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Issue No. 14 • MICA (P) 061/10/2010

AN NCCS BI-MONTHLY PUBLICATION January / February 2011

...HELPING R E A DERS TO ACHIEV E GOOD HE A LTH Salubris is a Latin word which means healthy, in good condition (body) and wholesome.


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In Other Words

RISING TO THE UNKNOWN

SALUBRIS

January / February 2011

National Cancer Centre Singapore is now the first ambulatory cancer centre to be JCI accredited in Asia. This was all thanks to Dr Joseph Wee who steered the staff and won their collective support that led to the centre’s accreditation. CHUA HWEE LENG finds out more about the man behind NCCS’ JCI success.

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wo years of intense discussions and meetings before JCI Day came on 22 September 2010. It was the day that NCCS was subjected to the closest scrutiny ever in all its work flow and practices. External audits are especially arduous, including the one conducted by the US-based Joint Commission International. The two female auditors are veterans in their own right, both coming with many years spent in the healthcare hospital environment. They were here to see if NCCS could pass the scrutiny and join the ranks of other renowned organisations that had been recognised for having healthcare practices that ensure safety, confidentiality and quality healthcare for patients. The auditors were very precised in what they wanted to see. They requested to be shown four perfect medical case notes, where all the information was properly recorded with no “gaps”. Earlier on they had spotted a few minor gaps in some of the notes and they had no intention of letting that pass. Quick-thinking Dr Wee was also not letting his two years of hard work go down the drain. He ordered everyone to stay back, except for research staff, and retrieved the perfect case notes for the auditors. He was confident that NCCS case notes were up to par. Indeed he was proven right. The staff produced 18 case notes and eventually four were given to the auditors.

The rest as they say is history. NCCS became the first ambulatory cancer centre in Asia to be credited with an audit score of 98% for JCI accreditation. Recounting that moment, Dr Wee felt very gratified by the tremendous support from the staff. “I am most grateful to all my NCCS colleagues for trusting me at that crucial moment – patiently “swatting mozzies” while waiting for further instructions. What that did was provide me with the mental space to think and strategise how to get the four perfect records,” he said.

For our patients, the accreditation means that they can be further assured of high quality in patient assessment and treatment, improved clinician-patient and caregiver communication, patient privacy and confidentiality, and a safe environment from stringent infection control amongst many others. Dr Wee acknowledged the hard work put in by each and everyone and especially those in what he calls his Quality Special Sub-committee. “It is the middle managers who are really the true heroes – they are the ones that helped us clinch the 98%. NCCS is extremely fortunate that we have this group of die-hards; they are the ones that make NCCS hum.” He thought the pass was secured through the skin of the teeth but it was by no means a reflection of how committed the staff was. “There were changes in the policies guidelines earlier this year and adjustments were needed. Considering this, I was glad we made it,” said Dr Wee. The preparation had been carried out early. He was gathering his team the first instance he was appointed Chairman of the Steering Committee. His selection criteria were that his team had to be extremely competent and the members also had to complement him.


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In Other Words

SALUBRIS

January / February 2011

Since then, whenever he travelled around the region, he would visit the ethnic minority museum of the region. In 2009, he also attended an archeological conference in Hanoi. That was the first time he met real life archeologists and convinced one of them who has a vast collection of skulls from south China to look for skull-base erosions, which was a classic hallmark of NPC (nasopharyngeal cancer).

Dr Joseph Wee receiving the report of accreditation from Ms Marlis Daerr, Surveyor, JCI.

Explaining why this was necessary, the radiation oncologist said, “I am a rather brash sort of chap, so my team had to have exquisite EQ and PR skills and be equally adept at handling anyone from senior management to their own colleagues to their subordinates.” And everyone has worked well seamlessly. Throughout the two years, there were many memorable moments that Dr Wee shared. He was pleased to find the doctors very much up to scratch, On one occasion, he was going through a particular casenote with a fine tooth-comb just to look for trouble and was glad no error could be found. That doctor had crossed every “T” and dotted all her “I”s. His meticulous and precise ways had stemmed from his enquiring nature about events around him. That was also the root for his interest in social science. Dr Wee, a senior consultant with the Department of Radiation Oncology, can now spend more time on his clinical specialisation and research and other interests. Currently, he is into the pre-history, migration patterns and genetic anthropology of Southeast Asia. Southeast Asia has a very rich and diverse pre-history and what he hopes for is that his understanding of this historical perspective will help him to pin point the site of the genes involved in Nasopharyngeal Cancer (NPC). His interest in this aspect of social science arose after he noticed that the Tinkling (“Bamboo Pole Dance”) – the National Dance of the Philippines, is also practiced by other ethnic groups in Southeast Asia – from Sabah to Indochina to south China and Hainan – all the way to northeast India – Assam region. The connection struck him, “This similarity of material culture, when there was no YouTube, suggest that there was some form of contact or relations between all these different ethnic groups spread over such a vast area. What was also interesting was that all these groups had a fairly high incidence of Nasopharyngeal Cancer.”

