Colorectal cancer unveiled

By Caroline Juinio Howard, ABS-CBN News

Posted at Jul 25 2009 11:51 PM | Updated as of Jul 26 2009 07:51 AM

Colorectal cancer is the third most common cancer and, next to Lung cancer and Breast cancer, the third leading cause of cancer deaths in the country today.

"The Colorectal rate in the Philippines is lower than in the U.S. except for Filipinos in the U.S. who assume the same rates in U.S.," says Dr. Ramy Roxas, Director of Cancer Center at the Medical City and Chief of the PGH Colorectal Surgery Division, proof that the environment has proven is a big factor to the disease. Still, despite the lower incidence, Roxas says, the Philippines has a higher Colorectal cancer mortality compared to other countries.

"Colon cancer starts out as a non cancerous growth in the lining of the colon called the "polyp" and if allowed to grow becomes an invasive growth," "Stage 1 is superficial, Stage 2 when it invades the colon, Stage 3 as it spreads to the lymph nodes, and Stage 4 once it spreads to other organs."

Stage 1 Colorectal cancer has very good prognosis, Roxas explains, in an interview over Dateline Philippines Saturday, with Stages 1 and 2 at times needing no chemotherapy.

"Stage 1 has a very good survival rate for colon cancer at 90% combined with rectal 75%." He however says, that is not the case in the later stage. (Department of Health 2005 Cancer Facts and Estimates shows, Colorectal Cancer has a median survival of 24 months. The 5-year survival rate for Colon Cancer in 47.72%, while that of the rectum is 19.45%. Meanwhile, the 10-year suvival rate for the colon is 32.38%, that of the rectum 5.48%.)

In terms of survival rates, Roxas says, the Philippines fares worse than other countries.

Based on global cancer statistics, the Philippines ranks low in terms of age standardized survival rates for Colorectal Cancer in both sexes. It ranks 27% for women, 29% for men, falling behind countries like the United States, West Europe, Japan, Thailand and India.
Roxas admits, late detection may be to blame for the low survival rate associated with the disease.

Given such worrisome figures, Roxas hopes to push for better prevention and treatment for colorectal cancer.

"Colorectal cancer is actually very preventable condition. There's evidence to show that with good screening," Roxas says. Screening and a multi-modality treatment (Chemotherapy, pre-operative radiotherapy, High quality surgery) are among the factors responsible for improving Colorectal cancer ourcomes.

"The actual public health recommendation is to do fecal occult blood or a stool exam to look for microscopic blood at age 50," Roxas says. He also advises earlier screening, for those with a strong family history of Colorectal cancer, or with two or more relatives who had it. Roxas says, screening should be done 10 years before the age of diagnosis of relatives with Colorectal cancer. "Colonoscopy is the most accurate and best test," Roxas adds.

Roxas says, a number of palliative and curative treatments are available for those found to have Colorectal cancer.

"Colorectal treatment is rapidly evolving. Younger patients may tolerate aggressive treatment better. With the older medication, the life span of a Stage 4 patient is 6 months, but with newer chemotherapy agents they've gone beyond two years," Roxas says.

He counts a high-protein and highly processed diet, carcinogens, smoking, alcohol, stress, and a sedentary lifestyle among the factors of Colorectal cancer.

He says, people should have themselves checked at the first signs of the problem. Symptoms include: blood in the stool, changes in bowel movement, unexplained weight loss, unexplained anemia, frequent abdominal pain.

Amid today's hurried pace and ever changing lifestyles, experts say, early detection is still key to battling the disease.