Beating Colorectal Cancer by Dr. Jun R. Ruiz

"As an advocate, I believe that we should continue to educate the general public and mobilize the health community into programs to beat colorectal cancer." ~Dr. Jun R. Ruiz, Head of the Colorectal Cancer Screening Program of The Medical City

Did you know that colorectal cancer (CRC) is the third most common cancer among Filipinos? Only breast and lung cancers are more prevalent in the Philippines. This is an important campaign since March is Colorectal Cancer Awareness Month. BUT don't feel scared because it is preventable, treatable, and beatable.

CRC screening can save lives, but not that many people are being screened. Screening for colorectal cancer can save lives and has been shown to reduce the cancer risk by as high as 70 percent.

During the forum, it was discussed that the benefits of screening, diagnosis, and management of Colorectal Cancer in the era of Universal Healthcare. Keynote speakers include:

• Dr. Eric Tayag, Director IV-Knowledge Management and Information Technology Service, Universal Health Care: Why we should care and what can we do about it.
• Ma. Rosario S. Vergeire, MD, MPH, CESO IV. 
• Dr. Napoleon Arevalo, Disease Prevention and Control Bureau of the Department of Health, talks about the National Integrated Cancer Control Act.
• Dr. Jun Ruiz, Head of the Colorectal Cancer Screening Program, emphasizes the importance of Colon Cancer Screening.
• Roman Romulo, Pasig City District Representative 

The Medical City aims to be at the forefront in the fight against colorectal cancer.

BE SCREENED

• In several countries, CRC screening is recommended for people starting the age of 50 years. Screening at an earlier age, usually at 40, is advocated in first-degree relatives of patients with colorectal cancer, and in those with other additional risk factors.

Almost all of these cancers start as abnormal growths in the lining of the colon and rectum called polyps. These polyps grow slowly and take around 10 years for some polyps to develop into cancer. Not all polyps progress to cancer. The removal of these polyps reduces the risk of developing cancer.

These polyps and occasionally early cancer do not cause complaints, like rectal bleeding, constipation, and abdominal pain that are experienced by patients in later stages of cancer.

Risk Factors for Colorectal Cancer

1. Age greater than 50
2. Personal history of colorectal cancer or advanced polyps
3. Family history of cancer in the colon and rectum

Age 50 is the most common risk factor for this cancer, as 90% occur after the age of 50. A family history of a first-degree relative with CRC is increased two to three-fold.

Lifestyle habits that can be modified that likely contribute to the formation of colon cancer:

Lifestyle habits that can be of the risk factors of Colorectal Cancer:

1. High consumption of animal fat/processed meat (beef, pork, lamb)
2. Long-term smoking
3. More than two alcoholic drinks per day
4. Obesity
5. Family history

Living a healthy lifestyle by avoiding smoking, not consuming excessive alcohol, regular exercise, and eating the right food can lower your risk for cancer in the colon and rectum.

The gold standard for CRC screening is a colonoscopy as it can detect and remove early lesions like polyps. The procedure involves a flexible fiberoptic scope with a camera that is inserted through the rectum and is carefully advanced to visualize the colon under mild anesthesia. However, it is an invasive test and it has the (low) potential to cause complications.

Some patients may not want to have an invasive test or may find the cost of a colonoscopy too expensive. A stool test called the Fecal Immunochemical Test (FIT) is a good screening alternative. FIT detects only human blood and is specific for bleeding in the colon. The test is repeated every year if the initial test is negative. 

If the test is positive, a colonoscopy is needed to rule out the presence of cancer. With the right organization, a population-based screening program among Filipinos involving this method will result in early diagnosis of colorectal cancer and improved clinical outcomes in the country.

If the patient does not want to start with a colonoscopy, it is suggestive by starting with FIT. After a discussion with his physician, the patient can choose his preferred screening test. After all, the best test is the one that gets done.

By undergoing either method of CRC screening, this would be one step towards beating colorectal cancer.

For inquiry and if you need to schedule a consultation contact the Colorectal Clinic of The Medical City, at 8988-1000/8988-7000 ext. 7789.

