Cancer cases on the rise in Singapore

[Ender]

3 hours ago, Ysc3 said:

This could save lives here!  

 

Can this be self diagnosed? Is it to feel for lumps or something hard like stone?

[Adrianli]

1 hour ago, Ender said:

Can this be self diagnosed? Is it to feel for lumps or something hard like stone?

Not sure how this works. What i learnt in lecture is using Per/Digit Rectal Examination. 

Spoiler

https://en.m.wikipedia.org/wiki/Rectal_examination#/media/File%3ADigital_rectal_exam_nci-vol-7136-300.jpg

 

[Ender]

17 hours ago, Adrianli said:

Not sure how this works. What i learnt in lecture is using Per/Digit Rectal Examination. 

  Reveal hidden contents

https://en.m.wikipedia.org/wiki/Rectal_examination#/media/File%3ADigital_rectal_exam_nci-vol-7136-300.jpg

 

Looks complicated.. Cannot self diagnose..really got to dropped pants in front of stranger.

[Adrianli]

6 hours ago, Ender said:

Looks complicated.. Cannot self diagnose..really got to dropped pants in front of stranger.

I do not know how to self diagnose using the Digit Rectum Examination. We were taught on the silent mentor and the silent mentor was also sliced open in the saggital plane like the diagram. So we can physically see exactly where to palpate and touch. We had both male and female silent mentor. Female also same examination but rather than prostate, we feel for the rectouterine pouch.

I am not a doctor, never done on a live human yet. And don't intend to.

[13177]

Some people do not want doctor to check their prostate. Cause they feel weird to have someone pock their a*s! Lol.

[Kangadrool]

Then Ownself checks Ownself lor.

[Fcw75]

Use finger to poke own ass? 😂

[Ender]

Looks promising..

 

https://sg.yahoo.com/news/cancer-trials-unexpected-result-remission-120646950.html

A Cancer Trial's Unexpected Result: Remission in Every Patient

 

The New York Times

A Cancer Trial's Unexpected Result: Remission in Every Patient

Gina Kolata

Mon, 6 June 2022, 8:06 pm

It was a small trial, just 18 rectal cancer patients, every one of whom took the same drug.

But the results were astonishing. The cancer vanished in every single patient, undetectable by physical exam; endoscopy; positron emission tomography, or PET scans; or MRI scans.

Dr. Luis A. Diaz Jr. of Memorial Sloan Kettering Cancer Center, an author of a paper published Sunday in the New England Journal of Medicine describing the results, which were sponsored by drug company GlaxoSmithKline, said he knew of no other study in which a treatment completely obliterated a cancer in every patient.

“I believe this is the first time this has happened in the history of cancer,” Diaz said.

Dr. Alan P. Venook, a colorectal cancer specialist at the University of California, San Francisco, who was not involved with the study, said he also thought this was a first.

A complete remission in every single patient is “unheard-of,” he said.

These rectal cancer patients had faced grueling treatments — chemotherapy, radiation and, most likely, life-altering surgery that could result in bowel, urinary and sexual dysfunction. Some would need colostomy bags.

They entered the study thinking that, when it was over, they would have to undergo those procedures because no one really expected their tumors to disappear.

But they got a surprise: No further treatment was necessary.

“There were a lot of happy tears,” said Dr. Andrea Cercek, an oncologist at Memorial Sloan Kettering Cancer Center and a co-author of the paper, which was presented Sunday at the annual meeting of the American Society of Clinical Oncology.

Another surprise, Venook added, was that none of the patients had clinically significant complications.

On average, 1 in 5 patients have some sort of adverse reaction to drugs like the one the patients took, dostarlimab, known as checkpoint inhibitors. The medication was given every three weeks for six months and cost about $11,000 per dose. It unmasks cancer cells, allowing the immune system to identify and destroy them.

While most adverse reactions are easily managed, as many as 3% to 5% of patients who take checkpoint inhibitors have more severe complications that, in some cases, result in muscle weakness and difficulty swallowing and chewing.

The absence of significant side effects, Venook said, means that “either they did not treat enough patients or, somehow, these cancers are just plain different.”

In an editorial accompanying the paper, Dr. Hanna K. Sanoff of the University of North Carolina’s Lineberger Comprehensive Cancer Center, who was not involved in the study, called it “small but compelling.” She added, though, that it is not clear if the patients are cured.

“Very little is known about the duration of time needed to find out whether a clinical complete response to dostarlimab equates to cure,” Sanoff said in the editorial.

Dr. Kimmie Ng, a colorectal cancer expert at Harvard Medical School, said that while the results were “remarkable” and “unprecedented,” they would need to be replicated.

