[Cancer Killer] Mistook bloody stool for hemorrhoids, Suzie Wong diagnosed with stage 3 colon cancer, doctor teaches how to distinguish colon cancer from hemorrhoids

Colon cancer is the third most common cancer in the world and the second most common cancer in Hong Kong. DJ Suzie Wong recently announced on social media that he was diagnosed with stage 3 colon cancer. He had intermittent bleeding in his stool in the past and thought it was caused by hemorrhoids. In fact, his father had also suffered from colon cancer.

There are many ways to detect colon cancer. Recently, a testing company launched a “fecal colon cancer gene test”, adding another option to the testing methods.

Colon cancer is often among the top three most common cancers in Hong Kong. Because there are no obvious symptoms in the early stages of the disease, once diagnosed, it is often in the middle or late stages, so it is called a “silent killer”.

According to data from the Hong Kong Cancer Registry of the Hospital Authority, there is a trend of younger patients with colon cancer in Hong Kong. The incidence rate of colon cancer among 20-44 year olds was 6.8 per 100,000 people in 2010 and rose to 9.1 per 100,000 people in 2019.

The colon is the last part of the digestive tract and can be divided into the colon and rectum. The main function of the colon is to convert undigested food residues into feces and then excrete them from the body. The last section of the colon that connects to the anus is the rectum, which also has the function of temporarily storing feces.

The colon is composed of many types of normal cells, each of which can mutate into cancer, so there are many types of colon cancer, more than 95% of which are adenocarcinomas.

Young patients only in their 20s

Surgical specialist Dr. Leung Kam Fung pointed out that the evolution and formation of colon cancer is not overnight. It takes 5 to 10 years from polyp stage to invasive cancerous tumor. High-risk groups include the elderly, or those who have some bad causative factors such as smoking, chronic constipation or cell mutation.

Dr. Leung pointed out that some cancers are related to aging, but colon cancer has a trend of younger patients, which is partly related to poor lifestyle and eating habits. High-fat and low-fiber diet, alcohol consumption, smoking, etc. increase the risk of colon cancer. Excluding congenital factors that cause intestinal cancer, such as familial polyposis syndrome and congenital syndrome diseases, he has seen young patients with colon cancer as young as 20 or 30 years old. Generally speaking, most patients are over 50 years old.

20% of colon cancer cases are related to genetics, such as familial colorectal polyposis syndrome. There are also some hereditary non-polyposis colorectal cancer patients. This type is a genetic mutation in the body that leads to a tendency to develop cancer easily. But this type of genetic factor is not common. Most colon cancer patients are related to acquired factors.

Pay attention to changes in polyps

“Colon cancer initially starts as a proliferative polyp, then becomes a tubular adenoma, and if left untreated, it will become a villous polyp. There is a chance of developing invasive cancer within 5 to 10 years. Patients with colon cancer may also spread to other parts of the body such as liver, brain, lung and bone.” Polyps may deteriorate into colon cancer. To reduce the risk, polyps should be considered for removal when found in the colon.

He said that symptoms include bloody stool and diarrhea, anemia, and intestinal obstruction when tumors occlude. At this time, treatment may not have ideal results. “But in fact, knowing that there is a process of 5 to 10 years for colon cancer, if screening is done appropriately during the polyp stage, especially for some high-risk people (over 50 years old, habitual high-fat diet, obesity , Alcoholism, smoking and family members with colon cancer), early detection and removal can greatly reduce the chance of developing cancer.”

Common screening methods for colorectal cancer

1.Traditional fecal occult blood test

Patients with colonic polyps, tumors or inflammation may have bleeding situations and mix with feces and excrete them. However, because the amount of bleeding is very small, it is generally difficult for citizens to detect it. Fecal occult blood test can detect whether there is microscopic blood in feces that cannot be observed by naked eyes.

2.New technology for colorectal cancer gene testing

It is the latest fecal DNA testing technology that assesses the risk of developing colonic polyps or cancer by measuring the methylation levels of three biomarkers in the DNA of cells naturally shed from the intestine in feces.

3.Microbial biomarkers and hemoglobin

Using the measurement of 4 microbial biomarkers and hemoglobin in feces, it can detect the non-invasive colorectal cancer risk of small polyps.

4.Colonoscopy

A common method for examining the lower digestive tract, the tube can check the condition of the entire colon; before the examination, you must take a laxative to clean the intestines.

Regular testing is one of the methods to prevent colon cancer. Dr. Leung suggested that those who have no symptoms and no special high-risk factors should start colonoscopy at 45 to 50 years old. If the situation is good, it can be done once every 5 years. If polyps are found and removed, they need to be tested every two or three years.

As for treatment, it depends on the stage of colon cancer. He said that it includes endoscopy, surgical removal, minimally invasive surgery, chemotherapy and targeted therapy. With the screening methods, many early-stage colorectal cancers have been found and can be removed by endoscopy. If it is a late-stage colorectal cancer, it is mostly removed by surgery; if it has unfortunately spread, it may need to be supplemented with chemotherapy and targeted therapy.

Original text: 【癌症殺手】便血以為痔瘡蘇施黃確診大腸癌三期 醫生教如何分辨大腸癌與痔瘡