Cancer is one of the four epidemic non-communicable diseases (NCDs) or lifestyle-related diseases (LRDs) which include cardiovascular diseases, diabetes mellitus, and chronic respiratory diseases. According to Dr. Antonio Miguel Dans in his paper “Introduction to Non-Communicable Diseases” in August 2014, the NCDs are now considered a “silent disaster” of massive proportion that is ravaging the Filipino population, killing 300,000 victims a year, 800 every day, and 33 every hour. Its toll on lives is likened to “two 747 planes packed with passengers crashing every day”. Those NCDs share common risk factors, such as tobacco use, unhealthy diet, insufficient physical activity and the harmful use of alcohol.

Cancer remains a national health priority in the country with significant implications for individuals, families, communities, and the health system.  Cancer is the third leading cause of morbidity and mortality in the country after diseases of the heart and the vascular system (Philippine Health Statistics 2009).  Among Filipino men, the 6 most common sites of cancer diagnosed in 2010 (Globocan) were lung, liver, colon/rectum, prostate, stomach, and leukemia. Among Filipino women the 6 most common sites diagnosed were breast, cervix, lung, colon/rectum, ovary and liver.  Furthermore, 189 of every 100,000 Filipinos are afflicted with cancer while four Filipinos die of cancer every hour or 96 cancer patients every day, according to a study conducted by the University of the Philippines’ Institute of Human Genetics, National Institutes of Health.

In response to this growing and alarming epidemic of cancer, there is a need to revisit and strengthen the Philippine Cancer Control Program which started in 1990 through Administrative Order No. 89-A s. 1990, amending A.O. No. 188-A s. 1973.  Hence, the National Cancer Control Committee (NCCC) developed the National Cancer Prevention and Control Action Plan (NCPCAP) 2015-2020.

The National Cancer Prevention and Control Action Plan 2015-2020 shall cover the following key areas of concern:

1. Policy and Standards Development

1. Development of “National Policy on the Integration of Palliative and Hospice Care into the Philippine Health Care System”
2. Development and Operationalization of National Cancer Prevention and Control Website and Social Media Sites
3. Development of “Comprehensive National Policy on Cancer Prevention and Control”
4. Establishment of National Cancer Center and Strategic Satellite Cancer Centers
5. Expansion of PhilHealth Z Benefit Package Coverage to Other Cancers
   • PhilHealth Z-Benefit Package for catastrophic diseases (breast, prostate, cervical cancers and childhood acute lymphocytic leukemia) is an in-patient package which includes mandatory diagnostics, operating room expenses, doctor/professional fees, room and board, and medicines.

2.)   Advocacy and Promotions

1. Cancer Awareness Campaigns

2. Partnership with DepEd, CHED, DOLE-Bureau of Working Conditions, and Civil Service Commission

3.)   Capacity Building and Resource Mobilization

1. Training of Trainers on Cervical Cancer Prevention and Control
2. Training of Trainers on Palliative and Hospice Care
   • Palliative and hospice care has been the missing link in our health care delivery system. Our Universal Health Care or Kalusugan Pangkalahatanwould not be complete without integrating palliative and hospice care into the existing promotive–preventive–curative-rehabilitative continuum of care. It is therefore imperative to institutionalize and integrate palliative and hospice care both in the hospitals or health facilities and in community or home-based level.
3. Training of Trainers on Patient Navigation Program
   • Patient Navigation Program / Medicine Access Program: It provides chemotherapy for early stage breast cancer and acute lymphocytic leukemia and other diagnostic standard procedures for eligible patients at no cost. This project involves seven (7) government hospitals, namely: Philippine General Hospital, Jose Reyes Memorial Medical Center, East Avenue Medical Center, Rizal Medical Center, Amang Rodriguez Memorial Medical Center, Philippine Children’s Medical Center and Bicol Regional Training and Teaching Hospital.

