better treatment options now for ovarian cancer

Transcription

Issue No. 29 • MICA (P) 140/03/2014
AN NCCS QUARTERLY PUBLICATION
April – June 2014
...HELPING R E A DER S TO ACHIEV E GOOD HE A LT H
Salubris is a Latin word which means healthy, in good condition (body) and wholesome.
BETTER TREATMENT
OPTIONS NOW FOR
OVARIAN CANCER
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SALUBRIS APRIL – JUNE 2014
CYTOREDUCTIVE
SURGERY AND
HYPERTHERMIC
INTRAPERITONEAL
CHEMOTHERAPY –
A VIABLE OPTION
FOR ADVANCED
OVARIAN CANCER
BY DR CLARAMAE CHIA AND DR MELISSA TEO
Division Of Surgical Oncology
Ovarian cancer is the 5th commonest cancer
amongst females in Singapore. There are
390 cases diagnosed yearly based on the
Singapore Cancer Registry 2008-2012. It
is the second most common female genital
tract cancer. Epithelial ovarian cancer usually
affects older women although it can also
happen to younger women.
M
ost patients with ovarian cancer present with
seemingly innocuous symptoms of abdominal
distension and discomfort at the onset. Other
common presentations may be the presence of a
pelvic mass, urinary urgency or frequency, nausea, anorexia and
early satiety. As the symptoms are not specific, patients may be
treated or worked up for other conditions before and hence are
often diagnosed at an advanced stage, with 60–70% presenting with
disease that has spread from the ovaries 1. 75% have International
Federation of Gynecology and Obstetrics (FIGO) stage III disease
(within the peritoneal cavity or involving para-aortic, pelvic, or
inguinal lymph nodes) and FIGO stage IV disease (beyond the
peritoneal cavity, including lung and liver parenchyma) 2.
Patients usually undergo blood tests that include the tumour
marker CA125. Imaging involves an ultrasound or CT of the
abdomen and pelvis to evaluate masses or distension as well as
evaluate the liver for metastasis. A CT chest may be done to look
for lung metastasis or pleural effusions.
Surgery remains the cornerstone of management
for ovarian cancers, as it is often required
initially to obtain a diagnosis, to formally
stage the patient, and is also the mainstay of
treatment in the majority of diagnosed cases.
In the advanced cases, it is followed by
adjuvant chemotherapy with platinum-based
and taxol-based chemotherapy.
The definition of optimal cytoreduction has evolved with the
initial definition of residual tumour less than 2cm being adjusted
to tumour less than 5mm. Over the years, there has been a
plethora of data concluding that complete cytoreduction, with no
gross residual disease, yields the best results in terms of survival.
Patients with no gross residual disease, 0.1–2cm residual disease,
and more than 2cm residual disease had 5-year survivals of 60,
35, and less than 20%, respectively 3,4.
For patients who have not metastasized to the lung or liver,
the disease remains confined to the peritoneal cavity and
retroperitoneal lymph nodes for much of its natural history
and hence, it is a good candidate for aggressive locoregional
therapy. Ovarian cancer is prone to spreading to peritoneal lining
and many patients may be found to have peritoneal disease
on preoperative imaging or during surgical exploration. When
the disease recurs, a large proportion of them also tend to be
in the peritoneum. Complete cytoreduction is the treatment of
choice. Recently, cytoreductive surgery (CRS) with peritonectomy
and hyperthermic intraperitoneal chemotherapy (HIPEC) is
increasingly being performed. CRS aims to remove all the visible
tumours in the abdomen. Intra-abdominal organs that are invaded
by tumour and can be safely removed will be resected to ensure
that no disease remains. Peritoneum that is commonly removed
includes the peritoneum in the pelvis, under the diaphragm and
the paracolic gutters (the right and left flanks of the abdominal
cavity where the colon lies).
HIPEC was first introduced in the early 1980s for the treatment of
peritoneal carcinomatosis. CRS and HIPEC for the management
of peritoneal surface malignancies were popularised by Dr
Sugarbaker in the 1990s 5. The addition of hyperthermia to
the intraperitoneal chemotherapy has been shown to increase
penetration of the chemotherapy and improve its absorption into
the tumour cells, increasing the intracellular accumulation of
the drug. The cytotoxic effect appears to be similarly potentiated,
secondary to an impairment of the cells’ ability to perform DNA
repair, hence has a greater deleterious effect.
HIPEC is performed intraoperatively under general anaesthesia
after cytoreductive surgery, via a pump that maintains
the temperature and circulation of the drug solution. This
ensures that the entire peritoneal surface is bathed in the
chemotherapeutic agent, prior to the formation of obstructing
adhesions that may develop in the postoperative period.
Cisplatin is the drug that is commonly used for ovarian cases.
