ROJoson PEP Talk: COLORECTAL CANCER AWARENESS - for Zoom

1. Colorectal
Cancer
Awareness
March 11, 2023
1400H - 1500H
Via Zoom
Empowerment
objective - for
laypeople to have a
basic understanding
of COLORECTAL
CANCER in their
health management.

2. Colorectal
Cancer
Awareness
March 11, 2023
1400H - 1500H
Via Zoom
Empowerment
objective - for
laypeople to have a
basic understanding
of COLORECTAL
CANCER in their
health management.
Welcome all!
MUTE yourself but always
show your video picture.
Sign in your name, FB
account, or email address in
the Chat Box! Include names
of companions attending.
Use the Chat Box to ask
questions and make
comments while the PEP TALK
is on.
Group pictures at start and
end of PEP TALK – show your
face in video.

3. Reminder after the PEP
Talk:
Take the Online Learning
cum Evaluation Test
Exercise (OLETE) for
mastery of learning and
have a perfect score to get
a Certificate.
Link is in Chat Box.

4. Reminder:
50 OLETE Certificates = 1
Voucher for ROJoson
Telemedical Consultation

5. Colorectal
Cancer
Awareness
Empowerment
objective - for
laypeople to have a
basic understanding
of COLORECTAL
CANCER in their
health management.
ROJOSON’S REQUEST:
FEEDBACK TO THIS
PEP TALK!
Pls. type in your
feedback in the chat
box during the open
forum and before we
adjourn!
Thank you!

6. Colorectal
Cancer
Awareness
Empowerment
objective - for
laypeople to have a
basic understanding
of COLORECTAL
CANCER in their
health management.
LET’S NOW HAVE A
GROUP PICTURE
TAKING BEFORE WE
START PEP TALK
PROPER IN 2
MINUTES!
Pls. turn on your
video!
Show your face!

8. Colorectal
Cancer
Awareness
Empowerment
objective - for
laypeople to have a
basic understanding
of COLORECTAL
CANCER in their
health management.
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.

9. I started the PEP Talk
on May 15, 2021.
There are 3 courses
in the PEP Talk.
I completed the Core
Course on October 9,
2021.

10. From October 23,
2021 onwards, I have
been tackling Health
Disorder and Health
Issue Courses. This
may take 3 years or
longer depending on
our enthusiasm and
perseverance.

11. Colorectal
Cancer
Awareness
Empowerment
objective - for
laypeople to have a
basic understanding
of COLORECTAL
CANCER in their
health management.
My PEP TALK today is
entitled:
COLORECTAL
CANCER
AWARENESS
In consonance with
DOH Health
Awareness Calendar
- COLORECTAL
CANCER AWARENESS
MONTH (March)

12. Contents
• Why the COLORECTAL Cancer Awareness Month?
• What is a COLORECTAL cancer (CRC)?
• What are the different types of COLORECTAL cancers?
• What are the causes and risk factors for COLORECTAL cancers?
• What are the symptoms and signs that will lead to suspicion of
COLORECTAL cancers?
• How are COLORECTAL cancers diagnosed? Clinically and paraclinically?
• What are the different treatment modalities for COLORECTAL cancers?
• What is the prognosis of COLORECTAL cancers?
• What are the screening strategies for COLORECTAL cancers to promote
early detection in the Philippines?
• What are ROJoson’s health advice on COLORECTAL cancers?
Colorectal
Cancer
Awareness

13. Why the COLORECTAL Cancer Awareness
Month?
To raise awareness on COLORECTAL
CANCERS as a health problem in the
community and in our personal life.
To highlight the importance of managing
colorectal cancer in the community
because it is
• so common
• causing a lot of deaths
• preventable, treatable and beatable
Colorectal
Cancer
Awareness
Colorectal cancer PH
2020 Globocan
3rd most common
overall
• 2nd in males
• 3rd in females
4th most common
death overall
• Lung
• Liver
• Breast
• Colorectal

14. Why the COLERECTAL Cancer Awareness Month?
The goals of the Awareness Campaign are to
decrease in PH
• Frequency or number of cases (17K new
cases – 2020)
• Death number (6K – 2020)
• Number of Filipinos suffering with poor
quality of life particularly those due to late
diagnosis and treatment wherein extensive /
complicated surgery with enterostomy /
colostomy; chemotherapy, radiation therapy
may be avoided if managed early enough.
Colorectal
Cancer
Awareness
Colorectal cancer PH
2020 Globocan
3rd most common
overall
• 2nd in males
• 3rd in females
4th most common
death overall
• Lung
• Liver
• Breast
• Colorectal

15. What is a COLORECTAL cancer?
Cancer in the colorectal parts of the human body.
Colorectal
Cancer
Awareness Colorectal =
colon
+ rectum
+ anus
or
large intestine +
rectum + anus
Colorectal – passage
way of stools or feces
to the outside.

