"Black Panther" star, Chadwick Boseman, recently passed away after a battle with colon cancer (also known as colorectal cancer). He was only 43. But is colon cancer preventable? Dr Winston Tan, Consultant from the Colorectal Service at Sengkang General Hospital (SKH), a member of the SingHealth group, answers this and other frequently asked questions about colon cancer.
1. Is colon cancer preventable?
Colon cancer (colorectal cancer) is the top cancer in Singapore - the number one cancer for men, and number two for women.
Prevention of colon cancer is definitely possible as a majority (>80%) of cancer cases develop from pre-cancerous colonic polyps.
Removal of these pre-cancerous colonic polyps has been shown in studies to reduce the incidence of colon cancer by up to 80%.
Thus, colonoscopy screening, with removal of pre-malignant polyps at the same setting, offers the most effective means of preventing colon cancer.
Other measures which can help minimise your risk of developing colon cancer include:
- Moderation of alcohol consumption,
- Quit smoking (if you haven't),
- Regular physical activity (exercise) and a
- Balanced diet that includes adequate fruits and vegetables
2. Colonic polyps, are they all cancerous?
There are many different types of colonic polyps. While not all of them may lead to cancer, the majority of colonic polyps discovered carry a risk of malignant transformation (adenomatous polyps).
The risk of cancer developing from adenomatous polyps also varies according to factors such as the:
- Size of the polyp and the
- Extent of abnormality on microscopic examination (degree of differentiation)
3. My relative has colon cancer. What is my risk?
There are multiple factors that need to be considered when assessing your risk of developing colon cancer based on family history.
In general, your risk of developing colon cancer depends on:
- The number of family members who have colon cancer,
- Whether family members who have colon cancer are first degree relatives (parents, siblings or child) and
- The age your relatives were diagnosed with colon cancer.
Read more: Your best protection against colon cancer
As a crude estimation, those with:
- One first degree relative with colon cancer, carry a 2-fold higher risk of developing the condition
- Two or more relatives with colon cancer, carry at 4-fold higher risk of developing the condition
4. Is chemotherapy needed for all cases of colon cancer after surgery?
It is important to understand that the main treatment for curable colon cancer is surgery.
Chemotherapy’s role is mainly to augment the surgical treatment so as to reduce the likelihood of cancer recurrence.
Thus, chemotherapy is usually recommended for patients with cancers that are deemed to be at higher risk of recurrence.
These are usually patients with cancers that have involved the lymph nodes (stage III cancer). An oncologist may also recommend chemotherapy in certain patients with stage II cancers that exhibit features which put them at an increased risk of recurrence.
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