C The Big
Early detection is imperative when it comes to cancer. We speak to the experts about risk factors, symptoms and when you should see a doctor
Cancer is a killer, even though it doesn’t set out to be so. All it takes is for just one cell to decide that it would rather multiply more than it should, and start growing out of control. This then forms a tumour, which can be benign or malignant. A benign tumour only starts to cause problems if it grows so big that it puts pressure on nearby tissues; but a malignant tumour is much more dangerous as it actively attacks the body. Cancer can happen anywhere in the body and it’s difficult to treat because it’s caused by our own cells going rogue. This means that any treatment that could kill the cancerous cells may also end up damaging our normal, healthy cells. However, there are multiple ways to treat it and getting a diagnosis of cancer is not an automatic death sentence. As with many diseases, the best way to fight it is by adopting healthy lifestyle habits and trying to prevent it from happening in the first place.
Age is a big risk factor for colorectal cancer, says Dr Christina Ng, Medical Oncologist at Sunway Medical Centre and the founder of Empowered, a cancer advocacy society. “Those who are aged 50 and above are at the highest risk. Most colorectal cancers are diagnosed over the age of 60.” According to her, your risk of colorectal cancer doubles if your family has a history of having members diagnosed with the cancer before 60 years old. The younger they are when diagnosed, the higher the risk.
Colorectal cancer can be present for several years before symptoms appear; these include passing bloody stool, persistent diarrhoea or constipation, lower abdomen cramps and unexplained weight loss. However, it’s important to note that these symptoms may not be due to cancer. For instance, blood in the stool may be due to stomach ulcers, Crohn’s disease or haemorrhoids. If symptoms persist for more than two weeks, see a doctor immediately.
The most effective prevention of colon cancer is the removal of precancerous polyps (small bumps) before they turn cancerous, but there is no need to worry unless they are of the adenoma type, which can be tumours and can develop into colorectal cancer over time. “Polyps can often be completely removed using a tool during a colonoscopy,” says Dr Christina.
People who have had adenomas should have regular screening tests as it can help lower your chances of getting colorectal cancer. “Regular screening tests are recommended for those aged 50 and above or younger if you have other risk factors for colorectal cancer,” she advises. Lifestyle changes play a huge part as well. Visit the gym regularly and add more greens to your diet. Cut back on smoking, alcohol and oily food.
Lung cancer affects men and women all around the world. “Globally, lung cancer kills 1.5 million people annually and remains a leading killer cancer regardless of nationality or ethnicity,” says Dr Anand Sachithanandan, Consultant Cardiothoracic Surgeon with a special interest in lung cancer at Sunway Medical Centre.
“There are two main groups of primary lung cancers; non-small cell lung cancer and neuroendocrine tumours, which account for 80 per cent and 20 per cent of cases respectively,” he says. Such primary tumours arise from the lungs itself but may spread to the brain, bone, lymph nodes, adrenal glands or liver by the bloodstream or lymphatic system in a process called metastasis. Secondary lung tumours arise from different organs in the body like kidney, colon and breast, before spreading to the lungs.
Any cancer is an interaction between carcinogens – an environmental and dietary risk factor that triggers a cancerous pathway – and a genetic predisposition. According to Dr Anand, each of us has a different threshold or trigger before a mutation results in a cancerous process.
In recent years, cases of lung cancer have increased among nonsmoking Asian females simply because there is an over-expression of the epidermal growth factor receptor gene in these individuals. The cancer affects Malaysian Chinese twice as much compared to non-chinese Malaysians regardless of age and gender.
Globally, lung cancer kills 1.5 million people annually and remains a leading killer cancer”
In Malaysia, cigarette smokers constitute 80 to 90 per cent of lung cancer sufferers. “Cessation of smoking is the single most important and preventable step in attenuating the risk of developing lung cancer,” says Dr Anand. Previous scarring of the lungs from tuberculosis, emphysema, prolonged exposure to asbestos, exposure to radon gas and passive smoking contributes to the risk as well.
What are the symptoms of having lung cancer? “They include a troublesome persistent cough for more than two weeks, voice hoarseness, recurrent chest infections, haemoptysis, unexplained weight loss and chest pain,” says Dr Anand.
Early stage lung cancer is usually best treated with surgery to remove tumours. After successful surgery, the patient may require chemotherapy, immunotherapy or radiotherapy to reduce the chance of a recurrence.
Gastrointestinal cancer is common among food-loving Malaysians. It’s as deadly as colorectal cancer but is the seventh most common cancer in the age group of 50 and above, according to Dr Ramesh Gurunathan, Upper Gastrointestinal & Obesity Surgery at Sunway Medical Centre.
Generally food plays an important causative factor, and lifestyle habits like alcohol consumption and smoking come right after. Preventive measures like going for regular medical examinations for those who are high risk are crucial.
Gastric cancers are more common in Malaysians, especially the Chinese, compared to expats. “This is due to the nature of food and the prevalence of a type of bacteria called Helicobacter Pylori, which is a cancer-related bacteria among Malaysian Chinese,” says Dr Ramesh. While expats – especially from the West – might have a low incidence of gastric cancer, colorectal and oesophageal cancers are common among Caucasians.
“Endoscopy is a fairly easy way to detect early gastrointestinal cancers,” Dr. Ramesh says. If you are diagnosed early, you’ll also need immediate treatment as there is a high chance of curing it. Treatments include nonsurgical and surgical methods, chemotherapy and radiotherapy.
No matter what type of cancer you might be at risk of, always go for regular check-ups. See a doctor whenever you feel any changes in your body as early detection means a better chance to heal. EL