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Rare case of early detection

Patient N.T.G (61 years old, K����) was one of the lucky few who accidentally discovered the disease at an early stage during a routine health check-up at K���� two years ago.

At the time, the patient felt generally healthy, experiencing only occasional bowel irregularities. Wanting to stay on top of their health, they consulted a gastroenterologist and underwent the necessary tests, including a gastroscopy and colonoscopy.

Test results revealed hidden blood in the stool, with an alarmingly high level of CEA (a tumor marker for digestive cancers). More concerningly, the patient’s colon had multiple polyps, and a large tumor was detected in the cecum. Both immediate biopsy results and later pathological analysis confirmed adenocarcinoma, a type of colorectal cancer.

Fortunately, the cancer was detected at stage 1, making treatment relatively straightforward. The patient only required surgery, followed by routine colonoscopies and health check-ups. Two years after the diagnosis, the patient remains in good health and leads a completely normal life.

Late-stage diagnosis despite only experiencing fatigue

Unlike N.T.G., another patient at K���� was diagnosed at an advanced stage when the tumor had already grown significantly, occupying nearly the entire transverse colon and spreading to surrounding lymph nodes.

During a trip to Vietnam, the patient visited K���� due to persistent fatigue. After an initial consultation and basic tests with a general practitioner, the cause of fatigue was identified as iron-deficiency anemia. Additionally, the patient experienced bloating and epigastric pain, prompting a referral to a gastroenterologist for further evaluation.

Suspecting a gastrointestinal cause of the iron deficiency, the doctor ordered a colonoscopy. The results revealed a massive tumor obstructing almost the entire transverse colon. The tumor had been slowly bleeding, causing iron deficiency and anemia. A CT scan with contrast confirmed the presence of multiple lymph node metastases around the colon.

Since the cancer was diagnosed at a late stage, the treatment process would be significantly more challenging, requiring a combination of surgery, chemotherapy, radiation therapy, and targeted therapy.

Early screening: the key to saving colorectal cancer patients

Both patients had one thing in common—their initial symptoms were vague and easily ignored. However, in the first case, routine screening led to an early diagnosis, significantly improving the patient’s chances of a full recovery.

Assoc. Prof. Dr. Nguyen Quang Duat – Gastroenterology and Hepatology Department, K����, states: “According to the latest recommendations from Vietnamese Federation for Digestive Endoscopy people over 45 with symptoms such as bowel movement disorders or changes in stool should undergo colorectal cancer screening to detect the disease early and improve treatment outcomes.”

This recommendation aligns with those of major health organizations worldwide. Recent data from the American Cancer Society indicates that colorectal cancer has become the leading cause of cancer-related deaths in men and the second leading cause in women under 50. However, when detected early, colorectal cancer is highly treatable, with a five- to ten-year survival rate nearing 100%. Recognizing this, the American Cancer Society revised its screening guidelines in 2018, lowering the recommended age for routine colonoscopies from 50 to 45.

For individuals at higher risk, screenings should begin even earlier, around age 40 or younger. High-risk groups include those with inflammatory bowel diseases such as Crohn’s disease or ulcerative colitis, a family history of colorectal polyps or cancer, and those with genetic conditions like familial adenomatous polyposis (FAP). Additionally, anyone with a positive fecal occult blood test (FOB) should undergo further testing, regardless of age.

Dr. Quang Duat explains: “Risk stratification should be conducted before deciding on a screening strategy and selecting an appropriate method for colorectal cancer screening. The most effective approach is colonoscopy, which enables the early detection of precancerous lesions and abnormal signs, the removal of polyps, and biopsy for histopathological analysis.”

To ensure accurate colorectal cancer screening results, proper preparation before the colonoscopy is crucial. Patients are guided to use bowel-clearing agents in a split-dose method to increase lesion detection rates and avoid missing polyps during the colonoscopy.

Colorectal cancer is not a death sentence if detected early. Be proactive—schedule regular health check-ups to protect yourself and your loved ones.

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