4.)   Service Delivery

1. Availability of Free Cervical Cancer Screening in all trained RHUs
2. Availability of cryotherapy equipment in every province (81 provinces)
3. Availability and accessibility of screenings for selected cancers in all trained RHUs
4. School-based HPV vaccination of 9 to 13-year-old females
5. Hepatitis B vaccination for all health workers nationwide

5.)   Information Management and Surveillance

1. Establishment of National Cancer Registry (hospital- and population-based)
2. Development and Operationalization of Cancer Helpline (including Telemedicine)

6.)   Research and Development

1. Establishment of National Research and Development Program for Cancer Control
2. Research: Study on the Socio-Economic Burden and Impact Assessment of Cancer in the Philippines
3. Determination of Cancer Incidence in the Philippines 2008-2013

NATIONAL CANCER CONTROL COMMITTEE

ROLES AND FUNCTIONS OF NATIONAL CANCER CONTROL COMMITTEE

1. Set the roadmap of National Cancer Prevention and Control Program (NCPCP)
2. Plan, establish and implement policies, guidelines and standards throughout the continuum of holistic health care (preventive, promotive, curative, rehabilitative and palliative)
3. Advise / recommend upgrading of existing cancer management facilities in the country
4. Coordinating body for all cancer works in the country
5. Ensure the implementation of NCPCP down to the grassroots level
6. Establish and carry out an effective nationwide cancer education program / dissemination
7. Provide technical and financial support on cancer prevention, early detection, treatment and palliative care
8. Establish and carry out effective training program
9. Ensure the collection and analysis of data from registry and surveillance
10. Implement, monitor and evaluate the NCPCP regularly through implementation review and impact evaluation
11. Empower and engage all the stakeholders to actively work on and participate in on various areas of NCPCP
12. Endorse support for researchers in the clinical, epidemiological, public health and knowledge management areas and in collaboration with international institutes
13. Others that may be identified and approved by the Secretary of Health

LEADERSHIP AND GOVERNANCE

LOCAL GOVERNMENT CANCER CONTROL COMMITTEE

EXPERTS GROUP

SUBCOMMITTEES OF NATIONAL CANCER CONTROL COMMITTEE

Program Manager/Contact Information

CLARITO U. CAIRO, JR., MD, FPSVI, FPCOM

Medical Officer IV

Program Manager

Philippine Cancer Prevention and Control including Palliative and Hospice Care

Department of Health

Disease Prevention and Control Bureau

Lifestyle-Related Disease Division

3rd floor, Building 14, DOH Central Office

San Lazaro Compound, Sta Cruz Manila, Philippines

Tel nos.: +632 651-7800, local 1751-1752

Direct line: +632 732-2493

SOURCE: http://www.doh.gov.ph/philippine-cancer-control-program

]]> http://www.protaciohospital.com/philippine-cancer-control-program/feed/ 0 http://www.protaciohospital.com/hepatitis-in-the-philippines/ http://www.protaciohospital.com/hepatitis-in-the-philippines/#respond Fri, 19 Jan 2018 03:05:57 +0000 http://www.protaciohospital.com/?p=1971 EXPERTS and officials from the Department of Health (DoH), the National Institute of Health, and the World Health Organization (WHO) in the Philippines recently convened to review the current situation of hepatitis in the country. The meeting hoped to gather a consensus on the understanding of the disease burden and the program of actions needed to address the challenges posed by hepatitis in the Philippines. The participants agreed to develop a National Hepatitis Action Plan as one of the cornerstones in “understanding the true burden of chronic viral hepatitis in the Philippines.”

The DoH estimates that 10% to 16% of Filipino adults suffer from chronic hepatitis B infection. It is also approximated that around 1% of the estimated 100 million Filipinos has chronic hepatitis C.

The WHO estimates that almost 40% of global mortality due to viral hepatitis occurs in the Western Pacific Region.

Despite this high rate, the many effective drugs to combat viral Hepatitis B and C are only slightly more accessible now due to prohibitive cost in the Philippines and elsewhere.

In the case of hundreds of millions of people with hepatitis, including Filipinos, the WHO said that Hepatitis B and C infections lead to chronic liver disease, which is the most common causes of liver cirrhosis and liver cancer.

Viral hepatitis is defined as “an inflammation of the liver caused by one of the five hepatitis viruses: A, B, C, D and E.” Infections, toxic substances, such as alcohol and certain drugs, and auto-immune diseases can also cause hepatitis.

Viral hepatitis is considered a significant public health problem because of the sheer number of people affected, the number of deaths caused, and because of its potential for outbreaks and epidemic spread. In particular, types B and C lead to chronic disease in hundreds of millions of people. Combined, hepatitis B and C are the most common cause of liver cirrhosis and cancer, globally.

