PERITONECTOMY FOR COMMON CANCERS - National Cancer ...

Issue No. 09 • MICA (P) 149/10/2009
AN NCCS BI-MONTHLY PUBLICATION
March / April 2010
...HELPING READERS TO ACHIEVE GOOD HEALTH
Salubris is a Latin word which means healthy, in good condition (body) and wholesome.
PERITONECTOMY
FOR COMMON
CANCERS

PAGE A2
In Other Words
SALUBRIS
March / April 2010
AN ASPIRING YOUNG
CLINICIAN-SCIENTIST
He is under no illusion that it will be a tough four years ahead, and
he is prepared to face the upcoming challenges resolutely. From the
Department of Medical Oncology at the National Cancer Centre
Singapore (NCCS), Dr Iain Tan will be embarking on his National
Research Foundation (NRF) – Ministry of Health (MOH) Healthcare
Research Scholarships.
It is great to see an aspiring young
talent take the arduous path of
being a clinician-scientist, and
that can only strengthen NCCS’
commitment to excellence in research
and clinical services.
Funded by the National Research
Foundation, the aim of this scholarship
is to equip doctors with the academic
qualifications and skills to pursue a
career as a clinician-scientist. The
NRF-MOH Research Scholarships also
seek to promote clinical and translational
research in Singapore.
The reasons that prompted Dr Tan
to apply for this scholarship were
straightforward. As a physician
with a deep interest in science,
it was his desire to participate in
such a translational research that
can potentially benefit cancer
patients and his aspiration to
undergo the rigours of scientific
training that can only be provided
by a formal PhD programme that
led to his decision.

PAGE A3
In Other Words
SALUBRIS
March / April 2010
Whilst there may be many others who will grab the opportunity of going overseas
with this PhD Scholarship, Dr Tan has gladly chosen to pursue his doctoral
programme locally. Started in January 2010, he devotes his time between the NCCS
and the National University of Singapore Graduate School.
The fervent interest in gastric cancer, which is a disease endemic in Asia, was
the rationale behind his stay in Singapore. In fact, Dr Patrick Tan, a principal
investigator from NCCS, has also set up a world leading genomics research
programme focusing specifically on gastric cancer.
“This is a perfect match of working in a scientific and clinical environment. I am
very comfortable in applying cutting edge translational research technologies on a
disease type I am interested in. I am indeed fortunate that all these can be found at
home, right at the Outram Campus,” said Dr Iain Tan.
Moreover, Dr Iain Tan will follow his interest and undertake research work under
the guidance of Dr Patrick Tan, who is also the associate professor at Duke-NUS
Graduate Medical School.
“I will be working mainly on the application of molecular technologies to identify
potential biomarkers in the tumour or blood of patients with gastric cancer that will
guide physicians in selecting the best treatment for individual patients, so that they
can benefit from the treatment with the least toxicity,” Dr Iain Tan explained.
It seemed like a great challenge for clinician-scientists to juggle the competing
demands between the lab, clinic and school. But Dr Tan believes that the most
important thing is to strive for a work-life balance. With a supportive supervisor and
department, and most importantly a loving and understanding wife, he is thankful
for their role in helping him to accomplish his achievements.
Dr Tan also believes that there are indeed many career opportunities for clinicianscientists
as the government has invested a large amount of resources in developing
the biomedical research environment in Singapore.
Cancer is a complicated field of study as there is no single standard treatment, and
it depends on the reactions of various individuals to the treatment. Therefore, it is
enlightening to see medical professionals, such as Dr Tan, putting in precious hours
for the benefit of cancer study in the long run.
“It is clear that cancer is not just one disease but extremely heterogeneous. Each
cancer profile is different and constantly evolves over time. The ‘personalised
medicine’ approach seeks to identify ‘predictive biomarkers’ for physicians to
select initial treatment, and adjust subsequent treatment that will be tailored to the
individual’s cancer profile. This is a paradigm shift away from the ‘one-size fits all’
approach and it is an area of intense research,” Dr Tan concluded.
By Joshua Tan
“I will be working mainly
on the application of
molecular technologies
to identify potential
biomarkers in the tumour
or blood of patients
with gastric cancer that
will guide physicians
in selecting the best
treatment for individual
patients, so that they can
benefit from the treatment
with the least toxicity.”
Dr Iain Tan

