The Philippine Online Chronicles

What do Chat Silayan, Rio Diaz, Helen Vela and the late President Corazon Aquino have in common?

They were all diagnosed with colon cancer and, unfortunately, died because of it.

Actress/beauty queen Rio Diaz was diagnosed with Stage 4 colon cancer in December 1998. She was only given three months to live but astounded her doctors by living six more years. She lost the battle against colon cancer on October 4, 2004 at age 45.

Chat Silayan, also an actress/beauty queen, found out she had colon cancer in April 2004 when she had surgery on her colon. She fought with colon cancer for two years but died in 2006.

Corazon Aquino, the 11^th President and first woman president of the Philippines, also succumbed in 2009 while battling colon cancer at the age of 76. Her death was mourned all over the country and the world.

But colon cancer does not only affect the rich and famous; it can strike anyone.

In a recent family gathering, I chanced upon an acquaintance who was exhibiting the early signs of colorectal cancer. Because I was researching for this article at that time, I was able to probe and, consequently, advise her to immediately see a doctor.

Awareness is key

Colorectal cancer is a deadly illness but it can be treated when detected early. March is National Colorectal Cancer Awareness Month.  Worldwide efforts focus on opening the eyes of the people about the risk of colorectal cancer.

This type of cancer is considered 2^nd most rampant cause of cancer deaths in the US.  In fact, colorectal cancer has claimed more lives of men and women in the US than breast cancer and AIDS put together.  There is an alarming estimate of 146,970 people diagnosed in 2009 and an estimated 49,920 people will succumb to the disease.  The alarming increase of cases pushes worldwide call for wider understanding of the disease.

In the Philippines, colorectal cancer is one of the most prevalent cancers (following behind cancers of the lung, breast, liver,cervix and leukemia).  Colorectal cancer ranks 6^th overall (5^th leading cancer among men and 7^th among women). The Philippine Cancer society estimates 8,000 new colorectal cancer cases to affect Filipinos.

Colon cancer, also called colon cancer or large bowel cancer, refers to the cancer of the colon (large intestines) or the rectum.  This cancer is attributed to the uncontrolled growth of abnormal cells in the colon or rectum, observed equally among men and women.

This cancer often starts as polyps (abnormal growths that are found within the inner lining of the color or rectum).  Polyps are not cancerous but have the potential to develop into one over the years.   Ninety-five percent of colorectal cancer is adenocarcinoma which refers to cancer of the gland cells lining the inner wall of the large intestine.

Who are at risk?

There is no substantial known cause for colorectal cancer but some people may be more at risk than others. Below are some risk factors to pay close attention to:

• Men and women at the age of 50 and above
• People who are tobacco users, are excessively overweight, or lead sedentary lifestyles
• People with personal or family history of colorectal cancer or non cancerous (benign) polyps in the colon
• Individuals with personal or family history of inflammatory bowel disease
• People with family history of inherited colorectal cancer

Colorectal cancer is asymptomatic; in other words, there are no exact symptoms categorized under this type of cancer.  However, there are warning signs that you can pay close attention to such as:

• Change in bowel habits:  recurrent diarrhea and constipation, accompanied by abdominal discomfort
• Persistent nausea
• Unexplained weight loss
• Unexplained anemia
• Sensation of bowel not emptying completely
• Persistent tiredness
• Presence of blood in the stool

Proper care of the body and self discipline can help people fight diseases such as colorectal cancer.

Eat a balanced diet. A balanced diet strengthens the body’s resistance against diseases. Evidence shows that colorectal cancer may be linked to diet high in fat and cholesterol and low fiber diets. Minimizing intake of red meat and fatty foods while eating more fiber, vegetables, fruits and whole grains can decrease chances of getting colorectal cancer.  It is also best to avoid food with too many preservatives.

Exercise regularly. Obesity makes a person vulnerable to different diseases, one of which is colorectal cancer.  A sedentary way of life is another factor of this disease. Prolonged sitting down and inactivity can cause waste to stay longer in the colon or rectum, building toxic materials in the body.  Regular exercise will help a person lose unwanted weight and stimulate peristalsis, a wave-like muscular contraction that pushes waste through the colon.

