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Colorectal carcinoma (CRC) is the second most common cancer in Malaysia (13.2%) as reported in Malaysian National Cancer Registry Report 2007-2011.

According to National Cancer Patient Registry on Colorectal Cancer 2008-2013, the overall incidence rate for CRC was 21.3 cases per 100,000 population. Age-adjusted incidence rate was 1.33 times higher among male than female. The incidence was highest in Chinese followed by Malay and Indian.

The most common presenting symptoms of CRC are altered bowel habit (41.7%) followed by blood in stool (35.5%), abdominal pain (31.5%), weight loss (31.0%), anaemia (9.8%) and intestinal obstruction (9.3%)( CPG Malaysia ).

Colorectal cancer is usually treated surgically with removal of the affected segment of colon or rectum. Patients with cancer of the rectum may require initial treatment with chemotherapy and radiotherapy. This has been shown to enhance the success of surgery in controlling cancer in the pelvis. Radiotherapy is not used to treat carcinoma of the colon. Bowel cancer surgery may be performed either with robotic, laparoscopic (keyhole) or traditional open techniques.

Your doctor will discuss the advantages and disadvantages of each approach with you. At our center most of the operations are done laparoscopically or key hole technique.

Most patients having bowel cancer surgery will have the divided bowel reconnected with an “anastomosis”. Bowel movements occur in the usual way.For patients having surgery for rectal cancer a temporary stoma (ileostomy) may be necessary. This means that the faeces is diverted away from the pelvis and empties into a pouch on the abdominal wall. Patients will tumours close to the anus will occasionally need a permanent stoma (colostomy). Your doctor will discuss the reasons for this and the implications with you.