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Issue No. 01 • MICA (P) 207/10/2008

AN NCCS BI-MONTHLY PUBLICATION October / November 2008

...HELPING R E A DERS TO ACHIEV E GOOD HE A LTH

TAKING CANCER CARE TO THE NEXT LEVEL An interview with Prof Soo Khee Chee


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In Other Words

SALUBRIS

October / November 2008

TAKING CANCER CARE TO THE NEXT LEVEL...

The National Cancer Centre Singapore (NCCS) is known not just for its expertise in cancer treatment but as one of the key centres in cutting-edge research. Behind this success is its founding director Prof Soo Khee Chee, whose passion for research has put NCCS on the world stage.

B

e it 0730 hours or 1930 hours, whichever time of the day you pick, it is not uncommon to see the lights at his office on the fourth level of Goh Song Chiang Building. Not an unearthly hour, yet many of us would still be in our pyjamas. But not for Prof Soo Khee Chee. Tranquility for him is an opportunity to get his paper work done. In more than one way, Prof Soo, or just Prof, as he is affectionately known to his colleagues, wears many hats but is a man of few words. As NCCS Director, he is tasked with looking into policy matters and research projects. On his plate is the constant need to raise funds to support these research projects. He attends to patients at his clinic, performs surgery, and also shares his experience and expertise with his specialists, as well as teach the younger doctors. Not only that, he is the Vice Dean, Clinical and Faculty Affairs, of the Duke-NUS Graduate Medical School, and his latest additional role is his appointment as Assistant CEO of SingHealth Group overseeing research and education.

Prof Soo is one of the pioneers who saw the birth of NCCS, and today runs it with clockwork efficiency, attending to the majority of public patients. He is the face of NCCS in the global fraternity and is one of the founders of the Asian National Cancer Centres Network. A firm believer in research, he is constantly strategising and encouraging his team of investigators and clinician scientists. His prime worry is finding the funds to keep their projects going. For the Penang-born professor, his efforts have not been in vain. Today, NCCS is an example of what a premier cancer centre should be. Teams of specialists from various medical disciplines work together, supported by a talented pool of clinician scientists, focusing on how the patients can benefit from their discoveries. On hand are also the latest medical equipment, for example in radiation technology, so that they can also leverage on advances in IT to complement their efforts. NCCS, as

part of its comprehensive service, also offers patients psycho-social counselling and carries out a whole menu of support programmes to help patients journey through their illness. Doctors at NCCS also carry out clinical trials as they have a wide patient base which is required for any trial to be effective. This also means that the doctors get to see the different types of cancer and hence are better exposed and experienced in responding to the patients’ needs. When asked about how things have turned out so far, a modest Prof Soo said: “I am pleasantly surprised that it has worked out better than we thought.” There were several issues that were important for NCCS at the time of its inception. One was to be able to create various multi-disciplinary segments so that sub-specialist care can be given to the patients in an efficient and timely manner. “This has turned out well because we are now able to offer a comprehensive range of specialist care in each of the major cancer groups,” he added.


Today, NCCS is an example of what a premier cancer centre should be. Teams of specialists from various medical disciplines work together, supported by a talented pool of clinician scientists, focusing on how the patients can benefit from their discoveries.

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In Other Words

SALUBRIS

October / November 2008

Prof Soo, who was recently conferred the first national award by the Ministry of Health in recognition of his contribution to mentoring young doctors, is not one to rest on his laurels. One area where he feels things could have turned out better would be to house all cancer specialists under one umbrella, attending to cancer patients throughout Singapore.

GETTING THE TALENTS The other consideration involved recruiting highly talented scientists to generate a regular flow of in-depth research papers and create intellectual property in a productive way given the limitation in grants and other financial support for research projects. “NCCS is getting recognition for its work not only within Singapore and the region, but also globally,” said Prof Soo. In fact each year, he also schedules a few overseas trips to keep abreast of the latest in cancer treatment. He is also a sought-after speaker at distinguished overseas gatherings. “…But, what’s more important – winning the prize or curing polio? Of course it’s curing polio. It’s the science that’s important, not the recognition.” Prof Peter Courtland Agre 2003 Nobel Prize in Chemistry, in reference to Jonas Salk who though he made the polio vaccine, he never won the Nobel Prize.

Some high profile research discoveries included the works by Dr Kon Oi Lian on developing cell-based treatments for metabolic disorders such as diabetes mellitus and haemophilia A; colorectal cancer vaccine and T cell therapy for nasopharyngeal cancer patients by Dr Toh Han Chong, and the role of the tumour-supressor genes, p53 and p73 by Prof Kanaga Sabapathy. Now, NCCS has moved to the next level where it is sharing its expertise with others. Already it has proven to be a fertile training ground for grooming cancer specialists in Singapore, but now it has moved beyond its boundaries and are training specialists within the region. Doctors from Indonesia, Malaysia, Thailand, Vietnam are benefiting from this programme. Prof Soo, who was recently conferred the first national award by the Ministry of Health in recognition of his contribution to mentoring young doctors, is not one to rest on his laurels. One area where he feels things could have turned out better would be to house all cancer specialists under one umbrella, attending to cancer patients throughout Singapore. So far NCCS has helped the other hospitals to set up clinics to provide cancer services to their patients, such as at Changi General Hospital, KK Women’s and Children’s Hospital, National University Hospital and Tan Tock Seng Hospital. NCCS continues to be the only centre providing training for healthcare providers in palliative medicine, and with the setting up of the new Lien Centre for Palliative Care, the training programme is expected to benefit even more people. Asked how he retains talent within NCCS, he said the human resource structure is undergoing some robust changes, and the main clinicians and scientific investigators are now becoming faculty members of Duke-NUS Graduate Medical School. This Duke-NUS collaboration will help create a more intellectual milieu for the campus and advance the course of academic medicine. At the same time, it will train more specialists to meet the demand of a greying and expanding population.

