Issuu

ISSUE 02/2015

HOME VISIT

2015

MAKNA Volunteers Colour of Life PG 09

TOBACCO & LUNG CANCER

PG 14

PG 19

Letter from Jien Loon

Content Issue 02/2015 page

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09 page

11 page

03 page

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01 From the President’s Desk

15 Worrying Trend - e-Cigarettes & Vaping

News & Happenings 02 Tabung Travelling Beruang MAKNA 03 AirAsia Gives Back to the Community

Cover Story 16 Home Visit 2015 19 Letter from Jien Loon

and Employees 04 A Day Of Charity & Culture Scottish Style 05 MOVEMBER - The Ultimate Shave Off Campaign 07 Softlan’s “We Stand By You” 08 Healthy Digestive System Key to Preventing Digestive Diseases

Volunteers 09 Celebrating Volunteers & Their Important

Contribution 11 LIFE BEYOND BREAST CANCER - Teaching Symposium for Survivors 12 A First For Self, A First For Society with Cancer Project 2015

Feature Story 13 World Tobacco & Cancer Relation 14 Tobacco and Lung Cancer a Worldwide Relationship

International 21 Hanging On To Hope 22 Prevention is Better Than Cure 23 Volunteers Training Takes Off in Vietnam 24 Meet Our Vietnam Volunteers 25 Immuno-oncology Could Be the Answer? 28 MAKNA’s Journey in Vietnam Humour 27 Laugh Together lah

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EDITORIAL

13 WORLD TOBACCO & CANCER RELATION

Editorial Geraldine Teoh Prema Ramasamy Penyumbang / Contributors Camilo Cupitre Nhan TB Dinh Norazirah Ayob Norizan Yahya Ravivarman Arron Suhaila Binti Nik Vemanna Appannah Diterbitkan oleh / Published by National Cancer Council (MAKNA) BG 03A & 05, Ground Floor, Megan Ambassy, 225 Jalan Ampang, 50450 Kuala Lumpur. Tel: +603-2162 9178 Fax: +603-2162 9203 Email: makna@makna.org.my www.makna.org.my www.facebook.com/maknacancer www.twitter.com/makna_malaysia Dicetak oleh / Printed by Percetakan Jiwabaru Sdn Bhd No.2 Jalan P/8, Kawasan MIEL Fasa 2, Bandar Baru Bangi, 43650 Bangi, Selangor Darul Ehsan. Tel: +603-8925 6688 Fax: +603-8925 1688

LUNG CANCER AWARENESS MONTH

Research 29 Employing Genetically-engineered Mesenchymal Stem Cells for Blood Cell Generation

Feedback 31 A Cycle of Poems About Cancer & Its Effect

Penasihat / Advisors Dato’ Mohd Farid Ariffin Farahida Mohd Farid

IMPORTANT MESSAGE: The content here is general in nature and is provided for information purpose only. It is not a substitute for professional medical advice. Please consult your physician on any questions or concerns you may have regarding your health.

Rekacipta / Design SG Global Support Services Sdn Bhd Level 18, Axiata Tower, No. 9 Jalan Stesen Sentral 5, KL Sentral, 50470 Kuala Lumpur. Tel: +603-2260 1717 Fax: +603 2260 2211 www.sgglobalsupport.com

PRESIDENT’S DESK

NEWS & HAPPENINGS

THE WILL TO FIGHT, THE MISSION TO HELP Bismillahirahmanirrahim, Assalamualaikum w.b.t and Salam Sejahtera

Dear friends and supporters, It is 2015. More people have smartphones than diaries. Anyone today can suddenly wake up and decide to start a group to help others. It is easier now, just start something via an online group chat, a blog or a posting on Facebook…however, it takes guts, sweat, tears and most importantly commitment to truly persevere. I applaud so many today who have come out to help various causes close to their hearts. In MAKNA, we too have to progress in how we help the underserved and in how we seek for help from kind souls like you. Throughout these new developments, our mission has never wavered. At MAKNA, we fight cancer on all fronts: through prevention, advocacy and research plus most importantly by helping those who are living with this dreaded disease. This is why more and more Malaysians believe in MAKNA. They know that with their support, MAKNA will have more impact against more cancers, in more communities and in more ways. With many more new causes today, the giving society is stretched and have many options before them: Who to donate to, what to sponsor and who is more worthy of the funds? Donors are now more involved and aware, choosing to ‘invest’ their hard-earned money in the cause they see fit. MAKNA has to continue to be relevant in the eyes of our donors and prove to you our continued successes in the fight against cancer as opposed to just a specific set of deliverables. There is no ‘end-of-the road’ for us. We have to keep innovating, keep fighting and keep proving ourselves. Being the first or the leader is no longer enough. I have said this before. We are ordinary people doing extraordinary things. We need to expand our giving base, increase our efforts and push boundaries to further serve the underserved. Our stories, our reach, our experiences and our track record show that cancer shall never have the last word and OUR SPIRIT WILL NEVER BE BROKEN. Thank you for your continued support and belief.

Farid 01

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Tabung

Travelling Beruang

(From left) Farahida Mohd Farid,General Manager MAKNA, Sherina Nordin Group Manager & Branding TV3 & TV9, Ungku Ismail, Spencer Lee, Head of Commercial AirAsia Berhad and Rizwal Mohd Ain, Head of Operations ALTEL

Travelling Beruang is a campaign initiated by TV3 to increase awareness towards cancer and to raise funds specifically for Malaysian children diagnosed with cancer. Like other children, these young cancer patients too have dreams to see the world, but are unable to, due to their conditions. This campaign aims to bring the world to them, via a travelling teddy bear, which will be travelling on their behalf with local artist Ungku Aziz. Ungku Aziz will be travelling to places with the teddy bear to fulfil the wish of Adik Mimie who is diagnosed with Acute Lymphoblastic Leukaemia (ALL). Adik Mimie will be the face of the campaign to raise funds to assist more children with cancer under the MAKNA bursary assistance programme. Funds raised will be channelled to Tabung Travelling Beruang MAKNA to assist children with cancer. Members of the public can donate directly to Tabung Travelling Beruang MAKNA (see details below) or by purchasing the Travelling Beruang soft toy for RM65.00,

MAKNA

which will be sold by TV3 as well as the campaign’s two sponsors, AirAsia and Altel at the following locations: • • •

Jom Heboh, Karnival Raudhah di Hatiku, TV3, Sri Pentas Bandar Utama AirAsia in-flight purchase Altel Flagship Store in Oasis Square, Oasis Damansara

Members of the public can make donations via Maybank: Name: Tabung Travelling Beruang MAKNA Account number: 514075616705 To find out more, visit www.travellingberuang.com.my

www.makna.org.my

NEWS & HAPPENINGS

A DAY OF CHARITY & CULTURE SCOTTISH STYLE

By Nhan TB Dinh, MAKNA International Division Executive

Gives Back to

Community and Employees AirAsia has not just given everybody a chance to fly, the low-cost airline has also given every one of its employees the means to take better care of their health and to give back to the community. AirAsia recently partnered with MAKNA to bring its Digital Mobile Mammogram to its employees at the Low Cost Carrier Terminal. The trailer was parked at the front of the LCCT departure hall from 27 to 28 May 2015, and employees were encouraged to take the opportunity to either go for breast screening or clinical breast examination. By the end of the two days, MAKNA mobile team had performed 101 clinical breast examinations and 50 breast screenings. To give back to the community by raising funds for cancer patients, AirAsia has introduced a limitededition T-shirt, designed and produced by its Allstars employees. The T-shirt features the iconic AirAsia Captain and Cabin Crew uniforms, and carries the MAKNA logo and its tagline, ‘A Meaning To Life’. 03

