Beating Colorectal Cancer by Dr. Jun R. Ruiz

"As an advocate, I believe that we should continue to educate the general public and mobilize the health community into programs to beat colorectal cancer." ~Dr. Jun R. Ruiz, Head of the Colorectal Cancer Screening Program of The Medical City

Did you know that colorectal cancer (CRC) is the third most common cancer among Filipinos? Only breast and lung cancers are more prevalent in the Philippines. This is an important campaign since March is Colorectal Cancer Awareness Month. BUT don't feel scared because it is preventable, treatable, and beatable.

CRC screening can save lives, but not that many people are being screened. Screening for colorectal cancer can save lives and has been shown to reduce the cancer risk by as high as 70 percent.

During the forum, it was discussed that the benefits of screening, diagnosis, and management of Colorectal Cancer in the era of Universal Healthcare. Keynote speakers include:

• Dr. Eric Tayag, Director IV-Knowledge Management and Information Technology Service, Universal Health Care: Why we should care and what can we do about it.
• Ma. Rosario S. Vergeire, MD, MPH, CESO IV. 
• Dr. Napoleon Arevalo, Disease Prevention and Control Bureau of the Department of Health, talks about the National Integrated Cancer Control Act.
• Dr. Jun Ruiz, Head of the Colorectal Cancer Screening Program, emphasizes the importance of Colon Cancer Screening.
• Roman Romulo, Pasig City District Representative 

The Medical City aims to be at the forefront in the fight against colorectal cancer.

BE SCREENED

• In several countries, CRC screening is recommended for people starting the age of 50 years. Screening at an earlier age, usually at 40, is advocated in first-degree relatives of patients with colorectal cancer, and in those with other additional risk factors.

Almost all of these cancers start as abnormal growths in the lining of the colon and rectum called polyps. These polyps grow slowly and take around 10 years for some polyps to develop into cancer. Not all polyps progress to cancer. The removal of these polyps reduces the risk of developing cancer.

These polyps and occasionally early cancer do not cause complaints, like rectal bleeding, constipation, and abdominal pain that are experienced by patients in later stages of cancer.

Risk Factors for Colorectal Cancer

1. Age greater than 50
2. Personal history of colorectal cancer or advanced polyps
3. Family history of cancer in the colon and rectum

Age 50 is the most common risk factor for this cancer, as 90% occur after the age of 50. A family history of a first-degree relative with CRC is increased two to three-fold.

Lifestyle habits that can be modified that likely contribute to the formation of colon cancer:

Lifestyle habits that can be of the risk factors of Colorectal Cancer:

1. High consumption of animal fat/processed meat (beef, pork, lamb)
2. Long-term smoking
3. More than two alcoholic drinks per day
4. Obesity
5. Family history

Living a healthy lifestyle by avoiding smoking, not consuming excessive alcohol, regular exercise, and eating the right food can lower your risk for cancer in the colon and rectum.

The gold standard for CRC screening is a colonoscopy as it can detect and remove early lesions like polyps. The procedure involves a flexible fiberoptic scope with a camera that is inserted through the rectum and is carefully advanced to visualize the colon under mild anesthesia. However, it is an invasive test and it has the (low) potential to cause complications.

Some patients may not want to have an invasive test or may find the cost of a colonoscopy too expensive. A stool test called the Fecal Immunochemical Test (FIT) is a good screening alternative. FIT detects only human blood and is specific for bleeding in the colon. The test is repeated every year if the initial test is negative. 

If the test is positive, a colonoscopy is needed to rule out the presence of cancer. With the right organization, a population-based screening program among Filipinos involving this method will result in early diagnosis of colorectal cancer and improved clinical outcomes in the country.

If the patient does not want to start with a colonoscopy, it is suggestive by starting with FIT. After a discussion with his physician, the patient can choose his preferred screening test. After all, the best test is the one that gets done.

By undergoing either method of CRC screening, this would be one step towards beating colorectal cancer.

For inquiry and if you need to schedule a consultation contact the Colorectal Clinic of The Medical City, at 8988-1000/8988-7000 ext. 7789.