By Sunny Wee


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In Focus

SALUBRIS

October / November 2008

A CURE AT WHAT PRICE? – Searching for Personalised Yet Affordable Medicine

F

or five years, Prof Huynh The Hung from the Laboratory of Molecular Endocrinology in National Cancer Centre Singapore (NCCS) and his team have been working towards a noble dream.

Recently, NCCS joined hands with AstraZeneca, an Anglo-Swedish pharmaceutical firm, to test drugs to combat HCC. The combination of drugs being tested by the team is almost infinite. Apart from testing new compounds periodically provided by pharmaceutical companies, they may also combine the new compounds with existing drugs to see if better results can be attained. And even though Prof Huynh and his team now primarily deal with liver cancer, results of their work could potentially be used on other solid tumours.

They embarked on a journey to come up with a personalised and yet affordable medicine to treat cancer. While personalised medicine is not new, most researchers are focused on looking for a treatment or drug that works in treating cancer. What sets this project apart is that the cost of therapy for the patient, should the treatment require more than two or three drugs, is another key consideration. Hence, Prof Huynh has to strike a tough balance, which could possibly explain why researchers often ignore the question of cost. This project entails taking tissues from a tumour of, for example, a liver cancer patient for implantation into the liver of six to eight mice. These SCID mice, as they are known, are immuno-deficient and they are commonly used as hosts for normal and malignant tissue transplants. This process is known as surgical orthotopic implantation and is believed to be available only in NCCS for research on hepatocellular carcinoma (HCC). The tumours are then allowed to grow in the mice while the team maps out several treatments for them using a combination of not more than three different drugs. These drugs are then administered to the mice as they would be to the patients. The mice are then monitored to gauge the response of the different drugs or combinations of drugs using the CT and PET scans. In doing so, it gives the team an idea of the combination of drugs that would work best for the respective patients whose tissues were grown in the mice.

It was not smooth sailing for Prof Huynh when he first embarked on his research. In fact, it drew a lot of flak from the research community as tissues from patients were implanted and grown under the skin of the mice.

However, due to the underlying liver disease, not all patients are able to donate their tumour tissue for making xenografts and not all the HCC tissues from the patients will successfully grow in mice for drug testing. Furthermore, many patients may not have enough time to wait for the test results or be able to finance the surgical orthotopic implantation procedure or the drugs recommended. In these cases, Prof Huynh may still be able to find effective solutions by comparing the protein profile and/or gene signature of the affected patient with other patient-derived HCC xenografts in his therapeutic programme database to look for similarities and therapeutic regimens. Following this, he may also be able to recommend less expensive drugs that are likely as effective.

But his persistence has finally paid off. With the new technique of surgical orthotopic implantation, many pharmaceutical companies have been approaching him to do pre-clinical testing for their new drugs. Hopefully, in the near future, this will result in patients having access to drugs that are personalised yet affordable. By Carol Ang


FACE OF A CANCER CELL

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Looking Forward

SALUBRIS

October / November 2008

of benign cells. In such instances, other associated features of cancer are used to corroborate a malignant diagnosis.

DO CANCER CELLS HAVE A RECOGNISABLE RELATIONSHIP WITH ITS ENVIRONMENT?

Cancer cells in groups and nests, revealing pleomorphic nuclei, prominent nucleoli and mitoses.

Cancer cells have the ability to invade the surrounding tissues. They form tonguelike groups and nests that permeate the stroma, sometimes even extending into blood vessels. The appearance of this irregular invasion is the underlying reason for its being called “cancer” which is derived from the latin word for “crab”.

OTHER ASSOCIATED FEATURES OF CANCER CELLS STRUCTURE OF CANCER CELLS In order to recognise a cancer cell, we need to be familiar with what makes a normal cell. A cell consists of a nucleus that contains the genetic matter, and cytoplasm which holds its organelles within a liquid environment. Cytoplasm is the cell substance between the cell membrane and the nucleus. Organelles are structures that are enclosed within its own membrane inside a cell and has a particular function. The nucleus has a small nucleolus that is involved in forming protein. The structure or form of a cancer cell results from underlying abnormal genetic changes that it has undergone. Its features are best appreciated with the light microscope, and in general, a cancer cell will show an enlarged nucleus reflecting the accumulation of abnormal genetic material, and a conspicuous nucleolus indicating increased cell activity. Other typical alterations are nuclear pleomorphism, referring to variation in nuclear size and shape; and hyperchromasia, which also results from excess genetic material contained in its chromatin. Often, a cancer cell is described as revealing a high nuclear-

cytoplasmic ratio, essentially implicating enlargement of the nucleus that occupies more of the individual cell volume. There is also increased mitotic (cell division) activity, reflecting rapid proliferation and growth of the cancer cells; abnormal mitoses such as tripolar mitoses may be seen. These characteristics of a cancer cell are termed anaplasia. Just as symmetrical and regular features lead to a pleasant face, anaplasia in a cancer cell is contemplated as ugly.

