Colon Cancer Can Be Cured if Detected Early

• Colon cancer screening is performed to detect precancerous conditions and cancer cells in asymptomatic individuals. If abnormalities are found, treatment can be administered immediately, increasing the chance of complete recovery and reducing mortality rates.
• The NBI (Narrow Band Imaging) endoscopic technology from Japan, when combined with Artificial Intelligence (AI), enhances the detection quality of gastrointestinal lesions, making early-stage polyps 1.5 times more visible than with conventional techniques.
•  AI technology can identify small polyps or those located in hard-to-see areas. If a polyp is found, it can be removed immediately during the examination, reducing unnecessary surgeries.

Colon cancer is the third most common cancer in Thailand. Patients are often diagnosed only after the disease has spread, which significantly increases the risk of death. Early detection and timely, effective treatment help lower the risk of mortality and increase the chances of a full recovery.

Colon cancer is caused by abnormal changes in the tissues of the colon and rectum, leading to continuous and uncontrolled cell division, eventually forming a mass or tumor. In the early stages, this may present as small growths called polyps. If left untreated, these polyps can develop into cancer, potentially becoming aggressive and invading the intestinal wall or spreading to other parts of the body.

•  Age over 45
• Alcohol consumption
• Smoking
• Lifestyle habits such as frequent consumption of red meat in large quantities, low intake of fruits and vegetables, inadequate water intake, and lack of exercise

Colon cancer may not show any symptoms until it has progressed. Common symptoms include:

• Alternating constipation and diarrhea that is unusual for the patient
• Chronic diarrhea
• Black or dark red stools, presence of fresh blood or blood mixed in the stool
• Narrowed stool caliber
• Feeling of incomplete evacuation, rectal pressure or pain
• Fatigue or weakness due to anemia or iron deficiency
• Unexplained weight loss
• Chronic abdominal pain, particularly in the lower abdomen, or the presence of a palpable mass in the abdominal area

Colon cancer screening is performed to detect precancerous conditions and cancer cells in asymptomatic individuals. If abnormalities are detected, immediate treatment can be provided, resulting in more effective outcomes, increased chances of complete recovery, and reduced mortality. Individuals at high and moderate risk should undergo early screening for colon cancer.

• Age over 45 years
• Having a first-degree relative diagnosed with colon cancer or with polyps, indicating a genetic predisposition to cancer
• Having chronic inflammatory bowel disease

• Aged 45–50 years, or over 50 years with no symptoms
• Presence of risk factors such as regular alcohol consumption or heavy smoking over a prolonged period
• Lifestyle-related risk factors, such as frequent consumption of large amounts of red meat, low intake of fruits and vegetables, and lack of physical activity

  

Screening for colon cancer can be conducted through various methods, depending on the risk group, as follows:

1. High-Risk Group:
   Colonoscopy is recommended for colon cancer screening. This method allows for detection of polyps, and if the polyps are not excessively large, they can be removed during the same procedure. Notably, over 90% of colon cancer cases originate from small polyps. Adenomatous polyps (adenomas) are considered precancerous lesions, with the potential to progress into cancer within 5–10 years.
2. Moderate-Risk Group:
   Multiple screening methods are available, including fecal occult blood test (FOBT), barium enema X-ray, CT colonography (virtual colonoscopy), or colonoscopy as an alternative option for screening.

Samitivej Hospital is a pioneer GI center in Bangkok has established a medical collaboration with Sano Hospital in Japan, a globally renowned institution recognized for its expertise in removing large colon polyps at an early stage using gastrointestinal endoscopy techniques. Samitivej has sent doctors to train and exchange knowledge, enhancing their skills in endoscopy and colon surgery. At the same time, doctors from Sano Hospital have been visiting Samitivej annually since 2015 to provide education and conduct case studies for patients.

The principle behind the Japanese Narrow Band Imaging (NBI) technique involves the use of green and blue wavelength light projected onto the intestinal wall, which absorbs the light and enhances the visibility of blood vessels on the gastrointestinal mucosa. This allows for clearer observation of two abnormal characteristics: changes in the mucosal surface and irregular patterns of capillaries. As a result, flat lesions resembling the normal intestinal lining, such as serrated polyps, can be detected more effectively.

The EndoBRAIN-EYE endoscopic program is designed to detect polyps within the lower gastrointestinal tract and is compatible with lower GI endoscopy systems. If a polyp is detected in the colon, the system will immediately notify the doctor via an on-screen alert.

Samitivej Hospital has implemented the Japanese NBI technique in combination with AI-assisted colonoscopy, a technology that enhances the quality of gastrointestinal lesion detection. This combined approach, referred to as EndoBRAIN, improves the visibility of early-stage polyps by up to 1.5 times compared to conventional techniques. The AI-assisted colonoscopy system captures real-time endoscopic images and identifies small or hard-to-see polyps. When such polyps are detected, the AI system issues a flashing visual alert and an audible signal, increasing the likelihood of detecting small polyps.

Research comparing the effectiveness of the EndoBRAIN technique with standard methods shows that EndoBRAIN can detect up to 1.5 times more polyps. It serves as an intelligent assistant in polyp detection and enables immediate removal of polyps during the procedure, helping to reduce unnecessary hospital visits and surgeries.

• Surgery: Surgical intervention can be performed at any stage of the disease. The doctor may also consider combining surgery with radiation therapy and/or chemotherapy.
• Chemotherapy: Chemotherapy may be administered orally or by injection into a vein or muscle, allowing the drug to be absorbed into the bloodstream to inhibit the division or destroy cancer cells. It can be used before and/or after surgery, with or without concurrent radiation therapy. Chemotherapy may cause side effects that impact normal cells and the function of other organs, such as nausea, vomiting, loss of appetite, and hair loss.
• Radiation Therapy: High-energy waves are used to destroy or inhibit the growth of cancer cells and help reduce the risk of recurrence. Radiation therapy can be combined with chemotherapy to enhance treatment efficacy.
• Targeted Therapy: This is a precise treatment designed to kill cancer cells while sparing surrounding healthy cells, resulting in fewer side effects. It is often used in patients with metastatic cancer, in combination with chemotherapy. Studies have shown that targeted therapy can extend overall survival and prolong disease-free intervals compared to chemotherapy alone.
• Immunotherapy: This approach stimulates the body’s immune system to better detect and destroy cancer cells, increasing the chance of long-term survival. It is mainly used in patients with metastatic cancer and requires detailed tumor tissue analysis to ensure optimal treatment effectiveness.
  

Patients who have been successfully treated for colon cancer remain at risk for recurrence, either at the original site or in other parts of the colon. Therefore, regular follow-up as recommended by a doctor is essential. During the first two years, follow-up visits may be scheduled every 3–6 months, including a colonoscopy every 6 months and abdominal X-rays every 3–6 months. After two years, if no recurrence is detected, the follow-up interval may be extended to once per year for up to three years.

In addition to attending scheduled medical appointments and continuing with annual health check-ups, patients should also reduce other risk factors. This includes limiting the intake of red meat and high-fat foods, increasing the consumption of fruits, vegetables, and high-fiber foods to support healthy bowel movements, exercising regularly, getting sufficient rest, maintaining mental well-being, and managing stress. These lifestyle habits contribute to overall health and help reduce the risk of colon cancer recurrence.