PAGE A4
In Focus
SALUBRIS
March / April 2010
PERITONECTOMY FOR
COMMON CANCERS
Besides the lymph nodes and blood
stream, another common site for the
growth and spread of cancer is the
peritoneum. Although it is unviable and
complex to treat peritoneal metastases
which is present in advanced stage
cancer, the National Cancer Centre
Singapore’s team of oncologists and
nurses recognise that treatment efforts on
the peritoneum can prevent the spread
of cancer and decided to take the lesstrodden
path to learn the intricacies of
the Peritonectomy – a procedure with
potential to prolong survival of patients.
Veronica Lee reports.
The team paid a month-long visit
to Dr Paul Sugarbaker, Director of
Surgical Oncology at the Washington
Cancer Institute and Washington Hospital
Center, the pioneer in this field to fine tune
their experience with Peritonectomy. They
later shared their learning in a seminar with
more than 60 surgeons, oncologists and
healthcare professionals at NCCS.
The peritoneum is a smooth transparent
serous membrane which lines the cavity
of the human body. With a massive
surface area comparable to that of the
skin which interlinks all parts of the body,
the Peritoneum can be implicated by
any pathological process that takes place
in the peritoneal cavity, enabling cross
metastasis of cancer to take place via the
fluid or cells within the cavity.
Peritonectomy was originally
used for Pseudomyxoma Peritonei
(PMP), a rare and slow-growing
type of cancer. The good results
with PMP has been encouraging
and led to an attempt of the
procedure on more common
cancers which affect the
peritoneum like colorectal and
ovarian cancers.
About 25% of colon cancer patients and 50% of ovarian cancer patients are known to have
metastasised cancer in the peritoneal cavity at some stage of their disease.
The treatment which removes all visible cancerous tumour deposits in the abdominal cavity
involves seven major surgical procedures in a single operation of between 7 and 14 hours.
This is followed by Hyperthermic Intraperitoneal Chemotherapy (HIPEC), a procedure
which rinses the abdominal cavity with heated chemotherapy to eliminate the residual
tumour implants that are invisible to the naked eye for more effective tumour cell death than
conventional chemotherapy.
On the complexity of Peritonectomy, Dr Tan Yu-Meng, Deputy Head and Senior Consultant,
Department of Sugical Oncology explained, “This surgical procedure requires a surgeon to
be familiar with surgery of not just the primary organ but the entire abdominal cavity and
especially the pelvic organs and the liver. It also requires significant stamina and meticulous
surgical technique. Ideally, we need a multi-disciplinary team to successfully carry out this
procedure. Surgeons and medical oncologists of different sub-specialties must synchronise
all efforts for the benefit of patients. It is a coordinated effort of every team member as
everyone has to avail themselves for such a complex surgery.”
Dr Tan added that the morbidity and mortality from this complex procedure are significant
and many of these cancers are already advanced at presentation and recurrence can be
high. Not all patients are suitable for such treatment.
Dr Tan however believes there is potential for better outcomes for patients and surgeons.
“It is possible to prolong survival in selected patients who would be deemed incurable.
This procedure involves a bridging of knowledge and expertise of sub-specialties also offers
us opportunities to learn from one another on how to handle difficult surgeries,” he said.
With more than 50 Peritonectomies performed at NCCS, Dr Tan said it is a good starting
point for the field to evolve into mainstream surgery and overcome the rarity of the
treatment in the future. This would lead to the prolonging of patients’ lives, a goal that NCCS
constantly seeks to achieve.

CUTTING CALORIES TO
PREVENT CANCER
PAGE B1
Looking Forward
SALUBRIS
March / April 2010
Obesity is on the rise and reaching epidemic
proportions in many parts of the world. The adverse
effects of obesity on health are causes for anxiety
because it is a fundamental problem of public
health. Recent studies have shown that many Asians,
including Singaporeans, have higher proportion of
body fat compared to Caucasians of the same age,
gender and Body Mass Index (BMI).
Singaporeans are consuming more calories than before, putting them at risk for
other diseases such as diabetes and cancer. At the same time, more of us are
leading a sedentary lifestyle. When you combine these two factors, it is not
surprising to see an increase in obesity rate in Singapore.
THE INCIDENCE OF OBESITY IS GREATER IN:
• the age group 50 to 59
• women (although men have a greater incidence of being
overweight i.e. BMI in the range of 25 to 30)
The increasing level of obesity amongst
children is also a concern. One of the
reasons is due to the rise in calorie
intake as more families dine out. Fast
food restaurants can be found in every
shopping mall and heartland, so it is
cheap and easy to maintain a high fat,
high calorie diet. Food portions served
at restaurants are typically larger and
contain high levels of unhealthy fats with
little fiber or nutrients.
These factors along with fewer
opportunities for exercise, contributes
to expanding waistlines. But people are
starting to pay attention to the kind of food
they eat as cancer incidences rises and
their awareness of the disease increase.
In 2004, members of the World Health Organisation (WHO) convened to hold an
expert consultation to review the BMI cut-offs which defines risks for diseases in Asian
populations. The Ministry of Health and Health Promotion Board have recommended
the following BMI cut-offs:
BMI (kg/m2) for Adults
Health Risk
27.5 and above High Risk
23 – 27.4 Moderate Risk
18.5 – 22.9 Low Risk (healthy range)
Below 18.5
Risk of nutritional deficiency diseases
and osteoporosis
Continued on page B2.

