New treatments, including targeted radiation, which have come into use over the years, have helped to raise median survival rates of end- stage colorectal cancer victims.
Twenty-five years ago, a victim would have just six to eight months left to live. Today, median survival has risen to 26 to 30 months in developed countries such as the United States, those in Europe and Singapore, said Dr Donald Poon, consultant medical oncologist at Raffles Cancer Centre.
Ms June Poon, 69, is one patient who has benefited from the new procedures. The office administrator was diagnosed with stage four colorectal cancer in December 2012.
A scan showed that the cancer had spread not only to her liver, but also to her ovary and peritoneum, which is the membrane lining the abdominal cavity.
She had surgery at Singapore General Hospital (SGH) to remove the tumours in the colon and ovary. But it was not possible to operate on those in her liver and peritoneum.
She then underwent several rounds of different types of chemotherapy. With these treatments, her cancer was kept under control for two years.
In the middle of last year, the cancer started to grow again, mainly in the liver.
Her oncologist at the National Cancer Centre, Singapore, Dr Iain Tan, then suggested that she undergo selective internal radiation therapy (Sirt).
In this procedure, a small catheter is inserted into the main blood vessel supplying the liver, and tiny microspheres or beads are passed through it.
These beads deliver radiation therapy directly into the tumour in the liver. It was a day procedure and she was awake throughout.
The therapy has so far worked very well for Ms Poon, said Dr Tan.
After that session in November last year, her cancer markers have come down and she has been in stable condition since.
"I am in good spirits most of the time and even travelled to Hong Kong recently," she said.
She is healthy enough to walk to SGH for her check-ups from her home near Chinatown, and has been going back to her office for a few hours a week to clear her work.
It has been more than nine months after her radiation therapy, and she has not required any further treatment and her cancer is still under control.
Colorectal cancer treatment has advanced tremendously in the past 20 years, said Dr Tan.
There are now many different chemotherapeutic drugs and targeted therapeutics available to control it, including Sirt. They are able to shrink the tumours, delay their growth and improve symptoms, so that patients live longer and better lives, he added.
Those whose cancer has spread only to the liver and who have it successfully removed surgically can even be cured - which means surviving beyond 10 years. This is despite the cancer being considered as stage four, said Dr Poon.
Ng Wan Ching