All this “tomb-digging” adventure has indeed been an eye-opening experience for Dr Wee. He is now expanding his medical field to include anthropological perspectives. Since the interest sparked off, Dr Wee had published a paper titled “Is Nasopharyngeal Cancer really a Cantonese Cancer?” It combined historical, anthropological, archeological and linguistic knowledge as well as modern genetic signatures to hypothesise how the current enigmatic epidemiological pattern of nasopharyngeal cancer could have risen. The NPC specialist explained, “There are many branches in archeology, including a fairly recent branch known as bio-archeology, whom someone described as being able to test the contents of your stomach and knowing what you have had for breakfast! There were also genetic studies of pigs from various parts of Islandic Southeast Asia, and from there migration patterns of humans were deduced (since pigs do not swim, they were most likely brought along by humans). Even as a Deputy Director relatively new to management practices, his enquiring mind and leadership skills have brought new perspectives to many of the issues relevant to JCI.


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In Focus

SALUBRIS

January / February 2011

BIOMARKERS FOR BREAST CANCER TREATMENT

With the recent passing of the annual Breast Cancer Awareness Month and coming of the new year, it is perhaps timely to review a wish list that is common to breast cancer specialist doctors and patients coping with this condition.

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We wish to be able to diagnose breast cancer at the earliest stage and detect recurrence before harm occurs.

3

We wish to predict which treatment will benefit a patient and which will be futile, allowing personalised therapy.

We wish to be able to predict which patients will suffer a relapse after surgical treatment and thus require further adjuvant therapy. Similarly, we want to know which patients are cured by surgery alone and spare them unnecessary treatment.

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PREDICTIVE BIOMARKERS address Wish 3. Estrogen/Progesterone receptors and HER2 are established markers found on breast cancer cells which strongly predict for response to hormonal therapy and anti-HER targeted therapy (such as trastuzumab and lapatinib) respectively. Intensive research efforts are underway globally to develop other markers which can predict response to commonly used chemotherapy agents with the hope of selecting the correct drug for the individual patient. Many candidate markers were tested in single arm studies from which definite conclusions on the predictive value of these markers cannot be drawn.

iomarkers are substances produced by normal tissues in minute quantities and secreted in excess by cancers. They include circulating tumour products in bodily fluids as well as protein and genes expressed by cancer cells.

For the past 40 years, biomarkers had captured scientific and public attention and led to hopes that the above wish list may be fulfilled. Biomarkers can be classified by its utility — diagnostic, prognostic or predictive. DIAGNOSTIC MARKERS address Wish 1. The best known diagnostic breast cancer markers include CA153 and CA27.29. Both tests detect a transmembrane glycoprotein which becomes overexpressed in breast cancer cells. However, CA153 has a sensitivity of only 9-38% for early disease detection and will thus miss majority of early breast cancers. Hence, they shall not be used as screening or diagnostic tools and the public shall not take a normal test to mean that there is no cancer. They can however be sometimes useful to monitor response to palliative chemotherapy in patients with advanced breast cancer. PROGNOSTIC MARKERS address Wish 2. The most important treatment for early breast cancer is surgery but some patients still face recurrence after cancer. More recently, a test known as Oncotype Dx is used to express a panel of genes in breast cancer specimens. It helps to predict the risk of recurrence in women diagnosed with breast cancers which have not spread to lymph nodes and which are hormone receptor positive breast cancer. The expression level of several sets of genes in the tumour allows for the assignment of a recurrence score. A low recurrence score is associated with a ten year risk of relapse in organ site below ten per cent. Furthermore, the low score shows that patients will not benefit from combination adjuvant chemotherapy and hormonal therapy compared to hormone therapy alone. A number of prognostic tests involving gene expression are under investigation, including Mammaprint and the Rotterdam signature. Tumour expression levels of proteins such as urokinase plasminogen activator (uPA) and plasminogen activation inhibitor 1 (PAI-1) have also been measured to predict the risk of recurrence in early stage lymph node negative breast cancer. Low expression levels of the two proteins in tumour tissue is associated with low risk of recurrence. This assay requires fresh or frozen tumour tissue and may be affected by prior biopsy, and as such has not gained wide acceptance locally.

