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Colorectal CancerColorectal Cancer
Roel Tolentino, MD, MBA, FPCS, FACS, FPSGS, FPSO, FMOSP
General Surgery-Surgical Oncology
OutlineOutline
 Colorectal Cancer Facts
 Getting Tested
 Preventive Strategies
No. 5 - both sexesNo. 5 - both sexes
No. 4 – MenNo. 4 – Men
No. 5 – FemaleNo. 5 – Female
What is colon cancer?
Begins in the colon or
rectum
Usually develops from
pre-cancerous changes
or growths in the lining
of these organs
These growths are
called polyps
Colon Polyp to CancerColon Polyp to Cancer
takes about 10-15 yearstakes about 10-15 years
Why don’t we talk about it?
Uncomfortable topic
Unaware of risk factors
Avoidance of doctor check-ups
Why don’t we talk about it?
Fear of getting tested
Perceived as “man’s disease”
No symptoms, no problem
Risk Factors
Nearly 90% of colon cancer patients
are over the age of 50.
Risk increases with age
Risk Factors
Other risk factors include:
family or personal history of colon cancer
or polyps
hereditary colorectal syndromes
use of cigarettes and other tobacco products
high-fat/low fiber diet
physical inactivity
Why get tested?
Testing can help detect pre-cancerous polyps
Removing the polyp early may prevent it from
becoming cancer
Get the test. Get the polyp. Get the cure.
Who should get tested?
American Cancer Society
recommends that all
average risk women and
men begin regular colon
cancer early detection
testing at age 50.
Colon Cancer TestsColon Cancer Tests
 Fecal occult blood testing
(FOBT)
 Barium enema
 Endoscopy
 Virtual Colonoscopy
Get the test. Get the polyp. Get the cure.
ColonoscopyColonoscopy
Polypectomy TechniquePolypectomy Technique
Colon Cancer TestingColon Cancer Testing
Is EFFECTIVE!!Is EFFECTIVE!!
Testing rates remain farTesting rates remain far
too low!too low!
Are people gettingAre people getting
tested?tested?
Don’t wait for your doctorDon’t wait for your doctor
Why aren’t people gettingWhy aren’t people getting
tested?tested?
The most common reason people give for not beingThe most common reason people give for not being
tested is:tested is:
““My doctor never talked to me about it !”My doctor never talked to me about it !”
Colon Cancer TestsColon Cancer Tests
New TechniquesNew Techniques
Future Alternatives for Colon Cancer Screening
VirtualVirtual
ColonoscopyColonoscopy
VirtualVirtual
ColonoscopyColonoscopy
Video CapsuleVideo Capsule
ColonoscopyColonoscopy
Average Risk IndividualsAverage Risk Individuals
No Symptoms
Age ≥ 50
No risk factors
Laparoscopic ColectomyLaparoscopic Colectomy
Robotic SurgeryRobotic Surgery
CurrentCurrent
RecommendationsRecommendations
Average RiskAverage Risk
Test Interval (years)
Fecal Occult Blood Test
(FOBT)
Yearly
Sigmoidoscopy Every 5
FOBT + Sigmoidoscopy Every 5
Colonoscopy Every 10*
Barium enema Every 5
ProbioticsProbiotics are defined as "live micro-organisms that confer aare defined as "live micro-organisms that confer a
health benefit on the host when administered in adequate amounts.“health benefit on the host when administered in adequate amounts.“
•The major source of probiotics for humans is dairy-based foods containingThe major source of probiotics for humans is dairy-based foods containing
intestinal species ofintestinal species of LactobacillusLactobacillus oror BifidobacteriumBifidobacterium..
PrebioticsPrebiotics improve the composition and/or activity of theimprove the composition and/or activity of the
gastrointestinal bacteria.gastrointestinal bacteria.
•They are non-digestible carbohydrates which act by promoting theThey are non-digestible carbohydrates which act by promoting the
growth probiotic bacteria.growth probiotic bacteria.
•They are found in in tomatoes, onions, garlic, and bananas.They are found in in tomatoes, onions, garlic, and bananas.
•Relatively stable and, arrive relatively unchanged in the gut.Relatively stable and, arrive relatively unchanged in the gut.
