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Colon Cancer Can Be Beaten With Effective Prevention and Treatment


  • Some types of colonic polyps have the potential to develop into cancer after 3-5 years. If these polyps can be identified through screening, they can be removed before the cancer has the chance to take hold.
  • Undergoing colonoscopy at the age of 45 and above, even when no symptoms are presented, can help reduce the mortality rate resulting from colon cancer.
  • There are currently various colon cancer screening techniques available, such as narrow band imaging (NBI) which shows flat polyps more clearly and allows for immediate polyp removal without the need for surgical incision.


Colon cancer is a disease that results from normal colon cells mutating and then dividing until there are so many of them that the body cannot cope. In its early stages, the disease may occur as a tumor, but if it is left untreated and is not removed, it could lead to the onset of cancer.

Studies have found that undergoing colonoscopy when reaching the age of 45 years, even when no symptoms are displayed, can dramatically reduce the mortality rate that result from colon cancer. Samitivej Hospital offers polyp screening which can identify up to 60% of polyps before they have the chance to develop into colon cancer, while the international average is currently at just 25%*. The faster a polyp can be identified, the greater the chance of successful treatment thereafter.

Nevertheless, for high risk groups who have a family history of colon cancer, it is recommended that 10 years be subtracted from the age at which that family member contracted the disease, as this will provide the age at which colon cancer screening should be carried out for that family member’s relatives. For instance, where a father contracted colon cancer aged 40, subtract 10 and the result is 30. Hence, his offspring should come in for colonoscopy once they reach the age of 30, regardless of whether any symptoms are displayed. They are considered to be at a much higher risk than the general population.

Symptoms of colon cancer

Many colon cancer cases do not display any symptoms whatsoever, meaning that people are often unaware that they are suffering from the condition. On the other hand, there are some cases where the disease manifests itself as symptoms similar to other conditions associated with the colon and digestive system, again resulting in the sufferer being unaware of the danger they are in. Such conditions include a change in bowel movements, alternating between bouts of diarrhea and constipation, a sudden unexpected loss of weight, severe exhaustion and a loss of color in the face.

Others may experience bloody stools or chronic stomach pain, especially around the abdomen area, all of which could be signifiers of colon cancer that has already reached stages 2-4. Therefore, if you do experience any digestive system irregularities continuously for a period of over two weeks, it is recommended that you attend a consultation to receive a thorough diagnosis of the cause, as well as to receive the appropriate treatment thereafter.

Stages of the disease

The onset of colon cancer can be categorized in to the following four stages:

  • Stage 1: A lump or polyp located in the colon wall tissue
  • Stage 2: The cancer begins to spread into the deeper tissue of the colon
  • Stage 3: Cancer spreads to the lymph nodes
  • Stage 4: At this stage, the cancer will have spread to other organs, such as the liver, lungs and brain

Screening for colon cancer

Screening for colon cancer can be carried out using the latest techniques, including narrow band imaging (NBI). Endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) are forms of painless minimally invasive surgery (MIS). These techniques allow surgeons to remove large polyps from the colon and stomach without the need for an incision into the abdomen, thereby reducing the risks associated with surgery and saving valuable time.

Patients can make a speedy recovery and return to their daily lives much more quickly than if they were to undergo invasive surgery, which also carries the risk of complications that may arise. Screening for colon cancer is therefore much safer and, more importantly, does not leave the patient with any long-lasting scarring that could become a constant source of anxiety.

There are some interesting data available which reveal that 90% of colon cancer identification comes in the form of an adenomatous polyp in the colon. These polyps are considered to be precancerous lesions which have the potential to develop into cancer over the next 3-5 years.

Hence, in cases where a polyp measuring less than 1 cm in size is found, it is recommended that the patient undergoes repeat screening every 3-5 years subsequently and, where polyps of over 1 cm in size are identified, the timeframe for screening is adjusted to every 1-3 years. Regarding those for whom a polyp is not found upon screening, it is advised that subsequent screening take place every 5-10 years (although, for those with insulin resistance, it may be necessary to increase the frequency of screening, depending on the individual’s body state and other associated colon cancer risk factors).

Preparation for colonoscopy

  • The first step is to clear the bowel. Patients will also need to abstain from eating and drinking for six hours before the screening.
  • When arriving at the hospital, the doctor will ask for the patent’s personal medical record, underlying health conditions and drug allergy record, including the medications that patients usually take.
  • The patient will receive laxative to clean the bowel until it is clear and ready to receive the colonoscopy. This may take around 2-3 hours.
  • Next, the doctor will inject the patient with a sedative. This should allow the doctor to see the interior of the colon in detail. However, if the patient is elderly and has a chronic illness, he or she will be administered a weaker sedative in the form of an inhalant, one that is fast-acting but wears off quickly.
  • The screening process should take about 20-30 minutes, but may take up to 45-60 minutes if there are many polyps that require removal.

In total, the colonoscopy procedure will only take around half a day.

The benefits of colonoscopy are that they can help provide an analysis of the issues present in the colon and, where an abnormality is spotted during its initial stages, doctors will be able to treat the disease before it has the chance to spread. Click here to read more about colonoscopy 

Although great strides have been made in terms of medical technologies able to cure colon cancer, preventing the condition from occurring is still much more important. Samitivej Hospital has partnered with Sano Hospital from Japan – an institution with huge amounts of experience in endoscopic procedures – to bring NBI technology to Thailand. NBI can help improve accuracy when identifying polyps by up to double the average rates. Click to read more

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Pathipat Durongpongkasem, M.D. Summary: Internal Medicine Gastroenterology