But to the 46-year-old’s shock, she was diagnosed with colorectal cancer.

“I had no symptoms at all. In April 2021, I underwent a colonoscopy and endoscopy, simply because I had entered my 40s. Honestly, I didn’t even know what colorectal cancer was.

“So, when the doctor told me the news, I was completely stunned. I couldn’t believe it, especially since I had no signs like changes in bowel habits, diarrhoea, constipation, changes in stool consistency, or unexplained weight loss,” she told Bernama.

The doctor told her there was a blockage in her rectum and took a biopsy sample. The next day, she had to go for a CT scan. “When I met the gastroenterologist with the results, he confirmed it was stage-three colorectal cancer.”

The mother of three struggled to process the diagnosis: with no family history of colorectal cancer, it felt even more unreal.

“I remember looking at my husband – his face had gone pale and he was in shock. In our society, stage-three or -four cancer is often seen as a death sentence.”

Tengku Nazeehah began learning everything she could about colorectal cancer and sought treatment at Universiti Malaya Medical Centre. Now, over four years later, she is a survivor, having completed surgery, chemotherapy and radiotherapy.

“Today, I only see my colorectal and oncology specialists once a year. I do a CT scan annually and a colonoscopy every three years,” she said, adding that the unwavering support of her husband and children kept her strong.

Tengku Nazeehah is now part of the Colorectal Cancer Survivorship Society Malaysia (Corum), and has been trained by the National Cancer Council Malaysia as a peer-support volunteer, offering guidance to patients while regularly giving talks and sharing her journey.

Second-most common cancer

After breast cancer, colorectal cancer is the second-most common cancer in Malaysia.

General surgeon and colorectal cancer specialist Dr Nurhashim Haron said the cancer – also known as colon or bowel cancer – develops in the large intestine. The term “colorectal” refers to the colon (large intestine) and the rectum (the final part leading to the anus).

Data from the National Cancer Registry shows that between 2017 and 2021, colorectal cancer accounted for 18.8% of cancer cases among men – an increase from 14.8% in 2012-2016.

Among women, colorectal cancer comprised 13.7% of cancer cases from 2017 to 2021, compared to 11.1% previously.

While the disease might show no symptoms in its early stages, bleeding is often the most common warning sign. Other red flags include changes in bowel habits, such as:

• going from defecating once a day to two or three times a day, or bowel movements becoming less frequent;
• abdominal pain that recurs every few weeks;
• changes in stool consistency (constipation, hard pellet-like stools, bloody or mucus-filled stools);
• unexplained weight loss and loss of appetite.

He added that people aged 45 and above are at higher risk, along with those with a family history of colorectal cancer.

Nurhashim noted that Malaysia records an estimated 4,000 to 4,500 new colorectal cancer cases each year, compared with 3,500 to 4,000 cases a decade ago. Alarmingly, most are detected at stage three or four.

The specialist strongly encourages regular screening, even before symptoms appear.

“Colorectal cancer often begins with small growths in the intestine called polyps, each of which has a 30-40% chance of developing into cancer. If we find and remove them early, we can prevent cancer altogether,” he said.

Screening methods include the faecal occult blood test, which detects hidden blood in stool samples. This test can be done at home or in clinics.

“If the results are positive, further diagnostic tests like colonoscopy are required,” he said. Treatment for colorectal cancer would involve surgery and chemotherapy.

‘Sensitive topic’

Despite advances in medicine, colorectal cancer remains a sensitive topic in Malaysia.

“Many people feel embarrassed to talk about stool or rectal symptoms, so they delay seeking help. Some confuse cancer symptoms with haemorrhoids, which can cause bleeding and mucus but are not life-threatening.

“The danger is when people dismiss warning signs as haemorrhoids when it is actually cancer,” Nurhashim cautioned.

He advises the public to stay alert and informed about colorectal cancer as it can be prevented if detected and treated early, giving patients a much higher chance of recovery and survival.

“Maintain a healthy lifestyle with regular exercise, avoid smoking and drinking alcohol, and prevent obesity. Those with a family history of colorectal cancer, or anyone concerned about their risks, should see a doctor for screening.”