PAGE B2
Looking Forward
SALUBRIS
March / April 2010
CUTTING CALORIES TO
PREVENT CANCER
Continued from page B1.
CALCULATE YOUR BODY MASS INDEX BY USING
THIS FORMULA:
BMI
(kg/m 2 )
=
Weight (kgs)
Height in metres 2
Or use the BMI Calculator at http://www.nhlbisupport.com/bmi/bmi-m.htm
HERE ARE SOME TIPS
TO KEEP YOUR HEALTH
UP AND YOUR
CALORIES DOWN:
Scrutinise food labels
It pays to scrutinise the ingredients
listed on labels. Manufacturers often
use misleading terms such as “sea salt”
instead of “salt”, “sucrose” or “fructose”
instead of “sugar”. There is as yet little
evidence that dietary supplements such
as vitamin pills can replace the benefits
of a healthy diet.
Exercise regularly
Regular exercise has been linked to a
reduction in the incidence of cancer in
some studies. Although some of these
studies are often difficult to interpret
with certainty: people who exercise, for
example, are less likely to smoke. There
is growing evidence that regular exercise
helps prevent cancer.
Start the day right
Breakfast is the most important meal of
the day. Some studies have shown that
people who consumed more calories
in the morning will take fewer calories
throughout the rest of the day. It is good
to have a large breakfast to start the day.
Smaller servings
Replace standard sized plates with
smaller ones. Even though you
fill up your plate, you will still be
getting fewer calories. Eat slowly
because it can take several minutes
for the brain to get the message that
the stomach is full. Leave the table
before you feel completely full so
that you won’t overeat.
Snacking
There is a large variety of unhealthy
snacks easily available in stores and
vending machines. Most of these
food are high in calories and low in
nutrition. Opt to take healthy snacks
such as fresh or dried fruit so that
you will not be tempted by the
unhealthy snacks.
Dining out
When you do dine out, make better
choices. Skip the soft drink and
choose water instead. Order a fruit
yoghurt instead of creamy desserts.
Many restaurants now offer a “lighter”
section that includes lower fat and
carbohydrate entrées.
Look for the “Healthier
Choice” label.
The healthiest diets are those rich in fruits,
vegetables, fiber and low in calories. Select dark
coloured fruits and vegetables such as spinach,
kale, strawberries and blueberries. They contain
more vitamins and antioxidants. Read the labels
and be aware of how many calories you are
consuming on a daily basis.
Keep your child slim
Instill a healthy dietary habit in children and
keep them slim and active. Avoid feeding
them food that contain excessive sugar, fat and
carbohydrate, and encourage regular exercises.
After all, a lifetime of “healthy eating” may
reduce cancer risk by as much as 30 to 50%, so
it is never too early to start!
By Flora Yong
Senior Nurse Manager
Cancer Education & Information Service
NCCS
REFERENCES:
Health Promotion Board – Revision of Body Mass
Index (BMI) Cut-Offs in Singapore. Press release
issued on 16th March 2005.
Department of Health and Human Services –
National Institute of Health Calculate your Body
Mass Index http://www.nhlbisupport.com/bmi/

CLUEING-IN TO
CHEMOTHERAPY SIDE-EFFECTS
PAGE B3
Tender Care
SALUBRIS
March / April 2010
Patients diagnosed with cancer receiving chemotherapy
will experience some side effects in the course of their
treatment. Not only are there changes to their body,
there are also emotional and psychosocial changes
associated with chemotherapy. As their child(ren),
next-of-kin or caregivers, it is important to give the
patient your utmost support and care.
Below is a table of common side effects which may be used as a guide to
help your loved ones manage it and achieve a better quality of life.
Side Effect Characteristics Non-Drug Management Drug Management
Alopecia
(Hair loss)
• Temporary
• Varies from slight thinning to
complete baldness
• Can start 10 to 21 days after
receiving chemotherapy
• Severity depends on type of drug
• Keep hair short
• Wear a wig or head covers
• Avoid using strong medicated
shampoo
• Use SPF-containing skin products to
protect skin and exposed scalp
Anorexia
(Loss of appetite)
Due to:
• Change in taste
• Psychological factor
• Reduced saliva production
Onset of anorexia varies with each
individual. Approximately 15 to 40%
of patients will experience it earlier
in the course of treatment.
• Patient should avoid food found
unpleasant previously
• Use seasonings, gravies, or sauces
to improve flavour
• Marinate meat to enhance
flavour or replace with other high
protein foods if there is a strong
dislike for meat
• Take small but frequent meals
• Discuss with your doctor
if appetite stimulant are
OK for patient (e.g. megestrol
or dexamethasone)
• Artificial saliva to moisten
the mouth
• Saliva stimulant
(e.g. pilocarpine)
Note: The above medications
are prescription items.
Nausea and
Vomiting
• If nausea or vomiting happens,
it is usually worst on the day
of treatment
• Can last for 3 or more days
after chemotherapy
• Try food or beverages that are
easy to consume
• Avoid fatty or fried food, or food
that is very spicy or sweet
• Eat food that has been cooled to
room temperature or cold
• Take anti-vomiting drugs
as prescribed by the doctor
e.g. metoclopramide,
dexamethasone, ondansetron
or granisetron
Tip: Take the medication as a
preventive measure or as soon as
the patient feels nausea. Do not
wait till the patient has vomited.
Continued on page B4.

