The month of March is Colorectal Cancer Awareness Month in Singapore:
If you are over 50, or have loved ones who are 50, make sure you are screened for colorectal cancer:
1. Fecal Immunochemical Test (FIT)
- Detects the presence of small amounts of blood (that can t be seen with the naked eye) in the stools.
- Is safe, quick and easy to do, and can be done at home, without the need to change your diet before the test.
- Should be done once a year
2. Colonoscopy
- Uses a flexible tube (colonoscope) to look at the inner lining of the large intestine (colon and rectum).
- Takes about 20 30 minutes to complete
- Has to be done in a hospital by a doctor trained in doing colonoscopies
- Should be done once every 10 years
- In Singapore, specialist trained in colonoscopies are Gastroenterologist, Colorectal Surgeons, General GI Surgeons. (in some countries only Gastroenterologist do coloscopies and other endoscopic procedures)
Most colon cancers develop from polyps, however polyps are usually asymptomatic, which means they don’t bleed, they don’t cause change of bowel habits and they don’t cause abdominal pain or abdominal discomfort. Polyps however, are easily removed and after doing so almost entirely eliminates the risk of it developing into a cancer.
In my personal opinion, both men and women above 50 should go for a colonoscopy and subsequently repeat the screening once every 10 years. Firstly the FIT test detects blood, which means that if your polyp doesn’t bleed you wouldn’t detect it which is unfortunate, and if it did bleed and the FIT test shows positive, they would still send you to have a colonoscopy done to find out the exact pathology. Either way someone’s got to look up your butt to be sure.
Most people are turned off by the idea of a long black scope snaking up through your butt and a team of human beings staring at your insides on a HD TV screen for what may seem to be an eternity, but just to help ease your nerves:
- You can opt for sedation, where you are semi-conscious, i.e. you’d probably be rambling rubbish to doctors telling them how your colon looks so weird or how the nurses are so nice and pretty and that you are so embarrassed, but you’d probably wouldn’t remember a thing when the drug wears off. Yes… it’s also called the date-Rape drug when abused… Sure thing is, it’ll save you from the discomfort and embarrassment. You should note that you would probably want to take the day off and not do it as a lunch time procedure before heading back to the office as some websites or doctors would offer although i have come across many business professionals transiting in Singapore rushing to Mt E to have their colonoscopy done. They however are doing it fully awake! The sedation drugs take a while to wear off and even after you think you are okay, you’d never know.
- A team of doctors/nurses staring at the screen is probably a good thing as 2 pairs of eyes are better than 1 and 3 are better than 2. Polyps may be as small as 0.5 cm in a 100 cm long colon. you don’t want to miss it.
- An eternity may be too long, but a reassuring 2 mins is definitely too short. During a colonoscopy, endoscopists push in the scope far enough to reach the cecum (end of your large colon). It is only during the withdrawal where they would start the screening proper. much like the view you have above. Very good practitioners can probably finish the whole procedure in 2 mins, however, studies have suggested that a colonoscopy withdrawal time of at least 6 minutes is associated with an increased adenoma detection rate in patients undergoing colorectal cancer screening. Which means if your endoscopist is completing the procedure in 5 mins you probably wanna ask him to have another go.
In an effort to raise awareness of colorectal cancer, award-winning local film maker, Royston Tan lends his hand to save our Singaporean Asses.
A Daily Pill 