The term “cancer” refers to diseases resulting from the abnormal growth of any cell in our body. There are over 200 distinct types of cancer, which vary substantially in cell behavior and treatment response.
How Does Cancer Start?
Trillions of living cells make up the human body. These cells continuously grow and divide. During your lifetime, many of these cells age and die. They must be replaced so that the body can continue functioning optimally. In most people, this programmed cell replacement occurs in an orderly and organized manner.
In cancer, however, the cells do not die. Instead, they continuously grow and divide uncontrollably. The continued growth may lead to the accumulation of the cells, forming a mass of tissue called a tumor.
What Are Tumors?
Tumors can either be benign or malignant. Benign tumors, such as a common skin wart, remain confined to their original position, neither invading the surrounding normal tissue nor spreading to distant body sites. These are non-cancerous and are rarely life-threatening, although problems may arise when they grow exceedingly in size. A malignant tumor, however, is capable of both invading its surrounding normal tissue and spreading to different areas of the body.
Malignant tumors cause cancer. Their capability to invade and spread is what makes cancer fatal and difficult to treat. However, not every type of cancer forms tumors. For example, leukemia is a type of cancer that typically occurs in the bone marrow and enters the bloodstream. They do not form tumors, but instead, they affect the amounts of white blood cells, red blood cells, and platelets within the body.
How Does Cancer Spread?
Unlike healthy cells, cancer cells can spread outside of the place they originated. This development is called metastasis. Almost all types of cancer can metastasize, depending on various individual factors. Metastatic cancer can grow directly into the tissue surrounding the tumor or travel through the bloodstream or the lymphatic system to distant parts of the body, forming new tumors.
For example, cancer that starts within the breast is called breast cancer. If it spreads to other organs such as the liver or bone, it is called metastatic breast cancer. With countless different cancers, it is crucial to know which type of cancer you have to receive the proper treatment.
Incidence of Cancer in The Philippines
Although there are many types of cancer, only a few occur frequently. According to the Philippine Statistics Authority (PSA) data, cancer is the second leading cause of death next to ischemic heart diseases.. In the year 2020, more than 150,000 Filipinos were diagnosed with cancer, with over 66,000 deaths recorded.
According to The Global Cancer Observatory, the five most common cancer sites diagnosed among Filipino men in 2020 were lung, colon/rectum, prostate, liver, and leukemia. On the other hand, cancer in Filipinas was most commonly found in the breast, cervix/uterus, colon/rectum, lung, and ovary.
Types of Cancer
Cancers of 35 different body sites account for the total incidence of cancer in the Philippines, with the three most common cancers--breast, lung, and colon cancer--accounting for more than half of all cancer cases.
Lung Cancer
This type of cancer is the most prevalent and the leading cause of cancer death in men and women. It is also, by far, the most fatal. In 2020, lung cancer incidence and mortality estimates were 19,180 cases and 17,063 deaths, respectively.
Smoking (e.g., cigarettes, pipes, or cigars) is the most critical risk factor in the development of lung cancer for both active smokers and nonsmokers exposed to secondhand smoke. The risk of developing lung cancer increases with the number of cigarettes smoked. The most significant lifetime cumulative exposure to cigarette smoking occurs between ages 70 and 80 years old.
Additional risk factors include exposure to certain industrial substances such as asbestos, nickel, soot, tar, or radon. Occupational, medical, and environmental determinants that cause radiation exposure is also a risk factor. In addition, repeated exposure to polluted air can also increase the risk of lung cancer.
The risk for developing lung cancer also increases for those with a family history of the disease and persons infected with the human immunodeficiency virus (HIV). Most individuals diagnosed with lung cancer have no presenting symptoms. When symptoms do occur, they may be indefinite and associated with other problems, especially in older adults with underlying lung problems or other chronic illnesses.
However, others may present symptoms when the tumor becomes large and cancer metastasizes to other organs. The typical symptoms of lung cancer include persistent cough, sputum streaked with blood, chest pain, fatigue, weight loss, recurring respiratory infections, shortness of breath, and hoarseness of voice.
Breast Cancer
Cancer of the breast(s) is the most common cancer in women, increasing incidence with progressing age. The Cancer Incidence in Five Continents (CI5) states that breast cancer occurrence and mortality have been increasing steadily in many Asian countries, most notably among Filipino women. The Philippines currently has the most number of breast cancer in Southeast Asia. Breast cancer also has the second-highest mortality rate next to lung cancer. In 2020, new breast cancer cases amounted to 27,000, with almost 10,000 deaths.
Women face a 12% risk of developing breast cancer during their lifetime (1 in 8 women). The incidence of breast cancer decreases after age 80, although this may be due to a decrease in cancer screening instead of an actual reduction in cancer development. In the Philippines, the 10-year survival rate among women with breast cancer is estimated to be only 57%, much lower than that in developed countries.
