A game-changing cancer treatment
Parkway Cancer Centre in Singapore’s Dr. Richard Quek talks about cancer immunotherapy
Cancer is one of the greatest causes of health burden all over the world. According to the World Health Organization (WHO), it is the second leading cause of death globally, and is responsible for an estimated 9.6 million deaths in 2018. The health agency noted that the economic impact of cancer is increasing. In 2010, its total annual economic cost reached approximately $1.16 trillion. For Dr. Richard Quek, a senior consultant specializing in Medical Oncology at Parkway Cancer Centre in Singapore, the cancer survival rate today is continuously improving with the advances in diagnosis and treatment options. “The survival rate has improved,” Dr. Quek said. “There are many reasons behind that. Number one, medical reasons — you have better treatment now and better facilities in terms of surgery, radiation and medication. Second, we are better at detecting cancers. So when you detect it early, you have a better chance; you can get better treatment.” One of the remarkable breakthroughs in treating cancer today, according to Dr. Quek, is the use of immunotherapy. It is a type of cancer treatment that helps the immune system fight cancer by boosting the body’s natural defenses — just like it would with a germ or virus. Immunotherapy may work by stopping or slowing the growth of cancer cells, stopping cancer from spreading to other parts of the body, or helping the immune system work better at destroying cancer cells, among others. “If I take out a patient’s tumor — and put it on my own body — the cancer will never grow because [my] immune system can get rid of it. Because the tumor is seen as foreign to me, it is not mine… However, that same cancer in that particular patient is not seen as foreign — the cancer is able to evade the immune system of the patient, thrive and grow,” Dr. Quek said. Dr. Quek, however, noted that the immune system cannot be overly strong, it has to be wellcontrolled. In cases of an overactive immune system, the body attacks and damages its own tissues that can result in various autoimmune diseases like lupus and rheumatoid arthritis. On the other hand, a weak immune system will leave the body vulnerable to illnesses, including colds, flu, and other infections. “So to me, immunotherapy is a huge breakthrough in this modern era. Immunotherapy is very promising, and melanoma is leading the way because it’s the first cancer to start with this treatment,” Dr. Quek who has also special interests in the management of melanoma, sarcoma, gastrointestinal stromal tumor (GIST) and lymphoma. Despite the significant developments in understanding, prevention, and treatment of cancer, Dr. Quek believes that there is still tremendous opportunity to move the field further. “We have not been able to cure and eradicate all cancers, yet we can prolong and control the disease. I think there are a lot of opportunities for development and improvement on what we have achieved today but it would require a lot of collaboration with all parties involved including clinicians and scientists. Without collaboration, it’s impossible to move the field forwards,” he said. In terms of modern cancer care, Dr. Quek said that Artificial Intelligence (AI) may play an important assisting role to the doctor in treating patients with cancer but it would be much longer for AI to completely replace humans. “I think that AI, in time to come, may take on and maybe even replace human doctors. But it would be some decades away before it can replace oncologists,” Dr. Quek said. “AI is impersonal. While cancer is a disease with a deeply emotive human aspect to it in addition to just treatment. The human aspect is the patient and their family.” For cancer patients, Dr. Quek has a message worth pondering on: “Cancer can be prevented. Cancer can be detected early. And if a person has cancer, it’s not the end of the world because there are good treatments available. A lot of patients have cancer, and a lot of patients are survivors.”’