LIFE begins at 40, and to help prolong it, colon cancer must also be detected early.
This is what Dr. Noel R. Fajardo, a Las Vegas-based Filipino gastroenterologist who recently visited the Philippines, has been advocating among his compatriots to combat such fatal disease. He is also pushing it to become a government priority, covered under preventive services.
Although he conceded there are no available figures showing the prevalence of this illness in the Philippines, he said it is the third leading cause of cancer death in the country, next only to those of lungs and liver.
“Colon cancer is something we can be at risk without us knowing it,” he said, noting the disease can affect both genders, especially when aging, and can be passed on to family members since it’s hereditary.
“As you get older, you’re at high risk. There really has been no sufficient data to suggest that it’s diet-related or because of constipation, [but it’s] more on the hard science data [pointing] to genetics. That’s why we’re seeing familial risk for colon cancer,” he said.
To date, there’s nothing revolutionary yet regarding the treatment of colon cancer. Prevention remains effective to address this health concern.
Proof is the initiative taken by Fajardo and his colleagues in Las Vegas, Nevada, a few years back, pushing for colonoscopy as a preventative medicine against colon cancer that should be provided as a free health-insurance service.
With the enactment in 2011 of the Patient Protection and Affordable Care Act in the US, otherwise known as the Obamacare, this procedure has become widely available and popular to help detect precancerous growth in the colon.
“I found it’s very helpful in saving lives, and we already have 1 million colon-cancer survivors in the US. So the idea of colon-cancer prevention drastically reduced the rate of colon cancer by 60 percent to 90 percent [there],” the doctor said. “And I think it’s just appropriate we bring this colon-cancer awareness campaign into the Philippines.”
Colonoscopy is a test that utilizes a scope inserted into the rectum on the way to the colon. Because it’s quite invasive, the patient is sedated; otherwise, it’s uncomfortable.
If there is a polyp or growth detected, it is removed right away through a minute wire. This outpatient procedure lasts from 30 minutes to 45 minutes.
“So you go home right after, and the next day you can work. If you don’t have anesthesia, you can get to work right away,” the gastroenterologist said.
The concept of colon-cancer prevention lies in the fact that a person is already at risk once they hit a certain age.
On the average, colon cancer occurs when a person reaches 50 years old. Beyond this age, one out of three patients will have a colon polyp.
“It’s genetic in the sense it can also happen even before age 50,” Fajardo said. “Statistics shows that if you hit age 40, you have a 30-percent risk of developing a colon polyp.”
Both the medical community and insurance providers in the country have agreed that 50 is the standard age to undergo screening even without symptoms.
But if there’s a family history of the disease, they recommend colonoscopy to be availed 10 years earlier or at age 40.
“The reason for that is because we know colon cancer has a genetic basis,” he said.
Individuals who undergo the test are advised not to be complacent, even if found negative, since it can occur later in their lives.
Fajardo suggests the procedure should be repeated every five years if there is a case in the family, even without symptoms, and every 10 years if not.
“If you are 65 and older, you’re recommended to repeat colonoscopy every two years; younger than that, every three years,” he added.
The treatment varies, depending on the seriousness of colon cancer. For Stage 0 to 1, the gastroenterologist said colonoscopy can work to remove the growth of polyp.
A surgery is needed beyond Stage 1, while a therapy or radiation or a combination of both treatments is applicable for Stage 2 and higher, with the spread of polyps growth.
“But the idea or the concept of prevention needs to be inculcated in the patient’s minds and the government that it should be provided as a service,” Fajardo said.
As an advocate of colon-cancer awareness here and abroad, he seeks to address the misconception that it is akin to a “death sentence” upon diagnosis.
“Colon cancer is one of the most curable cancers, and the survival rate is actually very good,” he said.
He said Stages 1, 2, 3 and 4 have a 92-percent, 89-percent, 83- percent and 40-percent five-year survival, respectively.
“So it’s not like once you have it, it’s a death sentence. It’s actually the idea of getting to it—getting the diagnosis and getting the treatment,” he said.
Bullish that there are still ways to mitigate the impact of colon cancer to the lives of Filipinos, especially older people, Fajardo sees the government’s role to make colonoscopy available for everyone and also bring down its ideal price from P5,000 to as high as P50,000, depending on where the procedure is done.
“Colonoscopy, as a preventive test, is not covered yet [by Philippine Health Insurance Corp.] And that’s what actually I’m trying to push forward,” he said of his recent advocacy, while noting some preventive medicines have been already covered by such state-provided health insurance.
“It’s just a matter of expanding the scope of what we’re trying to prevent. That’s how the US was some several decades ago [when] the concept of [colon-cancer] prevention was still something quite new. Now it’s invoked because people understand the value.
“So, hopefully in due time—and that’s what we’re trying to do with education and awareness—the legislation will follow and the services might be provided, making health care a right and not just a privilege.
“And if it’s a matter of cost with the equation, the bigger the market, the cheaper it will be. That’s how it seems [to be the result of making it widely available to the people]. So the more usage of a certain test like this, the cheaper it will be,” he said.
Fajardo opened the first independent endoscopy center in Clark County, Nevada, in 2008.
Prior to his advocacy on early detection and prevention of colon cancer, he has become a household name when he championed the diagnosis and treatment of hepatitis in the Asian American and Pacific Islanders community throughout the US.
Also, he has been a promoter and organizer of multiple large-scale regional screening and benefit events.