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The incidence of colorectal cancer in the peninsula has increased alarmingly. Oncologist Dr A.B. Manivannan tells Tan Bee Hong it is most prevalent among Chinese males
DR A.B. Manivannan, consultant oncologist and radiotherapist at Assunta Hospital, wears his age well. For a man nudging 60, he looks at least a decade younger, which is amazing considering that he has what must be a highly-stressed job.
Dr Manivannan or Dr Mani as he is affectionately known to his patients, deals daily with one of the top silent killers in the country — cancer.
No one really knows what causes cancer but Dr Mani attributes it to a hereditary background and diet. “Perhaps we are also seeing a hike in the figures because, with better education and increased awareness, more people are likely to go for cancer screening.”
He recommends those over the age of 40 to add cancer screening to their annual medical check-up. They should take tests for tumour markers and CEA (carcinoembryonic antigen) a test specifically done to detect colorectal cancer. Those in the high risk group should also undergo a colonoscopy every five years.
High risk groups include those with a family history of cancer, who suffer from inflammatory bowel disease and who have a history of colon polyps.
While the above tests are not totally conclusive, the results will show if they need to do a biopsy, which is the only confirmative test for colorectal cancer.
The first indications of colorectal cancer are occult blood in the faeces (the earliest sign), altered bowels and weight loss, says Dr Mani.
Colorectal cancer is tumours in the bottom part of the colon. There is a difference in managing colon cancers and rectal cancers, he says. Colon cancers are tumours arising from the caecum, ascending, transverse colon, descending colon and sigmoid colon.
Once a diagnosis is made after a colonoscopic biopsy, investigations such as CT chest abdomen and pelvis, blood tests including liver and renal function tumour markers (CEA) are conducted to stage the disease.
According to Dr Mani, the first and best line of treatment for colorectal cancer is surgery (Stages 1, 2, 3 and sometimes in Stage 4), whether curative or palliative.
Depending on the stage, radiation therapy or chemotherapy may also be prescribed.
These days, a single modality (surgery) is no longer used to treat cancers. To boost survival rates, it has been found that a combined modality of treatment works better. Combined modality treatment involves combining chemotherapy, radiotherapy and targeted therapy
with surgery. Targeted therapy does not affect normal cells. Combining targeted therapy with or after chemotherapy has shown to improve survival for patients with advanced colorectal cancer.
Close life-long monitoring of a patient is imperative to detect recurrence if any. In addition, Dr Mani feels a positive attitude goes a long way. “Patients should not think of cancer as incurable,” he says. “I have seen patients recover faster when they have a positive attitude.
Sometimes patients with low rectal cancer who require an ileostomy bag after surgery may feel uneasy in the beginning but when they learn to manage it, it becomes a part of daily life. In any case, the bag is hidden from public view, under clothing.
FILL UP WITH FIBRE
Dr Mani has one final word of advice for all: Fibre.
A diet packed with fibre is one that can lower the risk of colorectal cancer. “As fibre moves along the colon, it rubs against the wall, keeping it clean and healthy,” he adds.
THIS is an Assunta Hospital initiative to increase awareness on colorectal cancer. It will be held from 11am to 4pm on March 4 at the New Wing entrance of 1Utama, Petaling Jaya. It will start with free basic health screening, quizzes on colorectal cancer titled Hunt 4 Blue, free official merchandise handouts, healthy yummy treats, fun contests, including “Scope N’ Skip” telematch and a host of other exciting activities. Log on to Facebook, search for March4BLUE and hit the “Like” button to show your support. Register ahead to participate in the activities on the Facebook fanpage.