The most important prognostic factor remains the completeness
of cytoreduction, with a 5.5% increase in the median overall
survival for every 10% of patients undergoing optimal
cytoreduction, leading to the inevitable conclusion that the
changing surgical paradigm for ovarian cancer embracing
radical CRS has resulted in significantly better survival results 6.
The combination of CRS and HIPEC has shown promising
results, with median overall and progression-free survivals of
up to 64 and 57 months, respectively 7. Optimal cytoreduction
yields 5-year survivals of 12–66% 8.
The time points at which CRS and HIPEC have been used
in the management of advanced ovarian cancer include the
primary setting, after neoadjuvant chemotherapy, at the point of
recurrence, and as a second-line treatment. In the Milan 2006
consensus statement, it was concluded that CRS and HIPEC
could be feasible at all the abovementioned time points.
The morbidity and mortality for such a procedure range from 0 to
40 and 0 to 10%, respectively, and include nausea and vomiting,
gastrointestinal disturbances and ileus, anastomotic leaks,
perioperative bleeding, pleural effusions and pneumothoraces,
intra-abdominal collections/ abscesses, and sepsis. The key is in
patient selection, and it is imperative that patients with a good ECOG
and an ability to tolerate such a radical procedure be chosen. The
best candidates have long disease free intervals prior to surgery and
low volume disease that can be confidently optimally debulked.
NCCS has been performing CRS and HIPEC since 2001. In 2013, we
published our data on our initial 100 patients 9. Between 2005 and
2013, our unit has performed 55 cases of cytoreductive surgery and
HIPEC for patients with recurrent ovarian cancer. The median age
of the patients was 51 years old. The median SICU stay was 1 day
(range 0-15 days) and the median hospital stay was 16 days (range
8-188 days). The median disease free interval was 19.7 months.
We had no 30-day mortalities and the morbidity rate was 57.4%.
These rates are comparable to other major oncological surgeries
such as hepatectomies and esophagectomies.
The 1, 3 and 5 year overall survival rates are 91.6%, 56.5% and
56.5% respectively. The 1, 3 and 5 year disease-free survival rates
are 69.9%, 16.8% and 8.4% respectively. Without HIPEC, the 5-year
overall survival rate has been shown to be 11.5%. A higher PCI score
and a CC score of 1 or 2 were associated with a worse overall and
disease free survival.
In spite of the improved survival and acceptable morbidity and
mortality of cytoreductive surgery and HIPEC, concerns about the
quality of life for survivors remain. Multiple papers including our
own unit’s data, has shown that the quality of life drops initially after
surgery but returns to baseline or higher after 2 years 10. While we
compared our patients to a group of comparable advanced cancer
patients who were undergoing chemotherapy, our patients generally
had a better quality of life.
In conclusion, ovarian cancer is a common
gynaecological cancer and many patients present
at a late stage as the symptoms are non-specific.
Cytoreductive surgery and HIPEC with the aim of
no residual disease is a procedure that has improved
overall and disease free survival rates. It can be
considered as a viable option for patients who
present with peritoneal disease from ovarian cancer.
REFERENCES:
Coleman RL, Monk BJ, Sood AK, et al. Latest research and
treatment of advanced-stage epithelial ovarian cancer. Nat Rev
Clin Oncol 2013; 10:211–224.
2
Young RC, Decker DG, Wharton JT et al. Staging laparotomy in
early ovarian cancer. JAMA. 1983;250(22):3072.
3
Fotopoulou C, Savvatis K, Kosian P, et al. Quaternary cytoreductive
surgery in ovarian cancer: does surgical effort still matter? Br J
Cancer 2013; 108:32–38. doi: 10.1038/bjc.2012.544.
4
Chang SJ, Hodeib M, Chang J, Bristow RE. Survival impact of
complete cytoreduction to no gross residual disease for advancedstage ovarian cancer: a meta-analysis. Gynecol Oncol 2013;
130:493–498.
1
Mohamed F, Cecil T, Moran B, Sugarbaker P. A new standard of
care for the management of peritoneal surface malignancy. Curr
Oncol 2011; 18:e84–e96.
6
Kang S, Park SY. To predict or not to predict? The dilemma
of predicting the risk of suboptimal cytoreduction in ovarian
cancer. Ann Oncol 2011; 22 (Suppl. 8):viii23–viii28. doi:
10.1093/annonc/mdr530.
7
Biliatis I, Haidopoulos D, Rodolakis A, et al. Survival after
secondary cytoreduction for recurrent ovarian cancer: which
are the prognostic factors? J Surg Oncol 2010; 102:671–675.
