Defeating colorectal cancer

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