Early screening is best prevention for lung, colorectal cancers

The early detection of cancer through screening greatly increases the chances of its successful treatment. This was the message expressed by specialists at The Medical City’s (TMC) Center for Cancer Care and Research in a recent meeting with media and wellness bloggers.

Dr. Manuel Francisco T. Roxas, consultant director of TMC’s Colorectal Clinic, said screening could easily detect colorectal, breast, cervical, lung and liver cancers long before their symptoms manifest in an individual.

Roxas explained that screening is recommended to individuals belonging to a certain age bracket or those exposed to specific risk factors for certain types of cancer.

A fecal occult blood test (FOBT) is recommended annually for individuals aged 50 and above as a means of screening colorectal cancer. The test looks for traces of microscopic blood in stool samples that may indicate gastrointestinal bleeding. Screening for breast cancer is recommended for all women ages 35 and older. It involves an annual mammogram and ultrasound, apart from a clinical breast examination.

Screening for cervical cancer is recommended for all sexually active women, especially those who have a history of genital warts.

In the cases of lung and liver cancers, a person is a candidate for screening following an in-depth profiling for risk factors. Smokers are at a higher risk than non-smokers, while individuals with a history of alcohol consumption and/or hepatitis infection are candidates for liver cancer screening.

TMC’s Cancer Program adopts a multidisciplinary approach to cancer prevention, early detection, diagnosis and management. Under this program, specialists work in tandem in determining the treatment and care of a patient that is personalized to suit his specific requirements.

“No two cancers are alike. The behavior of breast cancer is so very different from colorectal cancer, from lung cancer and any other cancer. The treatment therefore differs. The surgery differs. You cannot have an expert in all cancers. You cannot have a wonder drug that cures all cancers,” Roxas said. The Medical City is presently the only hospital in the Philippines with a section that focuses solely on colorectal cancer.

According to the Philippine Cancer Society, Inc., almost 75 percent of the individuals diagnosed with colorectal cancer were aged 50 and above, while about three percent were children 14 years old and below. It is estimated that one out of 1,800 Filipinos will develop the cancer yearly. Roxas said screening helps in cutting down the incidence of colorectal cancer by 23 percent.

TMC’s Colorectal Clinic provides expert diagnoses and multimodality treatments for colorectal cancer, including chemotherapy, radiotherapy, and surgery. The clinic promotes minimally invasive procedures for early cases, as well as radical operations for advanced and recurrent cases. Laparoscopic surgery, trans-anal endoscopic microsurgery, and robotic-assisted surgery are among the minimally invasive procedures being offered by the clinic.

It also caters to patients with anorectal diseases, such as hemorrhoids, perianal infection, fistula, fissures, and fecal incontinence, to name a few. It offers various treatment options for hemorrhoids, such as rubber band ligation, transanal hemorrhoidal dearterialization (THD), and stapled hemorrhoidectomy, which are proven to be less painful procedures than traditional surgery.

On the other hand, lung cancer is the leading cause of mortality among cancer patients in the country, with 9,184 deaths recorded in 2010. Among cancer cases diagnosed that year, it was second to breast cancer with 11,458 incidences recorded.

Dr. Christine Chavez, head of the Lung Unit of TMC Center for Cancer Care and Research, said early diagnosis of lung cancer is needed for the successful treatment of the illness. However, she explained that the early stages of lung cancer have no symptoms. Many of the symptoms of lung cancer are non-specific and are common to all forms of respiratory ailments. These include infection, asthma, unresolved cough, blood in phlegm, and hoarseness. Other symptoms include sudden weight loss and a loss of appetite. “However, these symptoms manifest when the cancer is already at an advanced stage,” she said.

Screening of high-risk patients without symptoms is by low-dose chest CT scan which could decrease the number of patients who die from lung cancer by as much as 20%.

High risk individuals who can benefit from screening include those who smoke, those who have been exposed to second hand smoke for a certain number of years, those with a history of pharyngeal cancer, and those with a history of chronic obstructive pulmonary diseases

Abnormalities that are detected will be worked up according to international evidence-based guidelines that are tailored to the local setting.

For patients who need to undergo biopsy, TMC offers comprehensive diagnostic tools, one of which is Endobronchial Ultrasound or EBUS. With this latest technology, the number of central and peripheral lung abnormalities that may be easily diagnosed can be increased.

EBUS is a state of the art minimally invasive procedure used in the diagnosis of lung cancer, infections, and other inflammatory diseases in the chest. Presently, TMC is the first and currently the only hospital in the country to offer EBUS.

“With EBUS as an additional diagnostic option for high-risk patients, we are expecting to increase detection rates of early stage lung cancer, which may be salvageable by surgery and has good prognosis. In addition, EBUS can aid in the diagnosis of benign diseases that need specific pathologic confirmation,” said Dr. Chavez.

EBUS assists patients and doctors by shortening the time from diagnosis to treatment. It incorporates ultrasound technology in bronchoscopy. By means of a small video device, it allows bronchoscopists to view lung abnormalities through and beyond the surface of the airways for real-time image guidance during procedures for a higher degree of diagnostic accuracy and safety is possible.

For inquiries about The Medical City Center for Cancer Care and Research, call 988-1000 or 988-7000 ext. 6214.

The early detection of cancer through screening greatly increases the chances of its successful treatment. This was the message expressed by specialists from The Medical in a recent meeting with media and wellness bloggers.

(Left to right): Dr. Christine Chavez, head of the Lung Unit of TMC Center for Cancer Care and Research TMC Cancer Program; Dr. Manuel Francisco T. Roxas, consultant director of TMC’s Colorectal Clinic; Roberto C. Posadas Jr., manager, Center for Cancer Care and Research.