Medical Professionals Version - National Cancer Centre Singapore

More documents

Recommendations

Info

PAGE A4 In Focus SALUBRIS July / August 2009 NCCS TEAM IS GETTING THE ANSWERS FOR LIVER CANCER The NCCS team has come up with a modality to test drug combinations in laboratories and today their work has found its way to the patients who are on clinical trials. At the onset of this trial, a biopsy of the tumour from the patient was first taken and implanted into a mouse. The mouse underwent treatment with the use of one drug and its progress was monitored. Subsequently, other drugs were administered until the desired result was obtained. Thus far, the team has tested a combination of two drugs, both of which are produced by two different giant pharmaceutical companies, for liver cancer. The combination of two drugs was found to be more effective than the use of one drug. Based on this discovery, a Phase I clinical trial testing on liver cancer patients for this two-drug combination was conducted. Twenty-seven patients participated in this trial and the results were encouraging, with complete shrinkage of the tumour in a few patients. A Phase II trial will be launched on some 59 patients later this year. The team behind this timely discovery comprises of Adjunct Professor Huynh Hung from the NCCS Humphrey Oei Institute of Cancer research (Division of Cellular and Molecular Research) and clinician investigators Dr Toh Han Chong, Head of the Department of Medical Oncology and Dr Choo Su Pin, Consultant for the Department of Medical Oncology. Professor Hui Kam Man, Director, Division of Cellular and Molecular Research at NCCS said: “We could not have achieved this without the financial support from the Singapore Millennium Fund, the National Medical Research Fund and the Singapore Cancer Syndicate. They could see the significance of our project and gave us the necessary funding to make this a reality.” The team’s success has prompted more drug companies to come together and use NCCS as a platform to best their drug combinations. More clinical trials are in the works. However, exemplary treatment methods are futile if patients are late in seeking medical attention. Majority of liver cancer fatalities could have been prevented with early detection. Thus, for NCCS’s 2nd Liver Cancer Awareness Campaign in September this year, great emphasis was placed on raising public awareness and encouraging more people to do health screenings. To reach out to more households, public forums will be held at the Paya Lebar Kovan Community Centre on 12 and 13 September 2009. The forums will be presented in English and Mandarin. All attendees are entitled to free goodie bags and vouchers for free Hepatitis screenings at SingHealth Polyclinics. Madam Cynthia Phua, MP for Aljunied GRC, who will be launching the LiCAM campaign urged the public to go for regular medical screenings, their best defense against the disease. The campaign will focus on information on the latest treatment methods and care for liver cancer patients, the risk of Hepatitis and how to avoid contracting fatty liver. Fatty liver is a condition that is likely to become more common among affluent Singaporeans. It is expedited when fat accumulates in Hepatocytes, or tiny sacs of liver cells. Although fatty liver is a benign condition, it can give rise to a wide spectrum of liver diseases, lead to inflammation and scarring of the liver and eventually, liver cancer if left undetected. The campaign is sponsored by Bayer Healthcare. Dr Tan Yu Meng, Deputy Head and Senior Consultant, Department of Surgical Oncology, NCCS and Surgical Director, Liver Transplant Programme, SGH, who spearheads the Liver Cancer Awareness Month Committee said, “Early detection is the best solution for liver cancer as often by the time the patients are brought to our attention it is too late for treatment. Hence, we hope to raise public awareness so that they will come forward and take advantage of the free screening.” With greater public awareness and improved cancer treatments, liver cancer patients may look ahead with lighter hearts as NCCS brings its research work from the bench to the bedside.
ADVANCES IN RADIOTHERAPY IN THE MANAGEMENT OF EARLY PROSTATE CANCER PAGE C1 Under The Microscope SALUBRIS July / August 2009 INTRODUCTION Prostate cancer is a cancer whose incidence has been steadily increasing over the last 35 years. It is typically found in men older than 50 years but its incidence varies greatly around the world. In Singapore, it is now the 3rd most common male cancer. By Dr Terence Tan Sr Consultant Radiation Oncologist, Dept of Radiation Oncology, NCCS Early prostate cancer refers to cancer confined to the prostate (stage I & II) and these may be managed by surgery, radiotherapy or active surveillance. Locally advanced prostate cancer on the other hand is best treated by a combination of androgen suppression therapy and radiotherapy. This article looks at advances in the use of radiotherapy in the management of localised prostate cancer. DOSE It is now generally accepted that there is a doseresponse curve for prostate above the conventionally given 66 Gy. Studies from the Memorial Sloan- Kettering Cancer Center and M.D. Anderson Cancer Center have shown that patients have improved relapse-free survivals when given doses above 70 Gy. While studies into the delivery of even higher doses are on-going, the current recommendation is for doses of at least 74 Gy (minimum tumour dose) to be delivered. Dose escalation studies began in the era of 3-D conformal radiotherapy and it was noted that while increases in the total dose delivered to the tumour improved disease-free survival, rectal and bladder morbidity rates also increased. That was until the advent of Intensity Modulated Radiation Therapy (IMRT). IMRT Intensity modulated radiotherapy is a very sophisticated form of radiation where the cross-sectional exposure of each treatment beam is not uniform as in the past but is varied by computer control (intensity-modulated) such that parts of the beam passing through sensitive normal structures have reduced exposure rates while parts which pass through tumour and not normal tissues have higher exposure rates. In this way, when a number of such treatment beams are arrayed around the patient, the high-dose treatment volume can be made to envelope the tumour target volume very conformably while sparing the surrounding normal tissues to a degree even greater than the previously used 3-D conformal techniques. Even within the treatment volume, it is possible to vary the dose (dose-paint), giving for example a radical dose to the tumour proper while delivering a lesser prophylactic dose to the draining lymphatics, all within the same treatment session. The availability of this technology has made dose escalation to very high levels possible with even less side-effects. IMRT has been in use at the National Cancer Centre Singapore (NCCS) since 2001. Continued on page C2.
Page 1 and 2: Issue No. 05 • MICA (P) 207/10/20
Page 3: PAGE A3 In Other Words SALUBRIS Jul
Page 7 and 8: RATIONAL APPROACH TO TESTICULAR SWE
Page 9 and 10: 40th SMA National Medical Conventio
Page 11 and 12: WHERE DID YOUR FINGERPRINTS GO? PAG

Medical Professionals Version - National Cancer Centre Singapore

Create successful ePaper yourself

Delete template?

Save as template?