5
Chua TC, Robertson G, Liauw W, et al. Intraoperative hyperthermic
intraperitoneal chemotherapy after cytoreductive surgery in EOC
peritoneal carcinomatosis: systematic review of current results. J
Cancer Res Clin Oncol 2009; 135:1637–1645
9
Teo MC, Tan GH, Tham CK, Lim C, Soo KC. Cytoreductive surgery
and hyperthermic intraperitoneal chemotherapy in Asian patients:
100 consecutive patients in a single institution. Ann Surg Oncol.
2013 Sep;20(9):2968-74.
10
Tan WJ, Wong JF, Chia CS, Tan GH, Soo KC, Teo MC. Quality of
life after cytoreductive surgery and hyperthermic intraperitoneal
chemotherapy: an Asian perspective. Ann Surg Oncol. 2013
Dec;20(13):4219-23.
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SINGAPORE CTC CoRE –
PAVING THE WAY
FOR BETTER CANCER
MANAGEMENT
What if we tell you that in the near future,
medical treatments will be personalised to
ensure that they are effective, efficient and
minimises discomfort during treatment?
DIAGNOSIS
BY EDWIN YONG
Executive
Corporate Communications
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TREATMENT DECISION
TRADITIONAL
CANCER
DIAGNOSIS
TUMOUR BIOPSY
CANCER
DIAGNOSIS
WITH CTCS
TUMOUR BIOPSY
“LIQUID BIOPSY”
REAL-TIME FEEDBACK
For cancer patients, the road to recovery is
a long, enduring journey. Not only do they
have to bear the emotional stages of their first
diagnosis, the agony of chemotherapies and
operations are no less easy to pass. Mindful
of the woes of our patients, NCCS looks to
continuously refine our treatment processes
through research and collaboration.
TREATMENT DECISIONS BASED ON RESULTS
With the new technology, cancer cells can be harvested from
a regular blood sample without the need for complicated
procedures to obtain cells from tumours. To determine whether a
treatment is viable, blood samples will be drawn from the patient
pre- and post-treatment. Through separation of cancer cells from
other blood components, the number of cancer cells are counted
and documented. If there is no reduction in the number of cancer
cells, the oncologist may decide to modify the treatment regime to
best combat the cancer. These diagnoses will result in an increase
in treatment effectiveness in cancer therapy management, and will
also lead to reduced side effects and significant cost savings.
T
he Circulating Tumour Cell Centre of Research
Excellence or CTC CoRE in short, has begun works
to develop such treatments since late last year. The
end objective of the research is to facilitate the use
of circulating tumour cells (CTCs) 1 in clinical diagnostics,
which will allow better healthcare for cancer patients.
Lee, G.Y. and C.T.Lim, trends Biotechnol, 2007
1
Circulating Tumour Cells will potentially provide key
information in determining treatment effectiveness
through real time monitoring and post treatment diagnosis.
The collaboration between National Cancer Centre Singapore
(NCCS) and Clearbridge BioMedics, in partnership with the Pathology
Department at Singapore General Hospital (SGH) is still in its initial
phases and if successful, this will boost NCCS’ position as a centre for
cancer management, as well as enhance Singapore’s reputation as an
oncology thought leader in Asia.
CTCs are cells that have detached from a primary tumour and are circulating in the blood stream. They are rare, with only a few CTCs mixed with billions of blood cells per milliliter of blood.
“This is the age of personalised
medicine, and it’s important to be
able to tailor the treatment that we
give to patients based on the profile
of the tumours that they have,” said
Professor Soo Khee Chee, Director
of NCCS during the CTC CoRE
press conference.
The CTC CoRE team (from left): Prof Lim Chwee Teck,
co-founder of Clearbridge BioMedics and also newly
appointed NUS Provost’s Chair, NUS Faculty of Engineering;
Mr Johnson Chen, CEO of Clearbridge Biomedics; Assoc
Prof Tan Puay Hoon, Head & Sr Consultant, Department of
Pathology, SGH; and Prof Soo Khee Chee, Director of NCCS.
A technician at the CTC CoRE.
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PROTEIN ANP32E GENE
REGULATOR: THE KEY
TO GENETIC DISCOVERY
BY EDWIN YONG
Executive
Corporate Communications
Imagine a day when doctors are able to
foresee potential diseases and provide
the absolute treatment to every individual
through the study of their DNA structure.
This scenario may no longer be a fantasy.
A team of scientist from the National
Cancer Center Singapore (NCCS), the
Institut de Génétique et de Biologie
Moleculaire et Cellulaire (Strassbourg
France), and the Institut Albert Bonniot
(Grenoble, France) has made an important
finding on how genes are regulated, a big
step towards that vision. The study was
released on January 30, 2014 and was
published in the notable peer-reviewed
journal, Nature.