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MAKNA staff with CEO of AirAsia Berhad, Aireen Omar (middle), inside the Mobile Mammogram Trailer

AirAsia Berhad Chief Executive Officer, Aireen Omar said, “All proceeds will be channelled directly to MAKNA. We hope to lend a helping hand and contribute towards the cause of eradicating cancer, as well as to provide much-needed care for those who are not able to afford it through this #AirAsiaMAKNA campaign. More than 100,000 cancer patients have received assistance from MAKNA and we hope to boost the number even further from the funds collected from this campaign”. The sales of the t-shirts were designed as on-ground events where MAKNA was present at all sales locations to spread awareness about cancer and offer information on services that the organisation provides. AirAsia also launched a photo contest in conjunction with this campaign, giving away flight tickets to selected destinations for the most creative photo of participants wearing the T-shirt.

iddle of May this year saw MAKNA chosen as one of the few charities to benefit from the Selangor St Andrew’s Society’s annual grant event. Five families, who are currently aided by the MAKNA Bursary Programme, were also present to take part during the event. On top of promoting better health awareness, this wholeday event was also culturally rich, exposing children who have seen more than their fair share of the paediatrics ward the experience of playing log-lifting games, rope pulling and traditional dances. Most enjoyable for them was the Kid’s Village – an indoor area where they could challenge each other to sand painting and ball games, while most rewarding for us was seeing the joy on their faces as they played and laughed with abandon. www.makna.org.my

NEWS & HAPPENINGS

Grow It, Groom It, Shave It! MOVEMBER – The Ultimate Shave Off Campaign Prostate and testicular cancer will be the focus of a three-month awareness and fund-raising campaign, known as MOVEMBER – The Ultimate Shave Off, organised by MAKNA (National Cancer Council) together with the Rainbow Team volunteer group.

MOVEMBER (a portmanteau of “Moustache” and “November”), had its start in Australia in 1999, and has come to be synonymous with efforts to raise awareness on men’s health issues, including prostate, testicular and other male-related cancers, with the growing of moustache in the month of November.

Instagram your selfie at maknacancer and hashtag #theultimateshaveoff Tweet @maknashaveoff on Twitter Facebook it on www.facebook.com/theultimateshaveoff

In keeping with the theme of MOVEMBER, the campaign premise is to have men grow their moustache or beard from September until November then have an ‘Ultimate Shave Off’ towards the end of the campaign. The idea behind this campaign is for men to lend their voice to this cause and create meaningful conversations regarding male cancer awareness by stirring the curiosities of family, friends and colleagues with the growing of facial hair and ultimately shaving it off. MAKNA hopes that this would empower men to speak up about the less-spoken-of male-related cancer instead of avoiding the subject, which could put their well-being at risk.

A grand finale is planned at the Great Eastern Mall in Jalan Ampang for the closing of this campaign. At the finale, men with their moustache and beard will be shaven off by barbers from Truefitt & Hill, whose outlet is on the second floor of the mall. Anyone with creatively and outstandingly groomed moustache and beard can also walk-in to the finale location and stand a chance to be awarded with a surprise gift.

Three major initiatives have been planned around this campaign to keep the public engaged and continue to participate throughout its entire duration:

Finale

In conjunction with the campaign, MAKNA and the Rainbow Volunteer Team have released a theme song and music video. The song composed by local artistes DNavigator and Dr. Sakthi, sung by Suki Low, Caprice and Dr. Sakthi, is upbeat and carries the messages of hope, optimism and positivity towards life regardless of circumstances. Hence, the oft-repeated clarion call of, “You gotta live! Get up and live this life” within the song.

Video Contest

An online contest for the Most Creative Video. This contest calls for the submission of videos that creatively and effectively send messages to men on the importance of regular health checks to the theme of “Grow ‘Em, Wear ‘Em”. A grand prize will be given away to the most creative video which will be announced at the end of the campaign. An entry donation of minimum RM38 is required to participate in the video contest. Terms and conditions apply.

Lim Mei Fen

The music video also features cancer survivors and some of the best-known names in the local entertainment, sports and beauty scenes, including Jehan Miskin, Hans Isaac, Thanuja Ananthan, Carol Lee, Wilson Tan, Safee Sali, Pandelela Rinong, and Prem Shankar – all of whom generously contributed their time to the making of this video as a show of support for a meaningful cause. In total, 58 celebrities, artistes and personalities, as well as countless cancer survivors and students from five schools in and around Kuala Lumpur had come together, all generously contributing their time and energy to make the music video possible. This campaign has also garnered unstinting support from Golden Screen Cinemas Sdn Bhd (GSC), MIX FM, and Truefitt & Hill.

as the official shaving partner for this campaign. Truefitt & Hill, recognised as London’s finest traditional gentlemen’s barber and perfumer, provides only the best in grooming products and services, giving the discerning gentleman an opportunity to look and feel his very best. In fact, the campaign tag, “The Ultimate Shave Off”, is a spin-off of Truefitt & Hill’s own service menu – “The Ultimate Shaving Experience”. As cancer is in itself a solemn subject, MAKNA aims to reach out to as many people in as creative a way as possible to not only make a strong statement, but also encourage the public to take more ownership of their health. In addition, MAKNA hopes that this campaign would bring the spotlight on the seldom discussed prostate and testicular cancer to enable early detection and to hopefully save more lives.

As the cinema partner, GSC will be playing the 60-second version of the video in cinemas nationwide from August. MIX FM will get behind the campaign with Rod Monteiro, anchor of the station’s Breakfast Show, testing his moustache-growing skills and participating in the Ultimate Shave Off at the campaign’s finale in December. MIX FM will also air a series of public service announcements to encourage listeners to participate in the fundraiser as well as to promote awareness of prostate and testicular cancer. MAKNA and the Rainbow Volunteer Team are also proud to have Truefitt & Hill, the world’s oldest barbershop,

Saran Narayanan

Selfie Your `Stache Challenge

Anyone can participate in this – either grow and/or wear fake moustache, take a selfie, and upload it to MAKNA social media (#theultimateshaveoff), or they can even challenge their friends to it! Carol Lee

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MOVEMBER - The Ultimate Shave Off Campaign launch at GSC Cinema Midvalley - 18 August 2015 www.makna.org.my

NEWS & HAPPENINGS

(From left) Nhan TB Dinh, International Division Executive, MAKNA, Peter Torrington, General Manager of Colgate-Palmolive Malaysia, Lim Ching Wei, Honorary Treasurer of Breast Cancer Welfare Association Malaysia, and Clare Ratnasingam, Vice President of National Cancer Society Malaysia