Avoid smoking. Smoking has always been known to be dangerous to one’s health.  The smoke from the tobacco can transmit carcinogens to the colon. Twelve percent of colorectal deaths have been linked to smoking. Tobacco can also influence the increase of polyp size.

Take daily vitamins. Studies suggest that taking daily vitamins with folic acid or folate can decrease risk of colorectal cancer. The tandem components of calcium and vitamin D can also reduce chances of this disease.  Vitamin D helps the body absorb calcium. Recent study claim that a diet rich in magnesium can lower risk among women.

Get genetic counselling. Individuals who have genetic mutations linked to hereditary colorectal cancer have higher chances of acquiring the disease. People who have the mutation that leads to Familial Adenomatous Polyposis (FAP) have a hundred percent chance of getting the disease by age forty-five.  Individuals who have the mutation in relation to Hereditary Non-Polyposis Colorectal Cancer (HNPCC) have up to eighty percent chance of acquiring the disease. Genetic counselling is advised for people who carry such genetic mutations.

Be familiar with your family medical history. The chances of developing colorectal cancer may be influenced by one’s immediate and extended family history. A relative diagnosed with polyps or colorectal cancer before age 60, died because of stomach cancer or have breast or ovarian cancer history may increase the risk of acquiring the disease.

Consult doctor about personal medical history. Studies indicate that women with breast, uterine or ovarian cancer have greater risk of developing colorectal cancer.  Another factor increasing risk of colorectal cancer is chronic inflammation of the bowel.  Consulting a doctor about these can help address personal concerns.

Subject yourself to screening. As of now, there is still no efficient method to detect early colorectal cancer.  Individuals who see themselves at an average risk for colorectal cancer (based on risk factors and warning signs) can begin regular screening at age 50.  Those who are at a higher risk can start screening at an earlier age.   Upon recommended screening, colorectal cancer can be prevented (through removal of polyps before becoming cancerous) or when detected early, can be treated immediately.

What are the screening tests for Colorectal Cancer?

The purpose of screening is to check if a person has any health problem or to detect a disease at its earliest stage. Screening is initially done before the occurrence of symptoms.  There are several screening tests to determine possibility of colorectal cancer. Tests such as sigmoidoscopy, colonoscopy, barium enema and digital rectal examination (DRE) are used by doctors to screen for colon cancer.

What are the available treatments?

When a problem is revealed by screening, diagnosis and treatment can be administered accordingly. Colorectal cancer if detected early is curable. Surgery is the primary mode of treatment involving the removal of part of or the entire colon.  In some cases, a small opening is created in the belly where the remaining colon is placed; this is where waste from the body will exit.

In cases where the cancer has spread, the patient is subjected to chemotherapy or radiation therapy before or after surgery.

What is the role of cancer support groups?

People face the reality of cancer in different ways. Each person goes through a unique experience of accepting and coping with cancer. Despite the different experiences, cancer patients and their families need a good support system.

Cancer supports groups give cancer patients a venue to express their thoughts and feelings about living with cancer. It gives them a chance to air their concerns and worries.  Cancer can bring physical and emotional burden to a patient. Talking to other cancer patients can often bring solace to a distressed individual suffering from cancer. Sharing experiences, thoughts and feelings with other cancer patients can reduce stress and encourage an individual to embrace acceptance. A directory of cancer support groups in the Philippines are listed here.

Colorectal Cancer – Prevent, Treat and Fight It!

This deadly disease can be prevented and treated.  Be aware of the warning signs.  Brushing off signs can cause you your life.  Take care of your body and subject yourself to screening  if you are at high risk of getting colorectal cancer. Awareness can help prevent  and fight colorectal cancer.

Photo: “Corazon Aquino” c/o Flickr. Some Rights Reserved.

Photo: “Colorectal awareness month” by author. Some rights reserved.

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