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Issue No. 01 • MICA (P) 207/10/2008<br />

an nccs bi-monthly publication<br />

October / November 2008<br />

...helping readers to achieve good health<br />

Taking <strong>Cancer</strong> Care<br />

to the next level<br />

An interview with Prof Soo Khee Chee


Page A2<br />

In Other Words<br />

SALUBRIS<br />

October / November 2008<br />

Taking <strong>Cancer</strong> Care<br />

to the next level...<br />

The <strong>National</strong> <strong>Cancer</strong> <strong>Centre</strong><br />

<strong>Singapore</strong> (NCCS) is known<br />

not just for its expertise in<br />

cancer treatment but as<br />

one of the key centres in<br />

cutting-edge research. Behind<br />

this success is its founding<br />

director Prof Soo Khee Chee,<br />

whose passion for research has<br />

put NCCS on the world stage.<br />

Be it 0730 hours or 1930 hours,<br />

whichever time of the day you<br />

pick, it is not uncommon to see<br />

the lights at his office on the fourth<br />

level of Goh Song Chiang Building.<br />

Not an unearthly hour, yet many of us<br />

would still be in our pyjamas. But not<br />

for Prof Soo Khee Chee. Tranquility for<br />

him is an opportunity to get his paper<br />

work done.<br />

In more than one way, Prof Soo, or just<br />

Prof, as he is affectionately known to<br />

his colleagues, wears many hats but is a<br />

man of few words.<br />

As NCCS Director, he is tasked with<br />

looking into policy matters and research<br />

projects. On his plate is the constant<br />

need to raise funds to support these<br />

research projects. He attends to patients<br />

at his clinic, performs surgery, and also<br />

shares his experience and expertise<br />

with his specialists, as well as teach the<br />

younger doctors. Not only that, he is the<br />

Vice Dean, Clinical and Faculty Affairs,<br />

of the Duke-NUS Graduate Medical<br />

School, and his latest additional role<br />

is his appointment as Assistant CEO of<br />

SingHealth Group overseeing research<br />

and education.<br />

Prof Soo is one of the<br />

pioneers who saw the birth<br />

of NCCS, and today runs it<br />

with clockwork efficiency,<br />

attending to the majority<br />

of public patients. He is the<br />

face of NCCS in the global<br />

fraternity and is one of the<br />

founders of the Asian <strong>National</strong><br />

<strong>Cancer</strong> <strong>Centre</strong>s Network.<br />

A firm believer in research, he is<br />

constantly strategising and encouraging<br />

his team of investigators and clinician<br />

scientists. His prime worry is finding the<br />

funds to keep their projects going. For<br />

the Penang-born professor, his efforts<br />

have not been in vain.<br />

Today, NCCS is an example of what a<br />

premier cancer centre should be. Teams<br />

of specialists from various medical<br />

disciplines work together, supported by<br />

a talented pool of clinician scientists,<br />

focusing on how the patients can benefit<br />

from their discoveries. On hand are<br />

also the latest medical equipment, for<br />

example in radiation technology, so that<br />

they can also leverage on advances in<br />

IT to complement their efforts. NCCS, as<br />

part of its comprehensive service, also<br />

offers patients psycho-social counselling<br />

and carries out a whole menu of support<br />

programmes to help patients journey<br />

through their illness.<br />

Doctors at NCCS also carry out clinical<br />

trials as they have a wide patient base<br />

which is required for any trial to be<br />

effective. This also means that the<br />

doctors get to see the different types of<br />

cancer and hence are better exposed<br />

and experienced in responding to the<br />

patients’ needs.<br />

When asked about how things have<br />

turned out so far, a modest Prof Soo said:<br />

“I am pleasantly surprised that it has<br />

worked out better than we thought.”<br />

There were several issues that were<br />

important for NCCS at the time of its<br />

inception. One was to be able to create<br />

various multi-disciplinary segments so that<br />

sub-specialist care can be given to the<br />

patients in an efficient and timely manner.<br />

“This has turned out well because we are<br />

now able to offer a comprehensive range<br />

of specialist care in each of the major<br />

cancer groups,” he added.