The low survival rate is often attributed to the lack of awareness and low screening rates among Filipinos. In addition, inadequate access and the high cost of treatment also significantly contribute to the high morbidity and mortality rates in breast cancer patients. Dominant risk factors for breast cancer appear to be related to the duration and intensity of exposure to hormonal influences, especially estrogen, and early menstruation (before age 12), late menopause (after age 55), prolonged exposure to postmenopausal hormones, recent intake of oral contraceptives, having first given live birth after the age 35, and never having given birth.
Additional risk factors for the development of breast cancer include female gender, a personal or family history of breast cancer, history of benign breast disease or dense breast tissue, excessive alcohol use, and smoking. Obesity and weight gain after menopause and a sedentary lifestyle have also been shown to increase the chances of having breast cancer.
The primary presenting symptom of breast cancer is a lump in the breast. However, some may show symptoms of metastasis as the first indication of disease. The lungs, liver, bones, and adrenal glands are predominant sites for breast cancer to spread and grow. Specific symptoms are linked to the metastatic site and the extent of the disease. Although every woman is at risk for developing breast cancer, the older a woman is, the higher are her chances of developing breast cancer.
Colon/Rectal Cancer
The third most common cancer in the Philippines is colorectal cancer. It accounts for 7.4% of all cancer diagnoses. In 2020, new cases summed up to 11,300, with over 6,000 deaths. Early diagnosis with polyp removal, treatment leading to cure, and improvements in treatment modalities are the reasons for the declining rates.
A personal or family record of inflammatory bowel disease, polyps, or colorectal cancer has been associated with increased colorectal cancer risk, as having type 2 diabetes. Lifestyle choices linked to the development of colorectal cancer include having high red meat and processed meats diet and frequently eating fried, broiled, or grilled meat. Obesity and a sedentary lifestyle are also linked to colorectal cancer, as with smoking and excessive alcohol intake.
In the early stages, colorectal cancer may not manifest any symptoms. As the disease advances, presenting signs and symptoms depend on the location of cancer within the colon. Cancer of the right colon may cause pain, cramping, and appendicitis-like symptoms. Cancers located on the transverse colon may produce bloody stools, changes in bowel habits, and obstruction. Cancer on the colon’s left side tends to be constricting, progressively restricting the opening of the bowel, which causes bright red bleeding.
Rectal cancer is indicated with a change in bowel habits (alternating constipation and diarrhea).
Detection and Cancer Screening
Primary prevention of cancer is desirable and is affected by changes in lifestyle. Older adults are likely to have a lifetime of exposure to risk factors, and although changing lifestyles is advantageous for them, the changes may not reverse the effects of exposure. Furthermore, changing habits that you have developed over your lifetime is not easy. Given the difficulty of cancer prevention, cancer detection at an early stage can significantly improve survival rates.
Screening asymptomatic persons at risk are feasible in many common malignancies, including breast and colorectal cancers. Here is a table that may help illustrate the screening guidelines for cancer.
Major Treatment Procedures for Cancer
The four classic forms of cancer treatment are:
- Surgery
- Radiation therapy
- Chemotherapy
- Biologic therapy
These treatments may be used alone or in combination with another. Determination of the kind of treatment for the patient depends on the type and stage of cancer, the unique physiologic characteristics of the cancer cells, and an older patient’s overall health status at the time of diagnosis. Treatment goals also help determine the type of therapy.
The purpose for using cancer therapies may vary and can include the cure or elimination of the disease, control or minimization of the illness, or palliation or relief of the symptoms.
Cancer Support and Resources in The Philippines
Qualified cancer patients in the Philippines can get medical and financial assistance from certain government offices and agencies. These include the following:
- Philippine Charity Sweepstakes Office (PSCO)
- Department of Social Welfare and Development (DSWD)
- Department of Health (DOH)
- Philippine Amusement and Gaming Corporation (PAGCOR).
Financial assistance also comes from several non-governmental organizations and private charity organizations, such as the Philippine Cancer Society and the Andres Soriano Foundation. These agencies and organizations can settle the cost of hospitalization, including the medicines, medical and surgical supplies, and diagnostic procedures.
Quick Links:
Financial Assistance for Cancer Patients
Cancer Support Programs and Groups
Andres Soriano Foundation Cancer Care Program
Sources
Bibliography “CI5 I-X - Quality Indices.” Iarc.fr, 2021. https://ci5.iarc.fr/CI5I-X/Pages/Quality_sel.aspx.
“Philippines.” , n.d. https://gco.iarc.fr/today/data/factsheets/populations/608-philippines-fact-sheets.pdf.
“SECONDARY PREVENTION of CANCER.” , n.d. http://www.philcancer.org.ph/wp-content/uploads/2014/04/pcsi-secondary-cancer-prevention-guidelines-2011-pdf.pdf.
“Causes of Deaths in the Philippines (Preliminary): January to December 2020 | Philippine Statistics Authority.” Psa.gov.ph, 2020, psa.gov.ph/content/causes-deaths-philippines-preliminary-january-december-2020.
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