Ms Y, 26, walks with a slight limp today. She had bone cancer in the leg and had undergone surgery to remove the cancer.
She then had hip reconstruction with a titanium bone implant, followed by a year of chemotherapy.
Eight years have passed since she completed her treatment, and she remains cancer-free.
Despite having a prosthetic hip, she now walks unaided.
Forty years ago, 70 per cent of patients with bone cancer or osteosarcoma would relapse, with cancer spreading to the lungs. Most would die within five years.
Today, with a combination of chemotherapy and surgery, the odds have been turned around and 70 per cent will survive beyond five years.
LUMPS & BUMPS: IS IT CANCER?
Date: May 7
Time: 9am to 12.30pm
Venue: Auditorium,NUHS Tower Block, 1E Kent Ridge Road, Singapore 119228 (near Kent Ridge MRT station).
Admission is free. To register, call 6773-7888 or e-mail email@example.com
We doctors are frequently asked by friends and relatives to look at lumps and bumps on their bodies, the concern being that these lumps may be cancerous.
Fortunately, most of them are benign.
However, if a lump grows bigger progressively over weeks to months, becomes more firm to touch, or if discoloration or bleeding develops in the overlying skin, then medical attention is needed.
It could be a rare cancer called sarcoma, which arises from muscles, fat tissue, blood vessels or bone.
Sarcoma can grow in any part of the body, and accounts for 1 per cent of all adult cancers and 15 per cent of childhood cancers.
Most bone sarcoma occurs between the ages of 10 and 25 with a smaller peak after 60 years old.
The incidence of bone sarcomas is one in 100,000, while the incidence of soft tissue sarcomas is four times higher.
Around 200 Singaporeans are diagnosed with sarcoma every year, and there has been a small rise seen both locally and worldwide.
There are more than 50 different sub-types of sarcoma that arise from different tissues, with different genetic profiles.
They affect patients of different age groups, and differ in aggressiveness and response to treatment.
While treatments have improved over the past 20 years with an increase in novel targeted agents and chemotherapy as well as better knowledge of genetics and behaviour of the cancer, not much is known about the cause of sarcoma.
Patients with a genetic condition called neurofibromatosis develop multiple benign nerve tumours, and there is a risk that one of these tumours may become cancerous.
Patients with another condition, Li-Fraumeni syndrome, also have increased risk due to a defect in their tumour suppressor genes.
Some of you may have heard of and participated in the Terry Fox runs, which help to raise funds for medical research.
Like Ms Y, Terry Fox was diagnosed with osteosarcoma (bone cancer).
The Canadian was 19 years old then. When he was 21, he attempted to run across Canada to raise money for cancer research.
Despite having undergone an above-knee amputation, he managed to run more than 5,300km in 143 days with a prosthetic leg, before his cancer spread. He died at age 22 in 1981.
The money that he had helped to raise, and the money that is being continually raised through Terry Fox runs, has changed the treatment and prognosis not only of osteosarcoma, but also various other cancers.
But cancer remains a major disruption to a person's life.
It saddens us to see someone losing his leg due to cancer, and even more so when the patient is a child or teenager.
However, we believe that cancer should not define a person, and can instead motivate a person to succeed.
Last month, we met another cancer survivor in her 40s who had a below-knee amputation when she was six years old.
Now a successful lawyer, she is married with two children and can walk faster than us with her leg prosthesis.
Yet, no matter how much doctors and health professionals try to help patients prepare for and cope with the cancer, it cannot compare with talking to someone who has had the same experience.
Peer support is important, and the Singapore Sarcoma Support Group will be launched this Saturday to reach out to patients and survivors of sarcoma, as well as their families and caregivers.
It is a collaborative effort by multidisciplinary sarcoma teams from various hospitals under the umbrella of the Singapore Sarcoma Consortium. The support group will be run by cancer survivors for cancer patients.
To know more about sarcoma, register now for the Lumps and Bumps public forum and join the launch of this national support group.
- Dr Puhaindran is the head and senior consultant in the division of surgical oncology (musculoskeletal surgery) at the National University Cancer Institute, Singapore (NCIS). This article also had additional inputs from Dr Choo Bok Ai, consultant in the department of radiation oncology at NCIS.