T
he discovery was found using a genetically modified
mouse that was developed by Dr Patrick Reilly, a
Senior Scientist in the Laboratory of Inflammation
Biology at NCCS, to demonstrate that DNA
architecture in the living cell is maintained in part by a protein
called ANP32E. The ANP32E or Acidic leucine-rich nuclear
phosphoprotein 32 family member E is a protein in humans.
“While DNA is normally represented as a two strands
forming a helix, the actual amount of DNA in the cell
means that these strands must be compacted into complex
structures, called chromatin, which restricts the DNA
volume while still allowing access to encoded information,”
said Dr Reilly.
The ANP32E protein has the ability to remove a specific
component of the chromatin known as H2A.Z, which has
been previously known as an important element in controlling
specific regions of DNA expression. The removal of H2A.Z
will alter the gene expression and provide more insights to the
chromatin structure.
Over the recent years, researchers have discovered that errors
in chromatin structure are usually found in a wide array of
developmental diseases as well as in all types of cancers. Through
understanding the processes controlling chromatin structure,
the research aims to improve our tools for timely regulation of
specific genes, thus reversing the impact of many diseases and
could reveal novel therapeutic strategies in the long run.
“While DNA is normally represented as a two strands forming a helix, the actual
amount of DNA in the cell means that these strands must be compacted into
complex structures, called chromatin, which restricts the DNA volume while still
allowing access to encoded information.”
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ENREACH RETREAT: HEALING
THE BODY, MIND AND SOUL
STEPPING INTO CLINICAL
TRIALS WITH MR YOW
BY BRANDON GOH
Manager
Department of Psychosocial Oncology
A persistent cough that just wouldn’t go away for
months, Mr Yow froze to the ground when he was told
to be suffering from stage 4 lung cancer with barely
three months to live. Apart from the contrary, the
70 years old retired teacher doesn’t smoke or drink.
Thirteen months and counting, Mr Yow has been
experiencing better health, good appetite and had also
travelled to China during the recent period. EDWIN
YONG catches up with Mr Yow after his sharing
session at the EnReach Retreat.
The signature event of NCCS’ Patient Support Programmes was
the brainchild of A/Prof Koo Wen Hsin. The idea of providing
patients and caregivers with a short respite from their routine
lifestyles forms the foundation of the retreat. While at it, Dr
Gilbert Fan, Head of Department of Psychosocial Oncology,
and his team of medical social workers furthered his idea,
tailoring the programmes to encompass a wide variety of
knowledge sharing and educational activities. The three days,
two nights retreat has been ongoing for more than 10 years.
T
he retreat programmes range from talks to workshops that primarily focus on
three areas; medical, psychosocial and physiological aspects of cancer. The
Programmes include 1) workshop on common & chronic physiological symptoms
that patients with cancer may experience, 2) diet and nutrition workshop
on positive psychology in cancer and 3) panel discussions between participants and
oncologist, which were very well received by the attendees.
Adding wholesomeness to the event were programmes for the children. While parents
were attending talks and workshops, the kids were attended by social workers who are
cross-trained in Art Therapy. Using art as a medium, the medical social workers would then
be able to help these children process their feelings they have pertaining to their parents’
illness. The overall objective was really to provide an opportunity for children coping
with parental cancer to bond and support one another through their sharing of common
experiences. Art Therapy helps children to explore their inner and external self, promotes
the expression and release of associated feelings, and strengthens and enhances the coping
skills of each individual child.
“The EnReach Retreat is a golden
opportunity for patients and their
caregivers to experience personal
growth and transformation as they
interact with other persons affected
by cancer and hear from doctors
and allied health professionals
about how they can better manage
their medical condition.”
JOLENE GOH
Medical Social Worker
Besides the therapeutic component of the Children Programme, there were also fun games
and activities incorporated into the three days programme. The aim was to bring in the
elements of normalcy and fun in the children’s lives despite having to cope with their
parental illness. Such fun team building games also helped to promote the bonding and
trust among the children; leading to greater support for one another.
Participants were also treated to songs and dance during dinner on the second night by the
band “E Thrust” who has been supporting this retreat all these years.
Besides the knowledge acquired, participants shared how they continue to meet and
support one another, including going on holidays together, accompanying each other for
medical appointments and at times, babysitting their peer’s children. This was indeed a
touching testimonial of friendship forged during the three days that goes a long way.
Supported by Dr Yap Yoon Sim, Dr Chay Wen Yee, Dr Gilbert Fan and Brandon Goh, the successful event saw an increasing
number of participants with a total of 88 sign-ups this year. Special mentions were given to the team comprising of the
Department of Psychosocial Oncology, doctors, health professionals and volunteers who have made this event possible.