A promising area of biomarker research involves pharmacogenomics, which deals with the inheritance and genetics behind drug response and metabolism. A prominent example is the enzyme CYP2D6, which converts tamoxifen to its active metabolites endoxifen. Detection of genetic variants coding for this enzyme could identify patients with impaired activation and hence reduced response to tamoxifen, a commonly used drug used to treat early and advanced hormone receptor positive breast cancer. As we bid 2010 farewell and step into the new year, we are still a distance away from fulfilling our biomarker wish list. The optimal utilisation of biomarkers may involve consideration of a panel of markers pertaining not just to the tumour, but also patient factors.

By Dr Wong Nan Soon

Senior Consultant Department of Medical Oncology NCCS


AESTHETICS IN HEAD AND NECK CANCER

When we see a face, more often than not, what catches our attention is its aesthetic appeal. But to all of us, its importance is beyond that. In fact, its importance transcends every aspect of our being – from physical to functional to even cognitive behaviour.

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hysically, the face is the most prominent part of the body and provides a person’s sense of identity; functionally, it animates emotion, communication and intellect, and provides the essential access routes to the respiratory and gastrointestinal systems; cognitively, the region is the sole source of vision, hearing, taste and smell. Thus, facial disfigurements following head and neck cancer extirpation have the potential to cause multiple problems and psychosocial dysfunction.

Reconstructive surgery for head and neck cancer helps to minimise the trauma one may face in such an episode. It aims to establish anatomic normality as close as possible following disfigurement to optimise functional and aesthetic outcomes and the potential for normal psychosocial patient reintegration. In the past, regional pedicled flaps, such as the pectoralis major or deltopectoral flaps, in combination with local flaps and non-vascularised grafts , were the workhorses in head and neck reconstruction. They provided the only means by which larger or more complex facial defects could be reconstructed. Unfortunately, significant donor site morbidity, extensive scarring and contractures causing functional and aesthetic problems often plagued these patients. The development of microsurgical free tissue transfer, or otherwise commonly known as “free flaps”, in the late 1970s heralded a new age for head and neck cancer surgery. It has since matured into a reliable reconstructive option that has revolutionised the ability of surgeons to address increasingly difficult defects with improved outcomes. Surgeons are now better able to design flaps that meet exacting reconstructive demands. The volume and type of tissue that can be brought into the head and neck region are substantially increased with free flaps. Defects that previously did not allow reconstruction can now be reliably replaced with free flaps to achieve primary wound healing.

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Under The Microscope

SALUBRIS

January / February 2011

By Dr Tan Ngian Chye

Consultant Department of Surgical Oncology NCCS

These developments enable head and neck surgeons to be more aggressive in tumour resections, which translate to better local control of disease compared with the era before the routine use of free flaps. Today, it is the accepted standard of care for head and neck reconstruction after tumour ablation. Numerous large studies have demonstrated free flap survival rates beyond 95%.

But what does microsurgical free tissue transfer consist of? A free tissue transfer is actually an autogenous vascularised transplant. This involves: (1) harvesting of a patient’s own normal tissue with its blood supply, (2) completely detaching it from the donor site, (3) and transferring it to the recipient site, revascularising it under the microscope.

Continued on page C2.


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Under The Microscope

SALUBRIS

January / February 2011

AESTHETICS IN HEAD AND NECK CANCER

Continued from page C1.

