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Empowerment
objective - for
laypeople to have an
understanding of
CANCER CURABILITY
& SURVIVORSHIP in
their health
management.
Health Issue
Course –
CANCER
CURABILITY &
SURVIVORSHIP
August 13, 2022
1400H - 1500H
Via Zoom
Empowerment
objective - for
laypeople to have an
understanding of
CANCER CURABILITY
& SURVIVORSHIP in
their health
management.
Health Issue
Course –
CANCER
CURABILITY &
SURVIVORSHIP
ROJoson PEP Talk
I have a Patient
Empowerment
Program in which I
like to empower the
lay people or
patients to take
control in the
management of
their health.
There are 3 courses
in the PEP Talk.
I completed the Core
Course on October 9,
2021.
From October 23,
2021 onwards, I have
been tackling Health
Disorder and Health
Issue Courses. This
may take 3 years or
longer.
Empowerment
objective - for
laypeople to have an
understanding of
CANCER CURABILITY
& SURVIVORSHIP in
their health
management.
Health Issue
Course –
CANCER
CURABILITY &
SURVIVORSHIP
My PEP TALK today
is entitled:
CANCER
CURABILITY &
SURVIVORSHIP.
This is part of the
Health Issue Course.
Contents of CANCER CURABILITY &
SURVIVORSHIP
• What is a cancer?
• What is the basic cause of cancer?
• What is cancer curability? Can we talk of a cure
in cancer?
• What is cancer survivorship? Who is a cancer
survivor?
• What is ROJoson Cancer Survivorship Program?
• What are ROJoson’s advocating statements and
advice on cancer curability & cancer
survivorship?
Health Issue
Course –
CANCER
CURABILITY &
SURVIVORSHIP
• What is a cancer?
Health Issue
Course –
CANCER
CURABILITY &
SURVIVORSHIP
Cancer is a disease.
Cancer is a medical disease when some of the
body’s cells grow uncontrollably with a potential
to invade the adjacent body tissues or organs and
to spread to distant tissues or organs.
• What is a cancer?
Health Issue
Course –
CANCER
CURABILITY &
SURVIVORSHIP
Cancer is a medical
disease when some of
the body’s cells grow
uncontrollably with a
potential
to invade the adjacent
body tissues or organs
and
to spread to distant
tissues or organs.
• What is a cancer?
Health Issue
Course –
CANCER
CURABILITY &
SURVIVORSHIP
Cancer is a medical
disease when some of
the body’s cells grow
uncontrollably with a
potential
to invade the adjacent
body tissues or organs
and
to spread to distant
tissues or organs.
• What is the basic cause of cancer?
Health Issue
Course –
CANCER
CURABILITY &
SURVIVORSHIP
Cancer is basically
a genetic disease—
that is, it is caused
by changes
to genes that
control the way
our cells function,
especially how
they grow and
divide.
• What is the basic cause of cancer?
Health Issue
Course –
CANCER
CURABILITY &
SURVIVORSHIP
Cancer covers a wide spectrum of diseases
characterized by uncontrolled cell growth, which
is driven by down-regulation of tumour-
suppressing genes and/or up-regulation of
tumour-promoting genes.
Cancer is basically
a genetic disease—
that is, it is caused
by changes
to genes that
control the way
our cells function,
especially how
they grow and
divide.
Fail to stop uncontrolled cell growth!
Allow uncontrolled growth!
• What is cancer curability?
Health Issue
Course –
CANCER
CURABILITY &
SURVIVORSHIP
The conventional definition of “medical cure”: a
medical condition or disease that’s completely
gone and will never come back.
Cancer curability – is cancer curable or incurable?
• What is cancer curability?
Health Issue
Course –
CANCER
CURABILITY &
SURVIVORSHIP
For cancers, no doctors will guarantee your cancer
will NOT come back.
In other words, no doctors will guarantee you will
be cured of cancer after treatment (after any type
of treatment).
Why?
• What is cancer curability?
Health Issue
Course –
CANCER
CURABILITY &
SURVIVORSHIP
There are several reasons for this:
1. Doctors don’t know everything about
the disease yet.
The best knowledge so far is that the ultimate or
proximate cause of cancer is changes (or
mutations) to the DNA (genes) within cells; that
cancer is a genetic disease caused by changes
to genes that control the way our cells function,
especially how they grow and divide.
There are theories on how
gene mutations lead to
cancer development:
- Allowing rapid growth
- Failure to stop
uncontrolled growth
- Makes mistakes when
repairing DNA errors
EXACT MECHANISMS –
NOT DEFINITELY KNOWN
YET!
Thus, the targeted cancer
therapies on the molecular
or gene level are not yet
100% successful.
• What is cancer curability?
Health Issue
Course –
CANCER
CURABILITY &
SURVIVORSHIP
2. The usual cancer treatment modalities
(surgery, chemotherapy, and radiotherapy)
are not strictly treating the primary cause
of the cancer. They just extirpate, kill with
drugs, and burn the cancer. If the primary cause
is still around, there is always the possibility of
recurrence after treatment.
• What is cancer curability?
Health Issue
Course –
CANCER
CURABILITY &
SURVIVORSHIP
3. No two cancers are the same. Each
individual cancer possesses different
biological characteristics, even cancers of
the same type. Some are slow growing
while some are fast growing. Usually, the
biologic behavior of the cancer is not
known at the time of treatment. Thus,
only time will tell the outcome of
treatment.
• What is cancer curability?
Health Issue
Course –
CANCER
CURABILITY &
SURVIVORSHIP
4. After treatment, some cancer cells
may remain somewhere in the body
(unnoticed and patients are
asymptomatic) for a long time, even
as long as 10 years, but can
eventually grow, divide, invade,
spread to distant areas and become a
nuisance. (A RECURRENCE)
A reason why
doctors do not
guarantee NO
recurrence.
At the time there
are no symptoms,
doctors use the
word
“REMISSION.”
• What is cancer curability?
Health Issue
Course –
CANCER
CURABILITY &
SURVIVORSHIP
Complete remission means that tests,
physical exams, and scans show that NO
signs of your cancer are present.
Some doctors also refer to complete
remission as “no evidence of disease
(NED)” or “no evidence of recurrence
(NER)”.
