On-line presentation via Zoom application catering to the public of Miri. Presentation delivered in layman terms, encompassing occurrence, risk factors and symptoms that suggest colon cancer. Also covered on methods to be adopted to reduce risks of colon cancer, screening tools and principles of managing colon cancer patients.

1. Understanding Colon Cancer
Dr Chea Chan Hooi
Surgeon
Borneo Medical Centre (Miri)
15th July 2020

2. Content
• Introduction
• Epidemiology
• Risk factors
• Symptoms
• Investigations
• Treatment
• Screening
• Conclusion

3. Introduction
• The second most common
cancer in Malaysia
• Usually affects older people
• Begins as a polyp which then
grows over time (between two
to five years) to become cancer

4. Colon cancer occurence in Asia

5. Lifetime cancer risk in Malaysia
Male
• General 1 in 15
• Chinese 1 in 39
• Malay 1 in 72
• Indian 1 in 82
Female
• General 1 in 74
• Chinese 1 in 49
• Indian 1 in 91
• Malay 1 in 100

6. Top 10 most common cancer in Malaysia, 2007 -
2011

9. Risk factors
Modifiable
• Diet
• Obesity
• Smoking
• Excessive alcohol intake
• Inflammatory bowel disease
Non-modifiable
• Genetic predisposition
• Family history
• Aging

10. Modifiable risk factors

13. Non-modifiable risk factors
• Aging
• Genetic
• Family history

14. What are the symptoms that
might suggest colon cancer?

17. Tenesmus

20. Investigations
• Fecal occult blood test
• Cancer marker
• Colonoscopy

21. Fecal occult blood test
• Test for blood cells in stool
• Falsely raised if taking certain medication (e.g. aspirin) or high-iron
food

22. Cancer marker
• CEA
• Function
• To assist in screening
• Monitoring response to treatment
• Detect recurrence after treatment
• Not diagnostic
• Levels not elevated in up to 30% colon cancer patients
• Also detected in lung cancer

23. Colonoscopy

24. CT scan staging

25. Surgery - Laparoscopic

26. Surgery - Conventional open surgery

28. Chemotherapy and radiotherapy

29. Five year survival rate for colorectal cancer

30. Screening
• People with no symptoms
• Population
• Normal-risk
• High-risk
• Family history
• Previous colonic polyp
• Previous inflammatory bowel disease
• Methods
• Fecal occult blood test (FOBT)
• Colonoscopy

31. Screening schedule
Normal-risk
• FOBT every 1 - 3 years, proceed
with colonoscopy if positive
• Colonoscopy every 5 - 10 years
starting from age 45
High-risk
• FOBT every year, proceed with
colonoscopy if positive
• Colonoscopy every 1 - 5 years
Family history
Previous colonic polyp
Previous inflammatory bowel disease

32. Development of colon cancer

33. Conclusion
• Colon cancer is the second most common cancer in Malaysia
• Wide range of treatment options are available
• Early detection will enable higher chance of cure
• Screening is crucial

34. Thank you
E-mail: cheachanhooi@yahoo.com
WA: 0149972321
Tel: 085329333