Loreto B. Ong, MD,  FPSCRS Colorectal Surgery Department of General Surgery Vicente Sotto Memorial Medical Center
MARCH <ul><li>is considered </li></ul><ul><li>  Colorectal  Cancer Awareness Month </li></ul><ul><li>Brown /  Blue  Ribbon...
Epidemiology <ul><li>Colorectal cancer ranks  2 nd   in number and cause of mortality </li></ul><ul><li>In the Philippines...
Awareness! <ul><li>What is it? </li></ul><ul><li>What is the cause? </li></ul><ul><li>How does it kill you? </li></ul><ul>...
Definition <ul><li>Colon and Rectum </li></ul><ul><li>Cancer </li></ul>
Cause <ul><li>Genetic Changes / Alterations </li></ul>
Adenoma – Carcinoma Sequence MUTATIONS
Factors <ul><li>Aging </li></ul><ul><li>Hereditary  </li></ul><ul><li>Environmental </li></ul><ul><li>Dietary </li></ul><u...
Who is at risk? <ul><li>Age </li></ul><ul><ul><li>Are you 50 years old or above? </li></ul></ul><ul><li>Gender </li></ul><...
<ul><li>YOU   are at risk for  colorectal cancer ! </li></ul>
What if I have…? <ul><li>Changes  in bowel habits </li></ul><ul><li>Rectal bleeding </li></ul><ul><li>Abdominal pain </li>...
<ul><li>YOU  might have  colorectal cancer! </li></ul>
What should I do? <ul><li>Seek consult to your doctor </li></ul><ul><li>Inquire about the  prevention  and  treatment   me...
Diagnosis <ul><li>Colonoscopy </li></ul>
Diagnosis <ul><li>Colonoscopy </li></ul><ul><li>Biopsy </li></ul>
Diagnosis <ul><li>Colonoscopy </li></ul><ul><li>Biopsy </li></ul>
Diagnosis <ul><li>Colonoscopy </li></ul><ul><li>Biopsy </li></ul><ul><li>CT scan (for clinical staging) </li></ul>
Prognosis Cancer Staging 5 year survival Stage I 70 -95 % Stage II 54 – 65% Stage III 39 – 60% Stage IV 0 – 16%
Prognosis ………  UNFORTUNATELY Cancer Staging 5 year survival Stage I 70 -95 % Stage II 54 – 65% Stage III 39 – 60% Stage IV...
<ul><li>In the Philippines, the 5 year survival rate of patients with colon cancer is only  47.72% ; while that of rectal ...
Treatment Cancer Staging Treatment Stage I Surgery Stage II Surgery Stage III Surgery + Chemotherapy Stage IV Surgery + Ch...
Prevention <ul><li>Aging </li></ul><ul><li>Hereditary  </li></ul><ul><li>Environmental </li></ul><ul><li>Dietary </li></ul...
Screening <ul><li>Targets the general asymptomatic public for the risk of developing cancer </li></ul>
Screening <ul><li>Fecal Occult Blood Test </li></ul><ul><li>Sigmoidoscopy </li></ul><ul><li>Colonoscopy </li></ul><ul><li>...
Screening Guidelines Population Initial Age Recommended Screening Tool Average Risk 50 yo Annual FOBT Flexible sigmoidosco...
Colorectal cancer is preventable  <ul><li>With proper screening, they help find precancerous polyps so they can be removed...
Early Detection  <ul><li>Is the key </li></ul><ul><li>Decreased mortality rates from CA deaths </li></ul><ul><li>Earlier d...
Truths about  Colorectal Cancer Screening <ul><li>Colorectal cancer is the second leading cancer killer in the United Stat...
<ul><li>Screening helps prevent colorectal cancer.  </li></ul><ul><li>Screening helps find colorectal cancer early, when t...
<ul><li>Because polyps or cancer in the colon or rectum don’t always cause symptoms, it is important to be screened regula...
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Defeating colorectal cancer

