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1. How common is colorectal cancer in women?

Colorectal cancer is the second most diagnosed cancer in women after breast cancer. It is also the second most common cause of cancer death in women.

Between 2015 – 2019 in Singapore, 5253 women were diagnosed with colorectal cancer and 2015 women died from colorectal cancer*.

2. How is colorectal cancer diagnosed?

Patients who are suspected to have colorectal cancer will undergo a colonoscopy. This is a procedure where a long flexible tube with a camera at the end is inserted into the rectum and colon. Doctors can see any suspicious areas inside the rectum or colon and take a biopsy. The tissue from the biopsy is sent to the laboratory for a pathologist to determine if the tissue is cancerous or not.

3. How is colorectal cancer treated?

Treatment for colorectal cancer can involve surgery, chemotherapy and radiotherapy in different combinations depending on the stage of cancer. The treatment plan for each patient is usually decided by a team of doctors.

4. What are the side effects of radiotherapy treatment unique to women?

Radiotherapy will have slightly different side effects for women as compared to men. General side effects such as lethargy, skin changes, urinary symptoms and diarrhea are common for both genders. These side effects are usually mild and will improve once treatment is completed.

In women, vaginal dryness leading to dyspareunia (painful sexual intercourse), early menopause or infertility may occur. This is because the gynaecological organs (ovaries, uterus, cervix and vagina) in the pelvis of a women will be included in the radiation field and may be affected by it resulting in the abovementioned side effects.

Women are more likely to develop pelvic insufficiency fractures from radiation. This is due to weakening of the bones or osteoporosis leading to small cracks in the pelvic bone. This is more common in women as they are more likely to suffer from osteoporosis as they age.

5. What can I do to alleviate these side effects?

The use of estrogen creams and lubricating gels can help with vaginal dryness and dyspareunia.

Increasing your calcium intake and doing regular weight bearing exercise safely can help to prevent or delay osteoporosis.

This article is contributed by Dr Michelle Tseng Shu Fen, Women’s and Children’s Program Director & Consultant Radiation Oncologist at Asian Alliance Radiation & Oncology (AARO).

* Reference: Singapore Cancer Registry Annual Report 2019