PAGE B4
Tender Care
SALUBRIS
March / April 2010
CLUEING-IN TO
CHEMOTHERAPY SIDE-EFFECTS
Continued from page B3.
Side Effect Characteristics Non-Drug Management Drug Management
Constipation
• Unable to move bowels
(need to strain)
• Moving bowels less often
than before
• Hard stools
• Drink 6 to 8 glasses of fluid each day
• Consume more fiber (e.g. cereals,
fruits and vegetables)
• Exercise daily
• If the patient tends to develop
constipation after each
course of chemotherapy, take
medication e.g. lactulose,
senna, bisacodyl, liquid
paraffin, fybogel to prevent
it from recurring after
subsequent cycles
Diarrhoea
• More than 2 loose or watery
stools per day
• May occur within 24 hours of
chemotherapy (acute) or more
than 24 hours after chemotherapy
• Eat smaller but more frequent meals
• Eat low-fiber food e.g. white bread,
white rice, fish and yogurt
• Avoid high-fiber food e.g.
whole-grain breads, cereals and
raw vegetables
• Drink plenty of fluids (about 2 litres)
e.g. water, apple juice, clear soups
• Avoid milk and milk products
• Refrain from coffee, tea, and alcohol
• Take the anti-diarrhoea drugs
as prescribed by the doctor
e.g. loperamide, lomotil
Fatigue
• Weak, tired
• Lacks self-motivation
• Dizzy spells
• Feelings of laziness or depression
• Take well-balanced meals and
drink sufficient water
• Keep a bedtime routine
• Do light exercises
• Avoid doing over-tiring
household chores
• Supplement with energyfortified
drinks
• Discuss with your doctor if you
need treatment for anaemia
(supplement with iron tablets
or multivitamins, injection of
erythropoietin or even blood
transfusion may be deemed
necessary by your doctor for
treating or preventing fatigue
due to anaemia)
Mucositis
(Sore mouth)
• Inflammation of the mouth lining
leading to redness and ulceration
• Examine the mouth regularly to
check for ulcers, patches, or scars
• Keep mouth clean and moist
• Avoid hot, spicy or sour food
and drinks
• Avoid smoking and excessive alcohol
• Avoid using mouthwash that contain
more than 6% alcohol
• Gargle regularly throughout the
day with salt water or antiseptic
mouthwash (e.g. chlorhexidine,
glycerin thymol)
• Apply oral gel to the ulcers
as prescribed by the doctor
(e.g. kenalog in orabase,
ora-sed gel)
Please call our Cancer Helpline at tel: 6225 5655 if you would
like to know more about other side effects of chemotherapy and
ways to manage it.
By Ng Hui Cheng
Senior Oncology Pharmacist
Oncology Pharmacy
NCCS

减 少 卡 路 里 癌 症 远 离 你
PAGE B5
往 前 看
SALUBRIS
March / April 2010
肥 胖 是 一 般 健 康 问 题 的 根
源 。 最 近 的 研 究 显 示 , 与 年
龄 、 性 别 和 身 体 质 量 指 数 一
样 的 白 种 人 相 比 , 很 多 亚 洲
人 的 体 内 脂 肪 比 例 较 高 。
现 在 的 新 加 坡 人 比 以 前 摄
取 更 多 卡 路 里 , 罹 患 其 他 疾
病 ( 例 如 糖 尿 病 和 癌 症 ) 的
风 险 也 相 应 增 加 。 更 糟 的 是 ,
我 们 大 多 数 人 都 缺 乏 运 动 。
身 体 质 量 指 数 的 计 算 公 式 :
身 体 质
量 指 数
(kg/m 2 )
=
体 重 ( 公 斤 )
身 高 ( 平 方 公 尺 )
或 者 使 用 身 体 质 量 指 数 计 算 机 :
http://www.nhlbisupport.com/
bmi/bmi-m.htm
以 下 两 个 组 别 的 肥 胖 率 较 高 :
以 下 是 一 些 小 贴 士 , 帮 助 你 减 少 卡 路 里 的 摄 取 量 , 保 持 身 体 健 康 :
• 50 岁 至 59 岁 的 人
• 女 性 ( 虽 然 男 性 超 重 的 机 率 较 高 ,
即 身 体 质 量 指 数 在 25 至 30 之 间 )
此 外 , 逐 渐 增 加 的 儿 童 肥 胖 问 题 也 引 起
人 们 的 关 注 。 其 中 一 个 原 因 是 越 来 越 多
家 庭 外 出 用 餐 , 导 致 儿 童 摄 取 过 量 的 卡
路 里 。 快 餐 店 比 比 皆 是 , 而 且 餐 厅 提 供
的 食 物 份 量 通 常 比 较 大 。 加 上 缺 乏 锻 炼
身 体 , 现 在 的 人 容 易 肥 胖 。 但 是 , 随 着
癌 症 发 病 率 上 升 和 人 们 对 疾 病 的 意 识
提 高 , 人 们 开 始 注 意 他 们 的 饮 食 习 惯 。
2004 年 , 世 界 卫 生 组 织 召 集 专 家 检 讨
身 体 质 量 指 数 的 健 康 临 界 点 , 以 便 为 亚
洲 人 定 义 罹 患 疾 病 的 风 险 。 新 加 坡 卫 生
部 和 保 健 促 进 局 对 身 体 质 量 指 数 的 健
康 临 界 点 提 出 了 以 下 建 议 :
成 人 的 身 体 质
量 指 数 (kg/m 2 )
健 康 风 险
27.5 及 以 上 高 风 险
23 – 27.4 适 度 风 险
18.5 – 22.9 低 风 险 ( 健 康 )
18.5 以 下 罹 患 营 养 缺 乏 症 和 骨
质 疏 松 症 的 风 险 提 高
查 看 食 物 标 签
花 一 点 时 间 仔 细 查 看 食 物 标 签 上 的 成
分 。 制 造 商 往 往 会 采 用 一 些 误 导 性 的 字
眼 , 例 如 用 “ 海 盐 ” 来 取 代 “ 盐 ”、 用 “ 蔗
糖 ” 或 “ 果 糖 ” 来 取 代 “ 糖 ”。 目 前 也 没 有
实 例 证 明 像 维 他 命 丸 这 样 的 保 健 食 品 可
取 代 健 康 饮 食 所 带 来 的 益 处 。
经 常 锻 炼 身 体
虽 然 有 些 研 究 难 以 阐 明 其 确 定 性 ( 例 如
常 做 运 动 的 人 通 常 不 抽 烟 ), 但 有 越 来 越
多 证 据 显 示 , 经 常 锻 炼 身 体 有 助 于 预 防
癌 症 及 减 少 癌 症 的 发 病 率 。
一 日 之 计 在 于 晨
早 餐 是 一 天 当 中 最 重 要 的 一 餐 。 研 究 显
示 , 在 早 上 摄 取 较 多 卡 路 里 的 人 , 在 接 下
来 的 一 整 天 内 将 摄 取 较 少 的 卡 路 里 。
减 少 食 物 分 量
把 标 准 大 小 的 盘 子 换 成 较 小 的 餐 具 。 即
使 你 把 盘 子 装 满 , 你 还 是 摄 入 较 少 的 卡
路 里 。 吃 东 西 时 , 应 放 慢 速 度 , 因 为 大 脑
需 要 几 分 钟 的 时 间 来 接 收 吃 饱 的 信 息 。
此 外 , 你 应 在 感 到 很 饱 之 前 离 席 , 以 免 自
己 吃 得 太 多 。
学 会 选 择 零 食
商 店 和 自 动 贩 卖 机 有 各 式 各 样 高 卡 路 里 ,
营 养 成 分 很 低 的 垃 圾 零 食 。 选 择 健 康 的
零 食 , 例 如 新 鲜 水 果 或 干 果 , 以 克 服 垃 圾
零 食 的 诱 惑 。
外 出 用 餐 慎 选 食 物
外 出 用 餐 时 , 你 应 舍 弃 汽 水 和 奶 油 甜 点 ,
选 择 白 开 水 和 水 果 酸 奶 。 你 也 可 留 意 餐
馆 是 否 有 “ 较 健 康 选 择 ”(Healthier
Choice) 标 签 。
健 康 饮 食 指 的 是 选 择 卡 路 里 低 及 水 果 、
蔬 菜 和 纤 维 含 量 高 的 食 物 。 选 择 颜 色 较
深 的 蔬 果 , 例 如 菠 菜 、 甘 蓝 类 蔬 菜 、 草 莓
和 蓝 莓 。 它 们 含 有 更 多 维 他 命 和 抗 氧 化
剂 。 仔 细 查 看 标 签 , 并 注 意 自 己 每 天 的 卡
路 里 摄 取 量 。
帮 助 孩 子 保 持 身 材
培 养 孩 子 健 康 饮 食 的 良 好 习 惯 , 以 保 持
他 们 身 材 适 中 、 活 泼 健 康 。 避 免 给 他 们 吃
含 有 过 量 糖 分 、 脂 肪 和 碳 水 化 合 物 的 食
物 , 以 及 鼓 励 他 们 常 运 动 。 说 到 底 , 健 康
饮 食 一 辈 子 可 减 少 罹 患 癌 症 的 风 险 高 达
30% 至 50%。 今 天 就 开 始 行 动 吧 !
作 者 : 杨 宝 燕
高 级 护 士 经 理
癌 症 教 育 与 资 讯 服 务 部
新 加 坡 国 立 癌 症 中 心
参 考 : 保 健 促 进 局 – 检 讨 新 加 坡 身 体 质 量 指 数 的 健
康 临 界 点 。 新 闻 稿 发 布 于 2005 年 3 月 16 日 。
美 国 卫 生 及 公 共 服 务 部 – 国 立 卫 生 研 究 院 。
计 算 你 的 身 体 质 量 指 数 :
http://www.nhlbisupport.com/bmi/