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Defeating colorectal cancer

  1. 1. Loreto B. Ong, MD, FPSCRS Colorectal Surgery Department of General Surgery Vicente Sotto Memorial Medical Center
  2. 2. MARCH <ul><li>is considered </li></ul><ul><li> Colorectal Cancer Awareness Month </li></ul><ul><li>Brown / Blue Ribbon </li></ul>
  3. 3. Epidemiology <ul><li>Colorectal cancer ranks 2 nd in number and cause of mortality </li></ul><ul><li>In the Philippines, it now ranks third among cancers </li></ul>
  4. 4. Awareness! <ul><li>What is it? </li></ul><ul><li>What is the cause? </li></ul><ul><li>How does it kill you? </li></ul><ul><li>Are you at risk? </li></ul><ul><li>What do I have to do? </li></ul>
  5. 5. Definition <ul><li>Colon and Rectum </li></ul><ul><li>Cancer </li></ul>
  6. 6. Cause <ul><li>Genetic Changes / Alterations </li></ul>
  7. 7. Adenoma – Carcinoma Sequence MUTATIONS
  8. 8. Factors <ul><li>Aging </li></ul><ul><li>Hereditary </li></ul><ul><li>Environmental </li></ul><ul><li>Dietary </li></ul><ul><li>Inflammatory Bowel Disease </li></ul><ul><li>Others </li></ul><ul><li>50 years old and above </li></ul><ul><li>2x the risk </li></ul><ul><li>Obesity </li></ul><ul><li>Hi fat, low fiber </li></ul><ul><li>FAP, HNPCC </li></ul><ul><li>Alcohol and smoking </li></ul>
  9. 9. Who is at risk? <ul><li>Age </li></ul><ul><ul><li>Are you 50 years old or above? </li></ul></ul><ul><li>Gender </li></ul><ul><ul><li>Male = Female </li></ul></ul><ul><li>Do you have a Family History of Colorectal Cancer? </li></ul><ul><li>Do you have Inflammatory Bowel Disease? </li></ul>
  10. 10. <ul><li>YOU are at risk for colorectal cancer ! </li></ul>
  11. 11. What if I have…? <ul><li>Changes in bowel habits </li></ul><ul><li>Rectal bleeding </li></ul><ul><li>Abdominal pain </li></ul><ul><li>Bloating; vomiting </li></ul><ul><li>Unexplained anemia </li></ul><ul><li>Weight loss </li></ul><ul><li>Poor appetite </li></ul>
  12. 12. <ul><li>YOU might have colorectal cancer! </li></ul>
  13. 13. What should I do? <ul><li>Seek consult to your doctor </li></ul><ul><li>Inquire about the prevention and treatment methods against colorectal cancer </li></ul><ul><li>Promote the habit of screening to increase awareness of the disease </li></ul>
  14. 14. Diagnosis <ul><li>Colonoscopy </li></ul>
  15. 15. Diagnosis <ul><li>Colonoscopy </li></ul><ul><li>Biopsy </li></ul>
  16. 16. Diagnosis <ul><li>Colonoscopy </li></ul><ul><li>Biopsy </li></ul>
  17. 17. Diagnosis <ul><li>Colonoscopy </li></ul><ul><li>Biopsy </li></ul><ul><li>CT scan (for clinical staging) </li></ul>
  18. 18. Prognosis Cancer Staging 5 year survival Stage I 70 -95 % Stage II 54 – 65% Stage III 39 – 60% Stage IV 0 – 16%
  19. 19. Prognosis ……… UNFORTUNATELY Cancer Staging 5 year survival Stage I 70 -95 % Stage II 54 – 65% Stage III 39 – 60% Stage IV 0 – 16%
  20. 20. <ul><li>In the Philippines, the 5 year survival rate of patients with colon cancer is only 47.72% ; while that of rectal cancer is only 19.45% </li></ul>
  21. 21. Treatment Cancer Staging Treatment Stage I Surgery Stage II Surgery Stage III Surgery + Chemotherapy Stage IV Surgery + Chemotherapy; Palliation
  22. 22. Prevention <ul><li>Aging </li></ul><ul><li>Hereditary </li></ul><ul><li>Environmental </li></ul><ul><li>Dietary </li></ul><ul><li>Inflammatory Bowel Disease </li></ul><ul><li>Others </li></ul><ul><li>Screening, Surveillance </li></ul><ul><li>Screening, Surveillance </li></ul><ul><li>Modification </li></ul><ul><li>Modification </li></ul><ul><li>Surveillance </li></ul><ul><li>Modification </li></ul>
  23. 23. Screening <ul><li>Targets the general asymptomatic public for the risk of developing cancer </li></ul>
  24. 24. Screening <ul><li>Fecal Occult Blood Test </li></ul><ul><li>Sigmoidoscopy </li></ul><ul><li>Colonoscopy </li></ul><ul><li>Double Contrast Barium Enema </li></ul><ul><li>Computed Tomography Colonography </li></ul><ul><li>Fecal DNA Testing </li></ul>
  25. 25. Screening Guidelines Population Initial Age Recommended Screening Tool Average Risk 50 yo Annual FOBT Flexible sigmoidoscopy every 5 years Annual FOBT with Flexible sigmoidoscopy every 5 years Air contrast barium enema every 5 years Colonoscopy every 10 years
  26. 26. Colorectal cancer is preventable <ul><li>With proper screening, they help find precancerous polyps so they can be removed before they turn into cancer. </li></ul>
  27. 27. Early Detection <ul><li>Is the key </li></ul><ul><li>Decreased mortality rates from CA deaths </li></ul><ul><li>Earlier detection for early stage CA for better prognosis </li></ul>
  28. 28. Truths about Colorectal Cancer Screening <ul><li>Colorectal cancer is the second leading cancer killer in the United States, affecting both men and women, especially those over age 50. </li></ul><ul><li>If you’re over 50, see your doctor and get screened for colorectal cancer. </li></ul><ul><li>Screening for colorectal cancer saves lives. </li></ul>
  29. 29. <ul><li>Screening helps prevent colorectal cancer. </li></ul><ul><li>Screening helps find colorectal cancer early, when treatment can be very effective. </li></ul><ul><li>Currently, the Philippines has no national screening program for colorectal cancer. </li></ul><ul><li>Increased awareness through promotion of screening programs. </li></ul>
  30. 30. <ul><li>Because polyps or cancer in the colon or rectum don’t always cause symptoms, it is important to be screened regularly for colorectal cancer. </li></ul><ul><li>Be Screened for Life! </li></ul>

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