There are two broad indications for microsurgical free tissue transfer in head and neck oncologic reconstruction. Firstly, it is indicated when the size or complexity of the defect is outside the reconstructive bounds of conventional techniques involving local flaps, regional flaps and/or various grafts. For example in oral cavity cancers, resection can sometimes result in huge through-and-through skin defects that are impossible to reconstruct with regional or local flaps. In this instance, a microsurgical free tissue transfer of the anterolateral thigh flap will be able to address this issue. Secondly, free tissue transfer is also advised when it can offer definite advantages over standard techniques. This is indicated in segmental mandibular resection, where jaw bone from the lower face is resected. The mandible shapes the lower third of the face and functionally contributes to swallowing, chewing and speaking. A segmental mandibular defect, or inadequate reconstruction of such a defect, may therefore cause aesthetic, functional and psychosocial morbidities.

The various long-established mandibular reconstructive methods are limited by being non-vascularised or pedicled to surrounding tissues. Although such reconstructions produce reasonable results, they are still unable to address many concerns of the patient and surgeon. With microsurgical techniques nowadays, we are now able to utilise the fibula osteocutaneous flap for free tissue transfer. This allows replacement of “like for like” tissue, whereby the resected mandibular bone is replaced with the fibula bone. Such reconstruction enables us to improve both the aesthetic and functional outcome of head and neck cancer patients.

Secondary surgical revision of the transferred microsurgical free flaps is another important approach of improving the aesthetics in head and neck cancer. Many cancer patients who have undergone oncological resection and free flap reconstruction still suffer tremendously from the effects of these major surgeries. This is when secondary revisions may come in useful to further restore the patient’s look aesthetically and at the same time, solve problems like excessive drooling. Such revisions, usually only minor surgeries, can produce enormous improvements for the patient. It is important to note that although current microsurgical principles and techniques have allowed vast improvements in head and neck reconstructive surgery, we still strive to refine these techniques to further improve outcomes for our patients with this debilitating disease.


“THAT DON’T KILL ME, MAKES ME STRONGER” – KANYE WEST

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Spotlight

SALUBRIS

January / February 2011

By Dr Gopal Iyer

A MSKCC Experience

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hree o’clock on a Sunday morning, in the height of winter, my beeper wailed incessantly, ending my well-deserved sleep.

An oncology patient had a nosebleed and the urgent care unit wanted a head and neck assessment. I dragged myself up, ‘accidentally’ waking my wife with the cursing and swearing and trudged out in the snow at -10 degrees. The only thought that went through my mind was “Why am I doing this to myself?” I was too old for this, and if I were back in Singapore, I would have a houseman, medical officer or registrar do this for me. Unfortunately, at Memorial Sloan-Kettering Cancer Center, the head and neck fellowon-call IS the houseman, MO, registrar and junior consultant all rolled into one nearly frozen package. The whole process of assessing the patient, stopping the bleeding and getting back to my apartment took a mere 15 minutes. I returned home chilled to the bone, slumped on the couch and my mind raced into the events of the previous week. I had been in the hospital from 6.30am to 8pm almost every day that week, except on Wednesday when I only reached home at midnight. That was alas a typical week as I was working for Dr Jatin Shah, the godfather of head and neck surgery in the world. Outpatient clinics for that week were intense as Dr Shah was in between overseas trips. I had to keep up with his usual “bullet train pace” which one would expect from a 18 year old hotshot, not a 70 year old gentleman. Notwithstanding his speed, it was his precision, thoroughness and attention to detail that was amazing to observe and participate in.

Associate Consultant Department of Surgical Oncology NCCS

My job was to evaluate, assess and examine all patients with him, to pre-load all imaging which comes in numerous formats and platforms, to dictate the cases, fill out billing forms, and at the same time to answer questions on how best to manage complicated cases – all these, in the presence of visitors or observers to the department! This week was a typical gamut of new patients including a poor farmer’s son from Colombia with a massive osteosarcoma involving his mandible and maxilla who required surgery. Dr Shah pulled me aside and told me that he needed me to start this case and proceed with tumor resection, as he had a VVIP flying in on the same day for a consult. We discussed the procedure and surgical approach using the available CT scans and a skull model. He also pulled out his unending series of photographs collected through his illustrious career and found a similar case which he did four years prior and used the photos to go through the procedure with me, and exactly how he wanted me to proceed, including step-bystep photo documentation as I go along. Continued on page C4.


