Predictably, Cory’s condition pricked the nation’s psyche. For one brief, shining moment, messages of love and sympathy from warring political factions shared the airwaves.
A week later, Cory’s other daughters Ballsy and Viel would report her responsiveness to treatment, with no nausea and an improved appetite. Chemotherapy sessions were expected to go on for weeks or months, with surgery also possible.
What is colon cancer?
The colon is the large intestine, the lower part of the digestive system that comes after the small intestine. A muscular tube about five feet long, the colon absorbs water and nutrients from food and stores waste matter. The latter moves from the colon into the rectum, the last six inches of the tube, and goes out through the anus.
While colon cancer and rectal cancer may be considered separately, together these are referred to as colorectal cancers.
The wall of the colon and rectum has several layers of tissues. Starting in the inner layer, cancer can grow through some or all of the other layers.
How common is colon cancer in the Philippines ?
The Philippine Cancer Society’s 2005 Philippine Cancer Facts and Estimates, which derives data from two population based cancer registries, ranks cancers of the colon and rectum third overall among leading cancer sites, and also third among males and fourth among females. Estimates included 8,585 new cases and 5,558 deaths in the Philippines .
On the other hand, the U.S. National Cancer Institute reveals, “Colorectal cancer is the third most common malignant neoplasm worldwide and the second leading cause of cancer deaths (irrespective of gender) in the United States .”
The 2002 paper, “Cancer and the Philippine Cancer Control Program,” written by University of the Philippines-Philippine General Hospital and Jose R. Reyes Memorial Medical Center Medical Oncology Chair Corazon A. Ngelangel with Edward H. M. Wang, says:
“The top cancer sites in the Philippines include those cancers whose major causes are known (where action can therefore be taken for primary prevention), such as cancers of the lung/larynx (anti-smoking campaign), liver (vaccination against hepatitis B virus), cervix (safe sex) and colon/rectum/stomach (healthy diet). Except for the liver, the top Philippine cancer sites are also the top cancers worldwide.”
What are the stages of colon cancer?
Imaging procedures such as abdominal CT scan or chest X-ray determine the extent, or stage, of the colon cancer. Staging helps determine appropriate treatment.
• Stage 0. The earliest stage means the cancer hasn’t grown beyond the inner layer (mucosa) of the colon. This stage may also be called carcinoma in situ.
• Stage I. The cancer has grown through the mucosa but hasn’t spread beyond the colon wall.
• Stage II. The cancer has grown into or through the colon wall but hasn’t spread to near by lymph nodes.
• Stage III. The cancer has invaded nearby lymph nodes but isn’t affecting other parts of the body yet.
• Stage IV. The cancer has spread to distant sites, such as other organs – for instance to the liver or lung, to the membrane lining the abdominal cavity, or to an ovary.
Aside from stages, a cancer could also be recurrent meaning the cancer has come back after treatment, which may recur in the colon, rectum or other parts of the body. Though Cory’s cancer was made public, its stage was not disclosed.
What causes colon cancer?
Although the exact origin of colon cancer is unknown, it may result from a complex interplay of a person’s inherited susceptibility with environmental factors.
Ngelangel agrees, stating, “Cancers of the gastrointestinal tract have been positively associated with a variety of dietary exposures.”
In particular, she associates colorectal cancer with exposure to dietary fats. She further relates that an earlier study conducted by the Department of Health in 1996 reveals, “…the lack of knowledge about a healthy diet was not a problem among Filipinos; the gap was between knowledge and practice.”
How do we prevent colon cancer?
Medical science now also knows that adenomatous polyps are precursors for most colorectal cancers.
A polyp is a mass of tissue that develops on the inside wall of a hollow organ, such as the colon or rectum. If not benign, a small polyp takes many years to evolve into colon cancer. Reducing these growths may reduce the risk of cancer. The disease, says the Cancer Research and Prevention Foundation, is 90 percent preventable. Early detection leads to successful treatment 90 percent of the time.
The risk begins to increase after age 40, and rises sharply at age 50 to 55. The risk doubles with each succeeding decade, thereafter to balloon exponentially. Advancing age as a risk factor is best addressed by regular screening, with polyps removal.
Screening for all persons aged 50 years or over may include effective methods such as fecal occult blood test (FOBT) annually and sigmoidoscopy every 3–5 years. If the disease runs in the family, genetic counseling and testing should precede colonoscopy and other procedures. Cory’s mother, Doña Demetria Sumulong, was also afflicted by colon cancer.
In addition, maintaining a healthy weight, exercising regularly, quitting cigarettes and switching to a healthful diet can reduce the risk of colon cancer.
How do we treat colon cancer?
The Mayo Clinic lists three primary treatment options: surgery, chemotherapy and radiation. Which treatment the doctor recommends will depend largely on the stage of the colon cancer.
Colorectal surgeon Manual Francisco T. Roxas of the UP-PGH, Medical City , Asian Hospital and San Juan de Dios Hospital explains, “For colon cancer, the treatment is basically standard – you remove the tumor... and deal with chemotherapy and radiotherapy issues later.”
Cory received chemotherapy as the first step. This fuelled speculations that her cancer could be in an advanced stage, having already metastasized; chemotherapy was therefore employed to prevent further spread.
What are the chances of surviving colon cancer?
The Ngelangel paper does not list colon cancer as a top killer,. “The top three mortality cancer sites among females were breast, lung and cervix uteri and among males lung, liver and leukemia.” Another bright note: “Fiveyear survival in excess of 40 percent was observed for only three cancer sites: oral cavity, colon and breast.”
Elsewhere in the world, the overall five year survival rate is a high 65.6 percent. Sadly, however, strides in surgical techniques and adjuvant therapy have not dramatically improved survival from its advanced stage.
Colon cancer claimed the lives of Chat Silayan and Rio Diaz (a Cojuanco by marriage), besides former President Estrada’s brother, Antonio Ejercito. On the other hand, prominent survivors include Mandaluyong Mayor Benhur Abalos and former Commission on Higher Education Chair Rolando Dizon.
Cory turned 75 in January. The nation prays for more time for this beloved icon of democracy.
