something more serious such as colon cancer. Did you know that colon cancer is the commonest cancer in Singapore? Its symptoms can also include persistent abdominal discomfort or pain.

Seize this chance to ask any question you might have regarding colon cancer. Our expert is here to help.

 
  How does it work?  
  Each month, we offer 2 topics for discussion. Members can post their questions online. At the end of each month, we will publish the answers from our panel of specialists here.  
  Remember to sign up or log in before you post a question.  
 
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Hosted By:    
 

Dr Melissa Teo Ching Ching
Senior Consultant
Dept of Surgical Oncology
National Cancer Centre Singapore

 
 
     
 
 
 
Posted by riccia
Hi Dr Melissa,
 
My wife was diagnosed with stage 3 colon cancer and currently undergoing treatment at SGH, doing chemo and radio.
Doctor says she need to remove part of the colon with the tumour next month.
She already underwent 2 months of chemo and radio. Currently her chemo will stop for one month to prepare her for surgery.
 
My questions:
1) Is it a must she need to remove her colon as part of her treatment ? Even though if the MRI eventually shows that the tumour has subsided ?
 
2) Since her chemo has stop now, can she start to consume food like lingzhi, ginseng to help to boost up her  body and immune system ?
I am worried certain food will also boost up the growth of cancer cells.
 
Please kindly advice.
Thanks.
rgds
Koon
 
 
 
Answered by Dr Melissa Teo Ching Ching
Senior Consultant
Dept of Surgical Oncology
National Cancer Centre Singapore

Yes. Surgery is the only curative treatment for colorectal cancer.  Chemotherapy and radiotherapy are used together with surgery, either before (neoadjuvant) or after (adjuvant) the surgery to further increase the rate of overall and/or disease-free survival. 

In your wife’s case, chemotherapy and RT is used before surgery, as a form of neoadjuvant treatment, with the intention of decreasing the chance of local recurrence which means to decrease the chance of the cancer coming back at the same place. Occasionally, repeat imaging after chemo- and radiotherapy shows a marked improvement of the tumour size. However, even an apparent complete resolution of the tumour does not equate to a pathological complete response as microscopic tumour cells would still be present. 

This means that in 35 percent of patients receiving neoadjuvant chemotherapy and radiotherapy, no residual tumour is seen on imaging but 65 percent of these patients will still have tumour present microscopically when surgery is performed and the specimen is taken for analysis.  As such, your wife would still need to undergo surgery on top of the chemo- and radiation therapy as surgery would remove the entire tumour and is the only curative modality of colorectal cancer. 

Many forms of alternative therapy are associated with minimal or no risk.  However, there is no compelling evidence that alternative medicine will help to enhance the quality of life or improve the overall survival of a patient. In addition, there are potential toxicities, both direct and indirect, that are related to such therapy. 

Firstly, a variety of herbal medications may produce direct side effects such as diarrhea, headache, hypertension, insomnia, nausea and in more severe cases, renal failure.  Such alternative therapy may also interact with chemotherapeutic agents and hence should not be used during the course of chemotherapy. Such alternative therapy should also be avoided before surgery as its effect on immunity, bleeding or coagulopathy remain largely unknown.

 
 
 
Posted by ktphua
Dear Dr Melissa I have persistent abdominal discomfort and pain on my left abdomen cavity since 2008. Despite gone through Barium Enema, Endoscopy and Colonoscopy, the result shows normal. I have taken omeprazole on long term medication but it does no help to ease the pain. The pain occurs daily and worst if I miss my meal.I still have follow up appointment with Gastroenterology. Meantime,need your advice please. Thank you very much. rdgs, kok too
 
 
 
Answered by Dr Melissa Teo Ching Ching
Senior Consultant
Dept of Surgical Oncology
National Cancer Centre Singapore
By endoscopy, I assume that you have undergone an Oesophagogastroduodenoscopy (OGD).  If not, you may benefit from an OGD.  This may reveal gastritis that may be associated with the bacteria Helicobacter Pylori (H Pylori). 

H Pylori has been found to be associated more with gastric malignancies and only few studies have shown its relation to colon cancer.  Gastritis caused by H Pylori can be treated with triple therapy. 

Since the results of your colonoscopy and barium enema are shown to be normal, it is unlikely that you have colon cancer. However, colon cancer is the most common cancer in Singapore.  Even without relative risks and a normal colonoscopy, one should have a repeat colonoscopy in ten years (See MOH screening guidelines).
 
 
 
Posted by sbdtys

My grandma has recently been diagnosed with a stage 4 Colon cancer. She has started her first session of Chemo.

The chemo is in a 3-weeks a cycle for 6  cycles treatment. On a weekly basis, we will need to change the chemo medication for her at home. I read online that these chemo fluid is pretty toxic. And the fluid discharge of the patient is toxic as well. (ie sweat/saliva/urine etc) So, they would advise small kids and pregnant women to have minimal contact with the patient.

I would like to know if the online information is relevant as I have a one year old daughter at home, staying together. Do we need to separate the utensil for my granny as well?

Vivian

 
 
 
Answered by Dr Melissa Teo Ching Ching
Senior Consultant
Dept of Surgical Oncology
National Cancer Centre Singapore
Chemotherapy drugs are broken down and excreted from the body by the kidney, liver or intestines.  Chemotherapy drugs are extremely toxic and have the potential to have an adverse effect on those around the patient once it is removed from the body. 

Chemotherapy causes changes in the DNA of the patient and may potentially cause short and long-term effects on those who come into contact with it.   Mild side effects include skin irritation or damage. 

In general, chemotherapy takes about 2 days to be excreted.  During this period, no one should come into contact with the patients’ waste products and fluids.  Should any contact be made by accident, one should wash the area of contact thoroughly.
 
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