The five kinds of hepatitis viruses are transmitted through different routes: hepatitis A and E through contaminated food and water; hepatitis B through unsafe blood and other bodily fluids; and hepatitis C and D mostly through infectious blood. Hepatitis C can actually be transmitted through sexual contact as well, though this is rare. Hepatitis D is only transmitted to individuals already chronically infected with the hepatitis B virus.

While hepatitis A and E are typically caused by ingestion of contaminated food or water, hepatitis B, C, and D usually occur as a result of parenteral contact with infected body fluids. Common modes of transmission include transfusion of contaminated blood or blood products, invasive medical procedures using contaminated equipment, and, for Hepatitis B, transmission from mother to baby at birth, from family member to child, and also by sexual contact.

The five hepatitis viruses can cause an acute hepatitis which is characterized by fatigue, loss of appetite, fever, and jaundice. Most persons fully recover from acute hepatitis, but a small proportion can die from life-threatening complications.

Vaccination is still one of the most potent agents in the fight against hepatitis.

In the Philippines, about one in seven adults are infected with hepatitis B and more than half a million have hepatitis C, says a report in Medical Observer, a Philippine-based medical and health online publication. Hepatitis B accounts for more than two thirds of all cases of liver cancer, the second leading cause of cancer deaths in the country, said the article “Fight vs. Chronic Viral Hepatitis Rages in the Philippines,” in the Medical Observer.

The article estimated that the cost of hepatitis treatment and management in the Philippines can be prohibitive, given that the urban minimum daily wage is at P450.

“Hepatitis B profile costs P1,800; ultrasound, P450; hepatitis B viral load, P4,500; viral load for hepatitis C, P6,500; and genotyping, P14,350… Hepatitis B medication costs P135 a day or P49,000 a year that (may possibly run) for the rest of our lives. Hepatitis C treatment costs P732 per day for at least three months,” it said.

One notable aspect of the fight against the onslaught of hepatitis is the presence of two laws which give teeth and more power in the implementation of the vaccination program against hepatitis B.

From 1992, the nationwide immunization program started, to which the hepatitis B birth dose vaccination was included beginning 2006.

PhilHealth, the country’s version of a public or national health insurance program, also incorporated hepatitis vaccination in its newborn care package.

“Sadly, the program coverage for the entire 100 million Philippine population remains at its infancy; even the Department of Health has yet to turn up policies for viral hepatitis prevention and control,” the Medical Observer article said:

The article, meanwhile, noted that the “local government units are already integrating hepatitis B education in their information campaigns… that are usually integrated to their HIV programs and are implemented of varying degrees.”

source: Business World
http://www.weekender.bworldonline.com/2015/12/11/hepatitis-in-the-philippines/

PRIMARY CANCER PREVENTION GUIDELINES

Primary prevention of cancer is the prevention of cancer in an individual who does not have the disease. The PCS has primary prevention guidelines on:

• Lung Cancer
• Uterine Cervix Cancer
• Liver Cancer
• Oral Cancer
• Testis Cancer
• Skin Cancer

SECONDARY CANCER PREVENTION GUIDELINES

Secondary prevention of cancer is the early detection of cancer in an individual who has the disease but is asymptomatic for it; disease is at the pre-clinical stage.

Screening is the presumptive identification of unrecognized disease or defects by means of tests, examinations, or other procedures that can be applied rapidly among asymptomatic target population on a large scale.

PCS has secondary prevention guidelines for:

• Cervix cancer
• Breast cancer
• Colon cancer
• Recto-sigmoid colon cancer
• Prostate cancer
• Oral cavity cancer
• Stomach cancer

TERTIARY CANCER PREVENTION or CLINICAL TREATMENT GUIDELINES

Tertiary cancer prevention or better known as clinical treatment is the treatment of symptomatic clinical cancer to prevent disease progression or complication/s.