BREAST CANCER AWARENESS CAMPAIGN RAISES OVER RM115,000 MAKNA was one of the three charities to benefit from the Softlan “We Stand By You” breast cancer awareness campaign in 2014. The campaign, which ran from September to October, in conjunction with World Breast Cancer Awareness month, successfully raised over RM115,000 from the sale of Softlan® fabric softener. The collection was presented by Peter Torrington, General Manager of Colgate-Palmolive, to MAKNA (National Cancer Council), the Breast Cancer Welfare Association (BCWA) and the National Cancer Society Malaysia (NCSM). Torrington said, “We are very pleased and thankful to our customers for their contribution which exceeded our commitment to fundraise a minimum of RM100,000. We are grateful to have once again partnered with BCWA, MAKNA and NCSM to achieve a sense of fulfilment, knowing these funds will aid research towards the betterment of cancer patients and survivors.” Family members of breast cancer survivors were also present during the ceremony to share their experiences in overcoming a changed reality after their loved ones were diagnosed with breast cancer. Mohammad Saleh Hashim, whose wife Leha Osman received aid from MAKNA for her breast cancer treatment said, “It was devastating news and I honestly did not know what to do or how to react when Leha was first diagnosed. 07

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NEWS & HAPPENINGS

However, as a family, we ultimately decided that we need to be the supporting pillars for Leha in her battle against breast cancer.” Softlan also co-sponsored an episode of TV programme, Bersamamu, which focuses on the life of Pn. Jahlelawati, a single mother of three who is a stage 4 breast cancer patient. Softlan donated a wheelchair and also a product hamper to help ease the burden of Puan Jahlelawati and her family. Softlan also brought her children to Legoland, Nusajaya for a fun day out.

Over the past six years, Softlan’s breast cancer campaign has raised a grand total of RM549,435.30 in contributions. To capture the fighting spirit and emotional journey family members of breast cancer patients go through, Softlan also hosted a Pink Day Out where the husbands and children of breast cancer patients prepared a specially customised ‘Pink menu’ to surprise their wives and mothers. The event that was held at Tropicana Golf and Country Resort hosted three families who have survived breast cancer. Over the past six years, Softlan’s breast cancer campaign has raised a grand total of RM549,435.30 in contributions. The campaign focuses on combining support, care and experience to promote the importance of early detection of breast cancer. Throughout the month of October last year, Softlan and its charity partners brought their road shows to selected hypermarket locations where they provided the public with free check-ups and the opportunity to learn more about breast cancer from doctors and trained nurses.

Rafinasisma Ahmad Rafie, Head of Fund Raiser Department, MAKNA, receiving a token from YB Dato’ Seri Dr Hilmi Yahya, Deputy Minister of Health Malaysia

Healthy Digestive System Key to Preventing

Digestive Diseases By Ravivarman Arron, MAKNA MPAC Executive

MAKNA is proud to continue its collaboration with Digestive Health Malaysia to raise awareness on the prevention and treatment of digestive diseases through public health educational campaigns.

Laugh Together Lah

Launched on 30 May, the Vitagen World Digestive Health Day has grown to become a great platform for both MAKNA and Digestive Health Malaysia to disseminate valuable information on the importance of early detection and the prevention of stomach and colorectal cancer. This marks the seventh year MAKNA has been involved in the Vitagen World Digestive Health Day campaign.

www.makna.org.my

VOLUNTEERS

CELEBRATING VOLUNTEERS & THEIR IMPORTANT CONTRIBUTIONS volunteers for their hard MAKNA recently celebrated its ceremony known as work and dedication in an awards

‘VOLUNTEERS – The Colours

The ceremony was held to recognise volunteers for their commitment towards community work and volunteerism, a vocation which requires good time management and communication skills, in addition to a positive attitude, a strong sense of responsibility and management competencies. It was also at the ceremony that volunteers who have distinguished themselves through excellent performance and leadership skills were honoured. The deserving honourees were Shaharuddin Shawal, 60 years old, who took home the Volunteer Leader Award, and Shaznoor Shafilaz Shaharuddin, 29, Lebar Nopiah, 59, Ahmad Md Amin, 66, Lim Sow Eng, 51, Masliza Dugal, 55, Noor Aini Omar, 59, Zainurisham Samuri, 39, Heah Chew Teah, 51 and Zamzilla Omar, 49, who were named Potential Volunteer Leaders. Shaharuddin was presented with a Brown Vest, which acknowledged his leadership in planning, organising and executing MAKNA work with minimum supervision, which included having initiated cancer awareness and outreach programmes while mobilising the resources efficiently and fulfilling a minimum of 120 volunteer service hours. 09

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of Life’.

The Potential Volunteer Leaders were presented with a Blue Vest each to signify their readiness to lead and take on leadership challenges in the time to come. Each Blue Vest recipient had consistently demonstrated acts of selflessness towards community work and fulfilled a minimum of 40 hours of volunteer service. This award also recognised their responsibilities in building new teams and network of volunteers under their supervision.

Siti Zubaidah Zakaria, 21 and potential leader Shaznoor Shafilaz Shaharuddin received the Promising Youth Award which acknowledged their dedication in providing insights on volunteerism and in inspiring youths in doing community work. In addition, award recipients who are also cancer survivors and/or care givers were also awarded with Special Recognition Certificates for their admirable support to the volunteer group and to cancer patients and their families.

Farahida Mohd Farid, General Manager of MAKNA added that, “MAKNA has grown from an infant to an adult in the past 20 years. 2015 marks our 21 years in operations and this wouldn’t be possible without the help of the general public, the corporations and government bodies, and most importantly, the volunteers, who have been amazing. They are without doubt the walking ambassadors of MAKNA. It takes a big heart to help others, and there is no way we can repay these big hearts other than by recognising them with our gratitude. We are a family.”

Dato’ Mohd Farid Ariffin, Founder and President of MAKNA said, “Volunteers have been good, kind and loving in every way. I thank them for every single guidance, care and love they have showered to those in need. The challenges that come with their work do not faze these volunteers; they are truly selfless. I am proud to see people; young and not so young, black, brown and yellow, tall and not so tall, girls and boys, all coming together for one purpose – volunteering for a better today and tomorrow.”

www.makna.org.my

VOLUNTEERS

LIFE BEYOND BREAST CANCER Teaching Symposium For Survivors By Norizan Yahya, MAKNA Volunteer leader in Perlis

A FIRST FOR SELF, A FIRST FOR SOCIETY CANCER PROJECT 2015

By Norazirah Ayob, Faculty of Economics and Business, Universiti Malaysia Sarawak (UNIMAS) FEP Prihatin, a volunteer group that comprises students and staff of the Faculty of Economics and Business, Universiti Malaysia Sarawak (UNIMAS), came together to organise a cancer awareness initiative to raise funds for MAKNA and give many of its students a taste of volunteering for the first time.

MAKNA was part of the Pink Ribbon Wellness (L) Foundation’s Life Beyond Breast Cancer Teaching Symposium recently. Represented by volunteers, Norizan Yahya and Ashah Mat Isa, MAKNA is proud to have supported this symposium, which served as a platform for patients, survivors and medical personnel to talk about breast cancer more in-depthly and candidly while providing support as well as encouragement to each other.

According to Norizan and Ashah, the three-day-two-night symposium was impactful and beneficial to breast cancer patients who were given much exposure and updates on treatment options, patient care and issues that are commonly faced by patients.

Let ’s defeat breast cancer.

