Colon Cancer

This is the leading cause of death by cancer in Malaysia mainly due to a lack of urgency among many people who are at greater risk from developing this cancer yet fail to seek treatment until it is too late. But it not need be the case.

At Prince Court Medical Centre, it’s all about advanced medical expertise and equipment offering the full complement of preventative, diagnostic and therapeutic services with impeccable standards in patient care and comfort. Innovative procedures are a hallmark of the hospital’s health care platform.

Colon Cancer

Occurs when aberrant or even malignant cell growth begins to form in the tissues either of the large intestines known as the colon, or near the rectum. Depending on the location it is also collectively referred to as colorectal cancer (colon or rectal cancer).

In Malaysia, colon cancer is the most common cause of cancer death among men and until recently, was the third highest cause of cancer death among women behind breast and cervical cancer. But now it has risen to second.

Risk Factors

Certain conditions may make a person more susceptible to developing colon cancer. Although it is not an absolute certainty that they will, people who fall into one or more of the risk factors below should always have at the very least, annual check-ups and see a specialist. The risk factors are:

• People who are 50 years old or above – almost 90% of colon cancers diagnosed in Malaysia occur in this age group
• Those whose family have a history of colorectal cancer
• Women who have had either breast, ovary or uterus cancer have a higher propensity for developing colon cancer as well
• People who have developed polyps in their colon
• Eating a diet that is high in red meat, processed meat, fat and low in fibre
• Smoking and drinking alcohol
• Genetic factors

Symptoms

As with most cancers, the early stages often have little outward symptoms. However, several general indicators have been identified that can help vigilant patients get early screening and treatment, that can so often be the difference between a successful or unsuccessful cure. These symptoms include:

• Unexplained weight loss
• Pain and tenderness in the lower abdomen
• Diarrhea, constipation and other bowel irregularities
• If there is blood evident in the feces

Early detection and Prevention

Radiology diagnosis


The radiology Department at Prince Court works hand in hand with oncologists and specialist physicians to get the most accurate results in the least amount of time. This allows early diagnosis and also alleviates the anxiety of patients and their loved ones on the not knowing. The radiologists work with one of the latest equipment and can immediately notify the doctors, even while they are still in the OT with the patient whose tissue sample had just been sent off to the pathology department. Some of the services and techniques they offer include:

• CT scan – Computer Tomography (CT) scan is a technique of computer generated visuals using x-rays of the cross-sections of the body. CT scans are often employed to confirm which stage the patient’s cancer is at. Also referred to as colonography or CT colonography
• MRI – Magnetic Resonance Imaging (MRI) involves using magnetic and radio waves to construct computer generated visuals internal organs and tissues. The higher quality and detail makes this an invaluable asset in the radiologist’s diagnostic arsenal. In cases of lung cancer it is often deployed to scan the spine to see whether the cancer has spread there or even to the brain.
• PET CT scan – Positron Emission Tomography (PET) CT scan is basically a combination of nuclear medicine imaging techniques which involve the injection of radiotracers into the body, and computer tomography (CT) to produce more accurate and better quality images. In cancer treatment it is deployed for detecting the tumor growth and determining whether it is localized or has spread to other organs as that helps identify the stage

Gold Standard: Colonoscopy

Prince Court Medical Centre provides current modern minimally invasive techniques that are now revolutionizing healthcare and quality patient service. To that end, doctors can refer their patients for both diagnostic and therapeutic treatment with the procedure known as colonoscopy.

Colonoscopy is a diagnostic method that involves using a catheter or tube like instrument known as a colonoscope. The end of the tube houses a lens or camera that is connected to a video screen or monitor. It will also have specialized tools for polyp extraction.

The doctor inserts the colonoscope via the rectum and guides it till it reaches the colon or large intestines. There the camera will transmit images to the monitor screen allowing the doctor to assess whether a tumor is forming.

Polypectomy

If necessary, the doctor can maneuver the colonoscope and use it to remove the polyps before they become cancerous or for further analysis. Polyps are fleshy outgrowths that can occur on the colon lining. They may be harmless or cancerous. Small polyps can be removed by cutting away from the tissue lining of the colon. Larger polyps are removed by snaring it with a small noose, then using electric cautery to heat the noose and  polyp, separating it from the colon.

What makes this procedure truly impressive is that removing potentially cancerous polyps before they become malignant or infect other tissues and organs can prevent the cancer from occurring. Thereby curing the patient before the cancer has even begun

Extracting polyps either by slicing the tissue or burning it is relatively painless because the colon walls or the lining of the colon lacks the ability to experience pain. Like other minimally invasive procedures available at Prince Court Medical Center, it presents lower risk of physical trauma and damage to the internal organs and tissue, less complications from the danger of infection and little to no scarring. Recovery time is also much shorter than compared with conventional open surgery of the past.

There is however a 25-30% chance of cancerous polyps re-emerging again after three years for some patients.

Treatment

If cancer is positively detected and identified a range of treatment options including surgery, chemotherapy and radiotherapy are available to offer the best chance of a curative solution and hope to the patients and families afflicted.

• Surgery
 This involves a team of experienced gastroenterology oncology surgeons and general gastroenterology surgeons – all in collaboration to provide a complete surgical and medical solution, not only to the colon cancer, but also the patient’s future quality of life.
• Chemotherapy 
The oncologist prescribes anti-cancer drugs and medication which are ingested either orally (through the mouth) or intravenously (through a catheter). Possible side effects include vomiting, diarrhea, and hair loss.
• Radiotherapy
 This involves shining a focused x-ray onto the cancer cells so as to shrink them. It is done in sections and it can be one or multiple. The number of sections and their dosage is determined by the oncologist.

Facilities

Endoscopic Suites


To ensure that exceptional quality healthcare service is provided, Prince Court Medical Center spares no expense in establishing the most conducive and productive environment that is both medically effective and comfortable for patients. To that end the recent advances in endoscopy-based techniques for diagnosis and treatment of many gastrointestinal afflictions, necessitates the establishment of advanced and purpose built endoscopic suites fully equipped to offer the complete range of endoscopic therapies available. They are fully staffed with medical professionals of high caliber supported by trained nurses and staff.

Quality of Life and Palliative Care


If the colon cancer has advanced beyond a certain point and is no longer responsive to chemotherapy or surgery then the next stage is palliative care. Here at Prince Court the palliative care physician becomes involved in order to guide, assist and just be there for the patients, their families and loved ones in this most trying of times.

It’s all about quality of life care and the palliative physician is instrumental in the administration of drugs and medication, supervising nutritional intakes as well as physiotherapy exercises. But together with the

medical personnel and the doctors they also provide counseling for the patients and their loved ones – engaging with them on their fears and worries for the present and the future and doing all they can to make this difficult period as painless as possible. At heart it’s about the patient living their days with dignity.

At Prince Court Medical Centre, the full complement of diagnostic, remedial and rehabilitative facilities, equipment and skilled personnel will always do their utmost to ensure that patients can go home with a smile.