COMPLETE REMISSION DOESN’T MEAN
CURE.
A reason why
doctors do not
guarantee NO
recurrence.
At the time there
are no symptoms,
doctors use the
word
“REMISSION.”
• What is cancer curability?
Health Issue
Course –
CANCER
CURABILITY &
SURVIVORSHIP
RECURRENCE
Some cancer cells can remain unnoticed in
the body for years after treatment.
If a cancer returns after it has been in
remission, it’s called a “recurrence.”
A cancer can recur in the same place it was
originally diagnosed, or it can recur in a
different part of the body.
A reason why
doctors do not
guarantee NO
recurrence.
At the time there
are no symptoms,
doctors use the
word
“REMISSION.”
• What is cancer curability?
Health Issue
Course –
CANCER
CURABILITY &
SURVIVORSHIP
So, up to now, there is NO true cure for cancer
(NO guarantee it will not recur).
Physicians do not talk of “cure.” They use the
word “remission” if there are no signs of
recurrence.
But they together with the patients always hope
for a cure especially for those cancers which are
recognized, diagnosed and treated early and with
known track record of slow growth in behavior.
SAD REALITY
GLOOMY
HOPEFUL REALITY
OPTIMISTIC
• What is cancer curability?
Health Issue
Course –
CANCER
CURABILITY &
SURVIVORSHIP
There is currently no cure for cancer.
However, successful treatment can result in
cancer going into remission, which means that all
signs of it have gone. The early detection and
treatment of cancer can significantly improve the
chances of remission and a person's outlook.
SAD REALITY
GLOOMY
HOPEFUL REALITY
OPTIMISTIC
• What is cancer curability?
Health Issue
Course –
CANCER
CURABILITY &
SURVIVORSHIP
Literally, to cure refers to eliminate a disease or
condition without any relapse. However, the
relapsing nature (within months or years) after
remission makes the traditional definition of
“cure” impractical and rarely mentioned in
oncology.
SAD REALITY
GLOOMY
HOPEFUL REALITY
OPTIMISTIC
• What is cancer curability?
Health Issue
Course –
CANCER
CURABILITY &
SURVIVORSHIP
The cure of cancer implies not only numerically
long survival time, but also equal life expectation
between properly treated patients and
corresponding cancer-free population.
A plausible and empirical criterion for
curability is the maintenance of
recurrence-free survival for more than 10
years after effective treatments.
(https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3710180/)
SAD REALITY
GLOOMY
HOPEFUL REALITY
OPTIMISTIC
• What is cancer curability?
Health Issue
Course –
CANCER
CURABILITY &
SURVIVORSHIP
Optimistic Concept of Cancer Curability
Based on track records of different types of
cancers
Based on usual recurrence time (years) of a
particular cancer after standard complete
treatment
If no recurrence at this time, then one can use
“cured.”
HOPEFUL REALITY
OPTIMISTIC
• What is cancer curability?
Health Issue
Course –
CANCER
CURABILITY &
SURVIVORSHIP
Optimistic Concept of Cancer Curability
Based on track records of different types of
cancers
Based on usual recurrence time (years) of a
particular cancer after standard complete
treatment
If no recurrence at this time, then one can use
“cured.”
HOPEFUL REALITY
OPTIMISTIC
Example:
If the usual
recurrence time of a
particular cancer is
within 5 years and
if no recurrence on
the 5th year, then one
can say “cured”!
• What is cancer curability?
Health Issue
Course –
CANCER
CURABILITY &
SURVIVORSHIP
Optimistic Concept of Cancer Curability
Based on track records of different types of
cancers
Based on usual recurrence time (years) of a
particular cancer after standard complete
treatment
If no recurrence at this time, then one can use
“cured.”
HOPEFUL REALITY
OPTIMISTIC
Example:
If the usual
recurrence time of a
particular cancer is
within 10 years and
if no recurrence on
the 10th year, then
one can say “cured”!
In general, 10 years is
used as cut-off but
with exceptions.
• What is cancer survivorship?
Health Issue
Course –
CANCER
CURABILITY &
SURVIVORSHIP
• What is cancer survivorship? Who is a Cancer
Survivor?
Health Issue
Course –
CANCER
CURABILITY &
SURVIVORSHIP
The American Cancer Society uses the
term cancer survivor to refer to anyone who has
ever been diagnosed with cancer no matter
where they are in the course of their disease.
One who remains alive and continues to function
during and after overcoming a cancer is
considered to be a cancer survivor, so from the
time of diagnosis until the end of life.
“Both the National
Cancer Institute (NCI)
and Roswell Park
clinically define a
person as a cancer
survivor from the day
of their cancer
diagnosis onward, for
as long as they are
alive.”
Regardless of status of cancer – in remission,
with residual or recurrence after treatment.
• What is cancer survivorship? Who is a Cancer
Survivor?
Health Issue
Course –
CANCER
CURABILITY &
SURVIVORSHIP
Cancer Survivor
A cancer survivor is an individual with cancer of
any type, current or past, who is still living.
Personally, I like to add 10 years at least with no
recurrence (or in remission). I will also include
those patients who died after 10 years with no
recurrence and the cause of death is not due to
the cancer. My personal observation is that
chances of recurrence in this group of patients, 10
years with no recurrence, will be 1%.
• What is cancer survivorship?
Health Issue
Course –
CANCER
CURABILITY &
SURVIVORSHIP
I have a cancer survivor registry in which I keep
tract of patients who have been treated by me
starting 1980 and who are considered "cancer
survivors" using an operational criterion of at
least 10 years in remission after treatment.
• What is cancer survivorship?
Health Issue
Course –
CANCER
CURABILITY &
SURVIVORSHIP
The registry which I publish in the Internet (my
blog) serves as an inspiration to current and
future cancer patients and will debunk the
thinking that having cancer is always a death
sentence.
• What is cancer survivorship?
Health Issue
Course –
CANCER
CURABILITY &
SURVIVORSHIP
As of August 4, 2022, I have a registry of 157
cancer survivors who have been in remission for
10 or more years under my care. (as long as or
more than 30 years in remission)
Mostly- Filipino patients with breast cancers and
thyroid cancers.