CANCER CELL VS NORMAL OR BENIGN CELL A normal or benign cell will not have the described abnormal changes. It will instead appear regular in shape and size, and the nucleus will generally have smooth contours. The chromatin (the readily stainable substance of a cell nucleus consisting of DNA and RNA and various proteins) is fine and the nucleolus inconspicuous. The nuclear-cytoplasmic ratio is not increased, and if mitoses are discovered, they are normal in appearance. There are some cancer cells that are very well-differentiated, such that their appearances mimic that

Since cancer cells grow very quickly, they can outstrip their blood supply, resulting in necrosis or cell death. There is haemorrhage or bleeding, due to new vessel formation accompanying the cancer growth, or destruction of vessel walls by the invading cancer cells. The connective tissue in which cancer cells sit can respond by evoking a “desmoplastic” reaction, which features loose fibroblastic stromal cells surrounding the cancer cell nests. The ability of cancer cells to invade blood vessels allow them to circulate and “metastasise” (spread) to other organs and tissues of the body, distant from the site of origin.

CONCLUSION The cancer cell, while usually showing a fairly characteristic face, may sometimes assume less familiar appearances. It is important to understand that the cancer cell may have another countenance, and that a definitive diagnosis of malignancy relies on the careful interpretation of tissue and cell material by a pathologist.

By Dr Tan Puay Hoon Head, Senior Consultant, Dept of Pathology, Singapore General Hospital


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Looking Forward

SALUBRIS

October / November 2008

WHAT SHOULD I EAT TO REDUCE MY RISK OF CANCER?

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ating is widely regarded as one of life’s basic joys. It is not easy for anyone to change their dietary habits in response to advice about their health. However, with increasing awareness of cancer, people are starting to pay attention to the kinds of diet that may reduce the risks of eventually developing cancer. We have less hard evidence on this subject than we would like, reflecting the difficulties involved in reliably comparing dietary behaviours of people over a long period. However, the enormous amount of data that has been reported allow us to propose certain links between diet and cancer, as summarised in the table below:

READ FOOD LABELS It pays to scrutinise the ingredients listed on labels. Manufacturers often use misleading terms such as “sea salt” instead of “salt”, or “sucrose” or “fructose” instead of “sugar”. Products that are labelled fat-free still contain fat, but have to have less than 5g of it to qualify as being “fat-free”. Here are some numbers to remember when reading labels and choosing products.

DIETARY FACTORS THAT INCREASE RISK OF SOME CANCERS

DIETARY FACTORS THAT REDUCE RISK OF SOME CANCERS

Obesity

Ideal body weight

Low-fat:

Processed food such as canned meat or “fast” (fried) food such as hamburgers and french fries

Wholesome grains and fibre e.g. whole wheat, bran, oatmeal, multigrain bread

Less than 3g of fat per serving

Fat-free:

Less than 5g of fat per serving

Preserved (salted, cured, or smoked) food

Fruits and vegetables e.g. broccoli, cabbage, carrots, tomatoes

Red meat, especially if char-grilled

White meat e.g. fish and lean poultry (de-skinned)

Fat, especially animal fat or other saturated fat

Low fat food and other unsaturated fats e.g. olive oil, omega-3 fatty acids (in fish)

Excessive calories in any form e.g. sugar, starch, cakes, chocolates, soft drinks, beyond your daily energy requirement

Exercise daily for at least 30 mins

Alcoholic drinks especially if more than one per day

Folic acid found in green leafy vegetables e.g. spinach, asparagus, kai lan, peas and beans

Food that are contaminated by fungi that release mycotoxins (poisons produced by fungi), or by Helicobacter bacteria, e.g. rotten peanuts, stale meat or uncooked meat, certain mushrooms Chewing betel nut or tobacco

Properly stored food e.g. refrigerated Prompt disposal of food that have gone bad Meticulous oral hygiene (including dental flossing) to reduce bacterial growth

What Else Can I Do?

Low-cholesterol: Less than 20mg per serving and less than 2g of saturated fat Low-calorie:

Less than 40 calories per serving

Calorie-free:

Less than 5 calories per serving

Low-sodium:

140mg or less per serving

KEEP YOUR CHILD SLIM The best time to optimise dietary habits is in childhood and adolescence. Try to keep your children slim and active. Avoid feeding them foods that contain excess sugar, fat and carbohydrate, and encourage some exercise each day. After all, a lifetime of “healthy eating” may reduce cancer risk by as much as 30% to 50%, so it’s never too early to start!

EXERCISE REGULARLY Many factors such as genetics, diet, lifestyle, stress and environment being the most common have been linked to cancer. Like eating appropriately, regular exercise has been linked to a reduced incidence of cancer. There is increasingly convincing evidence that regular exercise may help to prevent cancer. Hence, cancer prevention would involve targeting these factors. Studies involving diet, smoking, alcohol and obesity, have indicated that obesity is a major risk factor of several types of cancer. Reviews have indicated that regular physical activity reduces the risk of colon and breast cancers. Exercise that targets the reduction of body fat causes changes in hormone level and enhances the immune system.

CALCULATE YOUR CANCER RISK You can estimate your risk of breast, bowel, uterine, ovarian, or prostate cancer by visiting the website http://www.yourcancerrisk.harvard.edu/.