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Spotlight

SALUBRIS

January / February 2011

“THAT DON’T KILL ME, MAKES ME STRONGER” – KANYE WEST

Continued from page C3.

It was a mouth-watering case for most head and neck surgeons but operating on a 14-year-old who had flown all the way to be operated by the great Jatin Shah added some pressure. Sensing my concern, he added “Don’t worry, you are ready for this.” How did they know if you are ready for anything? I trained in a place 10,000 miles away, which most Americans think is part of China. How is it they have so much faith in their own selection process and trust a young upstart like me? I had come to believe that Dr Shah had suddenly been leaving me alone to operate since my second week of being with him. Their process was far more involved yet subtle than I had previously realised. Prior achievement was only an entry criteria, as was the interview process. In fact Dr Shah confessed that he sometimes worries about candidates with ‘too much research credentials’ as they might not have the necessary clinical and operative skills. Apparently I fell under that category. There was also, apparently, much happening behind the scenes and unsurprisingly, my abilities and inabilities had been a topic of discussion between Dr Shah and Prof Soo Khee Chee, who was also a fellow under Dr Shah many years ago. The actual relinquishing of surgical responsibility was a more gradual process and I appreciated that. Years of didactic experience gives them the ability to quickly size up a trainee and craft a training plan which includes when to let go and when to reel in. My sudden independence was hardly real. It was truly a gradual process, as I surmised. It was a process of scrutinising the lightest of actions: tissue handling, an appreciation of tissue planes, basic techniques such as suturing, hemostasis, keeping a clean field and most of all being safe. These were valuable lessons I learnt in teaching and training surgeons. The last technique was much more obvious. Dr Shah usually sits in the surgeons’ common room clearing his paperwork with a keen eye on the CCTV. The moment the fellow takes one too many look at the door each time someone comes in, he knows its time to go in and ‘rescue’ the fellow! He is also brutally honest about the fellows’ abilities and inabilities. Indeed, it was shattering for me to be told on my first week with him that I operated like a ‘carpenter’ with no finesse or subtlety. I vowed to prove him wrong. Fast forward to 17 June 2010: Graduation night at Cipriani’s, one of New York’s institutions for fine dining for the rich and famous.

My sudden independence was hardly real. It was truly a gradual process, as I surmised. It was a process of scrutinising the lightest of actions: tissue handling, an appreciation of tissue planes, basic techniques such as suturing, hemostasis, keeping a clean field and most of all being safe. These were valuable lessons I learnt in teaching and training surgeons. DR GOPAL IYER

We had survived the fellowship and calls and all the trials and tribulations that it entailed. I had managed to clock up more than 600 operative cases, and a respectable number of publications – a total of 4 research papers, 4 review papers and 6 book chapters. The former was my main aim of the fellowship, which was to compress five years of advanced head and neck surgery experience into one. The latter was just to keep score with Prof Soo’s achievements when he was a fellow at MSK. To my amazement and disbelief, I was bestowed the night’s biggest honour, the Michael E Burt award for clinical excellence. As I staggered to the stage to accept the award, my thoughts went back to the winter nights of trudging back to the hospital in the snow, and perhaps had I known that this would be the reward, I would have sworn a little less and not woken my wife up!

In my thank you speech, I remembered to thank her for those sleepless nights I was responsible for; and to Prof Soo, for first telling me that there was a place called Memorial Sloan-Kettering Cancer Center when I was a wee third year medical student.


SELF-TALK, TALK TO YOUR CELLS

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Cancer survivor Ezzy Wang shares how he stays positive

SALUBRIS

People January / February 2011

Guangzhou, 16-17 Dec – The sudden cold snap was an additional challenge that Ezzy Wang had to contend with during the inaugural Asian Para Games.

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espite being well-prepared for the winter games, the biting cold weather was not something Singaporeans were attuned, especially when the thermometer read a low of 2-5 degree Celsius. Even Guangzhou was not accustomed to such bitter cold and it was the city’s coldest day in 30 years. As Ezzy found out, even wearing three pairs of gloves could not prevent his fingers from turning numb. Ezzy was one of the two hand-cyclists representing Singapore at the Asian Para Games’ Road Cycling Competition. Despite the odds, he did relatively well in the trials with keen competition coming from a fellow Singaporean and six other hand-cyclists from Japan, Korea, China and Lebanon. It pushed him to clock a personal best timing of 32.44 minutes doing 13.6km. On the actual race day, the weather was much kinder, at a cool 14 degree Celsius with a clear blue sky. Ezzy was positioned 6th.