The inspiration for the rectal cancer study came from a clinical trial Diaz led in 2017 that Merck, the drugmaker, funded. It involved 86 people with metastatic cancer that originated in various parts of their bodies. But the cancers all shared a gene mutation that prevented cells from repairing damage to DNA. These mutations occur in 4% of all cancer patients.

Patients in that trial took a Merck checkpoint inhibitor, pembrolizumab, for up to two years. Tumors shrank or stabilized in about one-third to one-half of the patients, and they lived longer. Tumors vanished in 10% of the trial’s participants.

That led Cercek and Diaz to ask: What would happen if the drug were used much earlier in the course of disease, before the cancer had a chance to spread?

They settled on a study of patients with locally advanced rectal cancer — tumors that had spread in the rectum and sometimes to the lymph nodes but not to other organs. Cercek had noticed that chemotherapy was not helping a portion of patients who had the same mutations that affected the patients in the 2017 trial. Instead of shrinking during treatment, their rectal tumors grew.

Perhaps, Cercek and Diaz reasoned, immunotherapy with a checkpoint inhibitor would allow such patients to avoid chemotherapy, radiation and surgery.

Diaz began asking companies that made checkpoint inhibitors if they would sponsor a small trial. They turned him down, saying the trial was too risky. He and Cercek wanted to give the drug to patients who could be cured with standard treatments. What the researchers were proposing might end up allowing the cancers to grow beyond the point at which they could be cured.

“It is very hard to alter the standard of care,” Diaz said. “The whole standard-of-care machinery wants to do the surgery.”

Finally, a small biotechnology firm, Tesaro, agreed to sponsor the study. Tesaro was bought by GlaxoSmithKline, and Diaz said he had to remind the larger company that they were doing the study — company executives had all but forgotten about the small trial.

Their first patient was Sascha Roth, then 38. She first noticed some rectal bleeding in 2019 but otherwise felt fine — she is a runner and helps manage a family furniture store in Bethesda, Maryland.

During a sigmoidoscopy, she recalled, her gastroenterologist said, “Oh no. I was not expecting this!”

The next day, the doctor called Roth. He had had the tumor biopsied. “It’s definitely cancer,” he told her.

“I completely melted down,” she said.

Soon, she was scheduled to start chemotherapy at Georgetown University, but a friend had insisted she first see Dr. Philip Paty at Memorial Sloan Kettering. Paty told her he was almost certain her cancer included the mutation that made it unlikely to respond well to chemotherapy. It turned out, though, that Roth was eligible to enter the clinical trial. If she had started chemotherapy, she would not have been.

Not expecting a complete response to dostarlimab, Roth had planned to move to New York for radiation, chemotherapy and possibly surgery after the trial ended. To preserve her fertility after the expected radiation treatment, she had her ovaries removed and put back under her ribs.

After the trial, Cercek gave her the news.

“We looked at your scans,” she said. “There is absolutely no cancer.” She did not need any further treatment.

“I told my family,” Roth said. “They didn’t believe me.”

But two years later, she still does not have a trace of cancer.

© 2022 The New York Times Company

[Kopites]

https://www.smh.com.au/national/nsw/why-i-stripped-down-at-bondi-beach-with-2500-strangers-20221126-p5c1i4.html

https://www.bbc.com/news/world-australia-63764448

 

A powerful message from the work of art.

Shared with wifey and she concurred we would likewise do the same. 👍

Edited November 26, 2022 by Kopites

[Ender]

5 minutes ago, Kopites said:

https://www.smh.com.au/national/nsw/why-i-stripped-down-at-bondi-beach-with-2500-strangers-20221126-p5c1i4.html

https://www.bbc.com/news/world-australia-63764448

 

A powerful message from the work of art.

Shared with wifey and she concur we would likewise do the same. 👍

My opinion, our problem is opposite. Most Singaporean lack Sunlight. We don't spent enough time outside, that's why don't get enough Vit D and we have highest rate of myopia for children. 

[Kopites]

6 hours ago, Ender said:

My opinion, our problem is opposite. Most Singaporean lack Sunlight. We don't spent enough time outside, that's why don't get enough Vit D and we have highest rate of myopia for children. 

NZ and Aust have the most cases of skin cancer. It is belief main cause likely to be the Ozone hole.

I loved walking barefooted to absorb the ground heat while in Aussie. 

 

[Windwaver]

https://www.straitstimes.com/singapore/health/new-820m-national-cancer-centre-building-has-double-the-capacity-of-previous-premises

New National Cancer Centre building officially opens with double the capacity of previous premises

SINGAPORE – A new $820 million National Cancer Centre Singapore (NCCS) building – which has twice the capacity of the centre’s previous premises – officially opened on Thursday, at a ceremony officiated by Deputy Prime Minister Lawrence Wong. 