LESSONS FROM SURVIVORS

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The lessons learnt after the diagnosis of cancer are common to many who have suffered from this disease, and perhaps a few are unique to our experience. Below is a compilation of valuable lessons learnt by survivors who had gone through the cancer journey, which we would like to share with our readers.

SALUBRIS

LESSON 1

LESSON 5

As the greatest physician, God appreciates the value of a referral.

The way you look affects the way you feel.

Early detection and prevention is important. We went through many months of denial and postponement that allowed the cancer to advance. This can be totally prevented. For those of us who have a religion, we believe that God has given our doctors an arsenal of treatments and the will to find a cure. Whatever faith we have embraced, our own God wants us to have faith, but at the same time God wants us to seek out earthly assistance.

It is terribly painful to lose one’s hair. But if it is going to happen, get a short haircut right away. It lessens the trauma as the hair comes out. Wigs can be an opportunity to experiment with the different look you fancy. Take special care to wear clothes that make you feel attractive. Pay attention to grooming and hygiene. Look for humour and find opportunities to laugh. It is one of God’s greatest gifts. Nothing can make you feel and look better than a smile.

LESSON 2 Make sure your doctor understands that hope is a vital part of the practice of medicine. We heard repeatedly from our doctors that attitude and faith had an enormous effect on healing. One wonders why more physicians are not prescribing it. It is at least as effective as some of our medications.

LESSON 3 Cancer is NOT an infectious disease. We will always be grateful for the overwhelming love we received from friends and family. But we are saddened by several personal and professional friends who never once responded to our most basic need to show they cared. The silence is deafening.

LESSON 4 Avoid doomsayers. Just as it is vitally important to hear encouragement from friends and family, it is equally important to avoid those who deliver gloom and doom. Seek out people who radiate a positive glow, and stay away from those who drain your energy and confidence.

Tender Care October / November 2008

Listen more, look more and love more.

LESSON 6

LESSON 8

Cancer does NOT mean the end of a sexual relationship.

Strengthen your faith.

It is not easy to talk about one of the most personal aspects of life. The closeness and bond between you and your partner during this time are critically important to maintain. While the period following the diagnosis and treatment requires untold patience and understanding, normal sexual relations can and should continue. It is important to discuss this with your doctor or nurse. They may be able to offer some helpful tips or advice.

LESSON 7 Listen more, look more and love more. Cancer changes everything. But it does not have to change everything for the worse. Even in this terrible situation, there is opportunity. It is important to slow down and reevaluate what and who is really important in life. Cancer can bring wonderful people into your life that will give you strength, love and special kindness.

Cancer is a lonely disease but you do not have to go through it alone. We are no longer in denial and are able to go on with our lives feeling enriched and happier than ever. For many, having faith in a religion helps and for those who do not have a specific religion, talking about your illness with your close friends and relatives will help to strengthen your hope and confidence to cope with it. We have confidence in the future and know that no matter what cancer has in store, we are prepared for it.

CANCER SUPPORT PROGRAMMES The National Cancer Centre Singapore conducts support programmes for patients, their families and cancer survivors to address issues of living with cancer. For more information, please call the Cancer Helpline at 6225 5655 or email: cancerhelpline@nccs.com.sg

ACKNOWLEDGEMENT: Special thanks to all cancer survivors for sharing their thoughts and experiences.


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癌细胞的真实面貌

SALUBRIS

October / November 2008

癌症细胞同周围细胞的关 系辨识度高吗? 癌细胞具有侵入周边细胞的能力。 它们所组成的舌装组织和巢状组织 能透过细胞基质,甚至延伸进血管。 癌细胞不规则的侵入路线也是癌症 英语名称 ”cancer” 的由来。”Cancer” 在拉丁文也有“螃蟹”的意识。 显现出多形体核子、细胞核仁和 有丝分裂细胞的癌症细胞群。

癌症细胞长什么样子? 在辨识癌症细胞之前,我们必须先 熟悉正常的细胞。每个细胞都有一 个核子,核子内蕴有基因成分和装载 液体和细胞器官的细胞质。细胞质 是细胞膜和核子之间的细胞物。细 胞器官是细胞内的其中一种裹在自 己的薄膜内的结构,并具有各自的功 能。细胞核内也有一个非常小的核 仁,负责制造蛋白质。

加快,反映了癌细胞的快速增生和扩 散;细胞可能出现三极细胞有丝分裂 等不正常的分裂。这些癌细胞的变化 被统称为退行发育。 就如一张悦目的脸庞需要对称和正 常的五官,我们可以说退行发育的细 胞是难看的。

癌症细胞的其他特性 由于癌症细胞增生的速度非常快, 血液供给不足可能导致细胞坏死。 此外,癌细胞增生也会导致新血管 的形成,引发出血的情况。癌细胞 的侵入也可能对血管墙造成破坏, 同样可能导致出血。启动“促结缔 织增生” (desmoplastic)反应也可 能让装栽癌细胞的联结组织产生 反应。侵入血管的能力也是导致癌 细胞能够扩散到其他器官和身体 组织的原因。

癌症细胞与一般或良性细胞 结论

细胞的结构在经过不正常基因变化 后就会形成癌症细胞。癌症细胞的 结构在显微镜底下最能清晰显现。在 显微镜下,我们可以看到细胞核子因 为积累了大量的不正常基因物质而被 撑大,核仁内的活动也比一般细胞核 仁活跃。癌变也会导致细胞出现其他 变化,包括:核子多晶化现象--细 胞核子的体积和形状出现变化,和 染色过深现象--染色质内产生过 多基因物质。由于细胞核子变大,核 子所占的细胞面积也随之增大,因此 癌细胞内的核子对细胞质比例一般 都会偏高。细胞有丝分裂的速度也会