The symposium also facilitated interaction among patients and survivors, enabling much exchange of information and experiences including dietary practices. Seeing, meeting and talking with other patients and survivors, who were also speakers and part of the organising team, was an uplifting, invaluable experience. “Well done to Pink Ribbon for organising this symposium, and to MAKNA for giving us the opportunity to be a part of it. It is through efforts like this that brought together people and resource that would help keep the fight going against breast cancer,” said Norizan and Ashah.

WE’RE STRONGER TOGETHER

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Cancer Project 2015, which ran from 7 to 16 May, was an opportunity for many first-year students of the Faculty of Economics and Business, who wanted to make a difference for themselves and for society, to embrace the spirit of volunteerism. Even from the planning stage, enthusiasm among students such as Nabihah Zin, Afiqah Kamal, and Hiyazi Hasbullah to name a few, was apparent. They took to the task with admirable passion, churning out ideas and programmes to distinguish this year’s Cancer Project from the previous two. One of the initiatives carried out was ‘Brunch with Love’ where volunteers cooked up a storm, dishing out healthy and tasty brunches for students and staff. A charity run, named the ‘Shock Run’ was also organised as the grand finale. True to its name, the run successfully ‘shocked’ all participants with various challenges and obstacles installed throughout the route, giving each runner a run to remember. Proceeds from the brunch sales and the run along with donations collected were channelled to MAKNA.

In addition, information leaflets and specially designed bookmarks were distributed to students and staff for the entire duration of the project to help raise awareness on cancer, on the importance of early detection and maintaining a healthy lifestyle. An exhibition and poster competition were also held in conjunction with efforts to raise awareness. The aim of FEP Prihatin has always been to instill the spirit of volunteerism and care among its students towards those in need of help and attention. “Though we’re only students, however little we can help, we will help.” Based on this sentiment and the level of participation as well as response, there is no doubt that FEP Prihatin has met its objective and will find even more encouragement to continue this learning and volunteering experience as the group look ahead to organising Cancer Project in 2016. Comments from student representatives, Exco members of Persatuan Mahasiswa Fakulti Ekonomi dan Perniagaan (PERFEP), UNIMAS Lim Jhin Horng and Wong Chen Chau

Although the proceeds collected might not be much, we are proud to see a growing awareness among students of UNIMAS, and students of the Faculty of Economics and Business in particular, towards cancer. We hope to continue inspiring others to spread the word on cancer, early detection and prevention. FEP Prihatin and PERFEP would like to take this opportunity to thank all participants who have participated and contributed towards Cancer Project 2015, in particular all participating volunteer members, project adviser Dr Norazirah Ayob, and the faculty management team – all of whom have contributed to this project’s success.

Lots of love from us FEBIANs! www.makna.org.my

FEATURE STORY

WORLD TOBACCO & CANCER RELATION

TOBACCO AND LUNG CANCER A WORLDWIDE RELATIONSHIP

LUNG CANCER AWARENESS MONTH U.K

U.S

Smoking: 28% cancer deaths, 27 times higher rate of oral cancer risks

224, 210 new cases 159,260 deaths (2013)

Tobacco usage has been linked with many harmful health effects, including the increase in chances of lung cancer.

E.U

Around 410,000 new cases (2012)

China

Out of 1,000,000 deaths, lung cancer risk was 2 to 4 times higher among male smokers

Africa

Up to 572 million smokers (2100) from 77 million (2013)

Latin America

According to numbers presented by the World Health Organizationâ€™s Tobacco Free Initiative (TFI), roughly two-thirds of all patients with lung cancer in India were smokers using cigarettes and/or bidis (hand-rolled tobacco). In China, lung cancer risk is two to four times higher among men who smoked compared to those who didnâ€™t. TFI records indicated that across low-income countries, there were an estimated 180,000 deaths from lung cancer in 2012 that could be directly related to tobacco usage. This however is not only prevalent in developing countries.

2/3 of lung cancer patients were smokers (cigarettes/ bidis/hand-rolled)

Tobacco kills nearly 5 millions annually and the number is likely to rise up to 10 millions by 2030. In high-income countries, nearly 1 million are dead each year and 220,000 are from lung cancer. In low-income countries, out of 1.3 million killed by tobacco deaths, lung cancer accounted for 180,000 cases.

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This shows that after over 60 years of official recognition from public authorities of smoking as a direct cause of lung cancer, it is still a global public health problem. The situation will likely persist for coming years. Among Latin American women, the number of cases and deaths from lung cancer is expected to almost double by 2030, while among men, it is estimated that the number of new lung cancer cases and deaths will increase by about 50% during the same period.

India

This article was developed by Camilo Cupitre of MAKNA International Division based on the information gathered from the following sources:

250,000 new cases, 84% attributed to tobacco (2012)

In Europe, more than 410,000 new cases of lung cancer were estimated to have been diagnosed in 2012 and more than 80% were diagnosed as directly related to the habit of smoking.

World Health Organization Tobacco Free Initiative (TFI) : http://www.who.int/tobacco/research/cancer/en/ Cancer Control Opportunities in Low- and Middle-Income Countries: http://www.ncbi.nlm.nih.gov/books/NBK54023/

WHAT ABOUT MIDDLE AND HIGH INCOME COUNTRIES? While the trend of tobacco use is decreasing due to the implementation of tougher regulations and the continuous efforts put into awareness campaigns, the impact is still considerable. TFI data showed that in high-income countries and former socialist economies, of the 1 million tobacco deaths among middle-age males, nearly a quarter were from lung cancer. In the US, tobacco use accounted for at least 30% of cancer deaths.

Cancer Control Opportunities in Low- and Middle-Income Countries, http://www.ncbi.nlm.nih.gov/books/NBK54023/ American Cancer Society Tobacco-Related Cancers Fact Sheet, http://www.cancer.org/cancer/cancercauses/ tobaccocancer/tobacco-related-cancer-fact-sheet Cancer Research UK Lung cancer Fact Sheet, http://www.cancerresearchuk.org/health-professional/ cancer-statistics/statistics-by-cancer-type/lungcancer#heading-Zero

www.makna.org.my

FEATURE STORY

COVER STORY

Worrying Trend Even while educational and awareness campaigns are ongoing to keep up the message on the danger of tobacco use among existing and potential users, another worrying trend has cropped up in the form of e-cigarettes which have been growing in popularity in recent times. Also known as vaporizers, many see vaporizing or vaping as an alternative to using traditional cigarettes and as a means to help them quit smoking. The question of whether e-cigarettes are less harmful or safer than tobacco remains as yet unanswered. It would seem that the research into the effects of e-cigarettes is lagging behind their growing popularity. In an article published in the Toronto Star, Dr Laurie Zawertailo of University of Toronto, whose area of research focuses on tobacco dependence and treatment, stated that even within the tobacco research and control community, vaping remains a polarizing issue – on one end, some of her colleagues believe that vaping could lead to an end to traditional cigarettes and should be encouraged, while another group believe that vaping would renormalize cigarette smoking and undo the progress made through tobacco control efforts over the last 20 years to get people to quit or never start smoking. Perhaps indicative of this is a statement published in a Webmd article, titled ‘E-cigarettes 101’, that claimed that “the number of teens and tweens using these products doubled between 2011 and 2012.” In the UK, the number of e-cigarette users surged to 2.1 million in 2013. 15

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What seems evident now is that vaping could be a potential new way to get a new generation of users hooked onto the bad tobacco habit. The global market for e-cigarettes is estimated to reach a value of $3 billion this year and Goldman Sachs sees annual global sales hitting the $10 billion mark within a few years. Even when the jury is still out, demand is on the rise. Clearly, in-depth research is required, and clearly it is required urgently, to determine the effects, whether they are benefits or health risks, of e-cigarettes. Meanwhile, the World Health Organization has called for a ban on the use of e-cigarettes in public places and work places since last August.