The Philippine Cancer Society Guidelines are constructed using the Clinical Algorithm Standards of the Society of Medical Decision Making. These charts are made of conditional logic (if/then) statements that have been mapped out.  In navigating through these maps, 4 kinds of symbols are used:

1. Clinical State Boxes (rounded rectangles) – These boxes define the clinical state or problem. They have only one exit path, and may or may not have an entry path. Clinical state boxes always appear at the beginning of an algorithm.
2. Decision Boxes (hexagons) – These boxes contain a question (?) that is answerable by yes or no. Two alternative paths always branch out from these boxes – the “yes” (Y) path usually exists to the right, while the “no” (N) path usually exits downwards. Decision boxes always have an entry path.
3. Action Boxes (angles rectangles) – These boxes contain an action, commonly either therapeutic or diagnostic in nature. They may not have an exit, but they always have an entry path.
4. Link Boxes (small ovals) – These boxes are used to link algorithms that cannot fit in a single page, to maintain path continuity.

Annotations ((A), (B), (C)…) are given as needed for a particular algorithm. The algorithms are so designed so that a large majority of patients presenting with a particular oncology problem can be handled with a minimum of tests, interventions or referrals, particularly in consideration of the Philippine setting. They serve as guidelines to the management of common oncology problems (with typical presentations), aiding the thinking process of the physician. It must be added, however, that some patients have clinical cancer presentations that are atypical, hence the need for other diagnostic procedures that may not be mentioned in the algorithms.

The major resource and reference of the cancer treatment guidelines is the National Comprehensive Cancer Network Clinical Practice Guidelines in Oncology (NCCN).  For further information go to http://www.nccn.org/

The PCS has Tertiary Cancer Prevention algorithms for:

 Primary Cancer Sites

• Breast
• Lung
• Lymph Node, Primary
• H & N, un-resectable
• Nasopharynx
• Esophagus
• Stomach
• Colon
• Rectum
• Liver
• Pancreas
• Ovary
• Uterine Fundus
• Uterine Cervix
• Prostate
• Testis
• Renal
• Urinary Bladder
• Soft Tissue
• Bone
• Brain
• Unknown Primary
• Palliative Management – Advanced Cancer

Oncologic Emergencies

• Superior Vena Cava Syndrome
• Spinal Cord Compression
• Malignant Pleural Effusion

Supportive Care

• Cancer Pain
• Chemotherapy-induced Anemia
• Chemotherapy-induced Neutropenia
• Chemotherapy-induce Emesis

SOURCE: http://www.philcancer.org.ph/learn-about-cancer/cancer-prevention-guidelines/

Republic Act No. 10526 of 2012 declares January as Liver Cancer and Viral Hepatitis Awareness and Prevention Month

(Research by Jobelyn Catama, Infographics by Dex Magno)

Cant’t see the infographics?

Click here: Liver and Viral Hepatitis Awareness and Prevention Month

Author: Ivan Olegario, MD, MDevCom

SOURCE: Cranial Calisthenics

Author: Stef dela Cruz, MD

Show gratitude because it’s good manners – or so our parents used to say. As children, we learned this much, showing gratitude whenever we received a compliment. We then learned to say thank you for the littlest of favors. We also learned to say a prayer of thanks for the food we ate each day.

Little did we realize that being grateful was actually beneficial to us health-wise. Yes, gratitude is the ultimate health potion!

More than just a soundbite, that supposition is based on a wealth of evidence. Below is proof that being grateful can actually give you plus points in health.

• Being grateful can help you live longer and happier

Gratefulness is widely perceived as part of good emotional health which, in turn, potentially leads to a longer life, according to a 2000 study by Glenn Ostir and colleagues published in the Journal of the American Geriatrics Society. Out of more than 2,000 participants, there was 50 percent less mortality among those with a positive outlook in life during the two-year follow up.

People who were positive – for instance, happy, grateful, and optimistic – also had better functional recovery after a serious health incident, according to a 2002 study by Ostir and team published in the same journal. They were less prone to experiencing disabilities that adversely affected their daily activities – in other words, they probably had a better quality of life overall.2. L

• Learning to be thankful is associated with less risk for illness

Different studies have shown that a life lived in contentment and gratitude was one with a lower risk for illness and injury. For three weeks, more than 300 participants were asked to rate each day based on different positive and negative adjectives. After being given nasal drops containing viruses that caused the common cold, participants who rated their day-to-day lives negatively developed an infection more than their more optimistic and grateful counterparts, reported Sheldon Cohen and colleagues in a 2003 study published in Psychosomatic Medicine.

