Kanker Kolo-Rektal

Kanker Kolo-Rektal
Pencegahan dan Pengobatan
Rofi Y Saunar
RS Mayapada Jakarta Selatan
Stadium Kanker Usus Besar
PRIMARY MALIGNANCY PATHOLOGICAL BASE
Faculty of Medicine University of Indonesia
1.
2.
3.
4.
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8.
9.
10.
11.
12.
CERVIX UTERI
BREAST
NASOPHARYNX
OVARIUM
OTHERS
SKIN
RECTUM
SOFT TISSUE
LYMPH SYSTEM
ENDOMETRIUM
COLON
BLADDER
1997
420
160
97
96
93
92
79
77
55
54
2000-2001
1154 (1)
321 (2)
187 (5)
198 (4)
-224 (3)
129 (6)
94 (7)
-83 (8)
82 (9)
76 (10)
Number of digestive neoplasm
5000
4500
4000
3500
3000
2500
2000
1500
1000
500
0
4759
3787
1757
646
476
369
243
108
102
Indonesia Health Department : 2009
Gastrointest Endosc 2006;64:751-9
Colorectal Cancer Incidence 2010 -2012 : RSUP Fatmawati
48
42
50
45
40
35
32
30
25
20
Tahun 2012
15
Tahun 2011
10
5
Tahun 2010
0
Insidensi kanker
kolorektal
Eko R , Taslim P, Rofi YS. 2014
Colorectal Cancer Incidence 2010 -2012 : RSUP Fatmawati
Kelompok usia penderita kanker
kolorektal
23
25
20
• stadium I (1%),
28
30
Stadium klinis pasca operatif :
19
15
15
• stadium II (17%)
• stadium III (43%)
10
5
•
stadium IV (24%)
0
<40 Tahun
40-49 Tahun
50-59 Tahun
>=60 Tahun
Stage
0
Stage IV
7%
19%
Stage I
24%
Stage III
25%
Stage II
25%
US National Cancer Database.
Eko R , Taslim P, Rofi YS. 2014
Surgical Therapy Colorectal Cancer : Fatmawati General Hospital 2010 -2012
Eko R , Taslim P, Rofi YS. 2014
Colorectal Cancer Chetherapy : Fatmawati General Hospital 2010 -2012
Kelengkapan kemoterapi
Jenis Kemoterapi
Capecetabine saja
Capeox
Capeox-Bevacizumab
Capeox-Cetuximab
Folfiri
Folfiri-Cetuximab
Folfox
Folfox-Bevacizumab
Folfox-Cetuximab
Tidak kemoterapi
Capecitabine-IrinotecanBevacizumab
Capecitabine-IrinotecanCetuximab
Total
Tidak kemoterapi Kemoterapi tidak lengkap
Kemoterapi
lengkap
Total
0
0
0
0
0
0
0
0
0
10
4
2
2
0
1
1
2
1
0
0
6
5
6
1
0
3
16
1
1
0
10
7
8
1
1
4
18
2
1
10
0
1
2
3
0
0
3
3
10
14
44
68
Eko R , Taslim P, Rofi YS. 2014
CRC Patients Survival (TNM): Fatmawati General Hospital 2010 -2012
Eko R , Taslim P, Rofi YS. 2014
CRC Patients Survival (TNM): Fatmawati General Hospital 2010 -2012
Eko R , Taslim P, Rofi YS. 2014
CRC Patients Survival (TNM): Fatmawati General Hospital 2010 -2012
Eko R , Taslim P, Rofi YS. 2014
CRC Patients Survival (TNM): Fatmawati General Hospital 2010 -2012
Eko R , Taslim P, Rofi YS. 2014
CONCLUSION
• Patients with metastatic colorectal cancer have a modest survival with a median of
18 months. In our study, the chance to live longer was comparable between stage IV
and relapsed patients.
• Chemotherapy combination with FOLFOX significantly prolongs survival, with about
one-third of patients live longer than 2 years, a figure not unlike reported in the
literature.
• We conclude that, with proper treatment and care, Indonesian colorectal cancer
patients have the same survival as in developed countries.
Here We are ???
FAKTOR-FAKTOR RISIKO
1.
2.
3.
4.
5.
Diit
Genetik
Inflamasi / Infeksi Usus Besar
Risiko Personal (Tambahan)
Polip Usus Besar
DIIT
1. Lemak / Fat
: Tinggi Lemak
2. Serat / Fiber
: Rendah Serat
3. Kalori
: Tinggi Kalori
GENETIK
1.
Familial Adenomatous Polyposis
2.
Sindroma Lynch / Hereditary Nonpolyposis – Colorectal
Cancer
RISIKO PERSONAL
1. Kanker Payudara
2. Kanker Ovarium
3. Kanker Uterus
4. Radiasi Perut Bagian Bawah
PENANGANAN KANKER USUS BESAR
1.
Pembedahan
2.
Khemoterapi
3.
Radiasi
GEJALA UTAMA
1. Perubahan Pola BAB
* Sulit BAB
* Diare Kronis
2. BAB Berdarah
3. Gejala-Gejala Kanker Pada Umumnya:
Lemah, Berat Badan Turun, Anemi
Penyakit kanker adalah seperti pencuri yang
merampas kesehatan, mencuri
kebahagiaan dan melemahkan semangat
hidup kita.
Pengetahuan mengenai kanker adalah
senjata utama kita dalam melawan kanker