16. What is a COLORECTAL cancer?
Cancer in the colorectal parts of the human body.
Colorectal
Cancer
Awareness
Colorectal cancer can occur in any parts
of the colon, rectum and anus
(may extend to adjacent parts / may be
multiple)

17. What are the different types of COLORECTAL
Cancers?
Colorectal
Cancer
Awareness
Colorectal cancer can occur in any parts
of the colon, rectum and anus
(may extend to adjacent parts / may be
multiple)
Based on origin/location and
extension on the colorectal

18. What are the different types of COLORECTAL
Cancers?
Colorectal
Cancer
Awareness
Colorectal cancer can occur in any parts
of the colon, rectum and anus
(may extend to adjacent parts / may be
multiple)
Based on cell types of origin
• Adenocarcinoma
• Squamous cell carcinoma
• Carcinoid
• Lymphoma
• Sarcoma
• Others

19. What are the causes and risk factors for
COLORECTAL cancers?
The ultimate cause is a gene mutation that leads
to uncontrollable growth of cells on the wall of
the colorectum.
The gene mutation may be hereditary (from
parents) or acquired or sporadic (environment
and lifestyle).
Hereditary gene mutation – 5 to 10%
Acquired gene mutation – 90 to 95%
Colorectal
Cancer
Awareness
Examples of
hereditary CRC:
• Lynch syndrome
(previously known
as Hereditary Non-
Polyposis
Colorectal Cancer
or HNPCC)
• Familial
Adenomatous
Polyposis (FAP)

20. What are the causes and risk factors for
COLORECTAL cancers?
Hereditary vs Familial Cancers
The two terms are sometimes used
interchangeably, but have different concepts.
•‘Hereditary’ refers to diseases with a known
genetic cause.
•’Familial’ disorders are those which appear to
have a genetic or hereditary component,
affecting more family members than would be
expected by chance alone; however, a single
genetic cause or explanation is NOT known.
Colorectal
Cancer
Awareness

21. What are the causes and risk factors for
COLORECTAL cancers?
What are the chances of getting colon cancer
with family history?
If you have familial risk, a single first degree
family member (parent or sibling) with colon or
endometrial cancer under age 50, your lifetime
risk increases to 10-20%.
Family history is an important indicator not only
because of shared genes, but similar lifestyles
too.
Colorectal
Cancer
Awareness

22. What are the causes and risk factors for
COLORECTAL cancers?
Acquired or sporadic genetic mutations are due
to environmental and lifestyle factors.
• Viruses [Epstein–Barr virus (EBV), human
papillomavirus (HPV) and John Cunningham virus (JCV)]
• Lack of regular physical activity
• A diet low in fruit and vegetables
• A low-fiber and high-fat diet, or a diet high in
processed meats
• Overweight and obesity
• Alcohol consumption
• Tobacco use
Colorectal
Cancer
Awareness
NOTE: Exact cause of
CRC difficult to
exactly identify at
time of diagnosis for
a particular patient.
• More commonly,
sporadic and not
hereditary.
• More commonly,
multifactorial –
sporadic ones.

23. What are the symptoms and signs that will lead
to suspicion of COLORECTAL cancers?
Many people with colorectal cancer experience
no symptoms in the early stages of the disease.
When symptoms appear, they'll likely vary,
depending on the cancer's size and location in
the colorectum.
Colorectal
Cancer
Awareness

24. What are the symptoms and signs that will lead
to suspicion of COLORECTAL cancers?
Common symptoms and signs:
•A persistent change in bowel habits, including
diarrhea or constipation or a change in the
consistency of the stool
•Rectal bleeding or blood in the stool
•Persistent abdominal discomfort, such as
cramps, gas or pain
•A feeling that the bowel doesn't empty
completely
Colorectal
Cancer
Awareness

25. How are COLORECTAL cancers diagnosed?
Clinically and paraclinically?
A suspicion of colorectal cancer diagnosis
warrants initially a palpation of the abdomen and
a rectal examination for any mass that may be
palpable.
Colorectal
Cancer
Awareness

26. How are COLORECTAL cancers diagnosed?
Clinically and paraclinically?
Subsequently, fecal occult blood tests and lower
alimentary canal endoscopy such as colonoscopy
(with a biopsy of any suspicious lesions) can be
done as indicated.
Other paraclinical diagnostic tests may be done
as indicated.
Colorectal
Cancer
Awareness