I will continue to track and increase the number
of cancer survivors under my care.
• What is cancer curability?
Health Issue
Course –
CANCER
CURABILITY &
SURVIVORSHIP
So, up to now, there is NO true cure for cancer
(NO guarantee it will not recur).
Physicians do not talk of “cure.” They use the
word “remission” if there are no signs of
recurrence.
But they together with the patients always hope
for a cure especially for those cancers which are
recognized, diagnosed and treated early and with
known track record of slow growth in behavior.
SAD REALITY
GLOOMY
HOPEFUL REALITY
OPTIMISTIC
RECALL THIS SLIDE!
• What is cancer curability?
Health Issue
Course –
CANCER
CURABILITY &
SURVIVORSHIP
So, up to now, there is NO true cure for cancer
(NO guarantee it will not recur).
Physicians do not talk of “cure.” They use the
word “remission” if there are no signs of
recurrence.
But they together with the patients always hope
for a cure especially for those cancers which are
recognized, diagnosed and treated early and with
known track record of slow growth in behavior.
SAD REALITY
GLOOMY
HOPEFUL REALITY
OPTIMISTIC
RECALL THIS SLIDE!
How do you relate this gloomy concept of cancer
curability or incurability to my Cancer Survivor
Registry wherein I already have more than 150
patients who survived more than 10 years and
longer?
• What is cancer curability?
Health Issue
Course –
CANCER
CURABILITY &
SURVIVORSHIP
Optimistic Concept of Cancer Curability
Based on track records of different types of
cancers
Based on usual recurrence time (years) of a
particular cancer after standard complete
treatment
If no recurrence at this time, then one can use
“cured.”
HOPEFUL REALITY
OPTIMISTIC
Example:
If the usual
recurrence time of a
particular cancer is
within 10 years and
if no recurrence on
the 10th year, then
one can say “cured”!
In general, 10 years is
used as cut-off but
with exceptions.
RECALL THIS SLIDE!
• What is cancer curability?
Health Issue
Course –
CANCER
CURABILITY &
SURVIVORSHIP
Optimistic Concept of Cancer Curability
Based on track records of different types of
cancers
Based on usual recurrence time (years) of a
particular cancer after standard complete
treatment
If no recurrence at this time, then one can use
“cured.”
HOPEFUL REALITY
OPTIMISTIC
Example:
If the usual
recurrence time of a
particular cancer is
within 10 years and
if no recurrence on
the 10th year, then
one can say “cured”!
In general, 10 years is
used as cut-off but
with exceptions.
RECALL THIS SLIDE!
How do you relate this optimistic concept of
cancer curability to my Cancer Survivor Registry
wherein I already have more than 150 patients
who survived more than 10 years and longer?
• What is cancer survivorship?
Health Issue
Course –
CANCER
CURABILITY &
SURVIVORSHIP
My recommendations:
Be optimistic but be vigilant in promoting cancer
cure and survivorship.
Though there is no guarantee of complete and
permanent cure from cancer, there is still a
chance for cure and survivorship.
Be vigilant on having early detection, early
consultation and early treatment to have best
chance for cure.
Then, hope and pray
that there will be
cure in terms of no
recurrence until you
die of another non-
cancer cause.
If there is cure, give
thanks.
If there is no cure,
say “thy will be
done.”
• What is cancer survivorship?
Health Issue
Course –
CANCER
CURABILITY &
SURVIVORSHIP
ROJoson Cancer Survivorship Program
• Patient-centered Cancer Care Management
• Group Psychosocial Therapy (ROJoson Cancer
Crusaders Club)
• Cancer Survivor Registry
• What is cancer survivorship?
Health Issue
Course –
CANCER
CURABILITY &
SURVIVORSHIP
ROJoson Cancer Survivorship Program
The goal of ROJoson Cancer Survivorship Program
is to help cancer patients move forward with their
life while carefully monitoring their disease or
surveillance.
• Patient-centered Cancer Care Management
(personalized – cost-effective / compassionate
care)
• Group Psychosocial Therapy (ROJoson Cancer
Crusaders Club)
• What is cancer survivorship?
Health Issue
Course –
CANCER
CURABILITY &
SURVIVORSHIP
ROJoson Cancer Survivorship Program
The goal of ROJoson Cancer Survivorship Program
is to help cancer patients move forward with their
life while carefully monitoring their disease or
surveillance.
• Patient-centered Cancer Care Management
(personalized – cost-effective / compassionate
care)
• Group Psychosocial Therapy (ROJoson Cancer
Crusaders Club)
• What is cancer survivorship?
Health Issue
Course –
CANCER
CURABILITY &
SURVIVORSHIP
ROJoson Cancer Survivorship Program
The goal of ROJoson Cancer Survivorship Program
is to help cancer patients move forward with their
life while carefully monitoring their disease or
surveillance.
• Patient-centered Cancer Care Management
(personalized – cost-effective / compassionate
care)
• Group Psychosocial Therapy (ROJoson Cancer
Crusaders Club)
• What is cancer survivorship?
Health Issue
Course –
CANCER
CURABILITY &
SURVIVORSHIP
ROJoson Cancer Survivorship Program
The goal of ROJoson Cancer Survivorship Program
is to help cancer patients move forward with their
life while carefully monitoring their disease or
surveillance.
• Patient-centered Cancer Care Management
(personalized – cost-effective / compassionate
care)
• Group Psychosocial Therapy (ROJoson Cancer
Crusaders Club)
• What is cancer survivorship?
Health Issue
Course –
CANCER
CURABILITY &
SURVIVORSHIP
ROJoson Cancer Survivorship Program
The goal of ROJoson Cancer Survivorship Program
is to help cancer patients move forward with their
life while carefully monitoring their disease or
surveillance.
• Patient-centered Cancer Care Management
(personalized – cost-effective / compassionate
care)
• Group Psychosocial Therapy (ROJoson Cancer
Crusaders Club)
• What is cancer survivorship?
Health Issue
Course –
CANCER
CURABILITY &
SURVIVORSHIP
ROJoson Cancer Survivorship Program
The goal of ROJoson Cancer Survivorship Program
is to help cancer patients move forward with their
life while carefully monitoring their disease or
surveillance.