正常或良性细胞不会呈现上述的不 正常变化。它的形状和体积看起来 都应该是正常的,细胞核子会有平 滑的轮廓。细胞染色体(细胞核子 内容易染色的脱氧核糖核酸、核糖 核酸和各种蛋白质)非常细致,核仁 非常不显眼。核子对细胞质的比例 并没有增加,如果发现有丝细胞分 裂迹象,分裂出来的细胞外表也是 正常的。 有些癌细胞属于分化良好 形,它们的外表和良性细胞很相似。 在这样的情况下,我们必须依赖癌 症的其他特征来确定癌症细胞是否 属于恶性。

一般而言癌症细胞的辨识度都非 常高,但有时侯也可能以大家比较 不熟悉的形态出现。我们必须知道 癌细胞可能以不同的面貌呈现,而 细胞是否属于恶性,要待病理学家 对细胞组织做仔细分析后才能做 出定论。

陈佩云医生 新加坡中央医院病理学部门主任及资深顾问


怎么通过饮食降低患上癌症 的风险?

民以食为天,要人们听取他 人的忠告,为了健康而戒口 或改变饮食习惯一点也不 容易。不过随着人们对癌 症的认识有所提高,大家也 开始注意如何通过饮食上 的改变来减低自己日后患 上癌症的风险。 要对人们的饮食习惯进行 长期的比较是一项非常艰 巨的任务。因为这样,我们 一直无法掌握足够的证据 证明饮食和癌症之间可能 存在的关系。虽然如此,各 方广泛收集到的大量资料 和报道却能让我们看出一 些端倪。

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October / November 2008

以下图表概括了饮食和癌症之间可能存在的关系:

提高患癌风险的饮食因素

降低患癌风险的饮食因素

肥胖

标准体重

罐头肉或汉堡包和薯条等以油炸食物为 主的快餐

全麦、燕麦、谷糠、杂粮面包等全谷、高纤 维食物

以盐或烟熏延长保存期的腌制食品

花椰菜、白菜、萝卜和番茄等水果和蔬菜

红肉,尤其是经过烘烤的红肉

白肉如鱼和家禽的瘦肉部分(去皮)

脂肪,尤其是动物脂肪或其他饱和脂肪

低脂食物和橄榄油、鱼类食品中可找到的 omega-3 脂肪酸等其他不饱和脂肪

摄取超过一天活动量所需的卡路里(如吃 太多糖、淀粉、蛋糕、巧克力和汽水)

定期运动半小时

含酒精饮料--尤其在一天内超过一杯

可在菠菜、芦笋、芥兰等绿叶食物和豆类 中找到的维生素B

被真菌污染并发出毒素,或被缠绕杆菌污 染的食物。例如坏掉的花生、已经存放很 久的肉类或未经烹煮的生肉,以及某种 蘑菇。

经过冷藏等正确方法储存的食物。 食物一旦腐坏就立即丢弃

嚼槟榔或烟草

保持口腔卫生(包括用牙线清理牙垢), 降低细菌增生。

续下一页。


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October / November 2008

怎么通过饮食降低患上癌症 的风险?

毕竟终身健康饮食可 以把患癌的几率降低 30% 至50% ,所以 开始培养良好的饮食 习惯永远不会嫌早!

续前一页。

我还能做什么?

定期运动 基因、饮食、生活习惯、压力和环境等 是导致癌症的常见因素。定期运动同 恰当饮食一样,也有助于减低患癌的几 率。有越来越多证据支持这个论点。因 此,要避免患上癌症就应该从它的导因 开始着手。同饮食、吸烟、喝酒和肥胖 有关的研究显示,肥胖会大大提高患 上几种癌症的风险,而定期运动可以减 低患上结肠癌和乳癌的可能性。以减低 体内脂肪为目标的运动会导致荷尔蒙 出现变化,从而加强免疫系统。

阅读食品标签

让您的孩子保持苗条的身材

仔细阅读标签上的食品原料成份对 你肯定有好处。商家通常会用“海 盐”、 “蔗糖”、 “果糖”等名词取 代“盐”和“糖”,企图混淆消费者。 那些标明无脂肪含量的产品其实还 是含有脂肪的,产品的脂肪含量只 要在5克以下就能自称“无脂肪”。 以下是选购产品阅读标签时应该留 意的一些数据。

幼儿或少年时期是培养良好饮食 习惯的最佳时期。尽量让您的孩子 保持活跃,以让他们维持苗条的体 型。尽量不要让他们吃糖份、脂肪和 热量过高的食物,同时鼓励他们每 天都做一些运动。毕竟终身健康饮 食可以把患癌的几率降低 30% 至 50% ,所以开始培养良好的饮食习 惯永远不会嫌早!

