By: Samuel Pimping
March is National Colorectal Cancer Awareness Month—the third most prevalent cancer across the world. Notwithstanding its highly treatable and preventable nature, Filipinos are plagued by persistent healthcare barriers that diminish survival rates.
The large intestine comprises the colon and rectum. Colorectal cancer occurs when the cells in these organs grow abnormally and uncontrollably. It can also be called either colon cancer or rectal cancer depending on the point of origin, but they are often grouped together because of similar characteristics.
To put a face to this ravaging illness, Chadwick Boseman (a celebrity famous for his role starring as Black Panther) died from the disease in 2020. He was only 43. This was four years after he was diagnosed with Stage III colon cancer, which progressed to Stage IV in his later years. Audrey Hepburn is another well-known icon who died from the illness when she was 63 years old.
Boseman’s death was considered to be a wake-up call not only for those within the medical field but also for society at large. Typically, the risk of colorectal increases with age as the majority of those afflicted are over 50 years old. However, in 2019, it was found that 20% of the diagnoses included those under the age of 55—almost double the rate in 1995. In fact, while colorectal cancer cases have greatly declined in 65-year-olds or older, instances of the affliction rapidly increased for the younger generation. This disturbing reality has forced us to think about its cause. What is so different about our generation today?
The answer may lie in the average person’s modern lifestyle. We have been dubbed the “fast food generation,” as stated by medical oncologist Eyal Meiri, MD. The preferred convenience of less healthy but cheap, quick, and satisfying alternatives have indeed taken their toll on an international level, mainly affecting the younger, busier working class.
Doctors from Yale have now warned that even those in their prime—including young professionals and college students—should start being more weary of the warning signs. They recounted that in one instance, all seven patients that have been diagnosed with colorectal cancer within the week were only 35 and younger. Lifestyles are becoming more hectic by the day as we struggle to keep up with advancements across the world, and as a consequence, many of us sometimes feel that we have no choice but to sacrifice our health just to be able to manage throughout the week.
So what are the warning signs? To understand the symptoms and possible complications, we have to know how it begins to take form within the body. Most cases start with an abnormal growth called a polyp on the lining of the colon or rectum. Not all polyps evolve into a cancerous form, and numerous larger polyps are more likely to be indicative of colorectal cancer. When the cells accumulate, tumors are formed and destroy healthy tissue. These cells further spread and wreak havoc within the body through metastasis, damaging other organs and manifesting as specific symptoms that may or may not be painful.
Bloated stomach, belly pain, continual constipation, diarrhea, or vomiting, blood in your excrement, fatigue, and unusual weight loss are a few symptoms that may be due to colorectal cancer. Even though it may be because of other underlying illnesses or afflictions such as hemorrhoids, doctors strongly recommend that you get yourself checked via colorectal cancer screening such as a colonoscopy to rule out the possibility of cancer or to be able to treat it as soon as possible.
Colorectal cancer tends to be slow-growing; polyps usually take around ten years to become cancerous. This fact, along with the availability of colonoscopies, is a big part of why we say it is one of the most highly preventable and treatable forms of cancer. Colonoscopies not only check for the disease as they also allow the doctor to remove precancerous polyps through the use of a tube, preventing instances of colorectal cancer before they even start. For this reason, the procedure has had the most significant impact on diminishing cancer rates.
How do you know whether you’re more at risk or not? Older age is the greatest contributing factor, so most doctors recommend regular screening once you are 50 years old. But even if you are under 50, whenever you experience persistent symptoms, it is best that you get checked as well. Controllable factors that make one more susceptible to colorectal cancer are smoking, alcohol, obesity, poor diet, lack of exercise, and diabetes. Uncontrollable factors include African-American genealogy, colorectal cancer within the family history, chronic intestinal inflammation, inherited syndromes, and previous exposure to radiation therapy.
Needless to say, when it comes to your health, you have to be prudent. You must never make assumptions on the favorable side and brush it off as something you can eventually weather through. If you have been experiencing symptoms, it is best to be safe and get tested should you have the resources.
Unfortunately, healthcare accessibility within the Philippines is one of the most well-known and long-standing problems. In a 2022 study on Filipinos’ insights on colorectal cancer screening, many respondents cited various barriers to screening, especially large out-of-pocket costs. In addition, the majority of the local population lack awareness regarding screening, tend toward a reactive approach to health, and hold fatalistic beliefs. Some citizens even avoid diagnosis because an unfavorable result essentially confirms their fears. These lead to lower colorectal cancer screening rates within our country and worse outcomes compared to non-Hispanic whites.
Out-of-pocket costs are significant when it comes to Philippine healthcare as insurance is viewed more of a luxury than as a necessity by many. On top of that, widespread poverty makes it so that financial awareness is insufficient because for a lot of citizens, they simply cannot afford it. The ideal answer is public intervention, such as when the government initiates insurance benefit programs. In 2020, data on selected colorectal cancer patients enrolled in the comprehensive benefits program of the Philippine National Insurance System conclusively revealed that patient survival can be maximized through the highest standards of patient care.
Early detection is more than half the battle. Colorectal cancer screening is a patient’s best defense against the illness. Two types of screening are highly acknowledged: colonoscopies and stool tests. A colonoscopy is the more invasive procedure as a tube is inserted through the rectum. It is more effective as it not only detects but also removes pre-cancerous polyps. A more convenient, less invasive alternative is a stool test called FIT. The latter is more on detection, while colonoscopies also include mitigation.
That said, active prevention is indispensable. Avoiding smoking and excessive alcohol use, promoting a healthy low-fat, high-fiber diet, and staying active are a few of the most basic recommendations that any doctor would tell you. Unfortunately, since the extended break in routine caused by the global pandemic, a lot of people have been leading more sedentary lifestyles. Plus, the bulk of screening and testing for colorectal cancer had been delayed to avoid spreading the coronavirus, leading to the occurrence of more advanced cases without prompt medical intervention.
To break the trend in the proliferation of colorectal cancer among the young, we must become more conscious of the hectic lifestyle being promoted among professionals. Health is the most important, irreplaceable investment there is, and it must never be sacrificed for the sake of work, wealth, or wants.
Awareness may be the catalyst for change, but it holds no value of its own—until you actively use it to transform your life for the better.