• Patient-centered Cancer Care Management
(personalized – cost-effective / compassionate
care)
• Group Psychosocial Therapy (ROJoson Cancer
Crusaders Club)
• What is cancer survivorship?
Health Issue
Course –
CANCER
CURABILITY &
SURVIVORSHIP
ROJoson Cancer Survivorship Program
The goal of ROJoson Cancer Survivorship Program
is to help cancer patients move forward with their
life while carefully monitoring their disease or
surveillance.
• Patient-centered Cancer Care Management
(personalized – cost-effective / compassionate
care)
• Group Psychosocial Therapy (ROJoson Cancer
Crusaders Club)
• What is cancer survivorship?
Health Issue
Course –
CANCER
CURABILITY &
SURVIVORSHIP
ROJoson Cancer Survivorship Program
The goal of ROJoson Cancer Survivorship Program
is to help cancer patients move forward with their
life while carefully monitoring their disease or
surveillance.
• Patient-centered Cancer Care Management
(personalized – cost-effective / compassionate
care)
• Group Psychosocial Therapy (ROJoson Cancer
Crusaders Club)
• What is cancer survivorship?
Health Issue
Course –
CANCER
CURABILITY &
SURVIVORSHIP
ROJoson Cancer Survivorship Program
The goal of ROJoson Cancer Survivorship Program
is to help cancer patients move forward with their
life while carefully monitoring their disease or
surveillance.
• Patient-centered Cancer Care Management
(personalized – cost-effective / compassionate
care)
• Group Psychosocial Therapy (ROJoson Cancer
Crusaders Club)
• What is cancer survivorship?
Health Issue
Course –
CANCER
CURABILITY &
SURVIVORSHIP
ROJoson Cancer Survivorship Program
The goal of ROJoson Cancer Survivorship Program
is to help cancer patients move forward with their
life while carefully monitoring their disease or
surveillance.
• Patient-centered Cancer Care Management
(personalized – cost-effective / compassionate
care)
• Group Psychosocial Therapy (ROJoson Cancer
Crusaders Club)
• What is cancer survivorship?
Health Issue
Course –
CANCER
CURABILITY &
SURVIVORSHIP
ROJoson Cancer Survivorship Program
The goal of ROJoson Cancer Survivorship Program
is to help cancer patients move forward with their
life while carefully monitoring their disease or
surveillance.
• Patient-centered Cancer Care Management
(personalized – cost-effective / compassionate
care)
• Group Psychosocial Therapy (ROJoson Cancer
Crusaders Club)
• What is cancer survivorship?
Health Issue
Course –
CANCER
CURABILITY &
SURVIVORSHIP
ROJoson Cancer Survivorship Program
The goal of ROJoson Cancer Survivorship Program
is to help cancer patients move forward with their
life while carefully monitoring their disease or
surveillance.
• Patient-centered Cancer Care Management
(personalized – cost-effective / compassionate
care)
• Group Psychosocial Therapy (ROJoson Cancer
Crusaders Club)
• ROJoson advocating statements and advice on
cancer curability & cancer survivorship
Health Issue
Course –
CANCER
CURABILITY &
SURVIVORSHIP
Summary
Take Away
• ROJoson advocating statements and advice on
cancer curability & cancer survivorship
Health Issue
Course –
CANCER
CURABILITY &
SURVIVORSHIP
There are a lot of uncertainties in cancer
management, particularly on curability and
survivorship.
These uncertainties give rise to anxiety on what
to expect and what to do. They usually give rise
to a GLOOMY reality.
A recommended optimistic stance will be to still
hope for the best in terms of curability and
survivorship but ready to accept the worst.
• ROJoson advocating statements and advice on
cancer curability & cancer survivorship
Health Issue
Course –
CANCER
CURABILITY &
SURVIVORSHIP
My advice: even before cancer develops in a
person, be proactive already in knowing the basic
principles and processes of cancer curability and
survivorship and on how early recognition, early
consult and early treatment which can give the
happier results and ending.
• ROJoson advocating statements and advice on
cancer curability & cancer survivorship
Health Issue
Course –
CANCER
CURABILITY &
SURVIVORSHIP
Although NO physician will guarantee cure on a
theoretical basis (because there is always a
chance, no matter how small, for cancer to recur
even after the most effective treatment), in
reality, one can still talk of CURE especially if
there is early recognition, early consult and early
treatment.
• ROJoson advocating statements and advice on
cancer curability & cancer survivorship
Health Issue
Course –
CANCER
CURABILITY &
SURVIVORSHIP
This is evidenced by my cancer survivor registry
wherein patients have been shown to live in
remission for more than 10 years and longer
(more than 30 years in my series – could be
more).
• ROJoson advocating statements and advice on
cancer curability & cancer survivorship
Health Issue
Course –
CANCER
CURABILITY &
SURVIVORSHIP
Remember this “Optimistic Concept of Cancer
Curability”
• that is based on usual recurrence time (years)
of a particular cancer after standard complete
treatment
• if no recurrence at this time, then one can say
“cured”
- NOT the absolute concept of NO CURE / JUST
REMISSION.
• ROJoson advocating statements and advice on
cancer curability & cancer survivorship
Health Issue
Course –
CANCER
CURABILITY &
SURVIVORSHIP
Because of the uncertainties and anxieties, a
patient needs a competent, holistic, and
compassionate physician to assist in the cancer
journey.
He needs a physician who has a Cancer
Survivorship Program which should consist of a
personalized patient-centered care management
inclusive of psychosocial therapy, and as much as
possible, a group psychosocial therapy.
Contents of CANCER CURABILITY &
SURVIVORSHIP
• What is a cancer?
• What is the basic cause of cancer?
• What is cancer curability? Can we talk of a cure
in cancer?
• What is cancer survivorship? Who is a cancer
survivor?
• What is ROJoson Cancer Survivorship Program?
• What are ROJoson’s advocating statements and
advice on cancer curability & cancer
survivorship?
Health Issue
Course –
CANCER
CURABILITY &
SURVIVORSHIP
Summary
Take Away
Health Issue
Course –
CANCER
CURABILITY &
SURVIVORSHIP
Take Away in
relation to
Patient
Empowerment
Be always in touch with reliable medical
information on CANCER CURABILITY &
SURVIVORSHIP.