Today, NCCS is an example of what a premier cancer centre should<br />

be. Teams of specialists from various medical disciplines work together,<br />

supported by a talented pool of clinician scientists, focusing on how the<br />

patients can benefit from their discoveries.<br />

Page A3<br />

In Other Words<br />

SALUBRIS<br />

October / November 2008<br />

Prof Soo, who was recently<br />

conferred the first national award<br />

by the Ministry of Health in<br />

recognition of his contribution to<br />

mentoring young doctors, is not<br />

one to rest on his laurels. One area<br />

where he feels things could have<br />

turned out better would be to<br />

house all cancer specialists under<br />

one umbrella, attending to cancer<br />

patients throughout <strong>Singapore</strong>.<br />

Getting<br />

the<br />

talents<br />

The other consideration involved<br />

recruiting highly talented scientists<br />

to generate a regular flow of in-depth<br />

research papers and create intellectual<br />

property in a productive way given the<br />

limitation in grants and other financial<br />

support for research projects.<br />

“NCCS is getting recognition for its<br />

work not only within <strong>Singapore</strong> and the<br />

region, but also globally,” said Prof Soo.<br />

In fact each year, he also schedules a<br />

few overseas trips to keep abreast of the<br />

latest in cancer treatment. He is also<br />

a sought-after speaker at distinguished<br />

overseas gatherings.<br />

“…But, what’s more important – winning<br />

the prize or curing polio? Of course<br />

it’s curing polio. It’s the science that’s<br />

important, not the recognition.”<br />

Prof Peter Courtland Agre 2003 Nobel Prize<br />

in Chemistry, in reference to Jonas Salk who<br />

though he made the polio vaccine, he never<br />

won the Nobel Prize.<br />

Some high profile research discoveries included the works by Dr Kon Oi Lian on<br />

developing cell-based treatments for metabolic disorders such as diabetes mellitus and<br />

haemophilia A; colorectal cancer vaccine and T cell therapy for nasopharyngeal cancer<br />

patients by Dr Toh Han Chong, and the role of the tumour-supressor genes, p53 and p73<br />

by Prof Kanaga Sabapathy.<br />

Now, NCCS has moved to the next level where it is sharing its expertise with others. Already<br />

it has proven to be a fertile training ground for grooming cancer specialists in <strong>Singapore</strong>,<br />

but now it has moved beyond its boundaries and are training specialists within the region.<br />

Doctors from Indonesia, Malaysia, Thailand, Vietnam are benefiting from this programme.<br />

Prof Soo, who was recently conferred the first national award by the Ministry of Health<br />

in recognition of his contribution to mentoring young doctors, is not one to rest on his<br />

laurels. One area where he feels things could have turned out better would be to house all<br />

cancer specialists under one umbrella, attending to cancer patients throughout <strong>Singapore</strong>.<br />

So far NCCS has helped the other hospitals to set up clinics to provide cancer services<br />

to their patients, such as at Changi General Hospital, KK Women’s and Children’s<br />

Hospital, <strong>National</strong> University Hospital and Tan Tock Seng Hospital.<br />

NCCS continues to be the only centre providing training for healthcare providers in<br />

palliative medicine, and with the setting up of the new Lien <strong>Centre</strong> for Palliative Care,<br />

the training programme is expected to benefit even more people.<br />

Asked how he retains talent within NCCS, he said the human resource structure is<br />

undergoing some robust changes, and the main clinicians and scientific investigators<br />

are now becoming faculty members of Duke-NUS Graduate Medical School. This<br />

Duke-NUS collaboration will help create a more intellectual milieu for the campus<br />

and advance the course of academic medicine. At the same time, it will train more<br />

