Read this from the online newspaper today on how advancement of genetic research nowadays has help cancer patients recover and help prevent reoccuring of the cancer cells. Below is a copy of the article.
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IT WAS unexplained aches and pains all over his body that set the alarm bells ringing for Mr Simon Woo, but something so niggling surely could not mean cancer.
The head of facilities management at the Institute of Technical Education was 56 after all, so the usual creaks that come with age were to be expected - and that was just what a succession of experts told him.
He trekked from one general practitioner to another and tried a series of sinsehs, acupuncturists and massotherapists, and ended up at the same place: 'You're getting on a bit, just take it easy.'
But Mr Woo was unsatisfied and had a full screening, including blood tests, a colonoscopy and gastroendoscopy. Even then, his condition still eluded the doctors.
It was only when he ended up at the National University Hospital, following a bout of diarrhoea and paralysing numbness in his legs, that the doctors realised that it could be something more serious.
After a series of investigations, a scan finally showed up a secondary tumour in his spine that was then traced to a tumour in his lungs.
The months of unease and medical checks finally ended with a grim punchline: Mr Woo's wife, Madam Jessie Lim, and their medical researcher son Kelvin were told that it was stage IV lung cancer and that he had six months to live.
A family friend suggested they consult oncologist Ang Peng Tiam, the medical director of Parkway Cancer Centre.Dr Ang assessed Mr Woo and told him there was a 60 per cent chance his cancer could be controlled. Mr Woo was relieved: At least he had a fighting chance.
There was more encouragement when his tumour started to shrink after just a couple of chemotherapy sessions. Cancer markers in his blood also dropped from above 500 to 300, 150, 60 and finally below 10 - all in four months.
Like most cancer patients, Mr Woo feared the side effects of chemotherapy, especially the nausea and vomiting. But he did not suffer as badly as he feared, thanks to some drugs Dr Ang prescribed.
By September 2006, he felt well enough to get back to work, but there was still the worry of how to keep his cancer from coming back.
Dr Ang had good news in the form of the drug gefitinib or Iressa, which has been found to be effective in stopping lung cancer from recurring.
At $120 a pill, it is not cheap, but Mr Woo decided to give it a try. Since then, the disease has been kept in check, and in September, Mr Woo hopes to celebrate four years of being cancer-free.
The near-miss has also promoted some soul-searching, particularly over his cigarette smoking when he was in his 20s and 30s. He knows only too well the statistics that point to a strong link between smoking and lung cancer. Studies show that 90 per cent of lung cancer cases are caused by smoking.
The beaming Mr Woo jokes that whenever he sees Dr Ang for regular check-ups, he asks for a birth certificate.
'I was facing a death sentence. But now, I feel reborn. God has given me a second chance.'
Dr Ang, 51, attributes Mr Woo's recovery more to the advances in genetic research, which have transformed the prospects of cancer patients like Mr Woo.
The specialist, who was the principal doctor who treated Prime Minister Lee Hsien Loong for lymphoma in the early 1990s, says doctors have long treated cancer with the 'blunt' instruments of radiation and chemotherapy. Blunt because they indiscriminately kill healthy and cancerous cells alike.
'But now, thanks to the unravelling of the human genome, we are on the brink of an era of narrowly targeted, genetically geared therapies tailored to just small segments of the patient population.'
He notes that chemotherapy and radiotherapy remain the standard treatments for cancer, but new drugs enable doctors to lessen side effects considerably while improving the effectiveness of the treatment.
For example, radiotherapy machines allow more accurate targeting of the tumours - and less collateral damage.
For chemotherapy, there are drugs like the granulocyte colony-stimulating factor, which prevent the lowering of white blood cells. This allows doctors to increase the chemotherapy doses while reducing the risk of infection.
Drugs like ondansetron have helped to reduce nausea and vomiting caused by chemotherapy drugs.
Dr Ang also cites new drugs like Mr Woo's Iressa, which enable doctors to target the genetic mutations that lead to cells turning cancerous.
'Genetic research into cancer has given doctors a better understanding of genetic mutations as the key drivers that fuel the cancer,' he says. 'This has led to drug companies developing newer, more sophisticated treatments that target these cell mutations.'
The problem is particularly complex given that at least 200 defective genes play a role in causing cancer. In any one patient, probably only five to six of these are involved, and in the next patient, a different gene mix is at work.
'The trick is to figure out how to tell which particular genes are the driving force in an individual patient's case,' explains Dr Ang.
The new cancer drugs tackle the problem in different ways. For example, Iressa blocks one of the growth factors (epidermal growth factor) involved in tumour growth, while Glivec (Gleevec in the US) or imatinib targets abnormal proteins that instruct cancer cells to grow.
Avastin or bevacizumab is used for bowel cancer patients to prevent the growth of new blood vessels around a tumour.
Drugs like Herceptin or trastuzumab block breast cancer cells by binding to the specific proteins they need to spread.
'As we understand the circuitry better, scientists are able to figure out how to block the pathway. We will have longer and longer patient survival,' says Dr Ang.
But what about affordability? Mr Woo says that his first five months of treatment cost him close to $80,000. He had to cash in two of his insurance policies and use up most of his retirement savings to afford it.
Even now he spends close to $4,000 a month on check-ups and cancer pills to strengthen his bones. He will have to be on this treatment for the rest of his life.
He now advises his friends to buy insurance policies that will cover them in the event of critical illnesses.
He hopes Medifund will be extended to help middle-income patients pay for expensive drugs. At the moment it is meant for only the very poor. The Government has said it is looking into it.
Dr Ang urges Singaporeans to buy medical insurance. He also advises patients to go through the contracts carefully to ensure that they have adequate coverage.
He suggests that those buying insurance get their family doctors to go through the medical aspects of insurance agreements. He also advocates early screening so that cancer can be caught in its early stages. Treatment will not only be less harrowing but also cheaper.
Mr Woo agrees. Besides insurance, he urges his friends to go for cancer tests and not wait for symptoms to appear.
He knows that having suffered stage IV lung cancer, he will never be completely 'cured' of it. After all, 95 per cent of advanced cancer patients experience a recurrence within five years.
'I know it can come back,' he says, adding that he hopes to see son Kelvin, 31, who is engaged in medical research overseas, settle down and have children.
He does not intend to give in to cancer. 'I'll fight it all the way. If there's something to try and I can afford it, I'll give it a go.'
This article was first published in The Straits Times.