Knowledge is power; it gives power.
Use the 4Ks of Patient Empowerment:
Kaalaman, Kakayanan, Karapatan and
Kapangyarihan
to gain greater control over decisions in
medical management of oneself by
knowing the basic principles and processes
in CANCER CURABILITY & SURVIVORSHIP.
Empowerment
objective - for
laypeople to have an
understanding of
CANCER CURABILITY
& SURVIVORSHIP in
their health
management.
Health Issue
Course –
CANCER
CURABILITY &
SURVIVORSHIP
My PEP TALK today
is entitled:
CANCER
CURABILITY &
SURVIVORSHIP.
This is part of the
Health Issue Course.

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ROJoson PEP Talk: CANCER CURABILITY & SURVIVORSHIP

  • 1. Empowerment objective - for laypeople to have an understanding of CANCER CURABILITY & SURVIVORSHIP in their health management. Health Issue Course – CANCER CURABILITY & SURVIVORSHIP August 13, 2022 1400H - 1500H Via Zoom
  • 2. Empowerment objective - for laypeople to have an understanding of CANCER CURABILITY & SURVIVORSHIP in their health management. Health Issue Course – CANCER CURABILITY & SURVIVORSHIP ROJoson PEP Talk I have a Patient Empowerment Program in which I like to empower the lay people or patients to take control in the management of their health.
  • 3. There are 3 courses in the PEP Talk. I completed the Core Course on October 9, 2021.
  • 4. From October 23, 2021 onwards, I have been tackling Health Disorder and Health Issue Courses. This may take 3 years or longer.
  • 5. Empowerment objective - for laypeople to have an understanding of CANCER CURABILITY & SURVIVORSHIP in their health management. Health Issue Course – CANCER CURABILITY & SURVIVORSHIP My PEP TALK today is entitled: CANCER CURABILITY & SURVIVORSHIP. This is part of the Health Issue Course.
  • 6. Contents of CANCER CURABILITY & SURVIVORSHIP • What is a cancer? • What is the basic cause of cancer? • What is cancer curability? Can we talk of a cure in cancer? • What is cancer survivorship? Who is a cancer survivor? • What is ROJoson Cancer Survivorship Program? • What are ROJoson’s advocating statements and advice on cancer curability & cancer survivorship? Health Issue Course – CANCER CURABILITY & SURVIVORSHIP
  • 7. • What is a cancer? Health Issue Course – CANCER CURABILITY & SURVIVORSHIP Cancer is a disease. Cancer is a medical disease when some of the body’s cells grow uncontrollably with a potential to invade the adjacent body tissues or organs and to spread to distant tissues or organs.
  • 8. • What is a cancer? Health Issue Course – CANCER CURABILITY & SURVIVORSHIP Cancer is a medical disease when some of the body’s cells grow uncontrollably with a potential to invade the adjacent body tissues or organs and to spread to distant tissues or organs.
  • 9. • What is a cancer? Health Issue Course – CANCER CURABILITY & SURVIVORSHIP Cancer is a medical disease when some of the body’s cells grow uncontrollably with a potential to invade the adjacent body tissues or organs and to spread to distant tissues or organs.
  • 10. • What is the basic cause of cancer? Health Issue Course – CANCER CURABILITY & SURVIVORSHIP Cancer is basically a genetic disease— that is, it is caused by changes to genes that control the way our cells function, especially how they grow and divide.
  • 11. • What is the basic cause of cancer? Health Issue Course – CANCER CURABILITY & SURVIVORSHIP Cancer covers a wide spectrum of diseases characterized by uncontrolled cell growth, which is driven by down-regulation of tumour- suppressing genes and/or up-regulation of tumour-promoting genes. Cancer is basically a genetic disease— that is, it is caused by changes to genes that control the way our cells function, especially how they grow and divide. Fail to stop uncontrolled cell growth! Allow uncontrolled growth!
  • 12. • What is cancer curability? Health Issue Course – CANCER CURABILITY & SURVIVORSHIP The conventional definition of “medical cure”: a medical condition or disease that’s completely gone and will never come back. Cancer curability – is cancer curable or incurable?
  • 13. • What is cancer curability? Health Issue Course – CANCER CURABILITY & SURVIVORSHIP For cancers, no doctors will guarantee your cancer will NOT come back. In other words, no doctors will guarantee you will be cured of cancer after treatment (after any type of treatment). Why?
  • 14. • What is cancer curability? Health Issue Course – CANCER CURABILITY & SURVIVORSHIP There are several reasons for this: 1. Doctors don’t know everything about the disease yet. The best knowledge so far is that the ultimate or proximate cause of cancer is changes (or mutations) to the DNA (genes) within cells; that cancer is a genetic disease caused by changes to genes that control the way our cells function, especially how they grow and divide. There are theories on how gene mutations lead to cancer development: - Allowing rapid growth - Failure to stop uncontrolled growth - Makes mistakes when repairing DNA errors EXACT MECHANISMS – NOT DEFINITELY KNOWN YET! Thus, the targeted cancer therapies on the molecular or gene level are not yet 100% successful.
  • 15. • What is cancer curability? Health Issue Course – CANCER CURABILITY & SURVIVORSHIP 2. The usual cancer treatment modalities (surgery, chemotherapy, and radiotherapy) are not strictly treating the primary cause of the cancer. They just extirpate, kill with drugs, and burn the cancer. If the primary cause is still around, there is always the possibility of recurrence after treatment.
  • 16. • What is cancer curability? Health Issue Course – CANCER CURABILITY & SURVIVORSHIP 3. No two cancers are the same. Each individual cancer possesses different biological characteristics, even cancers of the same type. Some are slow growing while some are fast growing. Usually, the biologic behavior of the cancer is not known at the time of treatment. Thus, only time will tell the outcome of treatment.
  • 17. • What is cancer curability? Health Issue Course – CANCER CURABILITY & SURVIVORSHIP 4. After treatment, some cancer cells may remain somewhere in the body (unnoticed and patients are asymptomatic) for a long time, even as long as 10 years, but can eventually grow, divide, invade, spread to distant areas and become a nuisance. (A RECURRENCE) A reason why doctors do not guarantee NO recurrence. At the time there are no symptoms, doctors use the word “REMISSION.”