specialists to meet the demand of a greying and expanding population.<br />

By Sunny Wee


Page A4<br />

In Focus<br />

SALUBRIS<br />

October / November 2008<br />

A Cure at what Price?<br />

– Searching for Personalised Yet Affordable Medicine<br />

For five years, Prof Huynh The Hung<br />

from the Laboratory of Molecular<br />

Endocrinology in <strong>National</strong> <strong>Cancer</strong><br />

<strong>Centre</strong> <strong>Singapore</strong> (NCCS) and his team<br />

have been working towards a noble dream.<br />

They embarked on a journey to<br />

come up with a personalised and yet<br />

affordable medicine to treat cancer.<br />

While personalised medicine is not<br />

new, most researchers are focused on<br />

looking for a treatment or drug that<br />

works in treating cancer.<br />

What sets this project apart is that the<br />

cost of therapy for the patient, should the<br />

treatment require more than two or three<br />

drugs, is another key consideration.<br />

Hence, Prof Huynh has to strike a<br />

tough balance, which could possibly<br />

explain why researchers often ignore the<br />

question of cost.<br />

This project entails taking tissues from<br />

a tumour of, for example, a liver cancer<br />

patient for implantation into the liver of<br />

six to eight mice. These SCID mice, as<br />

they are known, are immuno-deficient<br />

and they are commonly used as hosts for<br />

normal and malignant tissue transplants.<br />

This process is known as surgical<br />

orthotopic implantation and is believed<br />

to be available only in NCCS for research<br />

on hepatocellular carcinoma (HCC).<br />

The tumours are then allowed to grow<br />

in the mice while the team maps out<br />

several treatments for them using a<br />

combination of not more than three<br />

different drugs. These drugs are then<br />

administered to the mice as they would<br />

be to the patients. The mice are then<br />

monitored to gauge the response of the<br />

different drugs or combinations of drugs<br />

using the CT and PET scans.<br />

In doing so, it gives the team an idea<br />

of the combination of drugs that would<br />

work best for the respective patients<br />

whose tissues were grown in the mice.<br />

However, due to the underlying liver<br />

disease, not all patients are able to<br />

donate their tumour tissue for making<br />

xenografts and not all the HCC tissues<br />

from the patients will successfully grow<br />

in mice for drug testing. Furthermore,<br />

many patients may not have enough<br />

time to wait for the test results or be<br />

able to finance the surgical orthotopic<br />

implantation procedure or the drugs<br />

recommended. In these cases, Prof<br />

Huynh may still be able to find<br />

effective solutions by comparing the<br />

protein profile and/or gene signature<br />

of the affected patient with other<br />

patient-derived HCC xenografts in his<br />

therapeutic programme database to<br />

look for similarities and therapeutic<br />

regimens. Following this, he may also<br />

be able to recommend less expensive<br />

drugs that are likely as effective.<br />

Recently, NCCS joined hands with<br />

AstraZeneca, an Anglo-Swedish<br />

pharmaceutical firm, to test drugs to<br />

combat HCC. The combination of drugs<br />

being tested by the team is almost infinite.<br />

Apart from testing new compounds<br />

periodically provided by pharmaceutical<br />

companies, they may also combine the<br />

new compounds with existing drugs to<br />

see if better results can be attained. And<br />

even though Prof Huynh and his team<br />

now primarily deal with liver cancer,<br />

results of their work could potentially be<br />

used on other solid tumours.<br />

It was not smooth sailing for<br />

Prof Huynh when he first embarked<br />

on his research. In fact, it drew<br />

a lot of flak from the research<br />

community as tissues from patients<br />

were implanted and grown under<br />

the skin of the mice.<br />

But his persistence has finally paid<br />

off. With the new technique of<br />

surgical orthotopic implantation,<br />

many pharmaceutical companies<br />

have been approaching him to do<br />

pre-clinical testing for their new<br />

drugs. Hopefully, in the near<br />

future, this will result in patients<br />

having access to drugs that are<br />

personalised yet affordable.<br />

By Carol Ang


FACE OF A CANCER CELL<br />

Page B1<br />

Looking Forward<br />

SALUBRIS<br />

October / November 2008<br />

The structure or form of a cancer cell<br />

results from underlying abnormal<br />

genetic changes that it has undergone.<br />

Its features are best appreciated with<br />

the light microscope, and in general, a<br />

cancer cell will show an enlarged nucleus<br />

reflecting the accumulation of abnormal<br />

genetic material, and a conspicuous<br />

nucleolus indicating increased cell<br />

activity. Other typical alterations are<br />

nuclear pleomorphism, referring to<br />