M
r Yow was diagnosed with lung cancer on 26 December
2012 after undergoing a biopsy at Khoo Teck Phuat Hospital,
draining 6.5 litres of liquid from his lungs. He was then referred
to National Cancer Centre Singapore for further treatment.
Administered with chemotherapy as a first line of treatment, he immediately
felt relieved from the persistent coughing he had earlier.
He was offered a place in a phase 3 clinical trial programme when the doctors
found his tumour grew in size after the initial treatment. The second line of
treatment adopts immunotherapy drugs on top of his standard chemotherapy
treatments. We spoke to Mr Yow on his thoughts on participating in clinical trials.
Q
What were your considerations when the doctor broached to you the
idea of being in a clinical trial programme?
YOW: A glimmer of hope was all I see. A chance towards recovery and that
pushes me to participate without hesitation. Back of my mind tells me that this is
a trial, there are risks involved but I am willing to try.
Q
A leap of faith for success is indeed a good motivating factor. So how
did you physically and mentally prepare yourself for the trials?
YOW: Be positive and have a good attitude and mindset. Support from my family
is crucial and I do have great faith in my doctors. I also do simple exercises
where permitted to help to build up my strength. A short research on my doctor
also assures me that of his credentials and capability.
Q
Q
Were there any instances that made you feel
like withdrawing from the programme?
YOW: Withdrawal was not the top list on my
mind. Though there were some discouraging news
when my tumour grew slightly in size during the
late stage of the trial. The side effects of coughing
and numbness on my legs came along too. The
doctor then suggested proceeding to the third
line of treatment since it was not working well
for me. Even through all these, I know I am not
going down without a fight and am willing to push
further towards recovery.
Q
Congratulations as we know that your
tumour has shrunk in the last diagnosis
since commencing the third line of treatment,
could you share with us your overall experience
of being in clinical trial?
YOW: I am fortunate to be offered a place in this
clinical trial programme. The medical care team has
also showered me with care and concern, answering
whatever queries I have. I would truly encourage
fellow patients to enroll if given an option, as the
doctors know your condition and will provide the
best line of treatment for your disease.
Well, a little research does help in confidence building. What were
your expectations during the trial; did the doctors pass you any
special instructions to follow?
Q
YOW: Strictly no Traditional Chinese Medicine as this might obstruct or cause
complications with the results. Other than that, the nutritionist also reminded me
to refrain from eating raw and uncooked food. I will also feedback to my doctor
of any arising side effects during the weekly consultations.
YOW: Be positive, exercise when possible and
eat normally. Cancer is not a death sentence,
giving up is.
What are three pieces of advice you would
give to patients who are considering or are
already in clinical trials?
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NATIONAL CANCER SURVIVOR’S DAY
BY GILLIAN TAN
Executive
Marketing Communications
National Cancer Survivor’s Day is observed worldwide in June annually as a celebration
of life and an inspiration to cancer patients. It serves as an important outreach to the
community in raising awareness on cancer and survivorship. Many cancers can now be
prevented and treated. With early detection and the advances in treatment, life after cancer
can continue to be meaningful and productive. Take a look at the truth about cancer:
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Poster Exhibit
Upcoming Events booth
Quiz Trivia
The Butt Stops Here
The Great Smoke Free Sale
Photo Puzzle Blocks
Interactive educational games such as “Photo Puzzle Blocks”, “Quiz Trivia”, “The Butt Stops Here” and “The Great Smoke Free Sale”
were popular among children and youths. Information on signs of cancer as well as cancer screening were shared with parents
while the children and youths were engaged in these games.
CREATING CANCER
AWARENESS IN THE
COMMUNITY
BY ALICIA PANG
Executive
Cancer Education And Information Service
Stubbing out “cigarette butts” with Velcro balls; using
giant metal chopsticks to maneuver a golf ball while
managing the arduous task of dropping it into specific
cylindrical tubes; or solving cancer informationrelated photo puzzle blocks – these are some of the
interactive educational activities that one can partake
at cancer awareness roadshows organised by the
Cancer Education and Information Service (CEIS) of
the National Cancer Centre Singapore (NCCS). With
the rising incidence of cancer worldwide, cancer
education plays an indispensable role in reducing
the frequency of late stage cancer.
T
he inaugural roadshow for the year of Horse
was held at Woodlands Civic Centre from 22
to 23 February. Fusing fun with learning, the
roadshow provided knowledge on common
cancers and emphasised the importance of adopting a
healthier lifestyle. The two day event saw an estimated
crowd of 1,000 indulging in family-friendly activities.
The public was also encouraged to sign up for upcoming
Public Forums and CancerWise workshops, and subscribe
to NCCS’ newsletter, Salubris for more insights about
cancer and related matters.