PAGE B6
温 柔 呵 护 化 疗 副 作 用 知 多 少 ?
SALUBRIS
March / April 2010
接 受 化 疗 的 癌 症 病 人 往 往 会 面 对 一 些 在 治 疗 期
间 出 现 的 副 作 用 。 他 们 的 身 体 会 产 生 一 些 变 化 ,
情 绪 和 社 会 心 理 也 会 因 为 化 疗 而 起 伏 不 定 。 因
此 , 身 为 病 人 的 子 女 、 家 属 或 看 护 者 , 你 一 定 要
给 予 他 们 最 大 的 支 持 和 关 怀 。
以 下 图 表 是 化 疗 常 见 的 副 作 用 , 让 你 作 为 参 考 , 更 好 地 帮 助 病 人 控 制 这
些 副 作 用 , 维 持 良 好 的 生 活 品 质 。
副 作 用 特 征 非 药 物 控 制 法 药 物 控 制 法
脱 发
• 暂 时 性
• 保 持 短 发
• 因 人 而 异 ; 有 些 人 只 是 轻 微 脱
发 , 有 些 人 则 严 重 秃 头
• 接 受 化 疗 10 至 21 天 后 开 始
脱 发
• 严 重 程 度 视 所 服 用 的 药 物 而 定
• 戴 假 发 或 头 套
• 避 免 使 用 药 效 强 烈 的 洗 发 剂
• 使 用 含 防 晒 系 数 的 护 肤 品 , 以 保
护 皮 肤 和 外 露 的 头 皮
厌 食 症
( 没 有 胃 口 )
原 因 :
• 味 觉 产 生 变 化
• 心 理 因 素
• 唾 液 分 泌 减 少
出 现 厌 食 症 状 的 时 段 因 人 而 异 。
大 约 15% 至 40% 的 病 人 在 治 疗 初
期 就 会 出 现 这 种 症 状 。
• 避 免 一 些 令 病 人 食 欲 不 振 的 食 物
• 使 用 调 味 料 、 肉 汁 或 酱 汁 来 增 加
食 物 的 味 道
• 烹 煮 前 先 腌 肉 , 让 食 物 更 美 味 。
如 果 病 人 不 喜 欢 吃 肉 , 可 用 其 他
高 蛋 白 质 食 物 来 取 代
• 少 量 多 餐
• 咨 询 医 生 的 建 议 , 看 看 病 人
是 否 适 合 服 用 开 胃 剂 ( 例 如
甲 地 孕 酮 或 地 塞 米 松 )
• 使 用 人 工 唾 液 , 让 口 腔 湿 润
• 使 用 唾 液 刺 激 素 ( 例 如 匹 罗
卡 品 )
注 : 以 上 皆 为 处 方 药 。
恶 心 呕 吐
• 恶 心 呕 吐 的 症 状 通 常 在 化
疗 当 天 最 为 严 重
• 化 疗 后 , 这 种 症 状 可 持 续
三 天 或 更 久
• 选 择 易 于 下 咽 的 食 物 或 饮 料
• 避 免 油 腻 或 油 炸 、 太 辣 或 太 甜
的 食 物
• 食 用 已 经 降 至 室 温 或 放 凉 的
食 物
• 服 用 医 生 开 的 止 吐 药 , 例 如
甲 氧 氯 普 胺 、 地 塞 米 松 、 恩
丹 西 酮 或 格 雷 西 隆
提 示 : 在 病 人 感 到 恶 心 时 服
用 , 以 防 万 一 。 不 要 等 到 病 人
呕 吐 后 才 吃 药 。