• A grateful, positive outlook increases your tolerance for pain

Among people with chronic back pain, gratitude intervention led to more happiness and less anger, according to a small study in 2012 by Heidi Baxter and colleagues published in The Australian Journal of Rehabilitation Counselling. Positive emotions, in turn, could help people manage chronic pain.

• An appreciation of life’s blessings can lower stress hormone levels

A negative attitude was correlated to higher levels of cortisol, a hormone released in response to stress, according to a 2005 study by Deborah Polk and colleagues published in Psychoneuroendocrinology. Those with a more positive and content outlook, on the other hand, had lower stress hormone levels.

• Gratitude helps you bounce back from trauma and tragedy

After experiencing loss, people with more positive emotions moved on more effectively, as evidenced by faster cardiovascular recovery after negative stimuli, according to Michele Tugade and Barbara Fredrickson in a 2004 study published in Journal of Personality and Social Psychology.

• Feeling grateful can improve your compliance to health regimens

Sticking to an exercise program or your medication schedule can be difficult – but Sarah Jaser and her colleagues stated in a 2014 study published in the Journal of Pediatric Health Care that positive emotions, such as contentment and gratitude, make quite an impact on adult health conditions that require behavioral adjustment.

• Gratefulness develops and strengthens relationships

While positivity is pro-self and improves mood and self-esteem, gratitude is pro-social and increases one’s tendency to focus on someone else.

Proving the separate effects of positive emotions versus gratitude, participants of a 2006 study who thought they received a favor from a specific person were more motivated to do something good than those who thought they received a favor randomly. The study, authored by Jo-Ann Tsang, was published in Cognition and Emotion.

• A grateful outlook reduces envy and spite

Different experiments revealed similar evidence: Gratitude, by increasing one’s capacity for empathy, led to lower levels of aggression, according to C. Nathan DeWall and colleagues as reported in their 2012 study published in Social Psychological and Personality Science.

Gratitude: free but priceless

The longer you stay grateful, the more benefits you reap, according to a 2005 article by Sarah Pressman and Cohen published in Psychological Bulletin. After all, it usually takes a while before your emotions affect your mind and body.

Make gratitude a part of your daily habit – soon enough, it will be a treasure trove of health benefits.

source: www.thefilipinodoctor.com

Smoking increases the risk of developing a number of diseases, such as chronic obstructive pulmonary disease (COPD), coronary heart disease, stroke and peripheral vascular disease, all of which can potentially have negative effects on people’s physical, psychological and social health.

Frailty is considered a precursor to, but a distinct state from, disability. Frailty is a condition associated with decreased physiological reserve and increased vulnerability to adverse health outcomes. The outcomes include falls, fractures, disability, hospitalisation and institutionalisation. Frailty has also been shown to be linked to worse psychological or cognitive outcomes, such as poor quality of life and dementia.

Due to the potential for reversibility of frailty, identifying potentially modifiable risk factors of frailty may help to develop strategies to prevent or slow progression of adverse health outcomes associated with both frailty and smoking.

Researchers here aimed to examine the association of smoking with the risk of developing frailty, controlling for important confounding variables and using data from a nationally representative sample of older men and women living in England.

Researchers defined frailty using a combination of five physical frailty components: unintentional weight loss, self-reported exhaustion, weakness, slow walking speed, and low physical activity. Frailty is classified as having three or more of the five criteria.

The current study used data of participants who were aged 60 years or older. The final sample for this study was 2,542 participants, divided into two groups: current smokers and non-smokers. The non-smokers were further divided into another two groups: past smokers and never smokers. The past smokers were once again divided into two groups: those who quit within the last 10 years and those who quit more than 10 years ago. The analysis revealed that current smoking was associated with an approximately 60% increased risk of developing frailty.

There was, however, no significant association between past smoking and incident frailty in any models. Among 1,113 past smokers, 157 quit smoking within the last 10 years and 956 quit smoking for more than 10 years ago. Incident frailty risks of these two groups were not significantly different from that of never smokers in all models.

When COPD was added to the model, current smoking was no longer a significant predictor of incident frailty. In this model, COPD was strongly associated with incident frailty. These findings suggest that current smokers are more likely to develop frailty due to COPD, rather than smoking itself.

