An empowered fight against cancer
Singaporean experts stress right information in battling cancer
THE KEYS to dealing with the various cancers among women are knowing the facts, getting the right diagnosis, and determining the appropriate treatment. This, among other insights, was shared by cancer experts from Singapore in the recent BusinessWorld Insights online forum last September 5. The forum, themed “Empowering Women in the Fight Against Cancer,” gathered significant thoughts on how cancers among women can be detected, treated, as well as prevented.
BREAST CANCER
One of the common cancers affecting women is breast cancer. Dr. Tan Yah Yuen, senior consultant and breast surgeon at Mount Elizabeth Hospital Singapore, associates this with modern lifestyles. “Increase in breast cancer incidence is related to lifestyles associated with modernization or Westernization of society,” Dr. Tan noted.
Because of this prevalence, she highly encourages women to self-examine and get screened as early as possible.
“Whatever the age of the patient with breast cancer, early detection is absolutely critical in order for us to achieve high cure rates,” she said. “We encourage all women to perform breast self-examination once a month, and women above the age of 40 should also have regular mammograms every one to two years depending on age and personal risk factors such as family history.”
She also pointed out that there should be no fear for diagnosis after all, since with several modern treatments nowadays, breast cancer can be treated more effectively, and sometimes with minimal change in the patient’s outer appearance and lifestyles.
Among these developments is minimallyinvasive surgery. “Instead of having to do open surgery and removing large areas of the breast for diagnosis, we can often perform keyhole diagnostic procedures to biopsy the abnormal area that is seen on the mammogram and ultrasound,” the surgery expert explained.
For any woman who feels a lump in the breast, Dr. Tan highly advises seeing an experienced doctor who can do the necessary examinations, as well as a biopsy to confirm the diagnosis.
“The biopsy will be able to tell the doctor if the lump is breast cancer and what is its subtype,” she said. “Depending on the subtype of the breast cancer there will be different types of treatment strategies that are appropriate.”
Should a woman experience any symptoms such as breast lump and nipple discharge, the patient should get medical advice regardless if there is any pain or not.
When breast cancer is diagnosed, the general surgical options include lumpectomy, which preserves the breast; or mastectomy, which removes the entire breast, and breast reconstruction can often be done at the same setting.
While the choice for the most appropriate treatment largely relies on the doctor, Dr. Tan finds it useful for patients to speak to other patients who have gone through similar treatments to have a better understanding of the various treatment options.
GYNECOLOGICAL CANCERS
Aside from breast cancer, gynecological cancers also affect women. Dr. Lisa Wong, senior consultant and gynecological oncologist at Mount Elizabeth Hospital Singapore, shared that uterine cancer is currently the most common gynecological cancer, followed by ovarian and cervical cancers.
The gynecologist noted that these types of cancer tend to be diagnosed lately because of infrequent checkups. “A lot of women will see the doctor when they’re pregnant, and after that, they stop seeing the doctor for 10 to 15 years. Then, they will only come when there is actually a real problem,” Dr. Wong observed.
She stressed the importance of undergoing regular examinations even at a young age. “We encourage women 25 and above who are sexually active to do regular pap smears,” she said. “It’s not a painful examination, and it only takes a couple of minutes. And a lot of times, the pap smear can pick up pre-cancer changes so that steps can be taken to prevent cancer from occurring.”
Moreover, she stressed the importance for teenagers to get a human papillomavirus (HPV) vaccine, since this prevents cervical cancer. “They should do it when they’re teenagers, and it’s best while they’re younger because their immune system is stronger and it gives them very good protection,” she said.
If a woman experiences abnormal bleeding, it can be the first sign of uterine cancer. Dr. Wong advised seeing a doctor. “[Doctors] often do an ultrasound in the clinic to have a look at the womb and ovaries to check whether the endometrial lining is thickened,” she said.
Advanced technologies like PET CT and PET MRI scans help gynecologists like Dr. Wong to get an accurate diagnosis and determine the appropriate treatment. “In terms of cervical or uterus cancer, the MRI is very good at seeing whether the tumor has gone outside to invade the surrounding tissues and how much of the muscle walls were invaded,” she explained.
The treatments for such cancers often involve surgery. For cervical cancers, one of the treatments is a fertility-sparing operation called trachelectomy, where only the abnormal part of the cervix together with the parametrium is removed. For uterine cancers, medical treatments to avoid surgery are possible, such as hormonal therapy using progestogens.
If the cancer is more advanced stage, however, Dr. Wong recommends additional chemotherapy for ovarian cancer and radiation therapy for cervical cancer.
The treatment of choice, Dr. Wong noted, must take into consideration the medical condition of the patient. For patients who have no significant medical history, for instance, surgery will be a good option. For those who are much older and have issues like heart problems or stroke, they may not be fit for surgery and may be advised for upfront chemotherapy or radiotherapy instead.
Minimally-invasive and robotic surgery has also been helping a lot in treating gynecological cancers. “[It] is very suited for treating endometrium cancers and the survival has not been affected at all,” she said.
COMPREHENSIVE CANCER CARE
Getting the best treatment for the patient makes is crucial, Dr. Wong Chiung Ing, senior consultant for medical oncology at Parkway Cancer Centre, shared with the panel. Getting the right expertise, likewise, matters a lot.
“It’s very important to go to the right surgeon, because surgery often offers the best chance of cure,” Dr. Wong said. “If the cancer is still localized, and if we could remove everything with clear margin, that is actually the best chance of cure for the patient.”
She also agrees with the panel in the importance of detecting cancer at an early stage, as this will determine the chance of cure as well as recurrence. “For example, stage I breast cancer, or even cervical, ovarian, and uterine cancer, often have a survival rate of more than 90% if detected at an early stage,” she explained. “As one presents with more advanced stages of disease at diagnosis and more organs are involved, the chance of cure becomes less and less.”
Aside from the physical aspects, cancers also affect emotionally and mentally. Recognizing the need to meet these certain needs among cancer patients and their families, Mount Elizabeth Hospital and Parkway Cancer Centre has counselors and support groups.
“While we support the patient, we should also support the patient’s family. And, if applicable, there are also religious support groups which can help as well,” Dr. Wong added.
For more inquiries, please contact Parkway Hospital Singapore’s Patient Assistance Centre (Manila Office) via manila.ph@parkwaypantai.com or its 24-hour helpline at +63917-526-7576. The office, which will open in October, is located at the Ground Floor (hotel side) of Marco Polo Ortigas in Meralco Avenue and Sapphire Road, Ortigas Center, Pasig City, Philippines.
Through the Patient Assistance Centre, Parkway Hospital Singapore provides worldwide fuss-free access to quality healthcare services with round-the-clock helpline service links referral sources to its hospitals with professional yet personalized touch.