PAGE B7
温 柔 呵 护
SALUBRIS
March / April 2010
副 作 用 特 征 非 药 物 控 制 法 药 物 控 制 法
便 秘 • 无 法 排 便 ( 排 便 时 须 要 用 力 )
• 排 便 次 数 比 以 前 少
• 粪 便 很 硬
• 每 天 喝 六 至 八 杯 水
• 摄 取 更 多 纤 维 ( 例 如 麦 片 、 水 果
和 蔬 菜 )
• 每 天 运 动
• 如 果 病 人 每 次 化 疗 后 都 出 现
便 秘 , 可 服 用 乳 果 糖 、 番 泻
叶 、 比 沙 可 啶 、 石 蜡 油 和 纤
维 通 便 剂 等 药 物 , 以 避 免 日
后 再 出 现 这 种 症 状
腹 泻
• 一 天 腹 泻 超 过 两 次
• 会 在 化 疗 后 的 24 小 时 内 ( 急 性
反 应 ) 或 超 过 24 小 时 后 出 现
• 少 量 多 餐
• 吃 低 纤 维 食 物 , 例 如 白 面 包 、 白
饭 、 鱼 和 酸 奶
• 服 用 医 生 开 的 止 泻 药 , 例 如
洛 哌 丁 胺 、 复 方 苯 乙 哌 啶
• 避 免 高 纤 维 食 物 , 例 如 全 麦 面
包 、 麦 片 和 生 菜
• 喝 大 量 的 水 ( 大 约 两 公 升 ) , 例 如
白 开 水 、 苹 果 汁 和 清 汤
• 避 免 牛 奶 和 乳 制 品
• 避 免 饮 用 咖 啡 、 茶 和 含 酒 精 饮 料
疲 劳
• 虚 弱 、 疲 倦
• 喝 足 够 的 水 及 摄 取 均 衡 的 饮 食
• 喝 补 充 体 能 的 饮 料
• 干 劲 不 足
• 晕 眩
• 感 到 懒 惰 或 郁 闷
• 保 持 固 定 的 就 寝 时 间
• 做 轻 微 的 运 动
• 避 免 做 太 累 的 家 务
• 咨 询 医 生 的 建 议 , 看 看 病 人
是 否 须 要 治 疗 贫 血 ( 摄 取 补
铁 药 片 或 综 合 维 他 命 、 注 射
促 红 细 胞 成 长 素 或 医 生 可 能
认 为 需 要 输 血 , 以 治 疗 或 预
防 因 贫 血 而 引 起 的 疲 劳 )
口 腔 发 炎
( 口 疮 )
• 口 腔 发 炎 , 导 致 红 肿 和 溃 烂
• 定 期 检 查 口 腔 溃 疡 、 斑 点 或 疤 痕
• 保 持 口 腔 清 洁 和 湿 润
• 避 免 热 、 辣 或 酸 的 食 物 和 饮 料
• 避 免 抽 烟 和 酗 酒
• 避 免 使 用 含 有 超 过 6% 酒 精 的 漱
口 剂
• 全 天 定 时 使 用 盐 水 或 抗 菌 漱
口 剂 ( 例 如 洗 必 泰 、 百 里 香
酚 甘 油 ) 漱 口
• 使 用 医 生 开 的 口 服 凝 胶 ( 例
如 口 腔 软 膏 、 痱 滋 膏 ) , 治
疗 口 腔 溃 疡
请 拨 打 我 们 的 癌 症 援 助 热 线 6225 5655, 以 便 了 解 更
多 化 疗 的 其 他 副 作 用 及 控 制 方 法 。
作 者 : 黄 慧 真
高 级 肿 瘤 学 化 疗 药 剂 师
肿 瘤 学 化 疗 药 物 部 门
新 加 坡 国 立 癌 症 中 心

