Meet The Expert: Dr Wong Nan-Yaw

Colon surgery can be done via open surgery or via laparoscopic approach ('keyhole surgery'). The feasibility to perform via laparoscopic approach sometimes depends on the stage of the disease. For instance, a locally advanced disease may not be suitable for a laparoscopic approach. In addition, the stage of the disease may also affect the timing of the surgery. For example, a stage 4 disease with distant sites of spread may benefit from a course of chemotherapy first before considering surgery especially if the colon cancer itself is not causing too much symptom.

The success of colon cancer surgery depends a lot on the stage of the disease. The earlier the stage, the higher the chance of cure of the cancer. However, with current options of chemotherapy regime, it is still possible to achieve a high chance of cure with later stages of colon cancer. For instance, when the cancer has spread to the liver (stage 4), and liver alone, by removing all the tumor nodules in the liver, together with chemotherapy treatment, it is possible to achieve 40% to 50% chance of long term survival.

According to the current screening guidelines for colorectal cancer released by the Ministry of Health Singapore, there are 3 risk categories, namely average risk individual, increased risk individual and high risk individual. A direct family member of a patient with colon cancer is an increased risk individual. If the patient with colon cancer (your family member) was diagnosed before the age of 60 years, you are recommended to undergo colonoscopy once very 5 years starting at an age 10 years before the patient developed the cancer.

Transanal endoscopic surgery is a method of keyhole surgery without creating a scar by using the anus as a natural orifice access. A camera and 2 small keyhole instruments can be inserted to allow the surgery to be performed. It is used to remove benign growths in the rectum that are deeper than the reach of the surgeon's finger. This is indicated for benign tumours between 7-12cm from the anus.

Colon cancer surgery is complex and requires a team of specialists, nurses and specialised equipment. The average number of days in hospital is 7-10 days after the operation. As the cost depends on the complexity of the case and the technique used, it is difficult to quote a number but it would roughly range from $40,000 to $70,000 all inclusive. Colorectal cancer surgery is Medisave and insurance claimable. It would be best to contact your insurance provider as they are the best persons to answer your policy questions.