Given that smoking is a modifiable lifestyle factor, and smokers who quit did not appear to be at high risk for frailty, this research suggests that smoking cessation may potentially prevent or delay developing frailty, even in old age.

“Our study showed that current smoking is a risk factor of developing frailty. Additional analyses revealed that COPD seems a main factor on the causal pathway from smoking towards frailty,” said the study’s author, Gotaro Kojima, “but those who quit smoking did not carry over the risk of frailty.”

Story Source:

Materials provided by Oxford University Press USA.

With more and more Filipinos being diagnosed with diabetes, the goal is to encourage people to take preventive action to reduce the risk of developing the chronic disease. Regular physical activity, aside from adopting a healthier diet, is crucial to achieve this.

But unlike other countries where parks and other outdoor spaces are easily accessible to encourage physical activities, the Philippines has a severe shortage of these areas. However, it does not lack in malls.

The answer lies in adapting to environmental modifications, in this case, utilizing walk-friendly amenities like shopping malls.

There are currently 6 million FIlipinos with diabetes, according to the Philippine Center for Diabetes Education Foundation. The numbers, the PCDEF warned, could double in the next two decades.

Regular, moderate physical activity like walking pushes muscles to work harder and use more glucose for energy. Over time, this helps lower blood sugar levels as well as making insulin work better in the body. The result is lowered risk for developing diabetes and its complications.

Dr Iris Thiele Isip-Tan, an Endocrinologist who set up her practice at the Philippine General Hospital (PGH), put emphasis on the creation of more parks and mall-walking friendly areas, alongside addressing the food culture in preventing diabetes.

Mall-walking

“We need to do more about the environment. We don’t have [that many] parks to walk in. Mall-walking may not be ideal because of food restaurants, but it’s the safest place to walk because the areas are guarded and well-lighted,” Dr Isip-Tan told MIMS in an interview.

Mall-walking, essentially, is walking within mall complexes. Mall walkers may enter the mall an hour or two earlier before stores open for the public. Walkers are only going to use the premises for walking.

It is good to note, however, that, many malls in the country are increasingly incorporating outdoor amenities – such as gardens – within the mall complex and wider sidewalks built for the visitors to walk comfortably on.

No special equipment needed

Mall-walking is primarily associated with brisk walking – which not only lowers the risk for diabetes, but also heart disease, stroke and some cancers, according to University of California Berkeley Wellness.

Walking, foremost, requires no equipment to get started, and it can be done by everybody and of all ages. Even those with arthritis can engage in the activity as it doesn’t put much stress on joints.

And while being generally regarded as good for the body, brisk walking has been found to be better than running in reducing heart diseases. Running reduced heart diseases risks by 4.5 percent while walking does it by 9.3 percent, according to a study from the Lawrence Berkeley National Laboratory.

The risk of developing diabetes was reduced by 12 percent by running and walking, according to the same study.

The American College of Sports Medicine and American Diabetes Association, meanwhile, jointly recommend 150 minutes of moderate to vigorous physical activity per week.

Considering all these, however, Dr Isip-Tan noted in one of her Social Media posts that people wanting to walk outdoors or exercise outside may still be discouraged by inclement weather.

Complaints include the ground being slippery when it rains, and where water rise in certain areas, walkers are at risk of leptospirosis. This is where malls have the advantage.

The pros of mall-walking

In the United States, mall-walking is so prevalent that the US Centres for Disease Control and Prevention (CDC) made a guide.

Mall-walking, it said, prevents a number of physical activity barriers such as weather. Further, malls are typically temperature-controlled indoor environments regardless of the outdoor weather. The Philippines has wet and dry seasons, not summer. The rainy season starts in June and runs all the way to November.

Malls have level surface, as opposed to different terrains encountered outdoors – if going for areas with uneven grounds. Such surfaces lower the risk for injury. Malls also have security staff and/or programme leaders for walking programmes.

Importantly, clean and well-lit restrooms are always available within mall complex.

On another note, mall-walkers and programme leaders should know where first aid kit and emergency equipment are located, as well as access to route maps for mall-walkers.

SOURCE: https://today.mims.com/topic/mall-walking-as-alternative-to-lower-risk-of-diabetes?country=philippines