PAGE B8
Outreach
SALUBRIS
March / April 2010
UPCOMING PUBLIC EDUCATION
ACTIVITIES / PROGRAMMES
Event Name Date, Time, Venue Registration Details
CancerWise Workshop –
UNDERSTANDING
COLORECTAL CANCER
TOPICS:
a. Common Bowel Problems
b. Risks, Signs & Symptoms
c. Early Detection & Prevention
d. Screening & Diagnostic Procedures
e. Treatment Options
22 May 2010, Saturday
Session will be conducted in English.
1pm
– Registration
1.30pm to 4pm – Workshop
Function Room, Level 4
National Cancer Centre Singapore
11 Hospital Drive, Singapore 169610
Admission fee: $5
To register, please call: 6225 5655 or
register online: www.nccs.com.sg.
FOR MORE INFORMATION ABOUT CANCER
Cancer Helpline Tel: 6225 5655
Email: cancerhelpline@nccs.com.sg
Monday to Friday: 8.30am to 5.30pm
Saturday, Sunday & Public Holiday: Closed
欲 了 解 更 多 有 关 癌 症 的 资 讯 , 请 拨 打 癌 症 援 助 热 线
电 话 : 6225 5655
电 邮 : cancerhelpline@nccs.com.sg
星 期 一 至 星 期 五 : 上 午 8 点 半 至 下 午 5 点 半
星 期 六 , 星 期 天 及 公 共 假 期 : 休 息

ADDING SMILES TO PATIENTS’
FACES…WITH A KRUNCH!
PAGE A5
Community
SALUBRIS
March / April 2010
“Thank you. I’ve always enjoyed this,”
said the patient as she reached out for a
sachet of Oat Krunch crackers in the tray,
with the words ‘Bite Me’, and ‘Try Me’
scribbled on the pack.
This was the Monday morning routine for the team from Corporate
Communications Department as they went round distributing free Munchy’s
at the National Cancer Centre Singapore clinics since December last year.
Patients and visitors alike get the opportunity to sample Chunky Organic Hazelnut
and Strawberry & Blackcurrent Oat Krunch crackers.
As the name implies, oat is the main ingredient used, and is no wonder a big hit
among the patients. Those who return regularly for treatment often look forward to
this special Monday treat.
The project was sponsored by Munchy Food Industries Sdn Bhd. Munchy’s,
a Malaysian homegrown brand which started out in 1999, has since grown
tremendously and now boasts more than 70 products ranging from biscuits to wafers
and crackers. Their mission: “To provide fun, cheeky, yummylicious, and affordable
biscuits and snacks for everybody around the world.”
Fun aside, the company is committed to giving back to society. It thus came as no
surprise when Country Manager Munchy’s Singapore, Ms Vonnis Ho, knocked on the
doors of the NCCS, hoping a little ‘Krunch’ could make a difference in the lives of
patients, visitors, and healthcare staff there.
“It (giving back to society) has always been
part and parcel of Munchy’s culture,” said
Ms Ho. “It’s our way of thanking consumers
for their support.”
Indeed, apart from NCCS and the Singapore
General Hospital, Munchy Food Industries
has to-date supported more than 130 events,
including charity events, in Malaysia alone.
Commenting on the Corporate Communications
project, Mr Sunny Wee, Community and Media
Relations Advisor of NCCS expressed his
gratitude saying, “We are thankful to Munchy
Food Industries for their charitable support.
What we are doing is part of our corporate
policy to show care and compassion to our
patients in whatever way we can.”
By Carol Ang
Executive
Corporate Communications
NCCS

PAGE A6
People
SALUBRIS
March / April 2010
SCIENTIST MARISSA TEO GETS
TOP UNESCO-L’OREAL AWARD
- lst S’pore woman to win the international fellowship
Never mind the distance, never mind the
cold, Dr Marissa Teo did the honours for the
National Cancer Centre Singapore (NCCS)
to become the first Singaporean to receive
the coveted UNESCO-L’Oreal for Women in
Science International Fellowship.
Donning a knee-length white cheongsam, the petite Dr Teo went on stage
in Paris to receive what she would deem as “one of the highlights in my
arduous journey as a scientist”.
There was every reason to be happy as Dr Teo was among the 15 recipients of the
International Fellowship, awarded annually to young women scientists pursuing
their doctorate or post-doctorate in Life Sciences.
Three from each of the five regions, namely Africa, Latin America and the
Caribbean, Asia and the Pacific, Arab States, and Europe and North America are
selected by the UNESCO-L’Oreal Fellowship Selection Committee.
“It could possibly
stem from my sheer
determination, stamina
and ‘never-say-die’
attitude because in
research, months of
hard work very often
does not equate to the
output that we desire.
So we have to keep
trying and have no
fear of failure.”
Dr Marissa Teo
Dr Teo, 33, is a research fellow in the Laboratory of Cell Therapy and Cancer
Vaccine of the Humphrey Oei Institute of Cancer Research. She graduated from
the National University of Singapore with a Bachelor of Science in Pharmacy
degree in 1999 and pursued her PhD in biochemistry and molecular biology from
Washington’s Georgetown University.
Upon her return to Singapore in 2004, she joined NCCS as a fellow and has
been working alongside Dr Toh Han Chong, Associate Investigator and Head
of the Medical Oncology Department on a potential treatment for patients with
nasopharyngeal carcinoma.
Nasopharyngeal carcinoma, or
cancer of the nose, is the 6th
most common cancer amongst
Singaporean men, more so among
the Chinese. It claimed the lives of
542 men between 2003 and 2007,
according to the Singapore Cancer
Registry’s Interim Report on Trends
in Cancer Incidence in Singapore.
Photo courtesy of L’Oreal Singapore.

