Colorectal Cancer

With good screening and early diagnosis, 90% of colorectal cancers are curable. Screening and multi-modality treatments such as chemotherapy, pre-operative radiotherapy and surgery are among the factors responsible for improving colorectal cancer outcomes.

What is Colorectal Cancer?

Colorectal cancer is among the top five most common cancers in the Philippines today. However, recent statistics show that the Philippines has a higher colorectal cancer mortality than other countries.

Colorectal cancer starts in the digestive system. It usually starts as polyps, which are abnormal growths in the inner lining of the colon or the rectum. Colorectal cancer symptoms are rare in the early stages, but when they occur, the following maybe experienced:

• rectal bleeding,
• prolonged diarrhea or constipation,
• abdominal pain, and
• body weakness.

Colorectal Cancer Symptoms

Colorectal cancer can be avoided, and even cured – if detected early through screening, says Dr. Roxas of The Medical City Colorectal Department.

Most people who are diagnosed with colorectal cancer average 60 years of age. Since it takes 10 years for a polyp to become a cancer, Dr. Roxas strongly encourages every Filipino to get a screening once they reach the age of 50 to detect possible polyps in their early stages. Blood examination or fecal occult blood, another way for screening aside from colonoscopy, costs only P200 to P400 a year.

Dr. Roxas says that blood in the stool is the most obvious colorectal cancer symptoms – one needs to have a check up right away before it can worsen. “They won’t get any check-up for months until they find out that it is more advanced than we hope it should be. Any bleeding should be checked out; you don’t want to assume. Leave a hemorrhoid alone, as long as you know that it is a hemorrhoid,” he stresses.

Other colorectal symptoms include:

• change in bowel habits
• alternating diarrhea then constipation
• persistent abdominal discomfort (such as cramps)
• gas or pain, abdominal pain with bowel movement
• a feeling that bowel doesn’t empty completely
• unexplained anemia
• weakness or fatigue
• weight loss with no known reason
• narrow or thin stool

Prevention of Colon Cancer

A relatively inexpensive fecal occult blood test (FOBT), is recommended for everyone aged 50 and above. This test should be done every year after age 50. The alternative is to undergo colonoscopy every five (5) to ten (10) years.

Of course, those with strong family history of colorectal cancer or those with two or more family members who had the disease should be screened earlier, ideally 10 years before the age of diagnosis of their relatives with colorectal cancer.

Colonoscopy is admittedly one of the most unloved cancer tests, but it can save lives – it is the most accurate test for colorectal cancer.

Available Treatment Options for Colorectal Cancer

The main treatment for curing colon cancer is surgery. This entails removing the segment of colon involved by the cancer, as well as the lymph nodes draining via the mesentery. If the cancer is small and early, minimally invasive laparoscopic surgery can be done, with smaller incisions, less pain, and faster recovery.

In cases of Stage III and IV colon cancer, where the malignancy has spread to the lymph nodes and/or other organs such as the liver and lungs, chemotherapy is usually given either after surgery, or alone if surgery is not considered for cure anymore. In some cases of Stage IV colon cancer, cure is still possible with the use of surgery for both the colon and the other involved organ (such as the liver or lungs), as well as with chemotherapy.

Related Services at TMC

Screening:

• Fecal occult blood yearly with flexible sigmoidoscopy (every 3 years); or
• Colonoscopy (every 5 to 10 years); or
• Virtual CT Colonography (every 3 to 5 years).

Prevention:

• Colonoscopic Polypectomy

Treatment:

• Minimally Invasive Procedures for early cancers, including laparoscopic surgery
• Minimally Invasive Procedures for palliation, including
• Colonic stenting
• Laparoscopic surgery
• Multidisciplinary Treatment Planning

Additional Information

Colorectal Cancer Infographic from The Medical City Colorectal Clinic

Pope John Paul II, President Corazon C. Aquino, TV host and actresses Helen Vela and Rio Diaz are just some of the notable persons who have fought colorectal cancer.

Facts:

• 90% of colorectal cancer patients are 50 years or older and the average age of diagnosis is 64.
• Colon cancer is a cancer of the large intestines. When cancer occurs in the last 6 inches of the large intestines, it is called rectal cancer.A persons with colorectal cancer may not have symptoms at all. It could be subtle like fatigue and anemia. Blood in the stool (black or bloody red stools), change in bowel habits, diarrhea or constipation are common signs.
• In the Philippines, 5,787 new cases of colorectal cancer are diagnosed yearly.
• 1 out of 100 persons would have had a likelihood of getting colorectal cancer before age 75.
• While the five-year survival rate of colorectal cancer patients from advanced countries like the United states, Singapore and South Korea is 60% or higher, the five-year survival rate of Filipinos living in the Philippines is significantly lower at only 40%.
• Colorectal cancer is one of the most preventable malignancies through screening.
• Screening is recommended for everyone at age 50 either through colonoscopy every 5 to 10 years or yearly stool exam for fecal occult blood.
• TMC is committed to improve outcomes in colorectal cancer. This is the rationale for the TMC Colorectal Clinic.

Sources:
www.coloncancerresource.com, www.healthcommunities.com, www.colon-cancer-overview.html,
2010 Philippine Cancer Facts and Estimates.