“One in four Singaporeans is likely to get some form of cancer over their lifetimes, and close to 40 per cent diagnosed with cancer currently are aged 70 and above,” said Mr Wong.

“The good news is that cancer care and survival rates have improved significantly since the 1990s. The state-of-the-art facility will provide more comprehensive and holistic care for our cancer patients, housing clinical services, research, education and more, all under one roof.”

Cancer cases have been rising over the past 20 years and are expected to climb as Singapore rapidly ages. The increased load meant that NCCS had to move some of its administrative functions out of its old six-storey building at 11 Hospital Crescent to more than one other place within the Singapore General Hospital (SGH) campus.

Located at 30 Hospital Boulevard, a stone’s throw from the previous building, its new 24-storey home is not only bigger but also has enhanced facilities for cancer care, rehabilitation, research and education. It is directly connected to Outram Park MRT station via a link bridge.

The old building, which NCCS had occupied for more than 20 years, had 36 consultation rooms and 55 chemotherapy recliner chairs and beds. The new NCCS building has 64 consultation rooms and seven treatment suites with 108 chemotherapy recliner chairs and beds.

It features high ceilings, offering a sense of space, and plenty of natural light streaming in through the ample glass cladding.

Professor William Hwang, NCCS’ chief executive, said there was a need to double the capacity at the centre to address the needs of cancer patients in Singapore. He cited the 78,000 new cancer cases that were reported here between 2015 and 2019, and said that beyond 2030, this number is expected to soar.

By that time, one in four Singaporeans will be aged 65 and above. While medication, diet and healthy lifestyles can help reduce the incidence of many diseases and control them, one unavoidable aspect is genetic mutations that happen in the cells as one grows older, said Prof Hwang. These can cause cancer, he said.

NCCS, which sees the majority of cancer cases in the public healthcare sector, has about 160,000 patient visits a year. “With a doubling of capacity, we will have a doubling in terms of the ability to treat patients, contingent on us getting more manpower in the later years,” said Prof Hwang.

At the same time, NCCS also has three satellite clinics around Singapore.

The centre now has more than 200 oncologists and surgeons, more than 210 nurses, and more than 260 allied health professionals.

With Healthier SG – Singapore’s major preventive care strategy – slated for launch in July to keep the population healthy, NCCS has also begun to focus some of its efforts on cancer screening.

Professor Lim Soon Thye, deputy chief executive (clinical) of NCCS, said the team at the centre treats the full breadth of cancers and cancer-related disorders as it continually seeks to innovate to improve the prevention, diagnosis and treatment of cancer. 

NCCS will also be the only public institution here where one can get proton beam therapy, an advanced and highly precise radiation treatment. When it receives the go-ahead from the Government, NCCS will open the Goh Cheng Liang Proton Therapy Centre in basement three of the new building.

Strategic partners such as the Singapore Cancer Society are co-located on the premises to better provide cancer patients with accessible care and rehabilitation in the community.

A “Care Corner” station is available for financial counselling on each of the four levels where the clinics are located.

Given the introduction in Singapore of the Cancer Drug List – which includes only the clinically proven and cost-effective treatments that can be covered by subsidies, MediShield Life and Integrated Shield Plans – there is a greater need to help patients with financial counselling, said Associate Professor Ravindran Kanesvaran, deputy chairman of NCCS’ medical oncology division.

There was no dedicated space for this function at the old NCCS building, and counselling was done at the clinic counters. 

After counselling, patients can head home as they may pay their bills online and have their medication delivered to them.

NCCS started moving to the new building in late December 2022 and has been operating fully from there since March.

The new building is part of the first phase of development plans of the $4 billion, 20-year masterplan for the SGH campus. Outram Community Hospital opened officially in January 2022. After NCCS, SGH’s new Accident & Emergency building is expected to be ready next.

 

[Windwaver]

 

[Jamesc]

Sounds good to my untrained mind

 

[Jamesc]

Sounds good to my untrained mind

 

[Starry]

Study links gut bacteria to pre-cancerous growths, paves way for microbial testing for colorectal cancer risk

https://www.straitstimes.com/singapore/health/study-links-gut-bacteria-to-pre-cancerous-growths-paves-way-for-microbial-testing-for-colorectal-cancer-risk

One can then make specific changes to the diet or gut microbiome – the ecosystem of bacteria, fungi and other microbes found in the digestive system – to alter the growth patterns of the polyps to prevent them from turning into cancer.

Edited January 27 by Starry