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Colorectal cancer...an essay or more?

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An end of a semester. Fourth year semester1 at UEA I found to be a good first semester. We had Mondays free for projectwork, either in labs for the ‘sciencey’ subjects, or reading research papers/writingprotocols for medicines management projects.  The rest of the week was filled with lectures on our ownchosen topics and a few workshops. The last week involved a course test and anessay to be handed in, which just so happened to be both on the same day (forany consolation, the course test was open book).

The essay we were assigned was oncolorectal cancer. When I first read what the essay was about I thought tomyself ‘how am I going to do an essay for 2000 words on colorectal cancer?’However, as I started to work on the essay the more interested I became incolorectal cancer, otherwise known as bowel cancer. Did you know that someoneis diagnosed with colorectal cancer every 3 and a half minutes? And someonedies every nine minutes because of it? Well I didn’t. I also didn’t know thatit is the most common type of cancer in the UK, nor that it is the second mostcommon type of cancer in women (following breast cancer).  The fact that I didn’t know this definitelyshows that colorectal cancer and its prevention is not promoted enough. Eitherthat, or that I am just not as aware as I hoped!

So here is a small  summery of what I learned. Smoking increases the risk ofdeveloping colorectal cancer by 25%, alcohol by 8%, red and processed meat byup to 35% and a high fibre diet reduces it by 20-30%. Genes, obesity, age, lackof exercise and previous bowel diseases also are risks. But it was thestatistics for obesity I found to be most shocking. An obese male has a 50%chance of developing colorectal cancer (obese women have 30% less of a chance).

It develops from polyps (abnormal growthsin the colon or rectum). Most polyps are benign, but some turn cancerous andgive rise to symptoms such as blood in stools, cramps, bloating, vomiting,unknown weight loss, diarrhoea, constipation and/orfeeling tired. Tests are performed to diagnose it, and to find out if it hasspread. Treatment would then be offered such as surgery, chemotherapy orradiotherapy depending on the staging.

I could write forever on the treatmentoptions, but I will only mention a drug I found particularly interesting;capecitabine. An oral prodrug of 5-flurouracil (5-FU) and folinic acid. It isimportant to mention that this drug is not appropriate for all patients. Ascolorectal cancer is a cancer that is more common in elderly people, who tendto be more forgetful, it is likely that their compliance would not be the best,and it is VERY important to not forget to take this chemotherapy agent. I foundthis interesting because I associate chemotherapy with patients having to regularlygo into hospital to be administered. A small change, such as an oralmedication, could make such a big difference to a patient’s way of life anddealing with their cancer for example, not having their routine interrupted tohave to repeatedly go into hospital. To me, this is what pharmacy is about:making that big difference to a patient.

So maybe an essay is a good idea. Not justfor education purposes or because it needs to make up a certain percentage of amodule, but because it can help with the making of well informed and competentpharmacists. I am now fully aware of how to prevent colorectal cancer, how torecognize the symptoms and how to educate my future patients. In this case forme, an essay turned out to be more than an essay.

 

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