【Colorectal Cancer: Part 1】Long-Term Stomach Discomfort - Is It Early Signs of Cancer? The Complete Guide from Check-Up to Diagnosis: Explained by Oncologist, Dr. Teo Yin Keong (Johor Bahru)
- 2 hours ago
- 4 min read
Johor Bahru, Malaysia
Many people live with ongoing stomach discomfort for months, sometimes even year — especially in Malaysia, where our rich and diverse food culture is part of everyday life.
From spicy sambal to late-night suppers, it is easy to blame symptoms such as bloating, indigestion, or irregular bowel habits on “something we ate.”
But here is what I often tell my patients:
Common symptoms does not always mean normal.
If your stomach discomfort never truly settles, you need to understand why. Let me break this down clearly into 3 possible scenarios/steps where further medical evaluation may be needed and who you should see at each stage.
Scenario 1: Symptoms are mild & occasional
➜ See a General Practitioner (GP)
If you have mild or irregular stomach discomfort such as diarrhea, constipation, bloating, indigestion, or tenesmus (a constant urge to pass stool but little comes out), the first step is to consult a general practitioner.
What Your Family Doctor May Do:
Performa a physical examination of your abdomen
Arrange blood tests
Arrange stool test
These are preliminary investigations designed to rule out infection, inflammation, anemia or digestive imbalance.
Based on your results, your doctor may:
Prescribe medication and monitor your response
Refer you to a specialist if symptoms persist
‼️ Important Note: At this stage, your GP is performing early evaluation. If symptoms persist despite treatment, insist on further evaluation.
Scenario 2: "Functional" Digestive Problems
➜ See a Gastroenterologist (Stomach Specialist)
If scans and initial tests show no structural abnormality in your digestive organs, but you continue to experience persistent symptoms, you may have what we call a functional digestive disorder. This means:
Your digestive organs look normal on scans, but they are not functioning optimally.
Examples include:
Chronic bloating and indigestion
Irritable bowel syndrome (IBS)
Functional colitis
A gastroenterologist's role is to diagnose and manage these "functional" digestive conditions. Treatment may include:
dietary adjustments
medication
stress management
gut regulation therapy
Scenario 3: "Structural" Digestive Problems
➜ See a General Surgeon or Colorectal Surgeon
If investigations reveal physical abnormality in the colon, you should consult a general surgeon or a colorectal surgeon.
Structural problems include:
Haemorrhoids
Colon polyps
Tumours
Intestinal blockages
A surgeon's role at this stage is to arrange the necessary investigations, such as colonoscopy or imaging scans, to confirm whether there is a growth, blockage or tumour.
If the issue is a benign growth or obstruction ➜ it can often be removed surgically by the surgeon
If colon cancer is detected ➜ consulting a cancer specialist or clinical oncologist becomes essential for comprehensive treatment planning
When Should You See a Clinical Oncologist?
& Why is Early Consultation with A Cancer Specialist Essential?
If biopsy confirms colon cancer, especially when there are signs that the disease may have spread, you should consult or request to see a Clinical Oncologist.
An oncologist is not simply a doctor who "gives chemotherapy" like many would have assumed. A Clinical Oncologist or cancer specialist's role is to design the overall strategy of your colon cancer treatment.
Oncologists Are Trained To:
Accurately stage the cancer
Assess tumour biology and risk profile
Plan the correct treatment sequence (Hint: This is Very Important!)
Reduce the risk of recurrence
Preserve long-term quality of life
Why The Right Treatment Sequencing Matters
While most colon cancer patients will require surgery at some point in their treatment journey, surgery is not always the first step!
In some patients, especially for tumour close to the rectum, treatment may begin with chemotherapy or radiotherapy to shrink the tumour before surgery
This approach can increase the chance of complete tumour removal, while reducing the likelihood of requiring a permanent stoma.
However, in certain urgent or life-threatening situations, immediate surgery may be necessary before any other treatment can be given.
The correct of treatment order depends entirely on:
Tumour stage
Location of the cancer
Risk of obstruction or perforation
Your overall health condition
This is why proper oncological assessment is critical before deciding on the first step. Read more about Colon Cancer Treatment Sequence here.
Colon Cancer Treatment Is Not Just About Removing A Tumour
Surgery removes what we can see. But cancer treatment addresses what we cannot see — microscopic cancer cells that may remain in the body.
Colon cancer management is a structured, carefully planned process. Every decision affects:
Recurrence risk
Long-term survival
Bowel function after treatment
Quality of life
Even a small change in treatment sequencing (with the same treatment combination) can significantly influence outcomes.
Important Note: The key is not rushing into the first available procedure. What's more important is consulting the right specialist at the right stage. If colon cancer is confirmed, early consultation with a Clinical Oncologist ensures that your treatment plan is strategically planned for the best treatment outcome.
Conclusion: Do Not Ignore Persistent Gut Symptoms!
In Malaysia, including many of my cases in Johor Bahru (JB), colon cancer is often diagnosed late, not because symptoms appear late or suddenly, but because early signs were mistaken for "gastric", "food intolerance", or "just haemorrhoids".
If you experience bloating, persistent indigestion, constipation, diarrhea, blood in stool, unexplained weight loss, or ongoing fatigue that lasts more than a few weeks, keeps recurring, or gradually worsens ➜ seek proper medical evaluation and escalation
Proper Escalation Pathway
See the right specialist at the right stage:
Step 1: GP for initial assessment
Step 2: Gastroenterologist if a functional digestive issue is suspected
Step 3: Colorectal surgeon if a structural abnormality is identified
Step 4: Clinical Oncologist if colon cancer is confirmed
With colon cancer, timing matters. Early-stage disease is often highly treatable and even curable. Late-stage disease is far more complex. Early evaluation protects your options and life after.
Recommended Readings:
【 Colorectal Cancer Screening in Malaysia 】Who Needs It, Which Test to Choose & When to Start Screening
【 Colorectal Cancer Treatment in Malaysia 】Why is Treatment Different for Every Patient? Chemotherapy, Radiotherapy and Surgery Explained by Dr Teo Yin Keong, Cancer Specialist in Johor Bahru
Cancer / Oncology Care Brought To You By
👨⚕️Dr Teo Yin Keong
Clinical Oncologist, Johor Bahru (JB), Malaysia
©️ TEOncology