The digestive system constitutesThe digestive system constitutes
70 %70 % of the body’s immuneof the body’s immune
system which means it performs thesystem which means it performs the
important role of defending theimportant role of defending the
body against harmful bacteria andbody against harmful bacteria and
viruses.viruses.
Reduce Your RiskReduce Your Risk
Choices for good health
Follow testing guidelines
Know your family history
Get regular exercise
Do not smoke or use other tobacco products
Avoid excessive alcohol consumption
Reduce Your RiskReduce Your Risk
Choices for good health
Eat 5 or more servings of fruits & vegetables a day
Choose whole grain foods
Limit your intake of red meat
Maintain a healthy weight
Prevent Colon CancerPrevent Colon Cancer
Smart steps
Talk to your doctor
Get tested starting at age 50
Encourage your friends, family, and
co-workers to get tested
Maintain a healthy lifestyle
Colorectal Cancer Screening Saves LivesTITLE
Colorectal Cancer Screening Saves LivesTITLE

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Colorectal Cancer Screening Saves LivesTITLE

  • 1. Colorectal CancerColorectal Cancer Roel Tolentino, MD, MBA, FPCS, FACS, FPSGS, FPSO, FMOSP General Surgery-Surgical Oncology
  • 2. OutlineOutline  Colorectal Cancer Facts  Getting Tested  Preventive Strategies
  • 3. No. 5 - both sexesNo. 5 - both sexes No. 4 – MenNo. 4 – Men No. 5 – FemaleNo. 5 – Female
  • 4.
  • 5.
  • 6. What is colon cancer? Begins in the colon or rectum Usually develops from pre-cancerous changes or growths in the lining of these organs These growths are called polyps
  • 7. Colon Polyp to CancerColon Polyp to Cancer takes about 10-15 yearstakes about 10-15 years
  • 8. Why don’t we talk about it? Uncomfortable topic Unaware of risk factors Avoidance of doctor check-ups
  • 9. Why don’t we talk about it? Fear of getting tested Perceived as “man’s disease” No symptoms, no problem
  • 10. Risk Factors Nearly 90% of colon cancer patients are over the age of 50. Risk increases with age
  • 11. Risk Factors Other risk factors include: family or personal history of colon cancer or polyps hereditary colorectal syndromes use of cigarettes and other tobacco products high-fat/low fiber diet physical inactivity
  • 12.
  • 13. Why get tested? Testing can help detect pre-cancerous polyps Removing the polyp early may prevent it from becoming cancer Get the test. Get the polyp. Get the cure.
  • 14. Who should get tested? American Cancer Society recommends that all average risk women and men begin regular colon cancer early detection testing at age 50.
  • 15. Colon Cancer TestsColon Cancer Tests  Fecal occult blood testing (FOBT)  Barium enema  Endoscopy  Virtual Colonoscopy Get the test. Get the polyp. Get the cure.
  • 16.
  • 17.
  • 19.
  • 20.
  • 22. Colon Cancer TestingColon Cancer Testing Is EFFECTIVE!!Is EFFECTIVE!!
  • 23. Testing rates remain farTesting rates remain far too low!too low! Are people gettingAre people getting tested?tested?
  • 24. Don’t wait for your doctorDon’t wait for your doctor Why aren’t people gettingWhy aren’t people getting tested?tested? The most common reason people give for not beingThe most common reason people give for not being tested is:tested is: ““My doctor never talked to me about it !”My doctor never talked to me about it !”
  • 25. Colon Cancer TestsColon Cancer Tests New TechniquesNew Techniques Future Alternatives for Colon Cancer Screening
  • 27.
  • 29.
  • 30.
  • 32. Average Risk IndividualsAverage Risk Individuals No Symptoms Age ≥ 50 No risk factors
  • 33.
  • 34.
  • 37.
  • 38.
  • 39.
  • 40. CurrentCurrent RecommendationsRecommendations Average RiskAverage Risk Test Interval (years) Fecal Occult Blood Test (FOBT) Yearly Sigmoidoscopy Every 5 FOBT + Sigmoidoscopy Every 5 Colonoscopy Every 10* Barium enema Every 5
  • 41.
  • 42.
