In a new approach being tested by the National Cancer Centre Singapore (NCCS), neighbourhood general practitioners have been roped in to help prescribe medicine, relieve some of the unpleasant side effects of chemotherapy, like nausea, fever and diarrhoea or help take care of the cancer patients' wounds after surgery.

According to the Cancer Centre's doctors, this system will save patients time and money - they no longer have to travel to the centre and endure long waiting times just to get a refill of their medication for instance.

At the centre, the cancer specialists will be freed up to spend more time on complicated cases or to do more research.

The NCCS is one of two major cancer treatment centres in Singapore. Last year, it saw 19,000 new cases.

The other major cancer treatment institute here is in the National University Hospital.

The mathematics are simple: There are 20 medical oncologists working at NCCS and they see between 200 and 250 patients a month.

Even when they see patients at a steady clip, there is an inevitable wait, said the doctors - hence the attempt to see if some patients can be better managed by their colleagues in their neighbourhood clinics.

The NCCS' efforts mirror those in the United States, United Kingdom and Australia to 'decentralise' medical care.

The idea is to find a more efficient way of managing chronically ill patients.

The ideal, as Dr Denis Cortese, CEO of the world-famous Mayo Clinic, explained in an interview with The Straits Times last month, is to free up the specialist from a constant stream of patients who may not be very ill - and who may have to pay more because they are visiting specialists for relatively minor ailments and problems.

Instead, the specialist is 'like an orchestra's conductor' said Dr Cortese. The day to day care is handled by medical technicians, nurses, who can probably give more time and better care to the patients anyway.

In an ideal scenario of managing ongoing diseases, the role of a specialist is very much the 'controller' in the background. He decides on or adjusts the dosages, checks the overall progress, and, when necessary, calls the patient in for specific, specialised treatment.

In the NCCS' case, 300 GPs have already signed up to be part of the network of clinics patients can go to.

Eventually, this so called Family Physicians Cancer Network, or Famcan in short, will have about 1,500 GPs, said Dr Lee Kheng Hock, head of the Department of Family Medicine and Continuing Care at the Singapore General Hospital.

His department will be managing the Famcan database.

A consultant with the department of medical oncology at NCCS, Dr Daniel Poon, took pains to emphasise that patients would not suffer a decreased level of care. The GPs on the Famcan list will have to go through lectures and hands-on attachments at NCCS.

In addition, said Dr Poon, the general practitioners will have the specialists' cellphone numbers - and can call them at any time of the day, seven days a week.

So far, in the month that the programme's been up, 30 cancer patients have been cared for by their family doctors.

Cancer survivor Chun Wee Ping, 34, thinks moving cancer aftercare out to GPs is a good idea as it helps cut waiting and travelling time to the specialist centre.

'Cancer patients still have to go for our routine checks on a three to six month basis. During the period in between, if we are managed by the GP, then the GP will be able to fill the specialist in on how we are doing.'

juditht@sph.com.sg