Sources: The Toronto Star, http://www.thestar.com/life/health_wellness/2015/08/31/ jury-still-out-on-the-impact-of-vaping-on-your-health.html Webmd.com, http://www.webmd.com/smoking-cessation/features/ electronic-cigarettes The Guardian, http://www.theguardian.com/society/2014/may/05/rise-ofe-cigarettes-miracle-or-health-risk

MAKNA HOME VISIT Walking for miles in patients’ shoes One of the key services in the MAKNA organisation, the Home Visit department is tasked with the enormous responsibility of following up with all patients who receive Bursary assistance. In total, MAKNA is assisting over 450,000 cases across the country. It is therefore crucial for the MAKNA Home Visit team to diligently visit the patients to ensure their well-being, observe their living condition and more importantly, to interact with them, to further understand their lives and background.

They serve as the eyes and ears of donors and the public, to see and listen and report on how every contribution, no matter how small, brings hope and meaning to patients’ lives

At times, it is only upon visiting a patient that we find out that he or she has passed away. It is not an easy position to be in; one needs to be emotionally strong as one would be exposed to all types of conditions, some worse than others, including bedridden patients who are barely hanging on or a family of eight cramped inside a small room because they couldn’t afford anything bigger. The MAKNA Home Visit team bears witness to these and more; they serve as the eyes and ears of donors and the public, to see and listen and report on how every contribution, no matter how small, brings hope and meaning to patients’ lives. On top of that, the team also uses these visits as opportunities to evaluate if further assistance is required by the patients. This same level of service and this thoroughness in carrying out their duties is observed regardless of which corner of the country the team is at and no matter how remote the place is. www.makna.org.my

COVER STORY

MCE, Home Stay Programme

Home Visit in Seremban, Negeri Sembilan By Suhaila Binti Nik, MAKNA Home Visit Divison Executive

When he was first diagnosed with Xeruderma Pigmentosa with Squamous Cell Carcinoma, this patient from Seremban, Negeri Sembilan, was only around four years old. When the Home Visit team dropped by in May, he had just returned home from undergoing treatment at the hospital. Since the beginning of his illness, his parents have been stoically by his side, accompanying him on every hospital visit to ensure that he was able to continue with his treatment without interruption. According to his mum, the patient has been subsisting on milk powder instead of solids for his daily meal. However, the formula had run out and their application for new supply was still pending approval from the hospital. As they were unable to afford the formula on their own, his parents have had no choice but to replace the formula with Milo. On learning this, the Home Visit team then contacted the head of the social services department of Hospital Tunku Jaafar, Seremban, to inform him of the patient’s predicament. Upon hearing the news, he was able to locate new supply and agreed to have it set aside for the patient. The Home Visit team immediately went about to have the formula delivered to the patient the following day. Although he was unable to verbalise it, the team was able to discern from the patient’s body language the joy he felt when he was given the formula. With this, the team hoped that he would find the strength to continue fighting the disease.

in Miri, Sarawak

Hasrol Bin Mohd Sahri passed away early August after battling cancer for 28 years. His family would like to thank all MAKNA donors and staff for the support given.

NEOPLASIA { ISSUE 02/2015 }

It is also during MCEs that employees are able to have a clearer, closer look and to recommend to the management if the patients should be given additional assistance. There have been occasions when the MCE brought MAKNA employees to the homes of patients just when they needed help the most. In Miri, the father of a young cancer patient passed away suddenly and the team who was staying with them was able to lend a helping hand to the boy and his mother as they dealt with the sudden loss.

Seorang pesakit lelaki yang berusia 32 tahun dan berasal daripada Seremban, Negeri Sembilan telah disahkan menghidap Xeruderma Pigmentosa with Squamous Cell Carcinoma. Ketika disahkan menghidap kanser tersebut arwah baru sahaja berusia dalam lingkungan 4 tahun. Keadaan penyakitnya bertambah serius semenjak 10 tahun yang lalu. Namun ketika itu arwah tetap kuat melawan penyakit yang dihidapi.

Situations like this and many more over the years underline the importance of the Home Visit service and the MCE.

Sewaktu kunjungan Home Visit ke rumahnya dahulu, arwah baru sahaja selesai menjalani rawatan di hospital. Ibu bapa arwah sentiasa setia menemaninya ke hospital bagi memastikan arwah mendapat rawatan yang sebaiknya. Menurut ibunya, ketika itu arwah hanya bergantung kepada susu formula iaitu Nutren Optimum sebagai makanan hariannya. Akibat kehabisan bekalan susu dan permohonan baru masih lagi dalam proses hospital, ibunya terpaksa menggunakan milo sebagai ganti. Bagi membantu arwah ketika itu, pihak kami telah menghubungi Ketua Jabatan, Kerja Sosial Perubatan, Hospital Tunku Jaafar, Seremban untuk tindakan selanjutnya. Memang sudah rezeki arwah ketika itu, kebetulan pihak hospital mempunyai lebihan bekalan susu Nutren Optimum dan bersetuju untuk diberikan kepada arwah. Dengan bantuan pihak kami, arwah mendapat bekalan susu tersebut keesokan harinya. Jelas terpancar kegembiraan di raut wajah arwah ketika itu apabila menerima bekalan susu tersebut. *Hasrol Bin Mohd Sahri telah meninggal dunia pada awal bulan Ogos setelah hampir 28 tahun bertarung nyawa melawan penyakit kanser. Ahli keluarga arwah ingin merakamkan jutaan terima kasih kepada para penderma dan kakitangan MAKNA diatas bantuan dan sokongan selama ini.

at the same time. Living with the patients, MAKNA employees were able to fully experience the challenges of living in hardship and in most cases without even basic amenities. Being in their homes also gave MAKNA employees the opportunity to help them carry out their chores and home improvements, and to provide comfort as well as emotional support if needed.

Apart from Home Visit, another quintessentially unique practice of MAKNA is to have all its employees participate in an educational programme known as MAKNA Continuous Education (MCE). Taking a leaf from the best practices of medical and health organisations, the MCE’s main objective is to nurture and strengthen the feeling of empathy amongst MAKNA employees towards the plight of underprivileged cancer patients. This is achieved by having employees stay at the homes of the patients who are receiving aid from MAKNA, some that are located in the most remote and rural areas across the country.

The importance of Home Visit & Home Stay: • Get to know patients and their conditions • Ensure assistance is received and utilised in the manner it is intended • Build trust with patients and family • Advice or arrange for referrals or other services where needed • Update Bursary and Finance departments with patients’ latest info

The location of the most recent MCE, held at the beginning of this year, was Miri, Sarawak. Divided into 14 teams, MAKNA employees stayed at patients’ homes for three days, two nights. The patients varied, some in the initial stages of cancer, some critical, but all of them struggling with not just waning health, but also poverty www.makna.org.my

COVER STORY

Letter

from

Jien Loon My name is Chye Jien Loon and I am a happy, healthy college-going 22-year-old from Kota Tinggi, Johor. If you had asked me two years ago if I would be here writing this letter to you, it would have been anybodyâ€™s bet. Yet, here I am and it is in no small way because of you.

