Singapore Health & Wealth Advice: 'It felt like I was being stabbed'

His stomach was bloated and his stools were loose and dark.

At just 26 years old, he found out that he had stage three cancer of the colon.

Kiat (not his real name) is among the youngest to be affected with the disease, which normally affects those past the age of 50.

Colorectal cancer runs in his family, and his father and aunt had developed the same condition before.

For Kiat, a Singapore permanent resident, it started when he developed stomach cramps two years ago.

Said the IT consultant, now 28: "I didn't think it was anything. I mean, many people get abdominal pain."

But then, he started losing weight, going from 60kg to 53kg in just a few months.

The regular blood donor of six years was also surprised when he was turned away from donating blood.

He said: "I was told I had low blood pressure. I had also been feeling faint several times a month."

Then, in December 2010 when Kiat was in Malaysia, the bus he was on made a sudden turn, and he felt a sharp pain.

He said: "It was like I was being stabbed with a knife, like something tore inside me."

He bore with the pain for the rest of the trip, but when he returned to Singapore a few days later, he developed a fever.

Feeling weak and unsure if he could get help by himself, he called for an ambulance to take him to hospital.

Surgery

Initially thinking that Kiat was suffering from appendicitis, the doctors scheduled for him to undergo surgery to remove his appendix.

But during the operation, they noticed a hole in his colon.

It was then that they found out that he had colon cancer.

The cancer, caused by a hereditary gene leading to a condition called lynch syndrome, had spread to the lymph nodes in his abdomen.

Kiat said: "The cancer had literally eaten a hole in my colon. I was shocked. "I kept thinking that I was so young. I don't smoke or drink - why was this happening to me?"

His wife, 29, a Singapore PR who also works in the IT sector, said: "He kept asking the doctors how long he had left. He couldn't eat and kept crying.

"I was so scared of losing him. I prayed every day for him to get better."

The couple do not have children. To prevent Kiat's cancer from spreading, doctors removed the lower half of his colon. They also started him on chemotherapy to kill any cancer cells that remained.

For the next eight months, Kiat had the chemo drugs injected into him every three weeks. He said: "I felt physically weak after the sessions. But I kept telling myself that I had to be optimistic, be positive."

To take his mind off the cancer, Kiat continued working whenever he could. He also continued to travel and hang out with his friends watching soccer and playing PlayStation games. The cancer is now in remission.

He was given the all-clear in the middle of last year and is no longer on medication.

Looking back, Kiat is thankful to his wife and family, who supported him throughout my treatment.

He said: "There were days when I was down or had a short temper. But they were always patient and gave me space.

"I want to tell other young people that colon cancer is no laughing matter...If you have any of the symptoms, it's best to see a doctor right away.

"And if you know of someone with such a condition, please try to be understanding and supportive."

Colon cancer can be hereditary

March is National Colorectal Cancer Awareness month.

Colorectal cancer is the most common type of cancer here, The Straits Times reported in May last year. About 30 new cases are diagnosed here every week.

Singaporeans, along with Americans, have one of the highest rates of colorectal cancer in the world, it was reported in March last year.

Only 10 per cent of colorectal cancer patients are under the age of 50. And only 0.5 per cent are under the age of 30.

Such cancers in patients under 50 are usually hereditary, said Dr Koh Poh Koon, a consultant colorectal Surgeon from Capstone Colorectal Surgery Centre .

He added that patients with lynch syndrome, a genetic disorder, have up to an 80 per cent risk of developing colorectal cancer.

Most patients with lynch syndrome develop the cancer in their mid-40s. They are also at a higher risk of developing other forms of cancer. The mutated genes can lead to cancers of the stomach and urinary tract.

Women with lynch syndrome can also get cancer of the ovaries or the endometrium, which is the inner membrane of the womb,said Dr Koh. Such cancers tend to be detected only in the later stages because there are usually no early-stage symptoms.

And symptoms that do show are often dismissed by younger people in the mistaken belief that these cancers affect only older people. Former cancer patient Kiat told The New Paper that he had stools which were almost black in colour.

Blood in stools

It was only after he was diagnosed that he realised that this was caused by blood in his stools. Kiat said:"My colon was actually bleeding. But I didn't know because I didn't see actual blood in my stools."

Dr Koh said: "Often, the only clue we have that we might be at risk of such cancers is a family history involving more than three family members, over two generations.

"This is especially so if one of the affected is an immediate relative or is below 50 years old."

Individuals who suspect something is wrong should strongly consider genetic screening. "It has been shown that early diagnosis and appropriate genetic screening can prevent the number of deaths caused by lynch syndrome," Dr Koh added.

Colorectal cancer is cancer that starts in either the colon or the rectum. It is also commonly
known as bowel cancer.

According to HPB, colorectal cancer is the number 1 cancer in Singapore.

In the early stages, people with colorectal cancer may not experience any symptoms.

In the later stages, the common signs and symptoms include: A change in the bowel habits, including diarrhoea or constipation, and the presence of blood in the stool.

Symptoms typically include rectal bleeding and anemia which are sometimes associated with weight loss and changes in bowel habits.

How to tell if you are at risk:

1. Are you over 50 years old? More than 90% of those diagnosed with CRC are over 50 years old. It is recommended to go for screenings starting at age 50 and continuing until you are 75 years old.

2. Do you have a family history of CRC? If you do, or have a family history of polyps in the rectum or chronic inflammatory bowel disease, it's best to get tested.

3. Do you eat a lot of red meat? Studies have suggested that a high consumption of meat is linked to an increased risk of colon cancer. In all cases the worry is confined to red meat, not chicken.

4. Do you take care of your body? If you don't exercise, smoke or drink a lot, you are at risk.

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