  • 18. • What is cancer curability? Health Issue Course – CANCER CURABILITY & SURVIVORSHIP Complete remission means that tests, physical exams, and scans show that NO signs of your cancer are present. Some doctors also refer to complete remission as “no evidence of disease (NED)” or “no evidence of recurrence (NER)”. COMPLETE REMISSION DOESN’T MEAN CURE. A reason why doctors do not guarantee NO recurrence. At the time there are no symptoms, doctors use the word “REMISSION.”
  • 19. • What is cancer curability? Health Issue Course – CANCER CURABILITY & SURVIVORSHIP RECURRENCE Some cancer cells can remain unnoticed in the body for years after treatment. If a cancer returns after it has been in remission, it’s called a “recurrence.” A cancer can recur in the same place it was originally diagnosed, or it can recur in a different part of the body. A reason why doctors do not guarantee NO recurrence. At the time there are no symptoms, doctors use the word “REMISSION.”
  • 20. • What is cancer curability? Health Issue Course – CANCER CURABILITY & SURVIVORSHIP So, up to now, there is NO true cure for cancer (NO guarantee it will not recur). Physicians do not talk of “cure.” They use the word “remission” if there are no signs of recurrence. But they together with the patients always hope for a cure especially for those cancers which are recognized, diagnosed and treated early and with known track record of slow growth in behavior. SAD REALITY GLOOMY HOPEFUL REALITY OPTIMISTIC
  • 21. • What is cancer curability? Health Issue Course – CANCER CURABILITY & SURVIVORSHIP There is currently no cure for cancer. However, successful treatment can result in cancer going into remission, which means that all signs of it have gone. The early detection and treatment of cancer can significantly improve the chances of remission and a person's outlook. SAD REALITY GLOOMY HOPEFUL REALITY OPTIMISTIC
  • 22. • What is cancer curability? Health Issue Course – CANCER CURABILITY & SURVIVORSHIP Literally, to cure refers to eliminate a disease or condition without any relapse. However, the relapsing nature (within months or years) after remission makes the traditional definition of “cure” impractical and rarely mentioned in oncology. SAD REALITY GLOOMY HOPEFUL REALITY OPTIMISTIC
  • 23. • What is cancer curability? Health Issue Course – CANCER CURABILITY & SURVIVORSHIP The cure of cancer implies not only numerically long survival time, but also equal life expectation between properly treated patients and corresponding cancer-free population. A plausible and empirical criterion for curability is the maintenance of recurrence-free survival for more than 10 years after effective treatments. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3710180/) SAD REALITY GLOOMY HOPEFUL REALITY OPTIMISTIC
  • 24. • What is cancer curability? Health Issue Course – CANCER CURABILITY & SURVIVORSHIP Optimistic Concept of Cancer Curability Based on track records of different types of cancers Based on usual recurrence time (years) of a particular cancer after standard complete treatment If no recurrence at this time, then one can use “cured.” HOPEFUL REALITY OPTIMISTIC
  • 25. • What is cancer curability? Health Issue Course – CANCER CURABILITY & SURVIVORSHIP Optimistic Concept of Cancer Curability Based on track records of different types of cancers Based on usual recurrence time (years) of a particular cancer after standard complete treatment If no recurrence at this time, then one can use “cured.” HOPEFUL REALITY OPTIMISTIC Example: If the usual recurrence time of a particular cancer is within 5 years and if no recurrence on the 5th year, then one can say “cured”!
  • 26. • What is cancer curability? Health Issue Course – CANCER CURABILITY & SURVIVORSHIP Optimistic Concept of Cancer Curability Based on track records of different types of cancers Based on usual recurrence time (years) of a particular cancer after standard complete treatment If no recurrence at this time, then one can use “cured.” HOPEFUL REALITY OPTIMISTIC Example: If the usual recurrence time of a particular cancer is within 10 years and if no recurrence on the 10th year, then one can say “cured”! In general, 10 years is used as cut-off but with exceptions.
  • 27. • What is cancer survivorship? Health Issue Course – CANCER CURABILITY & SURVIVORSHIP
  • 28. • What is cancer survivorship? Who is a Cancer Survivor? Health Issue Course – CANCER CURABILITY & SURVIVORSHIP The American Cancer Society uses the term cancer survivor to refer to anyone who has ever been diagnosed with cancer no matter where they are in the course of their disease. One who remains alive and continues to function during and after overcoming a cancer is considered to be a cancer survivor, so from the time of diagnosis until the end of life. “Both the National Cancer Institute (NCI) and Roswell Park clinically define a person as a cancer survivor from the day of their cancer diagnosis onward, for as long as they are alive.” Regardless of status of cancer – in remission, with residual or recurrence after treatment.
  • 29. • What is cancer survivorship? Who is a Cancer Survivor? Health Issue Course – CANCER CURABILITY & SURVIVORSHIP Cancer Survivor A cancer survivor is an individual with cancer of any type, current or past, who is still living. Personally, I like to add 10 years at least with no recurrence (or in remission). I will also include those patients who died after 10 years with no recurrence and the cause of death is not due to the cancer. My personal observation is that chances of recurrence in this group of patients, 10 years with no recurrence, will be 1%.
  • 30. • What is cancer survivorship? Health Issue Course – CANCER CURABILITY & SURVIVORSHIP I have a cancer survivor registry in which I keep tract of patients who have been treated by me starting 1980 and who are considered "cancer survivors" using an operational criterion of at least 10 years in remission after treatment.
  • 31. • What is cancer survivorship? Health Issue Course – CANCER CURABILITY & SURVIVORSHIP The registry which I publish in the Internet (my blog) serves as an inspiration to current and future cancer patients and will debunk the thinking that having cancer is always a death sentence.
  • 32. • What is cancer survivorship? Health Issue Course – CANCER CURABILITY & SURVIVORSHIP As of August 4, 2022, I have a registry of 157 cancer survivors who have been in remission for 10 or more years under my care. (as long as or more than 30 years in remission) Mostly- Filipino patients with breast cancers and thyroid cancers. I will continue to track and increase the number of cancer survivors under my care.