variation in nuclear size and shape;<br />

and hyperchromasia, which also results<br />

from excess genetic material contained<br />

in its chromatin. Often, a cancer cell is<br />

described as revealing a high nuclearof<br />

benign cells. In such instances, other<br />

associated features of cancer are used<br />

to corroborate a malignant diagnosis.<br />

Do <strong>Cancer</strong> Cells Have a<br />

Recognisable Relationship<br />

with its Environment?<br />

<strong>Cancer</strong> cells in groups and nests,<br />

revealing pleomorphic nuclei,<br />

prominent nucleoli and mitoses.<br />

<strong>Cancer</strong> cells have the ability to invade the<br />

surrounding tissues. They form tonguelike<br />

groups and nests that permeate the<br />

stroma, sometimes even extending into<br />

blood vessels. The appearance of this<br />

irregular invasion is the underlying reason<br />

for its being called “cancer” which is<br />

derived from the latin word for “crab”.<br />

Structure of <strong>Cancer</strong> Cells<br />

In order to recognise a cancer cell, we<br />

need to be familiar with what makes a<br />

normal cell. A cell consists of a nucleus<br />

that contains the genetic matter, and<br />

cytoplasm which holds its organelles<br />

within a liquid environment. Cytoplasm<br />

is the cell substance between the cell<br />

membrane and the nucleus. Organelles<br />

are structures that are enclosed within<br />

its own membrane inside a cell and has<br />

a particular function. The nucleus has<br />

a small nucleolus that is involved in<br />

forming protein.<br />

cytoplasmic ratio, essentially implicating<br />

enlargement of the nucleus that occupies<br />

more of the individual cell volume. There<br />

is also increased mitotic (cell division)<br />

activity, reflecting rapid proliferation and<br />

growth of the cancer cells; abnormal<br />

mitoses such as tripolar mitoses may be<br />

seen. These characteristics of a cancer<br />

cell are termed anaplasia.<br />

Just as symmetrical and regular features<br />

lead to a pleasant face, anaplasia in a<br />

cancer cell is contemplated as ugly.<br />

<strong>Cancer</strong> Cell VS Normal or<br />

Benign Cell<br />

A normal or benign cell will not have<br />

the described abnormal changes. It will<br />

instead appear regular in shape and<br />

size, and the nucleus will generally<br />

have smooth contours. The chromatin<br />

(the readily stainable substance of a<br />

cell nucleus consisting of DNA and<br />

RNA and various proteins) is fine<br />

and the nucleolus inconspicuous.<br />

The nuclear-cytoplasmic ratio is<br />

not increased, and if mitoses are<br />

discovered, they are normal in<br />

appearance. There are some cancer<br />

cells that are very well-differentiated,<br />

such that their appearances mimic that<br />

Other Associated Features<br />

of <strong>Cancer</strong> Cells<br />

Since cancer cells grow very quickly,<br />

they can outstrip their blood supply,<br />

resulting in necrosis or cell death. There<br />

is haemorrhage or bleeding, due to new<br />

vessel formation accompanying the<br />

cancer growth, or destruction of vessel<br />

walls by the invading cancer cells. The<br />

connective tissue in which cancer cells sit<br />

can respond by evoking a “desmoplastic”<br />

reaction, which features loose fibroblastic<br />

stromal cells surrounding the cancer cell<br />

nests. The ability of cancer cells to invade<br />

blood vessels allow them to circulate and<br />

“metastasise” (spread) to other organs and<br />

tissues of the body, distant from the site<br />

of origin.<br />

Conclusion<br />

The cancer cell, while usually showing a<br />

fairly characteristic face, may sometimes<br />

assume less familiar appearances. It is<br />

important to understand that the cancer<br />

cell may have another countenance, and<br />

that a definitive diagnosis of malignancy<br />

relies on the careful interpretation of<br />

tissue and cell material by a pathologist.<br />

By Dr Tan Puay Hoon<br />

Head, Senior Consultant, Dept of Pathology,<br />

<strong>Singapore</strong> General Hospital


Page B2<br />

Looking Forward<br />

SALUBRIS<br />

October / November 2008<br />

What Should I Eat To<br />

Reduce My Risk of <strong>Cancer</strong>?<br />

Eating is widely regarded as one of life’s basic joys. It is not easy for anyone to<br />

change their dietary habits in response to advice about their health. However, with<br />

increasing awareness of cancer, people are starting to pay attention to the kinds of<br />

diet that may reduce the risks of eventually developing cancer.<br />

We have less hard evidence on this subject than we would like, reflecting the<br />

difficulties involved in reliably comparing dietary behaviours of people over a long<br />

period. However, the enormous amount of data that has been reported allow us to<br />

propose certain links between diet and cancer, as summarised in the table below:<br />

