#ASK THE EXPERT

Ask The Expert: How To Prevent The Most Common Types Of Cancer For Men

Know what increases your risk of pancreatic, colon and liver cancer, and how to manage it.

By Steve Thio      30 November 2021

One of the biggest health concerns for everyone is cancer. And among the types of cancer that affect men, the most common are pancreatic, colon and liver cancer. In fact, liver cancer is the fourth most common cancer in Singapore males. We speak to Dr Wang Yu Tien, a gastroenterologist/hepatologist with Nobel Gastroenterology Centre (a member of Healthway Medical), to find out what we can do to prevent and manage fatty liver, as well as pancreatic, colon and liver cancer.

Q: As a gastroenterologist/hepatologist, what do you think is a major health concern that most men in Singapore suffer from? Is there a specific age group that is prone to these ailments?

Dr Wang: One of the major health concerns would be helicobacter pylori infection. It is a chronic infection of the stomach which affects 20 to 30% of Singaporeans, and may cause abdominal pain, bloating, nausea and loss of appetite. The infection may cause peptic ulcers and increase the risk of developing stomach cancer.

Although infection often occurs before the age of 2 when the immune system is immature, symptoms may develop later in life. Acute infection may also develop in adulthood. Helicobacter pylori infection can be treated with medications.

Another health concern is colon cancer which is the most common cancer in Singaporean men. It usually occurs in older patients or those with a family history of colon cancer. It may cause symptoms like abdominal pain, bloating or change in bowel habits.

However, early colon cancer may have no symptoms. Therefore, colon cancer screening is the best way to prevent it. In Singapore, all men above the age of 50 are recommended to go for colon cancer screening which can be done by stool test or colonoscopy.

Q: Some of the top health issues in Singapore include obesity, hypertension and high cholesterol. How do these ailments affect our digestive organs?

Dr Wang: Fatty liver is part of metabolic syndrome, a group of conditions which includes obesity, hypertension and high cholesterol. Fatty liver, also known as non-alcoholic fatty liver disease (NAFLD), is a condition in which fat builds up in the liver.

NAFLD is increasingly common and it is now the most common cause of liver disorders in industrialised countries. In 20 per cent of NAFLD cases, the fat build-up is inflamed, which is known as nonalcoholic steatohepatitis (NASH). Chronic inflammation of the liver leads to hardening of the liver (cirrhosis) which may lead to liver failure and liver cancer, so patients with NASH require regular monitoring. There is no specific medication for treating NAFLD, and treatment is focused on exercise and weight loss. 

Q: Are all these ailments due to lifestyle choices? Or hereditary genetics?

Dr Wang: They are a combination of both.

Q: Pancreatic and liver cancer are among the top killers in Singapore. What are the measures one can take to address/avoid these health issues? And when should one start?

Dr Wang: Liver cancer risk is increased in patients with chronic liver disease such as hepatitis B,C or fatty liver. Patients should regularly follow up with their doctors to assess the progress of their liver disease and undergo treatment where appropriate. Poorly controlled liver disease can lead to hardening of the liver (cirrhosis) which increases the risk of liver cancer. They should undergo regular liver scans for liver cancer.

Pancreatic cancer is less common than colon, stomach, and liver cancers but it has a poor prognosis because symptoms usually don’t develop until the disease becomes advanced, so diagnosis is often made in advanced stages.

Currently, there is no national recommendation to undergo screening. Patients with a family history of pancreatic cancer and chronic pancreas inflammation are at increased risk and should consider screening with an abdominal scan. Smoking, physical inactivity and obesity are associated with increased risk of pancreatic cancer.

Q: As a gastroenterologist/hepatologist, if you had one piece of good health advice for men what would it be? Especially during this pandemic situation?

Dr Wang: The pandemic and the imposed social limitations have resulted in some people developing unhealthy eating habits, reducing physical activity and sometimes foregoing health screening. It is important not to neglect our long-term health by adopting a healthy lifestyle and continuing to go for the recommended medical appointments and screening.

For more information on Dr Wang, visit https://hmc.sg/3bYSQHy

Note: Please consult your GP or physician before embarking on any treatment plan.

Healthway Medical offers special health screening packages for SAFRA members. For more information, visit www.safra.sg/promotions/healthcare-products-and-services#healthwaymedical

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