  • 43. ProbioticsProbiotics are defined as "live micro-organisms that confer aare defined as "live micro-organisms that confer a health benefit on the host when administered in adequate amounts.“health benefit on the host when administered in adequate amounts.“ •The major source of probiotics for humans is dairy-based foods containingThe major source of probiotics for humans is dairy-based foods containing intestinal species ofintestinal species of LactobacillusLactobacillus oror BifidobacteriumBifidobacterium..
  • 44.
  • 45.
  • 46. PrebioticsPrebiotics improve the composition and/or activity of theimprove the composition and/or activity of the gastrointestinal bacteria.gastrointestinal bacteria. •They are non-digestible carbohydrates which act by promoting theThey are non-digestible carbohydrates which act by promoting the growth probiotic bacteria.growth probiotic bacteria. •They are found in in tomatoes, onions, garlic, and bananas.They are found in in tomatoes, onions, garlic, and bananas. •Relatively stable and, arrive relatively unchanged in the gut.Relatively stable and, arrive relatively unchanged in the gut.
  • 47.
  • 48.
  • 49. The digestive system constitutesThe digestive system constitutes 70 %70 % of the body’s immuneof the body’s immune system which means it performs thesystem which means it performs the important role of defending theimportant role of defending the body against harmful bacteria andbody against harmful bacteria and viruses.viruses.
  • 50.
  • 51. Reduce Your RiskReduce Your Risk Choices for good health Follow testing guidelines Know your family history Get regular exercise Do not smoke or use other tobacco products Avoid excessive alcohol consumption
  • 52. Reduce Your RiskReduce Your Risk Choices for good health Eat 5 or more servings of fruits & vegetables a day Choose whole grain foods Limit your intake of red meat Maintain a healthy weight
  • 53. Prevent Colon CancerPrevent Colon Cancer Smart steps Talk to your doctor Get tested starting at age 50 Encourage your friends, family, and co-workers to get tested Maintain a healthy lifestyle

Editor's Notes

  1. In order to begin talking about colon cancer comfortably, we first need to understand what the disease is. Colon cancer begins in the colon or rectum. The actual name is colorectal cancer because it includes cancers of the colon and rectum. But, because it is commonly called colon cancer that is the term that I am going to use today. The colon is a muscular tube approximately five feet long connecting the small intestine to the rectum. Cancer can begin in any part of the colon, but before it develops, changes typically occur in the colon’s lining. One change is a tissue growth called a polyp. Colon cancer is a relatively slow-growing disease and usually starts as a benign polyp. A polyp can be detected through testing and removed, preventing it from becoming cancerous later on.
  2. Why don’t we talk about colon cancer? From research, we know why some people are reluctant to talk about colon cancer. Just the term alone makes some people a little squeamish. People are unaware of the risk factors especially the primary risk factor – age. Because it most often affects older men and women, people shrug off discussion of the disease as if warding off the signs of aging. Many simply avoid visits to their doctor, particularly men. Research has shown that people don’t talk with their doctors about colon cancer and don’t get information about tests to detect the disease early. Many women are not aware that colon cancer affects women as much as men. Colon cancer is perceived as a “man’s disease.” And, still others believe if they feel fine, they are fine. No symptoms, no problem – which is not always the case, as you will find out in a moment.
  3. Why don’t we talk about colon cancer? From research, we know why some people are reluctant to talk about colon cancer. Just the term alone makes some people a little squeamish. People are unaware of the risk factors especially the primary risk factor – age. Because it most often affects older men and women, people shrug off discussion of the disease as if warding off the signs of aging. Many simply avoid visits to their doctor, particularly men. Research has shown that people don’t talk with their doctors about colon cancer and don’t get information about tests to detect the disease early. Many women are not aware that colon cancer affects women as much as men. Colon cancer is perceived as a “man’s disease.” And, still others believe if they feel fine, they are fine. No symptoms, no problem – which is not always the case, as you will find out in a moment.