低脂肪:

每份含少于3克脂肪

计算患癌的风险

无脂肪:

每份含少于5克脂肪

您可到 http://www.yourcancerrisk. harvard.edu/ 网址,计算自己患上乳 癌、肠癌、子宫癌、卵巢癌或前列腺 癌的风险。

低胆固醇: 每份含少于20毫克的 胆固醇及少于2克的饱 和脂肪。 低卡路里: 每份含少于40卡路里 无卡路里: 每份含少于5卡路里 低盐:

每份含少于140毫克


癌症的经验之谈

PAGE B7

温柔呵护 SALUBRIS

很多曾经患上癌症的病人都在被确诊后吸取了不少经验,而这 些经验都非常类似。在这里,我们整理了一些癌症康复者宝贵的 经验与读者分享。

经验1

经验 5

连最伟大的医者,神,也肯定 接受治疗的重要性。

外表会影响心情

预防和及早诊断疾病非常重要。在我 们不肯接受患癌事实,犹豫是否应该 接受治疗的那几个月里,癌症已经逮 到繁衍的机会,让病情进一步恶化。这 是完全可以避免的情况。对于有宗教 信仰的病人而言,我们相信神已经赋 予医生为我们治疗的智慧,以及找出 治疗方法的坚定意志。无论我们信仰 的是哪个宗教,神都希望我们不要放 弃任何希望,即使是万能的神也希望 我们能寻求世俗的援助。

经验 2 确保医生明白“希望”是治疗 过程其中的关键 我们的医生常说,正确的态度和信念 对治疗有莫大的帮助。这不仅让我们 纳闷,为什么一些医生就是没有在处 方中加入这两种“药”。它的效用至少 能够媲美现有的一些药物。

经验3 癌症不是传染病 我们非常感激所有亲友所给予的无 限关爱。但一些友人的不闻不问却让 我们倍感难过。他们的沉默简直是 震耳欲聋。

经验 4 远离末日主义者 对癌症患者而言,我们不但需要听到 亲友的鼓励,也得尽量避免接触消极 的言论。多接触乐观积极的人,远离那 些会打击你的自信、让你的心情陷入 谷底的人。

脱发对任何人来说都是一项沉 重的打击。但如果脱发是必然会 面对的局面,你应该马上把头发 剪短,减低头发开始掉落时的冲 击。你可以利用这个机会,以假发 尝试各种不同的造型。你也应该 多加留意穿着打扮,让自己看起 来更亮丽。在这个时候,个人卫生 也非常重要,必须多加注意。除 此之外,你也可在生活中寻找幽 默,找机会让自己展颜欢笑。笑 容是上天给我们最好的礼物。任 何其他事所带给你的快乐都不及 一个微笑,笑也可以让人看起来 更漂亮。

经验 6 患癌不表示需要停止性生活 “性”是生活最重要的环节之一,但也 是很多人不善于讨论的课题。在这段 艰难的时期,保持和伴侣之间的亲密 感,维持两人之间的联系,可说是异常 关键。在被确诊患上癌症之后,病人需 要接受治疗。这段期间,癌症病患和伴 侣都需要给于彼此不可言喻的耐性和 谅解。因此两人更应该继续维持亲密 的性关系。不妨跟主治医生和护士讨 论这个课题,他们可以给你宝贵的意 见和建议。

经验7 多听、多看、多关爱 癌症会改变一切,但改变可以是好 的。即使最糟的情况里也会存在着机 会。你可以乘这个机会放慢脚步,重新 检讨什么人或事,对你是最重要的。在 癌症期间,你会遇见更多给你力量、关 爱和对你示出好意的人。

October / November 2008

多听、多看、 多关爱

经验 8 加强信念 癌症会让人感觉自己被遗弃,但你并 不需要独自走这一段路。我们不再逃 避现实,而且能够继续过着比以往更 加充实且快乐的生活。对许多病人而 言,宗教信仰对他们有很大的帮助。如 果你没有任何宗教信仰,你也可以和 亲密的亲友谈论自己的病情,这将有 助于提高你对康复的希望、加强对抗 病魔的信心。我们对未来有信心,因为 我们知道无论癌症帮我们做了什么安 排,我们都已经做好准备。

癌症病人互助计划 国立癌症中心为癌症病人和他们 的家人,以及癌症康复者主办各 种活动,帮助他们克服所可能面 对挑战。预知详情,请拨打癌症 授助热线 6225 5655 或电邮至 cancerhelpline@nccs.com.sg。

感谢: 在此对所有与我们分享经验和看法的 癌症康复者献上万二分的谢意。


PAGE B8

Outreach

SALUBRIS

October / November 2008

UPCOMING PUBLIC EDUCATION ACTIVITIES / PROGRAMMES

Event Name

Date, Time, Venue

Registration Details

English Forum & Workshop – UNDERSTANDING ARM SWELLING IN BREAST CANCER

18 Oct 2008, Saturday

$5 per Person

12pm to 5pm (English)

CALL: 6225 5655 / 6236 9434 / 6236 9432

For breast cancer patients & healthcare professionals.

Lecture Hall / Function Room, Level 4 National Cancer Centre ;Singapore 11 Hospital Drive, Singapore 169610

TOPICS: i) Reducing the Risk of Lymphoedema ii) Non-surgical Treatment of Lymphoedema iii) Surgical Treatment of Lymphoedema

Pink Bridges – WALK FOR THE WOMEN IN OUR LIVES

25 Oct 2008, Saturday 4pm to 9pm HortPark, Hyderabad Road

For breast cancer survivors & healthcare professionals.

$10 for Adults $5 for Children (3 to 12 years) Dinner & goodie bag included CALL: 6436 8294 / 6436 8283 for enquiries on the event. Registration by phone will not be accepted.

The Breast Cancer Awareness Month closes with a walk along the Southern Ridges Trail, from Mount Faber to HortPark.

