Doc Talk

Cancer is not a death sentence

ST ILLUSTRATION: ADAM LEE

Treatments are now more effective and cause fewer side effects

Cancer is one of the most feared and dreaded words in the English language.

A word that evokes strong emotions of loss, despair, helplessness, shock and denial, not just in the person given the diagnosis but also his loved ones.

Given that one in three people dies of cancer, most people will know someone who has cancer.

In the past, outcomes were poor and treatments were associated with nasty side effects.

Many people would have vivid memories of losing someone to cancer. These experiences shape our concepts and ideas of cancer and, therefore, the tendency to generate very strong negative emotions towards the disease.

When I told Madam X that she had cancer, she reacted with these very same emotions.

One of the first questions the 50-year-old asked - after a prolonged pause to get over the initial shock - was whether she would die soon. She then inquired about the treatment and if she would suffer through it.

The usual assumption is that treat-ment is horrible and futile, while death is inevitable in the near future.

However, the treatment of cancer has come a long way.

While some types of cancer still kill within a short time, the treatments for others are now more effective and give rise to fewer side effects.

Today, patients can have a greatly improved quality of life. Many are living with cancer, rather than dying of it.

LIVING WITH CANCER

Cancer is not a single disease. It can originate from different parts of the body, and come with different characteristics.

Some types of cancer are curable even if they are not detected at the earliest stage. They include testicular cancer, childhood acute leukaemia, some types of lymphoma like Hodgkin's disease and adult acute leukaemia.

Many others cannot be cured as they tend to relapse and the person would require treatment again.

Examples include multiple myeloma, a type of bone marrow cancer; low-grade lymphoma, which affects the lymph glands; and chronic leukaemia, which is a slow-growing cancer of the blood.

But they can be treated.

In fact, these types of cancer are becoming like chronic illnesses, in the same vein as hypertension and diabetes. This is due to the advent of new treatments that are well-tolerated by patients. They receive ongoing treatment to keep the disease at bay.

Most importantly, some types of cancer can be prevented.

For example, there is a clear link between smoking and cancer of the lungs and bladder.

Refraining from smoking can greatly reduce one's chances of developing these types of cancer.

On the other hand, some types of cancer arise from viral infections. Hepatitis B and C cause liver cancer, while the human papilloma virus can trigger cervical cancer.

Vaccinating against these viruses can help a person avoid infections which may lead to cancer.

Several types of cancer can also be eliminated and cured if they are detected and treated early.

On this list are breast and colon cancer, as well as cervical cancer.

Here, screening is the key. To this end, one can take advantage of screening programmes available in Singapore.

They involve mammography to detect breast cancer; the testing of stools and colonoscopy for colon cancer; and the Pap smear for cervical cancer.

According to the Ministry of Health, these are the only cancer screening programmes that are recommended.

This is because we know that, for these three types of cancer, early detection gives patients a good chance of getting cured.

Cancer is a formidable foe that continues to evolve and find new ways to evade treatments.

But with recommended screening, early treatment and new medications, we can safely say that cancer is no longer a universal death sentence.

The medical and scientific profession will also continue the fight against the disease and pursue better treatments, especially for cancers that remain difficult to control.

Cancer patients and their families can be hopeful for the future.

Such as in Madam X's case.

She had lymphoma, a cancer of the lymph nodes, and underwent chemotherapy.

Although there were some side effects, they were minor and quite manageable.

She completed her treatment in 18 weeks, and tests show she is cleared of the cancer.

Five years on, she is still in complete remission. During this time, she has seen her son graduate from university and her older daughter get married.

  • Associate Professor Chng Wee Joo is the director of National University Cancer Institute, Singapore and senior consultant in its department of haematology-oncology. He received an A*Star international fellowship in 2004 to do research on multiple myeloma genetics at the Mayo Clinic.
A version of this article appeared in the print edition of The Straits Times on September 29, 2015, with the headline 'Cancer is not a death sentence'. Print Edition | Subscribe