  4. What are the risk factors for colon cancer? While the exact cause of colon cancer is not known, research shows it occurs more often among men and women over age 50. Nearly 90 percent of colon cancer patients are over the age of 50. Therefore, age is the primary risk factor. Other factors include: Family or personal history of colon cancer or polyps Chronic inflammatory bowel disease Hereditary colorectal syndromes Use of cigarettes and other tobacco products High-fat/low fiber diet Physical inactivity
  5. What are the risk factors for colon cancer? While the exact cause of colon cancer is not known, research shows it occurs more often among men and women over age 50. Nearly 90 percent of colon cancer patients are over the age of 50. Therefore, age is the primary risk factor. Other factors include: Family or personal history of colon cancer or polyps Chronic inflammatory bowel disease Hereditary colorectal syndromes Use of cigarettes and other tobacco products High-fat/low fiber diet Physical inactivity
  6. Why is it so important to get tested for colon cancer? Testing offers a powerful opportunity for the prevention, early detection, and successful treatment of colon cancer. Yet the majority of Americans aged 50 and older do not follow the ACS recommended testing guidelines for colon cancer. Following the testing guidelines for colon cancer can help detect precancerous polyps. Removing the polyps can lower a person’s risk by preventing some colon cancers before they are fully formed. Since some colon cancers cannot be prevented, finding them early is the best way to improve the chance of a cure and reduce the number of deaths. When colon cancers are detected at an early stage and have not spread beyond the colon or rectum, the five-year survival rate is 90 percent.
  7. Who should get tested for colon cancer? Because of the stealth nature (meaning that you may not have any symptoms) of the disease, the American Cancer Society recommends all average risk men and women begin regular testing at age 50 - unless you are identified as increased or high risk, you are considered to be at average risk starting at age 50.
  8. Why is it so important to get tested for colon cancer? Testing offers a powerful opportunity for the prevention, early detection, and successful treatment of colon cancer. Yet the majority of Americans aged 50 and older do not follow the ACS recommended testing guidelines for colon cancer. Following the testing guidelines for colon cancer can help detect pre-cancerous polyps. Removing the polyps can lower a person’s risk by preventing some colon cancers before they are fully formed. Since some colon cancers cannot be prevented, finding them early is the best way to improve the chance of a cure and reduce the number of deaths. When colon cancers are detected at an early stage and have not spread beyond the colon or rectum, the five-year survival rate is 90 percent.
  9. Why don’t we talk about colon cancer? From research, we know why some people are reluctant to talk about colon cancer. Just the term alone makes some people a little squeamish. People are unaware of the risk factors especially the primary risk factor – age. Because it most often affects older men and women, people shrug off discussion of the disease as if warding off the signs of aging. Many simply avoid visits to their doctor, particularly men. Research has shown that people don’t talk with their doctors about colon cancer and don’t get information about tests to detect the disease early. Many women are not aware that colon cancer affects women as much as men. Colon cancer is perceived as a “man’s disease.” And, still others believe if they feel fine, they are fine. No symptoms, no problem – which is not always the case, as you will find out in a moment.
  10. Why don’t we talk about colon cancer? From research, we know why some people are reluctant to talk about colon cancer. Just the term alone makes some people a little squeamish. People are unaware of the risk factors especially the primary risk factor – age. Because it most often affects older men and women, people shrug off discussion of the disease as if warding off the signs of aging. Many simply avoid visits to their doctor, particularly men. Research has shown that people don’t talk with their doctors about colon cancer and don’t get information about tests to detect the disease early. Many women are not aware that colon cancer affects women as much as men. Colon cancer is perceived as a “man’s disease.” And, still others believe if they feel fine, they are fine. No symptoms, no problem – which is not always the case, as you will find out in a moment.
  11. How can you reduce your risk for getting colon cancer? Follow the colon cancer testing guidelines that we just talked about Know your family history. If colon cancer runs in your family you may need to get tested earlier or more often. Get regular exercise. At least 30 minutes of moderate activity on most days of the week. Do not smoke or use other tobacco products If you drink alcohol, limit your consumption
  12. More ways to reduce your risk Eat five or more servings of a variety of vegetables and fruits each day Choose whole grain foods instead of processed (refined) grains Limit consumption of red meats, especially those high in fat Maintain a healthy weight
  13. Prevent colon cancer I’m here today because we consider you and your organization partners in the fight against cancer. Colon Cancer is a disease we can beat. If people talk to their doctor about testing, then follow through and get the test, thousands of lives can be saved – and one of them might be yours or someone you love. Also, don’t forget to encourage your friends, family, and co-workers to get tested for colon cancer. And, maintain a healthy lifestyle – it could save your life!