Life is so precious and has been even more so to me since 2012. just 19 then, I was diagnosed with stage IV Lymphoma, a cancer that affects a personâ€™s immune system. My family and I were devastated when we received the news. I was the eldest of three siblings. My mother is a housewife and my father works as a technician. I had so many hopes and dreams, and I was looking forward to my future, to finally becoming the man I knew I could be. One who could help my parents and one my family could rely on to help change their lives for the better. But the cancer had started in my right arm and had spread to other parts of my body. Receiving the news crushed my spirit and I had thought that at stage IV, life was over for me.

COVER STORY

We came to know of MAKNA through the hospital where I was getting treatment. WE applied for assistance. Coming from a family who lived from hand to mouth, the smallest amount of assistance would have made a significant difference. MAKNA funded my chemo port (a device that is implanted under the skin of a cancer patient to deliver the dosage of chemotherapy that he or she needs) and also supported me with monthly financial assistance. On top of that, the MAKNA Home Visit team came to visit me in 2013 to ensure that I was getting all the help that I needed. But much more than these, what MAKNA had really given us was hope and a fighting chance. Thanks to the funds that you contributed through MAKNA, I was able to undergo six rounds of chemotherapy at Hospital Sultanah Aminah, Johor, and to continue with my studies at Universiti Tun Abdul Razak, Kuala Lumpur without interruption, except for a brief hiatus when I was in treatment. I am now in my second year at the university. I have completed my treatment and am only required to go to the hospital once a month for follow ups. It is organisations such as MAKNA, that has never rejected any cancer patient truly in need of help, that opens the door of hope for many like me. I cannot thank you enough and I owe my life to you. Thank you and many blessings unto you.

The worst part about it was the helplessness. I could see how hard it was on my father who was the sole breadwinner of the family. He could not come to terms with the possibility of losing his eldest son at a young age and the exorbitant medical expenses that would be needed overwhelmed him.

NEOPLASIA { ISSUE 02/2015 }

www.makna.org.my

INTERNATIONAL

Prevention is Better Than Cure

Hanging On

Story from Hai Nguyen, MAKNA International Vietnam Branch Manager. Compiled and written by Nhan Dinh.

To HOPE

In a country of 90 million people, it is not surprising that each cancer patient and each case tells a different story. Some, such as Mr Lai Duc Son’s, introduce a good series of questions into our minds about the state of awareness and healthcare, and the lifestyle practices in many rural regions in Vietnam.

Story from Hai Nguyen, MAKNA International Vietnam Branch Manager. Compiled and written by Nhan Dinh.

At 53, Mrs Le Thi Tuong was looking forward to a more settled life in her golden years with her daughter and son. The family had come a long way since moving from Nghe An, a rural province 300 kilometres away from Ha Noi. Her children had finished their studies with her son having recently graduated from a vocational college in tourism and accounting. Less than a year ago, Mrs Tuong started developing a cough. The retired cook thought nothing of it and bought medicine from a pharmacy, hoping that that would be enough to treat the coughing. However, her condition worsened. She decided to seek treatment at a provincial hospital. That was when she received worrying news – doctors confirmed the presence of tumours in her lungs but had been unable to perform a biopsy to determine whether the tumours were malignant or benign. She then had her biopsy at the National Cancer Hospital (K Hospital in Ha Noi) and the result was devastating – the tumours were found to be malignant and the cancer had metastasized to her bone. The news shook the family to its core and took its toll on everyone. However, regardless of her condition, Mrs Tuong continued her work as a vegetable seller at a local market. Her family relied on this trade to survive. 21

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Mrs Tuong at K Hospital in mid-June, after six rounds of chemo

When she has to go for treatment, her children would take over. Although covered by a government insurance scheme that took care of 95% of her medical expenses, the remaining 5% was still difficult for the family whose daily income was unstable and amounted to no more than USD5 a day. Add to that the travelling expenses to and from the hospital – a journey of 600 kilometres by coach. Now, Mrs Tuong’s most immediate concern is her children’s future – both in their 20’s and who have yet to secure stable jobs or even have their own families. Even though the situation is tough and there are more questions than answers as she thinks of the days to come, Mrs Tuong remains hopeful and motivated to continue with her treatment.

A veteran from Nam Dinh province, Mr Son is 61 years old and has recently been diagnosed with lung cancer. About to undergo his first chemotherapy, Mr Son is a father of four grown children, three of whom are migrant workers in Mongolia. He moves around with the assistance of crutches, after a stroke 12 years ago left his right arm and foot weak. Even though limited physically and despite his cancer diagnosis, Mr Son still remains active and spends his days taking care of his grandchildren on the monthly allowance he receives from his sons. It seems that nothing can beat this retired soldier who used to fight in the anti-America war and was part of the movement that helped Cambodia wiped out the Khmer Rouge in the 70’s. Mr Son is not only strong in spirit, but also straightforward in his manner; he readily admits that his illness is due in large to unhealthy lifestyle practices.

Even now, he finds it difficult to beat the craving for cigarettes. Despite this and his health condition, Mr Son remains upbeat and takes pleasure in little things such as meeting up with his old army buddies. Reliving the memories of their time spent in the war helps him to forget his flagging health and to stay positive. And on hindsight, which is always clearer, Mr Son admits that the unhealthy habits he had acquired in his youth are practices that he hopes the young people of today would not pursue. His sentiment is felt even more strongly as we contemplate the rising number of cancer cases in this developing country with its increase of cigarette and alcohol consumption amongst its population. This makes it all the more important for MAKNA Vietnam to incorporate cancer and health awareness in our initiatives on top of cancer support group and volunteer training. Prevention is after all the best and most affordable treatment available.

I hope I would make it. I wish to see my daughter on her wedding day, says Mrs Tuong, tears silently running down her face. For now, life still goes on; Mrs Tuong and her family will soldier on as best they could while they hang on to a thread of hope.

Mr Son started smoking heavily since he was 15. He would smoke 1 to 1.5 packs of cigarettes and drink close of 1 litre of alcohol a day. Even after the stroke, he continued in this manner until he began to develop a persistent fever. On some days, he would develop severe pain in his joints to the point where he was unable to even hold a bowl of rice. He saw a doctor at a local clinic and was referred to the National Cancer Hospital where he was diagnosed with early stage lung cancer. His doctor had recommended surgery and chemotherapy treatment as cancerous cells have started to spread to other parts of his lungs.