Though he returned without a trophy or medal, 44-year-old Ezzy took it in his stride. He saw it as an invaluable experience being in the Games Village. Looking at other athletes including some who lost their sight or other limbs, he realised that he was better off in many ways. He still has one leg and is able to do many more things that others cannot. After the trip his wife told him, “Dear, if you do have a disadvantage, you’re certainly not showing it.” In fact, with his positive demeanour, it is easy to overlook the fact that Ezzy has only one leg. He was first diagnosed with “synovial chondromatasis”, a mass disorder of the pelvis due to leakage of bone calcium. Unfortunately, the condition mutated to a rare bone cancer called “chondrosarcoma of the pelvis”. Ezzy had to remove his right pelvis which seemed fine for three years before he suffered a relapse. This time he had his entire right leg amputated.

For many, amputation may be one of the hardest decisions they will ever have to make. But for Ezzy, there was only going to be one outcome. He said, “I know it has to be done as no treatment is 100 per cent foolproof. I have the utmost confidence in my surgeons’ decisions.” Eleven years hence, Ezzy not only drives to work but he gives his wife a ride to her office. He also finds the time to exercise daily. He believes that nothing is impossible. Although he can no longer participate in track and field sports or play basketball (because he does not want to be in a wheelchair), he had successfully attained a scuba diving certificate. “I just have to think of sports that will suit me,” he said matter-of-factly. Now, he cycles every day, with his hands. Ezzy would like to participate in the next Asia Para Games again, in celebration of the “can do” spirit. He has this advice to fellow cancer survivors, “Think positive, be positive. There is a relationship between your mind and your cells. Your cells in your body will react based on your thinking.”

By Chua Hwee Leng


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Community

SINGING AWAY THE BLUES…

SALUBRIS

January / February 2011

What better way to celebrate the season to be jolly than a rousing entertainment for the patients and staff at the National Cancer Centre Singapore in the last two weeks to Christmas.

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he singers and musicians certainly brought smiles to the audience, some of whom also clapped and sang with the performers. First to spread the Christmas joy was Ms Corrine Gibbons and her choir of amateur but talented singers on 8th Dec. Together with John Hamilton, Rob White, Sumitra Pasupathy, Kevin Hardy, Nina Pillai, Bojan Tercon, Louise Parr and Zoe Johnson, several of whom took time off from work, they were here to do their bit for the patients. Formed just weeks prior to the show, their vocal chords captivated the appreciative audience.

“The performance was very good and lightened up the whole atmosphere,” commented Madam Kum, an NCCS patient. The following day, the NCCS public area was engulfed by the angelic voices of students from St Hilda’s Secondary School. Under the baton of music director Ms Joanna Paul, they charmed the waiting patients and staff alike.

Ms Paul, who has spent 32 years teaching and performing music as well as conducting, played the electric organ, while her students sang traditional Christmas songs. The third performance on 16th Dec was by students from the Singapore American School who arrived in green and red – colours of Christmas. The 14 students formed a miniorchestra that consisted of choral singers, violinists, clarinetists and flutists. The group also performed at the Morning Glory Suite to cheer the patients who were receiving chemotherapy. This performance was arranged by student Preeti Varathan. The 17-year-old had months earlier held a solo Carnatic violin concert in New York to raise funds for NCCS research projects.

Said a patient who caught one of the performances, “Christmas is the season of sharing, giving, caroling and caring. It is nice that I get to enjoy the Christmas mood despite being in a hospital.” He left with a smile. By Mark Ko


LIVING LIFE TO THE FULLEST

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Community

SALUBRIS

January / February 2011

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nstead of the usual formal setting, there was mirth and laughter at the NCCS patient waiting area when it turned into a party venue on 18th December 2010. On hand were 172 cancer survivors, caregivers and staff from NCCS patient support groups. It was time to celebrate 2010 and to welcome the New Year. The gathering which included food, performances and lucky draws, was an important event for many friends to catch up with one another. It was here that they shared their many experiences and showed just how far they had come since they were first diagnosed with cancer. It was a sight to behold to see so many survivors whose presence was testimony of the good work done by NCCS doctors.

