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Q: What is colorectal cancer? 

A: Colorectal cancer is cancer that develops in the large intestine (colon) or rectum. It usually starts as benign growths called polyps that over time become cancerous. 

 

Q: What symptoms should I watch out for with colorectal cancer? 

A: Common symptoms include: 

• Changes in bowel habits (e.g., diarrhea, constipation) 

• Abdominal discomfort or bloating 

• Fatigue and unexplained weight loss 

• Blood in stools, which can be visible or detected through stool analysis. 

Note: Early-stage colorectal cancer often doesn't cause noticeable symptoms, which is why screening is important. 

 

Q: How is colorectal cancer diagnosed? 

A: Diagnosis involves several steps: 

• Endoscopy: A lighted tube is inserted through the anus to view the inside of the colon and rectum. A tumour found within 15 cm from the anus is considered rectal cancer, while those further up are colon cancer. 

• Radiological tests (e.g., CT scan, MRI) to locate and measure the tumour. 

• Blood tests: A tumour marker called carcinoembryonic antigen (CEA) may be measured but is not solely used for diagnosis. 

• Biopsy: A laboratory analysis of tissue from the tumour confirms the diagnosis through histopathology. 

  

Q: What happens if I have cancerous polyps? 

A: Cancerous polyps found in the colon should be removed. If the cancer has spread into deeper layers of the bowel wall, additional surgery might be needed. The treatment depends on the extent of the invasion. 

 

Q: What are the treatment options for colorectal cancer? 

Treatment is based on the stage of the cancer: 

• Stage 0: Cancer is confined to the superficial layer of the bowel wall. Surgery to remove the tumour is usually sufficient. 

• Stage I: Cancer has reached deeper layers (submucosa) and possibly the muscle of the colon or rectum. Surgical removal of the tumour and local lymph nodes is recommended. 

• Stage II: Cancer has invaded the muscle of the intestine and surrounding organs. Treatment involves surgery to remove affected tissues, and chemotherapy for colon cancer or chemoradiotherapy (chemotherapy + radiotherapy) for rectal cancer. 

• Stage III: Cancer has spread to adjacent structures and regional lymph nodes. Treatment includes surgery, adjuvant chemotherapy for colon cancer, and chemoradiotherapy for rectal cancer. 

• Stage IV: Cancer has spread to distant organs (e.g., liver, lungs). Treatment focuses on chemotherapy and targeted biological therapy. Chemotherapy aims to shrink metastatic tumours to potentially make them operable. 

 

6. What is the follow-up plan after treatment? 

Q: How often will I need follow-up appointments after colorectal cancer treatment? 

A: The follow-up plan depends on your cancer stage and type of treatment received. In general: 

• Your doctor will schedule visits after treatment to monitor for side effects, check for recurrence, and support your recovery. 

• Follow-up may last up to 5 years, with periodic visits to ensure you're returning to normal life. 

 

Q: Are there any new advancements in colorectal cancer treatment? 

A: Yes, recent advancements include: 

• Targeted therapies: New drugs are designed to target specific molecules involved in cancer cell growth, providing more effective and less toxic treatments. 

• Immunotherapy: This helps the body's immune system recognize and attack cancer cells. Drugs like nivolumab and pembrolizumab have shown promise for certain types of colorectal cancer. 

• Genetic testing: Testing for mutations, such as KRAS, NRAS, and BRAF, helps doctors select the most effective treatments tailored to the patient. 

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Q: What can I do to reduce my risk of developing colorectal cancer? 

A: You can reduce your risk by: 

• Eating a healthy, balanced diet rich in fiber and low in red meats and processed foods. 

• Staying physically active and maintaining a healthy weight. 

• Limiting alcohol and quitting smoking. 

• Regular screenings, especially for those over 50 or with a family history of colorectal cancer.