  • 33. • What is cancer curability? Health Issue Course – CANCER CURABILITY & SURVIVORSHIP So, up to now, there is NO true cure for cancer (NO guarantee it will not recur). Physicians do not talk of “cure.” They use the word “remission” if there are no signs of recurrence. But they together with the patients always hope for a cure especially for those cancers which are recognized, diagnosed and treated early and with known track record of slow growth in behavior. SAD REALITY GLOOMY HOPEFUL REALITY OPTIMISTIC RECALL THIS SLIDE!
  • 34. • What is cancer curability? Health Issue Course – CANCER CURABILITY & SURVIVORSHIP So, up to now, there is NO true cure for cancer (NO guarantee it will not recur). Physicians do not talk of “cure.” They use the word “remission” if there are no signs of recurrence. But they together with the patients always hope for a cure especially for those cancers which are recognized, diagnosed and treated early and with known track record of slow growth in behavior. SAD REALITY GLOOMY HOPEFUL REALITY OPTIMISTIC RECALL THIS SLIDE! How do you relate this gloomy concept of cancer curability or incurability to my Cancer Survivor Registry wherein I already have more than 150 patients who survived more than 10 years and longer?
  • 35. • What is cancer curability? Health Issue Course – CANCER CURABILITY & SURVIVORSHIP Optimistic Concept of Cancer Curability Based on track records of different types of cancers Based on usual recurrence time (years) of a particular cancer after standard complete treatment If no recurrence at this time, then one can use “cured.” HOPEFUL REALITY OPTIMISTIC Example: If the usual recurrence time of a particular cancer is within 10 years and if no recurrence on the 10th year, then one can say “cured”! In general, 10 years is used as cut-off but with exceptions. RECALL THIS SLIDE!
  • 36. • What is cancer curability? Health Issue Course – CANCER CURABILITY & SURVIVORSHIP Optimistic Concept of Cancer Curability Based on track records of different types of cancers Based on usual recurrence time (years) of a particular cancer after standard complete treatment If no recurrence at this time, then one can use “cured.” HOPEFUL REALITY OPTIMISTIC Example: If the usual recurrence time of a particular cancer is within 10 years and if no recurrence on the 10th year, then one can say “cured”! In general, 10 years is used as cut-off but with exceptions. RECALL THIS SLIDE! How do you relate this optimistic concept of cancer curability to my Cancer Survivor Registry wherein I already have more than 150 patients who survived more than 10 years and longer?
  • 37. • What is cancer survivorship? Health Issue Course – CANCER CURABILITY & SURVIVORSHIP My recommendations: Be optimistic but be vigilant in promoting cancer cure and survivorship. Though there is no guarantee of complete and permanent cure from cancer, there is still a chance for cure and survivorship. Be vigilant on having early detection, early consultation and early treatment to have best chance for cure. Then, hope and pray that there will be cure in terms of no recurrence until you die of another non- cancer cause. If there is cure, give thanks. If there is no cure, say “thy will be done.”
  • 38. • What is cancer survivorship? Health Issue Course – CANCER CURABILITY & SURVIVORSHIP ROJoson Cancer Survivorship Program • Patient-centered Cancer Care Management • Group Psychosocial Therapy (ROJoson Cancer Crusaders Club) • Cancer Survivor Registry
  • 39. • What is cancer survivorship? Health Issue Course – CANCER CURABILITY & SURVIVORSHIP ROJoson Cancer Survivorship Program The goal of ROJoson Cancer Survivorship Program is to help cancer patients move forward with their life while carefully monitoring their disease or surveillance. • Patient-centered Cancer Care Management (personalized – cost-effective / compassionate care) • Group Psychosocial Therapy (ROJoson Cancer Crusaders Club)
  • 40. • What is cancer survivorship? Health Issue Course – CANCER CURABILITY & SURVIVORSHIP ROJoson Cancer Survivorship Program The goal of ROJoson Cancer Survivorship Program is to help cancer patients move forward with their life while carefully monitoring their disease or surveillance. • Patient-centered Cancer Care Management (personalized – cost-effective / compassionate care) • Group Psychosocial Therapy (ROJoson Cancer Crusaders Club)
  • 41. • What is cancer survivorship? Health Issue Course – CANCER CURABILITY & SURVIVORSHIP ROJoson Cancer Survivorship Program The goal of ROJoson Cancer Survivorship Program is to help cancer patients move forward with their life while carefully monitoring their disease or surveillance. • Patient-centered Cancer Care Management (personalized – cost-effective / compassionate care) • Group Psychosocial Therapy (ROJoson Cancer Crusaders Club)
  • 42. • What is cancer survivorship? Health Issue Course – CANCER CURABILITY & SURVIVORSHIP ROJoson Cancer Survivorship Program The goal of ROJoson Cancer Survivorship Program is to help cancer patients move forward with their life while carefully monitoring their disease or surveillance. • Patient-centered Cancer Care Management (personalized – cost-effective / compassionate care) • Group Psychosocial Therapy (ROJoson Cancer Crusaders Club)
  • 43. • What is cancer survivorship? Health Issue Course – CANCER CURABILITY & SURVIVORSHIP ROJoson Cancer Survivorship Program The goal of ROJoson Cancer Survivorship Program is to help cancer patients move forward with their life while carefully monitoring their disease or surveillance. • Patient-centered Cancer Care Management (personalized – cost-effective / compassionate care) • Group Psychosocial Therapy (ROJoson Cancer Crusaders Club)
  • 44. • What is cancer survivorship? Health Issue Course – CANCER CURABILITY & SURVIVORSHIP ROJoson Cancer Survivorship Program The goal of ROJoson Cancer Survivorship Program is to help cancer patients move forward with their life while carefully monitoring their disease or surveillance. • Patient-centered Cancer Care Management (personalized – cost-effective / compassionate care) • Group Psychosocial Therapy (ROJoson Cancer Crusaders Club)
  • 45. • What is cancer survivorship? Health Issue Course – CANCER CURABILITY & SURVIVORSHIP ROJoson Cancer Survivorship Program The goal of ROJoson Cancer Survivorship Program is to help cancer patients move forward with their life while carefully monitoring their disease or surveillance. • Patient-centered Cancer Care Management (personalized – cost-effective / compassionate care) • Group Psychosocial Therapy (ROJoson Cancer Crusaders Club)