Nurses explaining to the public about FIT and BSE
Cancer screening was one of the key objectives
of the road show. With support from the
Singapore Cancer Society, colorectal Fecal
Immunochemical Test (FIT) kits were distributed
at the roadshow. Breast Self-Examination
(BSE) was taught to ladies using the silicone
breast models while BSE decals were given as
reminders to perform BSE regularly.
National Cancer Centre Singapore believes in being
pro-active when it comes to cancer awareness.
Empowering the public with knowledge is the key to a
cancer free tomorrow. After all, prevention is better than
cure, and early detection saves lives. We are looking
forward to holding more roadshows and public forums at
community centres, workplaces, schools, institutions and
faith-based organisations. If you or your organisation is
keen to share our cause, please do contact us.
All requests for health talks, roadshows and
education booths at events, institutions, or
at your workplace can be forwarded to
[email protected], or call us at 6225 5655.
With your support in the fight against
cancer, we believe we can lower the cases
of untreatable cancers in Singapore.
Health Talk
Cancer Awareness Roadshow
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海报展览
健康讲座
“问答游戏”
“把烟熄了”
照片拼图
“照片拼图”、
“问答游戏”、
“把烟熄了”和“无烟大热卖”等互动式教育游戏深受儿童和青少年欢迎。孩子沉浸于有趣
的游戏当儿，父母也有机会多了解有关癌症症状和检测的资讯。
培养社区居民
的癌症意识
彭薇洳
执行人员
癌症教育与资讯服务
随着癌症病患在世界各地的人数不断
增加，癌症教育在减少晚期癌症发生
率方面有不可或缺的作用。不少公众
在新加坡国立癌症中心癌症教育与资
讯服务主办的癌症意识路演上用魔
术帖球将“烟蒂”熄灭、以一双巨大
的筷子夹高尔夫球并小心翼翼将它们
放入个别的圆形管，或完成传递癌症
资讯的照片拼图，通过互动式教育游
戏，获取癌症知识。
“无烟大热卖”
马年的第一个路演于2 月22 日至 23 日在兀兰民事中心举
行。此次路演通过寓教于乐的方式，提供了许多有关常
见癌症的资讯，并强调健康生活的重要性。为期两天的
路演共吸引约1000名公众前来参与适合全家大小一同
进行的活动。公众可报名参加接下来将举办的公共论坛
以及CancerWise癌症预防工作坊，并订阅新加坡国立
癌症中心出版的 Salubris癌症资讯简报，加强对癌症和
相关课题的了解。
护士向公众解释进行粪便免疫化学检测和乳房自检的方法和作用
举办路演的一个主要目标，是向公众传达
癌症检测的重要性。新加坡防癌协会在路
演上分发粪便免疫化学检测器，并利用硅
胶乳房模型教导女士们如何自行检查乳
房。主办当局也在现场分发了乳房自检贴
纸，提醒女性朋友定期自行检查乳房。
新加坡国立癌症中心认为有必要积极进行提高癌症意
识的工作，因为让公众多了解癌症，是预防更多人日后
患病的关键。毕竟，预防胜于治疗，而尽早发现患病将
能挽救生命。我们希望未来能在民众俱乐部、工作场所
和学校以及为机构和宗教组织举办更多类似的路演和
公共论坛。如果您或您的机构有意加入我们的防癌行
列，请与我们联系。
若您想在自己的活动上、机构或工作场所举办
健康讲座和路演或设置癌症教育亭，请电邮
[email protected]或拨电6225 5655咨询。
有了您的支持，我们更有信心与病魔对抗，减
少新加坡无法治愈的癌症病例。
健康讲座
癌症意识路演
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OUTREACH – PUBLIC FORUMS
& CANCERWISE WORKSHOPS
OUTREACH – PUBLIC FORUMS
& CANCERWISE WORKSHOPS
Event
Date, Time, Venue
Registration
Event
Date, Time, Venue
Registration
CancerWise Workshop –
Nose Cancer – What You Need
to Know
5 April 2014, Saturday
Free Admission
10 May 2014, Saturday
Free Admission
Session will be conducted
in English.
TOPICS:
Registration : 1.00pm
Workshop : 1.30pm to 4.00pm
Strictly No Admission for children
below 12 years old. Registration is
a MUST as seats are limited.
Bilingual Public Forum –
Common Cancers in Female
Reproductive System
MANDARIN SESSION
Time: 9.15am to 10.30am
(Registration: 9.00am to 9.15am)
ENGLISH SESSION
Time: 11.15am to 12.30pm
(Registration: 11.00am to 11.15am)
REGISTRATION IS
BY PHONE ONLY
• What is Nose Cancer?
• What are the risks, signs & symptoms?
• What diagnostic tests to detect
Nose Cancer?