The Medical City launches Center for Gender Health and Wellness

The program is designed to provide holistic gender-sensitive health care to the LGBTQ+ community. Different gender identities, particularly those from the LGBTQ+ community, need a space where they can address their healthcare needs in an environment that encourages support and guidance from trusted professionals.

Access to comprehensive and quality health care is one of the vital rights of any individual. It should, first and foremost, serve all colors and harness gender-sensitivity practices within the community. As a way of forwarding this cause, The Medical City launches the Center for Gender Health and Wellness which is designed to provide holistic gender-sensitive health care to members of the LGBTIQ+ (lesbian, gay, bisexual, transgender, intersex, queer, plus) in order to maximize their overall health, psychological well-being, and self-fulfillment. 

The center provides services and packages that are catered to the LGBTIQ+ community’s needs to aid them in actualizing their chosen gender identities. Its health care services utilize a multidisciplinary approach, involving primary care, mental health services (e.g., assessment, counseling, and psychotherapy), hormonal and endocrine therapy, gynecologic and urologic care, reproductive options, and surgical treatments, as needed. 

It also offers different programs and services that aim to provide members and families of the LGBTIQ+ community to receive the proper care that they need to support them as they go along in their journeys. The Center for Gender Health and Wellness is comprised of various specialists who are highly trained in their own specializations, specifically in endocrinology, obstetrics and gynecology, psychiatry, pediatrics, and wellness. Also included in the team of experts are infectious disease specialists who will counsel, test, and treat infections, and surgery specialists who will help in counseling and assessing risks and benefits of procedures which include gender-affirming surgeries.

The center is located at the Wellness and Aesthetics Institute of The Medical City, a complex separate from the main hospital with its own elevators and a relaxing interior supplied with laminar airflow to reduce the risk for airborne contamination. It provides a safe and undiscriminating space where individuals can access services on Sexual Wellness, Transgender Wellness, Hypogonadism, Polycystic Ovarian Syndrome (PCOS), Fertility, and Menopause. 

It is now here to pave the way for individuals to make their gender their choice and for them to be able to transition to their preferred gender roles with the utmost care and support that they need.

Packages and Services

• The Sexual Wellness package provides counseling, testing, and treatment for common sexually transmitted infections, including HIV/AIDS, syphilis, chlamydia, gonorrhea, and viral hepatitis. Confidentiality and data privacy is assured throughout the entire process, from the time of counseling to the time of testing and treatment.
• The Transgender packages provide services for counseling for gender-affirming therapy, as well as testing and monitoring for any other possible concerning conditions and effects of the therapy. The gender-affirming therapy includes hormonal treatment and eventually, gender-affirming surgery as requested.
• The Hypogonadism packages are intended to investigate and treat the causes of incomplete physical sexual development for adults. These packages also cater to females who have not had their menses or who have very irregular menstrual periods, and males who have decreased libido and other sexual disorders.
• The PCOS package provides risk assessment, workup, and treatment for patients who have menstrual disorders. PCOS is the most common cause of menstrual disorders in the Philippines. These patients may also have other issues, such as male-pattern facial and body hair, as well as metabolic disorders such as high blood sugar and lipid (cholesterol and triglyceride) levels, high blood pressure, and obesity.
• The Fertility package helps determine the fecundity of reproductive-aged women. These diagnostics will guide the obstetrician-gynecologist towards tailored management for patients who seek help in trying to conceive children.
• The Menopause package helps determine the hormone levels affecting women’s well-being during their pre-menopausal and menopausal phases. These diagnostics will guide proper hormone replacement and symptom relief to help women through their journey in their later years.

Patients can be referred to any other specialists as needed. All existing specialties are more than adequately represented in The Medical City.

The Medical City Center for Gender Health and Wellness is located at 6/F, Wellness & Aesthetics Institute, Podium Building, The Medical City Ortigas.

For more information and to schedule an appointment, contact the Center for Gender Health & Wellness +632 8999 1000 / +632 8988 7000 ext 6576. The Medical City Facebook Page https://www.facebook.com/TheMedicalCity/.