Mr Lai Duc Son and Hai Nguyen at K Hospital

www.makna.org.my

INTERNATIONAL

Meet Our

VIETNAM Volunteers I’ve been a part of the Laughter Yoga Therapy for two months. This is such a meaningful initiative, from a medical student’s perspective, as we develop our expertise and soft skills while supporting patients. I decided to take part as I wish to see it grow nationwide and to stand as one with others against cancer. There’s a saying that I find very apt in describing Laughter Yoga: ”Let your smile change the world, not vice versa.” If we can get to know our patients pre-session, I believe iit could have greater impact! Ngoc Binh, MiV Volunteer,

Cancer Support Group

VOLUNTEER TRAINING TAKES OFF IN VIETNAM Successful volunteer training format of MAKNA Malaysia replicated in Vietnam Middle of May this year saw the successful volunteer training programme of MAKNA Malaysia introduced to volunteers of its international arm in Vietnam. On top of the weekly Laughter Yoga Therapy and Cancer Support Group, “Basic Nursing Care 1” volunteer training is now replicated by MAKNA International Vietnam (MiV) in collaboration with the Hung Viet Oncology Hospital and the Hanoi School of Public Health. Goodness needs to be carried forward. In this full-day course, the 27 volunteers of MiV learned the 7-step handwashing techniques and practices, nurse-patient communication, and how to lift as well as move bed-ridden patients. This was the first “Basic Nursing Care” training initiated by MiV and partners for its volunteers. Volunteers would only be given the green light to support cancer patients in medical centres after this compulsory learning. MAKNA volunteers learned practical knowledge and skills that would help them participate actively and voluntarily in public healthcare and cancer support activities, such as proper handwashing using soap or hand sanitizer; lifting and moving bed-ridden patients; resuscitating victims of drowning, in addition to soft skills that included learning to communicate and probe patients as well as their families. 23

NEOPLASIA { ISSUE 02/2015 }

I realised I was nowhere as resilient as those patients when I saw just how happy, carefree they were during Laughter Yoga. Join us as volunteers – everything has its moments, so regardless of your position and commitment, it all counts! Thuy Duyen, MiV Volunteer, Cancer Support Group

Hands-on learning on how to lift and move bed-ridden patients

The training schedule, prepared with care by MiV, allowed volunteers to not only learn, but also to practice. They worked in small groups then in pairs – an approach which benefited the volunteers as it helped hone their communications skills. The success of the Basic Nursing Care training was a good step-up for MiV as it aims to replicate the effective training programme of MAKNA Malaysia and grow its volunteer base in Vietnam.

Happy 2nd Birthday, MAKNA in Vietnam!

Whether you’re sad or you’re feeling positive, no matter your state of mind, there’s only one message we wish to convey – when you laugh, you change; when you change, the whole world changes. Anh Tuan Le,

MiV Volunteer Leader

Cancer patients like us do need therapeutic sessions like Laughter Yoga. It helps offset the stress of the treatment and the fear of bad days to come, giving us joy and helping us to relax. Thank you MAKNA. Mai Oanh,

Breast Cancer Patient www.makna.org.my

INTERNATIONAL

IMMUNO-ONCOLOGY COULD BE THE ANSWER? T-cells are a type of immune sell that protects the body from infection. They destroy virally infected cells. T-cell (immune cell)

Cancer cells produce a molecule which stops T-cells from recognising them as a threat allowing the cancer grow.

Cancerous cell

Connection reads as a non-threat Infected cell

The nivolumab drug attaches itself to T-cells, blocking the cancer’s ability to hide. It is then attacked and destroyed. Meanwhile ipilimumab allows T-cells to multiply.

Every year, the American Society for Clinical Oncology’s annual meeting is seen as the platform for the unveiling of the latest advances in cancer treatment by pharmaceutical labs and cancer research institutions. This year was no different with the announcement regarding immuno-oncology (also known as immunotheraphy) and the enthusiastic opinions of experts that followed. According to Professor Roy Herbst, chief of medical oncology at Yale Cancer Centre, “We are seeing a paradigm shift in the way oncology is being treated, the potential for long-term survival, effective cure, is definitely there.” “For the first time in my career I honestly believe we are seeing the dawn of a new era,” expresses Dr Mark Porter, The Time’s medical correspondent.

NEOPLASIA { ISSUE 02/2015 }

Connection blocked

The enthusiasm notwithstanding, there are notable voices that mitigate the expectations on the promise of immuno-oncology, as the fifth way to treat cancer after the four known ways, namely surgery to cut out the tumour, radiotherapy, chemotherapy and targeted therapy.

These four types of treatment – used individually or in combination – have contributed to increasing survival rates. Immuno-oncology could improve the numbers.

Scientists have discovered that cancer cells, similar to the human immunodeficiency virus (HIV) that causes AIDS, are able to hide from the body’s own defensive immune system such as the T-cells that seek out and kill invaders. Cancer cells, according to Cancer Research UK, have developed a “secret handshake” that persuades the T-cells to not attack. A molecule on the T-cells has been identified as part of this secret handshake. Scientists have termed this molecule as “programmed death 1” or PD1 and have been trying to “disrupt” it, and the drugs used appear to work for now in advanced melanoma which has a high death rate. In an international trial managed by the Memorial Sloan Kettering Cancer Center, 945 patients with advanced melanoma were treated using the drugs ipilimumab (also known under the brand name Yervoy) and nivolumab (under the brand name Opdivo). The treatments stopped cancer advancing for nearly a year in 58% of cases, with progression-free survival in melanoma (the amount of time during which a patient’s cancer did not become worse) for an average of 11.5 months, as researchers found. This is an important result compared with 6.9 months for those on nivolumab alone and 2.9 months for those taking only ipilimumab. According to Dr Alan Worsley, senior science information officer of Cancer Research UK, “Together these drugs could release the brakes on the immune system while blocking cancer’s ability to hide from it.” He however added that combining these treatments also increases the likelihood of potentially quite severe side-effects. “Identifying which patients are most likely to benefit will be key to bringing our best weapons to bear against the disease.” Other experts, while enthusiastic, also pointed out that some issues need to be solved before talks of final result can take place. The first is about the reported side-effects that can include fatigue, rash and diarrhoea. Nearly 50% of cases experienced significant symptoms and 36% dropped out of the trial due to “adverse events”. “Your immune system is designed normally not to attack your body’s own cells,” said Nell Barrie of Cancer Research UK. “You have to boost the immune system beyond its normal function and you are going to sensitize the immune system. It’s very, very complex.” The second concern is how long the drugs will keep the cancers at bay, as most drugs delay progression but do not cure. Professor Karol Sikora, the dean of the

University of Buckingham’s medical school explained, “The prolongation of survival from these very expensive immune therapies is often a matter of weeks or months and we’ve got to make it long-lasting and that has to be our priority.”

The last and probably most important issue is the cost of these new treatments; ipilimumab (given intravenously every three months) costs $130,000 per patient per year, nivolumab (given every two weeks) about $150,000. Dr Ranjana Srivastava wrote in her column for The Guardian: “As a privileged doctor working in a rich country, I know my patients are likely to realise the promise of new discoveries. I will keep telling them that advanced melanoma remains incurable but that incremental gains will help them live longer and better. But as a global citizen, I struggle with the implications of mind-bogglingly expensive drugs. I think about the societal responsibility we bear to ensure that cancer suffering is reduced not only in our direct vicinity but for the millions of invisible and forgotten patients in poorer countries too.” The conclusion is that while the latest advances certainly make immuno-oncology a promising option for cancer treatment and more breakthroughs can be expected in the future, it is still a long way to go and many challenges to face before we can talk about a “cure for cancer”, especially one that would be affordable for the average person.

This article was developed by Camilo Cupitre of MAKNA International Division based on the information he gathered from the following sources: • “Immunotherapy: the big new hope for cancer treatment”, The Guardian, June 1st 2015. • “And then there were five”, The Economist, June 6th 2015” • “Why I won’t be rushing to tell my cancer patients there’s a cure”, The Guardian, June 2nd 2015. www.makna.org.my

HUMOUR

Laugh Together lah

INTERNATIONAL

Makna’s Journey In Vietnam 2015

• Increase number of volunteers for MiV.

