The recent passing of a popular American actor at the age of 48 has sent shockwaves through the international community. While he may not be very well-known among Singaporeans, his story carries a particularly urgent message for all of us here in Singapore, and for good reasons.
James Van Der Beek, most famously known for his role in Dawson's Creek, was said to had been in "amazing cardiovascular shape" before his diagnosis. Despite having no family history of the disease, he was surprisingly diagnosed with Stage 3 colorectal cancer—a condition he initially brushed off as a minor digestive quirk.
In Singapore, colorectal cancer is the most common cancer among men and the second most common among women. His experience serves as a vital wake-up call: cancer does not always look like a "sick" person, and the symptoms we often dismiss as "just something I ate" or "too much coffee" could be our body’s way of sounding an alarm.
The Danger of "Explaining Away" Symptoms
The actor revealed that his first sign was a simple change in bowel habits. Like many busy professionals in Singapore, he tried to rationalise it. He initially thought he needed to cut out cream from his coffee or stop drinking caffeine altogether. When the changes persisted despite these dietary tweaks, he finally sought medical advice.
This "rationalisation" is a common trap. We often blame our hectic lifestyles, spicy hawker food, or lack of sleep for feeling "off." However, as medical experts point out, the key factor is persistence. If a symptom doesn't go away after a few weeks, it requires professional investigation, regardless of how healthy you think you are.
Five Red Flags You Should Never Ignore
Medical professionals have highlighted five specific symptoms that often appear subtle but can indicate bowel cancer:
- Persistent Change in Bowel Habits: This is often the earliest indicator. It could mean going to the toilet much more or less frequently than usual, or experiencing ongoing diarrhoea or constipation. You might notice your stools becoming looser, narrower, or "pencil-thin" for several weeks.
- The Sensation of Incomplete Emptying: Even after using the bathroom, you might feel as though there is still something left inside. This persistent feeling, known medically as tenesmus, is frequently dismissed but is a significant sign that something in the lower bowel needs checking.
- Blood in the Stool: This is a major red flag. Blood may appear bright red on the toilet paper, or it may be mixed within the stool, making it look dark maroon, black, or tarry. Many Singaporeans delay seeing a doctor out of embarrassment or by assuming it is just "heatiness" or piles (haemorrhoids), but any repeated bleeding must be investigated.
- Ongoing Abdominal Pain and Bloating: Persistent bloating, cramps, or a dull ache in the stomach are often mistaken for IBS or food intolerances. If the pain keeps coming back, feels like a "colic" sensation, or worsens after eating, it should not be self-treated with over-the-counter antacids indefinitely.
- Unexplained Weight Loss or Fatigue: Feeling unusually wiped out or short of breath—often due to anaemia caused by hidden internal bleeding—is a serious warning sign. If you are losing weight without trying, especially alongside bowel changes, your body is telling you something is wrong.
Why Singaporeans Are at Risk
While the actor’s case was surprising given his fitness, the reality is that our modern Singaporean lifestyle contains several risk factors that make us particularly vulnerable to colorectal cancer.
- Dietary Habits: Our love for food is a national identity, but many local favourites are high in red meats (like beef and mutton) and processed meats (such as bak kwa, sausages, and luncheon meat). Diets high in these foods and low in fibre—often a result of eating out frequently at hawker centres where vegetables are a side thought—are strongly linked to increased cancer risk.
- Sedentary Lifestyle: Many Singaporeans spend long hours at a desk or commuting. A lack of physical activity slows down the digestive system, increasing the time that potential carcinogens stay in contact with the bowel lining.
- The "Younger" Trend: While cancer risk traditionally increases after age 50, Singapore is seeing a worrying trend of "early-onset" colorectal cancer in individuals under 50. This mirrors the actor’s experience and suggests that lifestyle factors are catching up with younger generations sooner.
- The "Heatiness" Myth: Locally, there is a tendency to attribute digestive issues or blood in the stool to "heatiness" or a poor diet. While lifestyle does play a role, self-diagnosing with herbal tea instead of seeing a doctor can lead to dangerous delays in diagnosis.
Where and How to Get Screened in Singapore
The good news is that colorectal cancer is highly preventable and treatable if caught early. Singapore has robust systems in place to help residents stay ahead of the disease:
- The FIT Kit (Faecal Immunochemical Test): This is a simple, painless stool test you can do in the privacy of your own home. It detects trace amounts of blood not visible to the naked eye. The Singapore Cancer Society (SCS) provides these kits free of charge to Singaporeans and Permanent Residents aged 50 and above.
- Screen for Life (SFL): Under this National Health Screening Programme, eligible Singaporeans can go for colorectal cancer screening (FIT) at a very low cost (often $0 to $5) at participating CHAS GP clinics.
- Colonoscopy: For those with a family history or those who receive a positive FIT result, a colonoscopy is the gold standard. It allows doctors to look inside the colon and even remove polyps (pre-cancerous growths) before they turn into cancer. This procedure is Medisave-claimable at public and private hospitals.
Taking Action
Early detection is the difference between a manageable condition and a life-threatening one. If you notice any of these symptoms persisting for more than three weeks, do not wait. Visit a GP or a polyclinic. In a fast-paced city like Singapore, we often put our health on the back burner to focus on work and family, but listening to your body is the most important job you have.