PHILIPPINE CANCER CONTROL PROGRAM

Cancers figure among the leading causes of morbidity and mortality worldwide, with approximately 14
million new cases and 8.2 million cancer related deaths in 2012 (WHO). More than 60% of world’s total
new annual cases occur in Africa, Asia and Central and South America. These regions account for 70% of
the world’s cancer deaths (WHO). It is expected that annual cancer cases will rise from 14 million in
2012 to 22 within the next 2 decades (WHO).

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.

HEADLINES

Incidence of breast cancer rising in PH, say experts

Philippine Daily Inquirer / 07:10 AM November 04, 2017

The Philippines has the highest incidence of breast cancer in Asia with one in every 13 Filipino woman at
risk of getting it in her lifetime.

While the cause has yet to be pinpointed, medical experts have attributed this to several factors
including the decision of many Filipino women not to have children or to delay marriage and having kids
until they are in their 30s.

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Oncologist Dr. Christina Galvez, president of the Philippine Breast Cancer Society (PBCS), said during the
Pink Ribbon Day event, held in partnership with SM Cares at the SM Mall of Asia in Pasay City, that the
decision to delay having children until their 30s is making Filipino women at risk of having breast cancer
because of the longer duration of exposure to estrogen.

“Women naturally produce estrogen through the ovaries. It is a natural hormone. But this hormone
feeds cancer cells so when you have constant high levels of estrogen in your body, it raises your risk of
breast cancer. The production of this hormone only stops when you get pregnant and give birth so when
you have kids, it shortens the period of your exposure to this type of hormone,“ Galvez explained.

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Other risk factors, she pointed out, are intake of oral contraceptive pills, high fat diet, obesity, sedentary
lifestyle, alcohol consumption and family history of cancer. Pregnancy and breastfeeding offers some
protection against breast cancer.

Due to its high incidence, the PBCS has teamed up with SM Prime Holdings to hold the Pink Ribbon Day
to promote breast cancer awareness and to encourage regular breast examination for early detection
and intervention.

During the event hosted by Kris Aquino, free consultations and clinical breast exams were conducted.
Cancer survivors led by movie and TV director Bibeth Orteza and TV host Jaymee Joaquin, Aquino, SM
and PBCS executives signed a pledge wall to fight breast cancer.

Elena Bautista Horn, vice president for corporate affairs of SM Prime, who is herself a breast cancer
survivor said “Pink Ribbon Day” is their way of telling women that breast cancer is not a death sentence
but a challenge that can be won with early detection with the help of prayers and the support of family
and friends.

“So to all women out there, don’t be afraid to have yourself checked. You have to do it for you and your
loved ones,” Horn said.

Galvez said regular breast examination is the single best way to detect the disease at the earliest possible
stage
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galvez-philippine-breast-cancer-society-bibeth-orteza#ixzz6DGSRioHV

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Among Asian countries, the Philippines has the No.1 incidence of breast cancer. “Three out of 100
(Filipino) women will get breast cancer before age 75 and one out of 100 will die before reaching 75,” an
official of the Philippine Society of Medical Oncology reported.

Breast cancer accounts for 15 percent of all new cancer cases in the country for both sexes and 8 percent
of all cancer deaths. “So, you can just imagine the magnitude of the problem,” the oncology society
official pointed out.

And yet, not too many really know about the disease. “Public awareness on cancer prevention is low,”
the oncology society deplored. “Most Filipino patients consult a doctor only when their cancer is already
in its advanced stage.”

As a result, “survival rates in the country are relatively low.”

Breast cancer usually begins with formation of a small, localized tumor. “Some tumors are benign that
they do not invade other tissue; others are malignant or cancerous,” explained The Medical Advisor: The
Complete Guide to Alternative and Conventional Treatments. “The potential for a malignant tumor to
spread is common to all cancer. Once such a tumor grows to a certain size, it is more likely to spread to
other parts of the body through the bloodstream and lymphatic system.”
No one knows why a woman will get the disease, but there are risk factors. These are the following,
according to Dr. Rachel Rosario of the Philippine Cancer Society Inc. (PCSI): being overweight, having no
children at the age of 30, having a family history of breast cancer, drinking excessive alcohol, and having
early menstruation and later menopause.

Actually, health experts say there are two types of breast cancer: ductal carcinoma (begins in the milk
duct and is the most common type) and lobular carcinoma (starts in the lobules).

The cancer can be either invasive or noninvasive. It is considered invasive when the cancer cells break
out from the inside the lobules or ducts and invade nearby tissue, increasing the chance of spreading to
other parts of the body.

Noninvasive is when the cancer is still inside its place of origin and has not broken out. However, these
cells can eventually develop into invasive breast cancer if nothing is done soon.

In early stages, breast cancer usually has no symptoms. As a tumor progresses, a woman may
experience pain or tenderness in her breast. She may also observe swelling in the armpit. But the most
apparent symptom is a lump in the breast. More than 80 percent of breast cancer cases are discovered
as a lump by the woman herself.

Generally, a lump in the breast can be known through breast self-examination (BSE). As such, the
Geneva-based World Health Organization (WHO) suggests that women should examine their breasts
regularly—at least once a month.

MCF-7 is a cell line that was first isolated in 1970 from the breast tissue of a 69-year old Caucasian
woman. Of the two mastectomies she received, the first revealed that the removed tissue was benign.
Five years later, a second operation revealed a malignant adenocarcinoma in a pleural effusion from
which tissue was taken that would eventually result in the MCF-7 cell line. The donor was treated for
breast cancer with radiotheraphy and hormonotherapy.

MCF-7, a widely studied epithelial cancer cell line derived from breast adenocarcinoma, has
characteristics of differentiated mammary epithelium. MCF7 cells can be used for detecting PI3K and
MAPK involvment, along with easy detection of ERK and Akt phsophorylation. Also, via cytoplasmic
estrogen receptors, these cells have the ability to process estradiol.

Copyright picture from altogen.com Reproduced with permission from Altogen Biosystems.

Uses for MCF-7 Cell Line

MCF-7 cells are useful for in vitro breast cancer studies as a result of the cell line retaining several ideal
characteristics particular to the mammary epithelium. These include the ability for MCF-7 cells to
process estrogen in the form of estradiol via estrogen receptors in the cell cytoplasm. This results in the
MCF-7 cell line being an estrogen receptor (ER) positive cell line. MCF-7 is also progesterone receptor
positive and HER2 negative.