• Preventing Nose Cancer
Level 4 Function Room
National Cancer Centre Singapore
11 Hospital Drive
Singapore 169610
REGISTRATION IS
BY PHONE ONLY
Please call: 6225 5655 /
6236 9447 /
6236 9432
• What are the treatments available?
Monday to Friday:
8.30am to 5.30pm
• New development in Nose Cancer
TOPICS:
• The Female Reproductive System
• Anatomy & Functions
• Common Gynecological Problems
• Contraceptive Pills & Hormone
Replacements Therapy - Are there
health risks?
• Other Myths & Misconceptions
Peter & Mary Fu Auditorium
11 Hospital Drive
Singapore 169610
6236 9447 /
6236 9432
Monday to Friday:
8.30am to 5.30pm
• Cancers of the Female Reproductive System:
Cervix, Ovary and Uterus
• Risk Factors, Signs & Symptoms
• Early Detection & Prevention
• What is PAP smear?
• Screening & Treatment Procedures
Nutritional Concerns for
Cancer Patients
12 April 2014, Saturday
Free Admission
in English.
TOPICS:
• Benefits of good nutrition
• Goals of nutrition for cancer patients
• Special nutrition needs of cancer patients
• Dietary supplementation
• Managing treatment side effects through diet
• Nutrition after treatment ends
Level 4 Function Room
11 Hospital Drive
Singapore 169610
Beat Cancer Blues with Exercise
and Relaxation
14 June 2014, Saturday
Free Admission
in English.
TOPICS:
REGISTRATION IS
BY PHONE ONLY
• The relationship between exercise
and cancer
6236 9447 /
6236 9432
• Make fitness work for you – Choose the
Right Exercise
Monday to Friday:
8.30am to 5.30pm
The information is correct at press time. NCCS reserves the right to change programmes or speaker without prior notice.
• Getting fit after cancer
• Cancer treatments options
• Maintaining a healthy weight
Peter & Mary Fu Auditorium
11 Hospital Drive
Singapore 169610
REGISTRATION IS
BY PHONE ONLY
6236 9447 /
6236 9432
Monday to Friday:
8.30am to 5.30pm
The information is correct at press time. NCCS reserves the right to change programmes or speaker without prior notice.
17
18
SEMINARS / FORUMS / TUMOUR BOARDS /
SMC-CME ACTIVITIES
APRIL 2014
Date
SEMINARS / FORUMS / TUMOUR BOARDS /
SMC-CME ACTIVITIES
MAY 2014
Time
Event Information
CME Pt
Registration Contact
2, 9, 16, 23, 30
4.30 pm
NCCS Tumour Board Meetings:
Sarcoma Tumour Board Meeting
Date
Time
Event Information
Lim Shufen / V. Kalai
6436 8283 / 6436 8294
[email protected] / [email protected]
1
7, 14, 21, 28
1.00 pm
Hepatobiliary Conference
@ NCCS Level 4, Peter & Mary Fu Auditorium
1
6436 8283 / 6436 8294
2, 9, 16, 23, 30
5.00 pm
General Surgery Tumour Board Meeting
1
7, 14, 21, 28
5.00 pm
Head & Neck Tumour Board Meeting
@ NCCS Level 2, Clinic C, Discussion Room
1
Daphne
6436 8592
[email protected]
22
5.00 pm
NCC Neuro Onco Tumour Board Meeting
1
Low Peak Wah / Ang Hui Lan
6436 8165 / 6436 8174
2, 9, 16, 23, 30
1.00 pm
@ NCCS Level 4, Lecture Hall
1
V. Kalai / Lim Shufen
6436 8924 / 6436 8283
29
7.30 am
Endocrine and Rare Tumour Meeting
1
Tan Si Xuan / Rachel Tan
6436 8280 / 6436 8172
3, 10, 17, 24
11.30 am
Lung Tumour Board Combine SGH-NCCS
Meeting
@ SGH Blk 2 Level 1, Radiology
Conference Room
1
Christina Lee Siok Cheng
6326 6095
[email protected]
16
1.00 pm
Journal Club
Topic: To be advised
@ NCCS level 1, Mammo Suite
Discussion Room
1
Phua Chay Sin
6436 8043
[email protected]
3, 17
5.00 pm
NCC-SGH Joint Lymphoma Workgroup Meeting
1
6436 8280 / 6436 8172
23
1.00 pm
1
Phua Chay Sin
6436 8043
[email protected]
PH
–
Journal Club
Discussion Room
1
Phua Chay Sin
6436 8043
[email protected]
Teaching Session
Discussion Room
24
7.30 am
1
6436 8280 / 6436 8172
Date
Time
Event Information
4, 11, 18, 25
1.00 pm
24
5.00 pm
1
6436 8165 / 6436 8174
@ NCCS Level 4, Peter & Mary Fu Auditorium
25
1.00 pm
Teaching Session
Discussion Room
1
Phua Chay Sin
6436 8043
[email protected]
4, 11, 18, 25
4.30 pm
1
4, 11, 18, 25
5.00 pm
1
2, 9, 16, 23, 30
5.00 pm
1
5, 12, 19, 26
11.30 am
Lung Tumour Board Combine SGH-NCCS Meeting
Conference Room
1
6326 6095
[email protected]
5, 19
5.00 pm
