Colon Cancer
CEBU, Philippines - Incidence and mortality. Colon cancer ranks sixth overall, fifth among males and seventh among females. An estimated 2,963 new cases - 1,548 in males; 1,415 in females, together with 1,567 deaths was estimated seen in the early 2000s. Colon cancer increases markedly after age 50.
Risk factors and prevention. Personal or family history of colon cancer; personal or family history polyps in the colon; inflammatory bowel disease. Pieces of evidence suggest that colon cancer may be linked to a diet high in fat and deficient in whole grains, fruit and vegetables.
Warning signals. A change in bowel habits such as recurrent diarrhea and constipation, particularly with the presence of abdominal discomfort, weight loss, unexplained anemia, and blood in the stool.
Early detection. Unfortunately, early colon cancer is asymptomatic, and there is still no efficient screening method for early detection. The aim should be earlier diagnosis of symptomatic patients who complain of changes in bowel habits, vague abdominal pains, and unexplained weight loss and anemia, particularly among patients 50 years old and above, by means of barium enema or colonoscopy. The mistaken obsession of our physician with amoebiasis and other forms of inflammatory bowel disease had for decades been a major factor that had delayed diagnosis of colon cancer. The wider availability of antidiarrheals, antibiotics and amoebecides may have worsened the situation. Too many physicians still insist in giving vitamin preparations and hematinics for chronic unexplained weight loss and anemia without carefully looking for the cause.
Treatment. Early colon cancer is curable, and surgery is the most effective method of treatment.
Liver Cancer
Incidence and mortality. Liver cancer is the third leading sites for both sexes. It ranks second among males and ninth among females. In the late 1990s, an estimated 5,249 new cases were recorded: 3,906 cases in males and 1,343 cases in females, and about 4,403 deaths are expected to occur every year. The incidence in males is practically 2 ½ that of females. Incidence increases at age 40.
Risk factors and prevention. Studies point to a causal relationship between Hepatitis B virus carrier state and liver cancer. Primary Liver Cancer is much more common in countries where HBV carriers are prevalent, such as the Philippines and other Southeast Asian countries, as compared to most developed countries where Hepatitis B is less prevalent. Hepatitis C infection, though less prevalent, can also lead to liver cancer. Other factors implicated are heavy alcohol consumption, prolonged heavy intake of aflatoxin and other chemical carcinogens. Emphasis should be towards prevention, by lowering the prevalence of Hepatitis B through infant vaccination and improving sanitation nationwide.
Warning signals. Abdominal pain, constitutional symptoms such as weight loss, weakness, and loss of appetite. An abdominal mass or an enlarged liver are noted.
Early detection. Unfortunately, there is no efficient early detection method for liver cancer.
Treatment. For the occasional patient seen in an early stage, surgery can be curative. For the majority of cases, who are usually seen in an incurable stage, judicious and cost-effective palliative care can provide an acceptable quality of life.
Ovarian Cancer
Incidence. Cancer of the ovary is 12th overall, and ranks fifth among females. An estimated 2,032 cases was estimated to occur in the early onset of the new millennium. Incidence increases starting at age 40.
Risk factors. Few specific risk factors have been defined - nulliparity, history of breast or endometrial cancer and of menstrual difficulties. Increased familial incidence has also been reported. Pregnancy and oral contraceptives are possibly protective. The role of exogenous hormones as a protective factor is still being studied.
Warning signals. Ovarian cancers are usually asymptomatic at the outset and many cases are detected late. It is usually detected because of an abdominal mass, or mass felt during pelvic examination.
Early detection. Thorough annual pelvic examinations may detect early ovary cancer. This is recommended to start at age 40.
Treatment. For early cancer of the ovary, surgery is curative. In some cases of advanced cancer, surgery followed by chemotherapy may increase survival. Advanced cancer requires judicious and cost effective palliative care.
Source: Department of Health