As a healthcare provider with a family member who recently died of bile duct cancer, I empathise with Ms Koh Ee Miang's situation (Cancer patient dealt another blow - insurer refuses to pay for drug, April 21).

Following surgery, my uncle's remission period lasted only nine months before the aggressive and rare cancer returned. The issue of limited approved treatments - which my uncle did not tolerate well - was aggravated by the fact that exploring other options would require him to fully bear the costs of genomic sequencing, an important step in cancer management that potentially expands options to include clinical trials, compassionate drug access programmes and use of off-label drugs.

While my uncle had the means to finance this test, there are others for whom funding to support diagnostics is a critical roadblock.

While we shift towards prioritising prevention as a country, we also need to ensure that we understand the roles and applications of evolving diagnostics and therapies, and ensure that healthcare providers can support patients with life-limiting conditions promptly.

One consideration, given the nature of the Singapore ecosystem where centres of excellence and key opinion leaders serve in the public and private sectors, is the sharing of critical insights gleaned from patient management through efficient insight-sharing systems. This may better inform how specialists can manage the next unique cancer condition.

The ability to better manage and share clinical insights at a systemic level can also serve the larger populace by determining how funding can be justified for diagnostics and therapeutics. This will require careful consideration and stakeholder buy-in, but we need to start somewhere.

In the meantime, I ask for empathy on a case-by-case basis in supporting patients like Ms Koh who have possibilities to explore treatments.

Huren Sivaraj (Dr)