CancerWise Workshop – DIET & FITNESS IN CANCER PREVENTION Speaker: Ms Hozaidah Hosain Principal Physiotherapist & Chief Lymphoedema Management SGH

Mr Philip Chia Private Chef & Consultant Rice Cooking Studio, Singapore

TOPICS: i) The Role of Fitness in Cancer Prevention: Achieving Your Ideal Weight • Make Fitness Work for You – Choosing the Right Exercise • Benefits of Exercise & Fitness • Role of the Physiotherapist • Getting Fit After Cancer ii) The Role of Diet in Cancer Prevention: Types of Diet to Reduce Cancer Risk • Dietary Myths and Misconceptions • Nutrition for Cancer Patients • Simple Healthy Cooking Tips, Rice Cooking Demonstration

22 Nov 2008, Saturday 1pm to 4.30pm (English) Function Room, Level 4 National Cancer Centre Singapore 11 Hospital Drive, Singapore 169610

$10 for Public $5 for Healthcare Professionals CALL: 6225 5655 EMAIL: cancerhelpline@nccs.com.sg


NCCS ACTIVITIES IN AND AROUND THE COMMUNITY

PAGE A5

Community

SALUBRIS

October / November 2008

PUBLIC FORUM

ADVANCES IN CANCER RESEARCH AND TREATMENT 28th June 2008 HDB Convention Centre (HDB Hub), Auditorium A well-attended forum where NCCS medical oncologists, Dr Toh Han Chong and Dr Tan Min-Han, together with research scientist, Mr Johnson Ng, of Biochip Devises Pte Ltd, shared with audiences on the cancer research and treatment advancements.

The forum, which was conducted in two sessions (Mandarin and English), highlighted topics such as: • Importance of Research in State-ofthe-Art-Cancer Treatments • New Experimental Therapies • Converting Research to Bedside Treatment

LIVER CANCER AWARENESS MONTH Liver cancer is the 4th most common cancer among men and ranks number two in terms of fatality. “Even so, there is potential hope for cure if individuals go for early detection and appropriate intervention,” said Prof London Lucien Ooi, Chairman of Liver Cancer Awareness Month (Liver CAM) also Deputy Director and Senior Surgical Oncologist at NCCS. Thus, to educate and update the public, general practitioners (GPs) and specialists on the disease, treatment options and prevention, NCCS held a public forum and sharing sessions with the medical professionals in conjunction with the 1st Liver CAM held in September 2008.

PUBLIC FORUM

MEDICAL FORUM

LIVER CANCER AND YOU ~ PREVENTION AND TREATMENT

LIVER CANCER AND GPS ~ TREATMENT OPTIONS AND CASE STUDIES

6th September 2008 HDB Convention Centre (HDB Hub), Auditorium

20th September 2008

About 850 participants attended the English and Mandarin forum and found out more about liver cancer and related issues such as hepatitis B, which may lead to liver cancer.

MAKING SENSE OF LIVER CANCER MANAGEMENT 27th September 2008 Some 60 GPs benefited from a medical update on liver cancer when they attended the special forum organised as part of this year’s Liver CAM. A roundtable discussion session was also held with specialists in the field.


PAGE A6

People

SALUBRIS

October / November 2008

AWARD WINNERS, NEW APPOINTMENTS AND MORE...

NCCS SHARES LIMELIGHT AT SCIENTIFIC MEETING

Pictured below, from left to right: Dr Joanne Ngeow (right), Dr Ang Mei-Kim, Dr Ho Gay Hui (right) and Mr William Chin Wei Lim (left).

S

taff from Outram Campus, namely, SGH, NCCS, National Dental Centre, National Heart Centre, National Neuroscience Institute SGH Campus, Singapore National Eye Centre and Duke-NUS Graduate Medical School were invited to submit an abstract of their work to compete in 13 award categories. Dr Joanne Ngeow, Registrar of the Medical Oncology Department clinched the Young Investigator’s Award (Clinical) with her paper on “PET/CT versus Conventional CT Scans and Bone Marrow Biopsy in the Initial Staging of Lymphoma Patients: A Comparative Analysis”.

Three doctors and a Research Officer from National Cancer Centre Singapore (NCCS) each walked away as winners at the Singapore General Hospital (SGH) 17th Annual Scientific Meeting which was held from 25th to 26th April 2008 at the College of Medicine Building.

Her department colleague, Dr Ang Mei-Kim, an Associate Consultant, won the Best Poster (Clinical) prize for her work which featured “A Promising New Chemoimmunotherapy Regimen for Advanced Hepatocellular Carcinoma”. Dr Ho Gay Hui, Senior Consultant of the Surgical Oncology Department, took home the second prize in the Best Oral Paper (Clinical). Her winning paper “Cancer Miss Rate in Women Under 30 Who Undergone Excision Biopsy of Clinically Benign Breast Lumps without Preoperative Ultrasonography”.

The Best Oral Paper (Scientist) prize was awarded to Mr William Chin Wei Lim, Research Officer of the Laboratory of Photodynamic Diagnosis and Treatment in the Medical Sciences Division, for his paper on “Membrane Transport Enhancement of Chlorin e6 – Polyvinylpyrrolidone and its Photodynamic Efficacy on the Chick Chorioallantoic Model”.


CONGRATULATIONS TO ALL!

PAGE A7

People

SALUBRIS

October / November 2008

T

he SYA recognises and commends contributions by youths who excelled in their respective fields and served the community in one way or the other.