NCCS – SGH Joint Lymphoma Workgroup Meeting
1
6436 8280 / 6436 8172
26
7.30 am
1
6436 8280 / 6436 8172
26
5.00 pm
1
6436 8165 / 6436 8174
Time
Event Information
8, 15, 22, 29
11.30 am
1, 15
5.00 pm
JUNE 2014
MAY 2014
Date
CME Pt
CME Pt
Lung Tumour Board Combine SGH-NCCS
Meeting
Conference Room
1
6326 6095
[email protected]
NCC-SGH Joint Lymphoma Workgroup Meeting
1
6436 8280 / 6436 8172
7, 14, 21, 28
4.30 pm
7, 14, 21, 28
5.00 pm
1
5, 12, 19, 26
5.00 pm
1
1
6436 8283 / 6436 8294
Daphne
6436 8592
[email protected]
CME Pt
1
Lim Shufen / V Kalai
6436 8283 /6436 8294
6436 8283 / 6436 8294
Daphne
6436 8592
[email protected]
19
20
A G.R.E.A.T.
DAY AT NCCS
BY SHAWN SOH
Senior Executive
Community Partnership
Staff at the National Cancer
Centre Singapore (NCCS)
don’t just talk when they
seek public support in their
fund raising drive for cancer
research. They also donate
to the effort by signing
up for monthly GIRO
deductions from their salary.
E
mployee Giving was introduced in NCCS
in 2011. Since then, more than 690 NCCS
employees have pledged to make monthly
contributions via salary deduction to support
cancer research and patient care initiatives at NCCS.
Not only did our staff answer their call of duty with
passion and excellence, they also went the extra
mile to give back to their organisation through
the G.R.E.A.T. Employee Giving Programme,
which aims to create and cultivate a culture
of philanthropy within the organisation.
Friendship and camaraderie took centre stage amidst a fun-filled atmosphere. Friends
and colleagues alike made a beeline for the photo booth where memorable moments
were captured as co-workers from various departments got together to pose in front of
the camera complete with outlandish props. Their megawatt smiles were priceless and
were caught on prints to be cherished forever.
Staff Philanthropy was also celebrated on that day. Each staff donor
received a cookie to symbolise the “sweetness of giving” and also
to thank them for their continuous support. Their act of kindness
was reciprocated with a mouth-watering, freshly baked
raspberry macadamia cookie. It is the cohesiveness and
generous spirit that makes NCCS and its people so special!
NCCS held its annual Staff Appreciation
Day on 25 February 2014 to acknowledge
the contributions of all employees for their
hard work and dedication.
A sumptuous buffet spread consisting of
local and Peranakan cuisines were served
by Departmental Heads and Supervisors while
employees enjoyed the carnival themed games
specially organised for the day. It was a simple
yet significant gesture by the management to
appreciate their staff.
While there is still much to be done in the area of research
and in patient care, it is hoped that this simple gesture can
motivate and inspire other non-staff donors to sign up as a
G.R.E.A.T. employee. With each contribution, it enables our
researchers to take closer steps to finding a cancer cure and our
healthcare team to provide better care and facilities to our patients.
It is the gift from your heart that touches the life of a patient.
No gift is too small when it is given with a big hope of making a
difference to our patients and towards a cancer-free tomorrow.
Editorial Advisors
Medical Editor
Members, Editorial Board
Prof Kon Oi Lian
Prof Soo Khee Chee
Dr Tan Hiang Khoon
Dr Richard Yeo
Ms Lita Chew
Dr Mohd Farid
Ms Sharon Leow
Ms Jenna Teo
Dr Melissa Teo
Dr Teo Tze Hern
Dr Deborah Watkinson
Editorial Consultant
Mr Sunny Wee
Executive Editors
Ms Rachel Tan
Ms Siti Zawiyah
Mr Edwin Yong
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 [email protected].
NATIONAL CANCER CENTRE SINGAPORE
Reg No 199801562Z
11 Hospital Drive Singapore 169610
Tel: (65) 6436 8000 Fax: (65) 6225 6283
www.nccs.com.sg
www.facebook.com/NationalCancerCentreSingapore
www.linkedin.com/company/NationalCancerCentreSingapore

better treatment options now for ovarian cancer

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