PAGE A7
People
SALUBRIS
March / April 2010
Dr Teo’s International
Fellowship award came with
prize money and a short
stint at the world renowned
Center for Cell and Gene
Therapy in Baylor College
of Medicine, Houston, USA.
There at the Center, she
will study EBV and “train”
lymphocytes, a type of white
blood cells drawn from the
patient and inject it back to
the donor to fight EBV.
Epstein Barr virus (EBV) which is linked to the causation of nasopharyngeal
carcinoma is also common in China, Southeast Asia, the Arctic region and North
Africa. So the success of her research will be beneficial not only to Singaporeans but
also to people in the region suffering from the disease.
Dr Teo’s International Fellowship award came with prize money and a short stint
at the world renowned Center for Cell and Gene Therapy in Baylor College of
Medicine, Houston, USA. There at the Center, she will study EBV and “train”
lymphocytes, a type of white blood cells drawn from the patient and inject it back to
the donor to fight EBV.
On her secret to success, Dr Teo shared that “it could possibly stem from my sheer
determination, stamina and ‘never-say-die’ attitude because in research, months of
hard work very often does not equate to the output that we desire. So we have to
keep trying and have no fear of failure.”
By Carol Ang
Executive
Corporate Communications
NCCS
PROMOTIONS
WELCOME
NAME
Dr Soong Yoke Lim
Dr Tan Min-Han
Dr Ngeow Yuen Yie Joanne
Dr Chau Noan Minh
Dr Tan Ngian Chye
Dr Harsh Kumar Ashok Kumar Sadana
Dr Lim Hwee Yong
Dr Tay Kuang Wei Kevin
Dr Kiattisa A/P Sommat
TITLE
Consultant, Radiation Oncology
Consultant, Medical Oncology
Associate Consultant, Medical Oncology
Consultant, Medical Oncology
Consultant, Surgical Oncology
Associate Consultant, Oncologic Imaging
Associate Consultant, Medical Oncology
Associate Consultant, Medical Oncology
Registrar, Radiation Oncology

PAGE A8
NCC Foundation
CYCLE OF HOPE
SALUBRIS
March / April 2010
The 2nd OCBC Cycle
Singapore is more than
just a cycling event where
competitive cyclists
congregate at the F1 race
track to compete against
each other or where amateur
cyclists, families and friends
come to have fun.
With their strong belief to do their bit for the community, OCBC supported
Adviser of the National Cancer Centre Singapore (NCCS), Prof London
Lucien Ooi’s initiative to host a non-competitive category together with
NCCS – The Cycle of Hope, for the first time to increase cancer awareness amongst
Singaporeans as well as to raise funds to support cancer research.
The result? A turnout of more than 400 participants. These included cancer survivors
from the various cancer support groups within NCCS, their families and friends, staff
of NCCS, as well as a strong contingent from Methodist Girls’ School (MGS) who
took part in the ride, covering a distance of 2.5km or 5km along the F1 Pit Building
on the beautiful evening of 6th March 2010.
Also present were Dr William Tan, ambassador and friend of NCCS and Mr Ezzy Wang
a cancer survivor. It was truly an inspiring moment for many who were there to cheer
for them on their return lap. The duo were an embodiment of the true spirit of hope
in the event. “It was something that I had to do. I want to show everyone that there is
still hope. As long as we keep going, we will reach the finish point and find a cure for
cancer,” said Ezzy.
Besides taking time off from their books to hit the road, MGS students also contributed
their time and effort towards cancer education and cancer research. Dressed in
laboratory coats, the students engaged visitors to the NCCS booth and encouraged
them to pen their notes of encouragements on coloured cards for cancer patients.
The coloured cards, sold to raise funds for
NCC Research Fund (NCCRF), formed a
delightful rainbow currently on display at the
NCCS lift lobby on level two.
More than $15,000 was raised in total for
NCCRF through the consolidated efforts of
these avid supporters.
“The Cycle of Hope would not have been
possible without the participation of our brave
cancer warriors, supporters, generous sponsors,
MGS and NCCS staff who volunteered their time
for this momentous event,” said Prof London
Lucien Ooi.
“Every cent raised for cancer research
will help propel our researchers,
scientists and clinicians further in their
knowledge and understanding of the
disease. This in future will allow them
to bring breakthroughs in treatment or
diagnosis to benefit cancer patients.”
Editorial Advisors
Dr Kon Oi Lian
Prof Soo Khee Chee
Executive Editors
Ms Carol Ang
Ms Veronica Lee
Mr Sunny Wee
Contributing Editor
Dr Wong Nan Soon
Members, Editorial Board
Ms Audrey-Anne Oei
Ms Sharon Leow
Ms Flora Yong
Medical Editor
Dr Richard Yeo
Members, Medical Editorial Board
Ms Lita Chew
Dr Mohd Farid
Dr Melissa Teo
Dr Teo Tze Hern
Dr Deborah Watkinson
is produced with you
SALUBRIS in mind. If there are other
topics related to cancer that you would like to read about
or if you would like to provide some feedback on the
articles covered, please email to salubris@nccs.com.sg.
NATIONAL CANCER CENTRE SINGAPORE
Reg No 199801562Z
11 Hospital Drive Singapore 169610
Tel: (65) 6436 8000 Fax: (65) 6225 6283
www.nccs.com.sg