27. How are COLORECTAL cancers diagnosed?
Clinically and paraclinically?
Fecal occult blood tests (FOBT)
• used to find blood in the feces, or stool
• finds blood in the stool that one cannot see
(occult)
• blood in the stool may be a sign of colorectal
cancer
• Note: often used as a screening test for CRC.
Colorectal
Cancer
Awareness

28. How are COLORECTAL cancers diagnosed?
Clinically and paraclinically?
Fecal occult blood tests (FOBT)
Two types:
• Guaiac-based FOBT
• Fecal immunochemical test (FIT) or
immunochemical FOBT
FIT - do not need to make any dietary changes
but need to avoid certain medications such as
NSAIDs and blood-thinning medications
Colorectal
Cancer
Awareness

29. How are COLORECTAL cancers diagnosed?
Clinically and paraclinically?
Lower alimentary canal endoscopy (scope and
biopsy as indicated)
• Anoscopy
• Proctoscopy
• Sigmoidoscopy
• Colonoscopy
Colorectal
Cancer
Awareness

30. How are COLORECTAL cancers diagnosed?
Clinically and paraclinically?
Colonoscopy – commonly done
Colorectal
Cancer
Awareness

31. How are COLORECTAL cancers diagnosed?
Clinically and paraclinically?
Colonoscopy
Scope with
Biopsy
Colorectal
Cancer
Awareness

32. What are the different treatment modalities for
COLORECTAL cancers?
Common treatment modalities:
• Surgery
• Chemotherapy
• Radiotherapy
Singly or in combination depending on the stage
of the CRC: Examples:
• Surgery only
• Surgery + chemotherapy
• Chemotherapy + radiotherapy + surgery
Colorectal
Cancer
Awareness

33. What are the different treatment modalities for COLORECTAL cancers?
Common treatment modalities:
• Surgery
• Chemotherapy
• Radiotherapy
• Surgery. The goal of surgery is to remove the cancer or as much of the
cancer as possible.
• Chemotherapy. Chemotherapy uses drugs to kill cancer cells.
• Radiation therapy. Radiation therapy uses high-powered energy
beams, such as X-rays or protons, to kill cancer cells. Radiation
treatment can come from a machine outside your body (external beam
radiation), or it can be placed inside your body (brachytherapy).
Colorectal
Cancer
Awareness

34. What are the different treatment modalities for
COLORECTAL cancers?
Surgery
The treatment of choice for colorectal cancers
is usually surgical resection, which involves
removing the cancer through surgery.
Surgery is performed to remove the cancer
completely and reconstruct the bowel, if
possible, so your postoperative bowel function is
normal or near normal.
Colorectal
Cancer
Awareness

35. Colorectal
Cancer
Awareness

36. Colorectal
Cancer
Awareness

37. Colorectal
Cancer
Awareness

38. Colorectal
Cancer
Awareness
At times, aside from the removal of the CRC, stomas (artificial anus) may
be created, either on a temporary or permanent basis.

39. Which is more serious, colon cancer or rectal
cancer?
"The rectum doesn't have the same protective
outer layer (called the serosa) as the colon, so it's
easier for a tumor to break through and spread
locally."
"That makes rectal cancer 10 times more likely
than colon cancer to come back after treatment
where it started.“
Colorectal
Cancer
Awareness

40. Which is more serious, right-sided or left-sided
colon cancer?
Right-sided colon cancers are more likely to be
diagnosed at a later stage and this alone makes
for a poorer prognosis
Compared to left-sided colon cancers.
Colorectal
Cancer
Awareness

41. What is the prognosis of COLORECTAL cancers?
For colorectal cancers (US Statistics):
Overall 5-year survival rate (around – 63%)
Localized stage – 91%
If the cancer has spread to surrounding tissues or
organs and/or the regional lymph nodes – 72%
If colon cancer has spread to distant parts of the
body – 15%
Colorectal
Cancer
Awareness

42. What is the prognosis of COLORECTAL cancers?
Philippine Statistics:
5-year relative survival estimates were obtained
for Philippine residents (37%)
as compared to those in Filipino-Americans
(60.3%) and Caucasians (62.4%).
Redaniel, M.T., Laudico, A., Mirasol-Lumague, M.R. et al. Inter-
country and ethnic variation in colorectal cancer survival:
Comparisons between a Philippine population, Filipino-Americans
and Caucasians. BMC Cancer 10, 100 (2010).
https://doi.org/10.1186/1471-2407-10-100
Colorectal
Cancer
Awareness

43. What is the prognosis of COLORECTAL cancers?
Philippine Statistics:
estimate 3- and 5-year survival for colon
cancer to be 38.1% and 33.9%
and that of rectal cancer 31.3% and 20.0%
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7000227/#:~:tex
t=Colorectal%20cancers%20(CRCs)%20are%20currently,%25%20a
nd%2020.0%25%2C%20respectively.
Colorectal
Cancer
Awareness
Patients enrolled in
the PhilHealth Z-
package program
had a 2- and 3-year
survival probability
of 74% and 70% for
colon and rectal
cancers
respectively (2018).