SINGAPORE YOUTH AWARDS 2008

Dr Tan Min-Han, an Associate Consultant of the Medical Oncology Department, NCCS, is also a dedicated researcher whose work focuses on kidney cancer. He shuttles between the laboratory and clinic where he hopes the knowledge gained about the disease can be translated to treating his patients. Despite his busy schedule, he would still spend time with the junior doctors, medical students and even junior college students to give them guidance.

On 6th July 2008, Dr Tan Min-Han received the Singapore Youth Award (SYA), Science and Technology category, from Deputy Prime Minister Prof S. Jayakumar at the Istana.

HEALTHCARE HUMANITY AWARD

G

PROMOTIONS

iven out in year 2003 as the Courage Award after the SARS (Severe Acute Respiratory Syndrome) outbreak in Singapore, the Healthcare Humanity Award, as it is now known, recognises outstanding healthcare workers who go the extra mile in caring and comforting the sick and the infirmed.

Dr Joanne Ngeow, Registrar of the Medical Oncology Department, NCCS, is one of the six doctors, to receive the award from President S.R. Nathan at a presentation ceremony held on 26th May 2008 at the NTUC Centre Auditorium. Winners of the award are recognised for demonstrating values such as courage, extraordinary dedication, selflessness, steadfastness in ethics, compassion as well as humanity.

NAME

TITLE

Dr Chua Eu Tiong

Head, Radiation Oncology

A/Prof Koong Heng Nung

Head, Surgical Oncology

Dr Fong Kam Weng

Deputy Head, Radiation Oncology

Dr Tan Yu Meng

Senior Consultant, Surgical Oncology

Dr Wong Zee Wan

Senior Consultant, Medical Oncology

Dr Preetha Madhukumar

Consultant, Surgical Oncology

Dr Teo Ching Ching Melissa

Consultant, Surgical Oncology

Dr Quek Hong Hui Richard

Consultant, Medical Oncology

Dr Ng Chee Hui Raymond

Consultant, Medical Oncology

Dr Soong Yoke Lim

Associate Consultant, Radiation Oncology

Dr N. Gopalakrishna Iyer

Associate Consultant, Surgical Oncology

Dr Ang Mei-Kim

Associate Consultant, Medical Oncology

Dr Tan Min-Han

Associate Consultant, Medical Oncology

Dr Ngo Su-Mien Lynette

Associate Consultant, Medical Oncology


NCC FOUNDATION: WHY WE DO WHAT WE DO

PAGE A8

NCC Foundation

SALUBRIS

October / November 2008

A leader once asked a group of executives during a corporate retreat: How do you make this organisation an interesting place? This is an established company in the service sector striving to renew itself. Someone replied: To be interesting, you have to be interested.

In present terms, the primary functions of the NCC Foundation are to raise and manage funds for the NCC Research Fund (NCCRF), the Centre’s registered charity and its flagship fundraising and grant-making channel. NCCRF provides seeding and bridging funds for strategic research needs at the institution. Fundraising and grant making are thus the operative functions of the Foundation. Yet it is not just about money.

T

he NCC Foundation will be celebrating its first birthday soon. You may have seen our posters around – in the lifts, beside the business office, by the clinics; you may have heard of or even participated in our fundraising and outreach events – ‘Circle of Life’, ‘Light of Life’, ‘Muffins Monday’ and our national event, the ‘Run For Hope’ in October. You sensed our interest, but how does one define this Foundation?

It is really about the idea of giving. Essentially, the Foundation hopes to facilitate giving as part of National Cancer Centre Singapore’s (NCCS) cultural fabric. Giving can come in various forms – of treasures, talents and time. There are grateful patients who donate regularly, and there are others who leave significant bequeathment; there is a painter who shares her talent in support of our cause; there is a warmhearted baker who donates fresh pastries regularly; and there are staff who volunteer their time and efforts in our events. These are all actual examples of giving which took place, and the Foundation hopes to provide a holistically meaningful platform for all such practical and symbolic gifts. Moving ahead, the Foundation will consolidate its bedrock and put in place programme structures where different forms of giving can benefit the myriad areas of research, education and patient welfare. Naturally, we work alongside the crucial support of various departments. At this juncture, as the Foundation’s first birthday meets the 10th year anniversary of NCCS, we would like to say a big ‘Thank You’ to one and all who have guided us in our modest beginning. We look forward to your continuous goodwill in our journey ahead.

By Eugene Sng Programme Director, NCC Foundation

SALUBRIS

Editorial Advisors

Contributing Editors

Dr Kon Oi Lian Prof Soo Khee Chee

Dr Lim Soon Thye Dr Wong Nan Soon

Executive Editors

Members, Editorial Board

NATIONAL CANCER CENTRE SINGAPORE

Ms Carol Ang Ms Adeline Teo Mr Sunny Wee

Ms Audrey-Anne Oei Ms Sharon Leow Ms Flora Yong

11 Hospital Drive Singapore 169610 Tel: (65) 6436 8000 Fax: (65) 6225 6283 www.nccs.com.sg Reg No 199801562Z

is produced with you in mind. If there are other topics related to cancer that you would like to read about or if you would like to provide some feedback on the articles covered, please email to salubris@nccs.com.sg.


NCCS Salubris Issue No. 01 (Public Edition)  

A razorSHARK design. Salubris is a National Cancer Centre Singapore (NCCS) bi-monthly newsletter publication.

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