  • 46. • What is cancer survivorship? Health Issue Course – CANCER CURABILITY & SURVIVORSHIP ROJoson Cancer Survivorship Program The goal of ROJoson Cancer Survivorship Program is to help cancer patients move forward with their life while carefully monitoring their disease or surveillance. • Patient-centered Cancer Care Management (personalized – cost-effective / compassionate care) • Group Psychosocial Therapy (ROJoson Cancer Crusaders Club)
  • 47. • What is cancer survivorship? Health Issue Course – CANCER CURABILITY & SURVIVORSHIP ROJoson Cancer Survivorship Program The goal of ROJoson Cancer Survivorship Program is to help cancer patients move forward with their life while carefully monitoring their disease or surveillance. • Patient-centered Cancer Care Management (personalized – cost-effective / compassionate care) • Group Psychosocial Therapy (ROJoson Cancer Crusaders Club)
  • 48. • What is cancer survivorship? Health Issue Course – CANCER CURABILITY & SURVIVORSHIP ROJoson Cancer Survivorship Program The goal of ROJoson Cancer Survivorship Program is to help cancer patients move forward with their life while carefully monitoring their disease or surveillance. • Patient-centered Cancer Care Management (personalized – cost-effective / compassionate care) • Group Psychosocial Therapy (ROJoson Cancer Crusaders Club)
  • 49. • What is cancer survivorship? Health Issue Course – CANCER CURABILITY & SURVIVORSHIP ROJoson Cancer Survivorship Program The goal of ROJoson Cancer Survivorship Program is to help cancer patients move forward with their life while carefully monitoring their disease or surveillance. • Patient-centered Cancer Care Management (personalized – cost-effective / compassionate care) • Group Psychosocial Therapy (ROJoson Cancer Crusaders Club)
  • 50. • What is cancer survivorship? Health Issue Course – CANCER CURABILITY & SURVIVORSHIP ROJoson Cancer Survivorship Program The goal of ROJoson Cancer Survivorship Program is to help cancer patients move forward with their life while carefully monitoring their disease or surveillance. • Patient-centered Cancer Care Management (personalized – cost-effective / compassionate care) • Group Psychosocial Therapy (ROJoson Cancer Crusaders Club)
  • 51. • ROJoson advocating statements and advice on cancer curability & cancer survivorship Health Issue Course – CANCER CURABILITY & SURVIVORSHIP Summary Take Away
  • 52. • ROJoson advocating statements and advice on cancer curability & cancer survivorship Health Issue Course – CANCER CURABILITY & SURVIVORSHIP There are a lot of uncertainties in cancer management, particularly on curability and survivorship. These uncertainties give rise to anxiety on what to expect and what to do. They usually give rise to a GLOOMY reality. A recommended optimistic stance will be to still hope for the best in terms of curability and survivorship but ready to accept the worst.
  • 53. • ROJoson advocating statements and advice on cancer curability & cancer survivorship Health Issue Course – CANCER CURABILITY & SURVIVORSHIP My advice: even before cancer develops in a person, be proactive already in knowing the basic principles and processes of cancer curability and survivorship and on how early recognition, early consult and early treatment which can give the happier results and ending.
  • 54. • ROJoson advocating statements and advice on cancer curability & cancer survivorship Health Issue Course – CANCER CURABILITY & SURVIVORSHIP Although NO physician will guarantee cure on a theoretical basis (because there is always a chance, no matter how small, for cancer to recur even after the most effective treatment), in reality, one can still talk of CURE especially if there is early recognition, early consult and early treatment.
  • 55. • ROJoson advocating statements and advice on cancer curability & cancer survivorship Health Issue Course – CANCER CURABILITY & SURVIVORSHIP This is evidenced by my cancer survivor registry wherein patients have been shown to live in remission for more than 10 years and longer (more than 30 years in my series – could be more).
  • 56. • ROJoson advocating statements and advice on cancer curability & cancer survivorship Health Issue Course – CANCER CURABILITY & SURVIVORSHIP Remember this “Optimistic Concept of Cancer Curability” • that is based on usual recurrence time (years) of a particular cancer after standard complete treatment • if no recurrence at this time, then one can say “cured” - NOT the absolute concept of NO CURE / JUST REMISSION.
  • 57. • ROJoson advocating statements and advice on cancer curability & cancer survivorship Health Issue Course – CANCER CURABILITY & SURVIVORSHIP Because of the uncertainties and anxieties, a patient needs a competent, holistic, and compassionate physician to assist in the cancer journey. He needs a physician who has a Cancer Survivorship Program which should consist of a personalized patient-centered care management inclusive of psychosocial therapy, and as much as possible, a group psychosocial therapy.
  • 58. Contents of CANCER CURABILITY & SURVIVORSHIP • What is a cancer? • What is the basic cause of cancer? • What is cancer curability? Can we talk of a cure in cancer? • What is cancer survivorship? Who is a cancer survivor? • What is ROJoson Cancer Survivorship Program? • What are ROJoson’s advocating statements and advice on cancer curability & cancer survivorship? Health Issue Course – CANCER CURABILITY & SURVIVORSHIP Summary Take Away
  • 59. Health Issue Course – CANCER CURABILITY & SURVIVORSHIP Take Away in relation to Patient Empowerment Be always in touch with reliable medical information on CANCER CURABILITY & SURVIVORSHIP. Knowledge is power; it gives power. Use the 4Ks of Patient Empowerment: Kaalaman, Kakayanan, Karapatan and Kapangyarihan to gain greater control over decisions in medical management of oneself by knowing the basic principles and processes in CANCER CURABILITY & SURVIVORSHIP.
  • 60. Empowerment objective - for laypeople to have an understanding of CANCER CURABILITY & SURVIVORSHIP in their health management. Health Issue Course – CANCER CURABILITY & SURVIVORSHIP My PEP TALK today is entitled: CANCER CURABILITY & SURVIVORSHIP. This is part of the Health Issue Course.