HERE’S A SAMPLE OF WHAT THE SURVIVORS HAD TO SAY: “The Exhibition Corner was a new item in the year end party this year. We wanted to showcase the creative talent of our members in addition to the usual party fare of food and lucky draw. Members who visited the Corner were impressed with the painting, handicraft, poems and deco arrangement, and many expressed their wish to join the classes to learn the art of making them. Yes, this is our ultimate aim – that members are motivated to discover the joy of immersing in art and craft, living life to the fullest, despite cancer.” – WAI CHENG

“It was a party organised by the survivors for the survivors in an atmosphere filled with the spirit of fun and teamwork. It all goes to show that despite cancer we are all able to continue to lead a full and happy life.” – T.C.

“We celebrated another year of our survival by having fun and showcasing our artistic and musical talents through dance and song. I think it was the bonding with fellow survivors and the networking across the support groups that I appreciated most amidst the revelry.” – LAI ORE

“I was particularly touched by a patient I had invited. He and his wife, in spite of being held back by unforeseen as well as difficult circumstances, turned up at the end of the party to thank me. He was comforted to learn from the massive turnout that there were many others like him.” – MERLE

By Chua Hwee Leng


MANY HELPING HANDS

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NCC Foundation

SALUBRIS

January / February 2011

We all lead such busy lives whether we are working a full time position, married or dating, taking care of the kids or going to school. Our lives feel complicated and rushed, sometimes not even being able to keep our heads on straight to look forward to what lies ahead of us.

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hristmas is always a busy time for many people, but some were looking for more meaning in their holiday. That was what some 89 people did last Christmas when they answered NCCS Foundation’s call for volunteers to help with gift wrapping to raise funds for cancer research at both Borders Bookstores from 10am to 10pm daily. From 26 Nov to 24 Dec, NCCS and Borders Bookstore worked together to raise the much needed funds for cancer research in their first collaboration. Patients and survivors also chipped in by allowing their artwork to be printed on gift cards which sold for a minimum of $1 donation to NCC Research Fund. NCCS staff from the Research departments, Human Resource, Department of Radiation Oncology, Healthcare Performance Office, Service Quality Management Unit and Corporate Communications also volunteered their time over weekends and after work hours to wrap gifts for customers at Borders. After countless paper cuts on their fingers, sore and tired feet from many hours of standing and acceding to the demands of customers, the volunteers raised $10,053 for cancer research. Between the two Borders stores, the volunteers wrapped more than 15,000 books and other gifts. A BIG THANK YOU, to all the volunteers and Borders staff who have helped in this meaningful project.

It is not difficult for many people to give back to the community; they open their checkbook, write a dollar amount and sign it over to the charity of their choice. They give annually because they know their money can help. However, charities do not live by money alone; they need the help of volunteers. Barbara Bush once said, “Giving frees us from the familiar territory of our own needs by opening our mind to the unexplained worlds occupied by the needs of others.” Giving should be a way of life. Giving makes you part of a community. You see the world for what it really is, and you become aware of problems plaguing our society you may not have been aware of.

By Flora Yong

Manager Community Partnerships and Fund Raising, NCCS

“Successful people are always looking for opportunities to help others. Unsuccessful people are always asking “What's in it for me?” BRIAN TRACY

Editorial Advisors Dr Kon Oi Lian Prof Soo Khee Chee Executive Editors Ms Chua Hwee Leng Ms Veronica Lee Mr Sunny Wee

Contributing Editor Dr Wong Nan Soon

Medical Editor Dr Richard Yeo

Members, Editorial Board Mr Mark Ko Ms Sharon Leow Mr Joshua Tan Dr Shiva Sarraf-Yazdi Ms Flora Yong

Members, Medical Editorial Board Ms Lita Chew Dr Mohd Farid Dr Melissa Teo Dr Teo Tze Hern Dr Deborah Watkinson Cover Illustration: Roy Foo

SALUBRIS

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.

NATIONAL CANCER CENTRE SINGAPORE Reg No 199801562Z

11 Hospital Drive Singapore 169610 Tel: (65) 6436 8000 Fax: (65) 6225 6283 www.nccs.com.sg


NCCS Salubris Issue No. 14 (Medical Edition)  

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

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