44. PhilHealth Z package for Colorectal Cancers
The Z package rate for the entire course of
treatment of colon cancer, Stages I to II (low risk)
is P 150,000.00, while package rate for Stages II
(high risk) to III is P 300,000.00.
On the other hand, the Z package for the entire
course of treatment for rectum cancer, Stage I
(clinical and pathologic) is P 150,000.00.
Colorectal
Cancer
Awareness
Patients enrolled in
the PhilHealth Z-
package program
had a 2- and 3-year
survival probability
of 74% and 70% for
colon and rectal
cancers respectively
(2018).

45. PhilHealth Z package for Colorectal Cancers
PhilHealth will also pay P400,000.00 for pre-
operative clinical stage I, but with post-operative
pathologic Stages II-III using linear accelerator as
mode of radiotherapy. Coverage for the same
stages but using cobalt as mode of radiotherapy
is P320,000.00.
Rectum cancer with clinical stages II-III, using
linear accelerator as mode of radiotherapy is also
covered at P400,000.00, and using cobalt as
mode of radiotherapy is covered at P 320,000.00.
Colorectal
Cancer
Awareness
Patients enrolled in
the PhilHealth Z-
package program
had a 2- and 3-year
survival probability
of 74% and 70% for
colon and rectal
cancers respectively
(2018).

46. What are the screening strategies for
COLORECTAL cancers to promote early detection
in the Philippines?
Who:
+ Family history (screening – earlier at age 40)
Age 50 and above
What:
FIT (Fecal immunochemical test)
If FIT is +, colonoscopy
Listen to your body all the times for possible CRC.
Colorectal
Cancer
Awareness

47. What are ROJoson’s health advice on
COLORECTAL cancers?
• Avoid the modifiable risk factors of CRC
(healthy lifestyle).
• Listen to your body all the times for possible
CRC (know the symptoms and signs that may
suggest presence of CRC).
• Consult early if with suspicious symptoms and
signs of CRC.
• Have early treatment if with established CRC.
• Undergo cost-effective screening programs for
CRC as indicated.
Colorectal
Cancer
Awareness

48. Contents
• Why the COLORECTAL Cancer Awareness Month?
• What is a COLORECTAL cancer (CRC)?
• What are the different types of COLORECTAL cancers?
• What are the causes and risk factors for COLORECTAL cancers?
• What are the symptoms and signs that will lead to suspicion of
COLORECTAL cancers?
• How are COLORECTAL cancers diagnosed? Clinically and paraclinically?
• What are the different treatment modalities for COLORECTAL cancers?
• What is the prognosis of COLORECTAL cancers?
• What are the screening strategies for COLORECTAL cancers to promote
early detection in the Philippines?
• What are ROJoson’s health advice on COLORECTAL cancers?
Colorectal
Cancer
Awareness
Summary
Take Away

49. Colorectal
Cancer
Awareness
Be always in touch with reliable medical
information on COLORECTAL cancers.
Knowledge is power; it gives power.
Use the 4Ks of Patient Empowerment:
Kaalaman, Kakayanan, Karapatan and
Kapangyarihan
to gain greater control over decisions in
the prevention, recognition and treatment
of COLORECTAL cancers in one’s health
management.
Take Away in
relation to
Patient
Empowerment

50. Colorectal
Cancer
Awareness
Empowerment
objective - for
laypeople to have a
basic understanding
of COLORECTAL
CANCER in their
health management.

51. Reminder after the PEP
Talk:
Take the Online Learning
cum Evaluation Test
Exercise (OLETE) for
mastery of learning and
have a perfect score to get
a Certificate.
Link is in Chat Box.

52. Reminder:
50 OLETE Certificates = 1
Voucher for ROJoson
Telemedical Consultation

53. Colorectal
Cancer
Awareness
Empowerment
objective - for
laypeople to have a
basic understanding
of COLORECTAL
CANCER in their
health management.
ROJOSON’S REQUEST:
FEEDBACK TO THIS
PEP TALK!
Pls. type in your
feedback in the chat
box during the open
forum and before we
adjourn!
Thank you!

54. Colorectal
Cancer
Awareness
Empowerment
objective - for
laypeople to have a
basic understanding
of COLORECTAL
CANCER in their
health management.
LET’S NOW HAVE A
GROUP PICTURE
TAKING BEFORE WE
START Q&A AND
INTERACTIONS!
Pls. turn on your
video!
Show your face!