• Provide training for • Develop volunteers MiV website and health and blog. practitioners. • 05/2014 • 03/2014 Fundraising training in Charity football Ha Noi, Vietnam, match to conducted by MAKNA raise funds. Malaysia. • 09/2014 Study trip to Kuala Lumpur, Malaysia. 2013

2014

• Organised 2 breast and cervix cancer screening trainings for 127 doctors in Ha Noi and Hue, which benefited 10,000 Vietnamese.

2012 Official partnership with Bright Future Foundation Vietnam for cancer support. • 10/2012 MiV officially opened its doors!

2011 • Co-organised “Light the Pink” with Hanoi Medical University – an awareness campaign on early breast cancer detection.

2010 • Obtained license to operate in Vietnam. Organised joint anti-tobacco campaign for cancer control.

2009 07/2009 Delegates from the Ministry of Health for Cancer Control in Vietnam participated in a cancer database development programme – a stepping stone towards the setting up of MAKNA International Vietnam (MiV). 27

NEOPLASIA { ISSUE 02/2015 }

www.makna.org.my

RESEARCH

Figure 2 shows the experimental plan prior to assessing the capability of MSCs to deliver EPO protein in an in-vivo study. The results showed that despite stable expression of EPO protein in MSCs culture, the effect of EPO protein on the generation of red blood cells were short-lived in the mice following cell transplantation under the skin. We observed presence of macrophages at the site of transplantation and attributed immune responses against either MSCs or EPO protein to the transient effect in the animal study. More works have to be done to improve cell survivalability following injection to enhance red blood cells production.

Cancer patients are prone to anaemia. This research explored the usage of stem cells to help patients generate red blood cells to treat their anaemia, which would help them respond better to treatment. The results of this research have been published in four international peer-reviewed journals and received more than five awards in local and international conferences.This research was partially sponsored by MAKNA and most experiments were carried out at the Pusat Perubatan UKM-MAKNA Cancer Centre, UKM Medical Centre, Kuala Lumpur. By Dr Mok Pooi Ling, Department of Obstetrics & Gynaecology, Faculty of Medicine & Health Sciences, Universiti Putra Malaysia

Employing GeneticallyEngineered Mesenchymal Stem Cells for Blood Cells Regeneration Bone marrow is a tissue rich in stem cells important for renewal of blood cells. Stem cells are capable of self-replication and of forming other cell types to replenish old, damaged or dying cells in order to maintain optimal body functions.Haematopoietic stem cells (HSCs) are responsible to give rise to various blood cells such red blood cells and white blood cells in our body. HSCs reside and depend on the bone marrow microenvironment,which is continuously provided and nourished by the mesenchymal stem cells (MSCs). This microenvironment provides a suitable home for growing and nurturing blood cells development. 29

NEOPLASIA { ISSUE 02/2015 }

Figure 1: Culture of mesenchymal stem cells harvested from normal donors. These spindle-shaped cells could propagate very fast in the laboratory. The propagated cells were genetically-engineered to express human erythropoietin.

During treatment of blood cancers, patients undergo radiotherapy and chemotherapy to eliminate cancerous cells. The effect of the chemotherapy treatment is harmful to the bone marrow microenvironment. As an effect of the damaged microenvironment, bone marrow transplantation could not generatethe desired effect to fully replenish normal blood cells functions.

The importance of this research in summary: Figure 2: The research plan to test the efficiency of erythropoietin secreted by the genetically-engineered MSCs to stimulate red blood cells formation from HSCs.

As a result, patients are prone to anaemia and rely on other supporting therapy, such as erythropoietin (EPO),to prevent it. Hence, treatment strategy to target the repair of the bone marrow microenvironment should be given equal importance. As such, the main focus of this research is to improve the bone marrow microenvironment using MSCs-based therapy. We also incorporated EPOgene into MSCs to stimulate red blood cells production for anaemia correction. Under the guidance and supervision of Emeritus Professor DrCheong Soon Keng, we were able to successfully generate human MSCs carrying and expressing EPOprotein. Figure 1 shows the culture and expansion of MSCs from the bone marrow. The EPO protein was tested to be functional to induce differentiation of HSCs into red blood cells both in the in-vitro and animal model using nude mice.

1. This study highlights the ability of human MSCs, engineered to express EPO protein, in stimulating red blood cells production. 2. Cell therapy using MSCs is a promising new approach for blood cells regeneration for anaemia correction in cancer patients.

Figure 3: Observation of stem cells culture and discussion among research team members at PPUKM-MAKNA Cancer Centre.

More about the author: At present, Dr Mok Pooi Ling is interested to devise a method to kill cancer cells by employing genetically-engineered immune cells. She also has interest to expand the possible use ofmesenchymal stem cells for repairing tissue damage or degeneration due to various inherited or acquired diseases. www.makna.org.my

FEEDBACK

A cycle of poems about Cancer & Its Effects By Cecil Rajendra

His wife was diagnosed with breast cancer and had a mastectomy

Breaking News

Like the day Kennedy was shot… Like the day the tsunami hit Asia… you remember exactly where you were when news first broke: biopsy results proved positive. You were standing in the middle of your daughter’s living room in Damansara, Kuala Lumpur; it was 4.44 in the afternoon Wednesday,16 October 2013. The clocks stood at exactly 4.44.

Dear Sir/Madam

Greetings!

and on/about cancer s m e o p f o e cl cy h is a Enclosed herewit its effects... d breast cancer an h it w d se o n g ia d a, was My wife, Rebecc y in 2013. has a mastectom through various t sa I s a s e lv se them them in any of The poems wrote sh li b u p to e m o lc r. You are we sessions with he the subject. your journals on Yours sincerely,

HER 2/ He Too The night after ion your chemo sess you toss & turn… too drug-hyped . for a sound sleep Not unlike … the night before as when I w too fear-hyped to fall asleep!

Questions & Answers “Why, why me?” is the universal cry of every casualty.

Non-smokers, vegans pious church-goers regimental exercisers are the most vociferous. There is no answer… man, woman, infant any age, race, colour infidel or believer can be hot at anytime, place, hour in any square inch of the anatomy... there is no shelter. In our long battle against lethal Cancer millions have fallen; exceeding the total of all lives lost in all wars waged since Man’s descent… But while we expend trillions on illusory ‘security’, only a fraction of Defence budgets are spent on the very real fight against the big ‘C’ Somewhere in these statistic s perchance, lies the answer.

Small Mercies You enter the hospital for another chemocursing the cruel hand fate has dealt… Hours later witness to a colonnade of hopeless case terminal beds… you exit spent with a silent prayer of thanksgiving.

NEOPLASIA { ISSUE 02/2015 }

www.makna.org.my

National Cancer Council (MAKNA) BG 03A & 05, Ground Floor, Megan Ambassy, 225 Jalan Ampang, 50450 Kuala Lumpur. Tel: +603-2162 9178 Fax: +603-2162 9203 Email: makna@makna.org.my www.makna.org.my www.facebook.com/maknacancer www.twitter.com/makna_malaysia

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Every ringgit raised from this section will literally transform lives. This is where donations â€œwill never go out of fashion.â€?