Dietary Factors that Increase<br />

Risk of Some <strong>Cancer</strong>s<br />

Obesity<br />

Processed food such as canned meat or<br />

“fast” (fried) food such as hamburgers and<br />

french fries<br />

Preserved (salted, cured, or smoked) food<br />

Red meat, especially if char-grilled<br />

Fat, especially animal fat or other<br />

saturated fat<br />

Excessive calories in any form e.g. sugar,<br />

starch, cakes, chocolates, soft drinks,<br />

beyond your daily energy requirement<br />

Alcoholic drinks especially if more than<br />

one per day<br />

Food that are contaminated by fungi that<br />

release mycotoxins (poisons produced by<br />

fungi), or by Helicobacter bacteria, e.g.<br />

rotten peanuts, stale meat or uncooked<br />

meat, certain mushrooms<br />

Chewing betel nut or tobacco<br />

What Else Can I Do?<br />

Exercise Regularly<br />

Dietary Factors that Reduce<br />

Risk of Some <strong>Cancer</strong>s<br />

Ideal body weight<br />

Wholesome grains and fibre e.g. whole<br />

wheat, bran, oatmeal, multigrain bread<br />

Fruits and vegetables e.g. broccoli, cabbage,<br />

carrots, tomatoes<br />

White meat e.g. fish and lean poultry<br />

(de-skinned)<br />

Low fat food and other unsaturated fats e.g.<br />

olive oil, omega-3 fatty acids (in fish)<br />

Exercise daily for at least 30 mins<br />

Folic acid found in green leafy vegetables<br />

e.g. spinach, asparagus, kai lan, peas<br />

and beans<br />

Properly stored food e.g. refrigerated<br />

Prompt disposal of food that have gone bad<br />

Meticulous oral hygiene (including<br />

dental flossing) to reduce bacterial growth<br />

Many factors such as genetics, diet, lifestyle, stress and environment being the most<br />

common have been linked to cancer. Like eating appropriately, regular exercise has<br />

been linked to a reduced incidence of cancer. There is increasingly convincing evidence<br />

that regular exercise may help to prevent cancer. Hence, cancer prevention would<br />

involve targeting these factors. Studies involving diet, smoking, alcohol and obesity,<br />

have indicated that obesity is a major risk factor of several types of cancer. Reviews<br />

have indicated that regular physical activity reduces the risk of colon and breast<br />

cancers. Exercise that targets the reduction of body fat causes changes in hormone level<br />

and enhances the immune system.<br />

Read Food Labels<br />

It pays to scrutinise the ingredients<br />

listed on labels. Manufacturers often<br />

use misleading terms such as “sea<br />

salt” instead of “salt”, or “sucrose” or<br />

“fructose” instead of “sugar”. Products<br />

that are labelled fat-free still contain<br />

fat, but have to have less than 5g of<br />

it to qualify as being “fat-free”. Here<br />

are some numbers to remember when<br />

reading labels and choosing products.<br />

Low-fat:<br />

Fat-free:<br />

Less than 3g of fat<br />

per serving<br />

Less than 5g of fat<br />

per serving<br />

Low-cholesterol: Less than 20mg per<br />

serving and less than<br />

2g of saturated fat<br />

Low-calorie:<br />

Calorie-free:<br />

Low-sodium:<br />

Less than 40 calories<br />

per serving<br />

Less than 5 calories<br />

per serving<br />

140mg or less<br />

per serving<br />

Keep Your Child Slim<br />

The best time to optimise dietary habits<br />

is in childhood and adolescence. Try<br />

to keep your children slim and active.<br />

Avoid feeding them foods that contain<br />

excess sugar, fat and carbohydrate, and<br />

encourage some exercise each day. After<br />

all, a lifetime of “healthy eating” may<br />

reduce cancer risk by as much as 30%<br />

to 50%, so it’s never too early to start!<br />

Calculate Your <strong>Cancer</strong> Risk<br />

You can estimate your risk of breast,<br />

bowel, uterine, ovarian, or prostate<br />

cancer by visiting the website<br />

http://www.yourcancerrisk.harvard.edu/.


LESSONS FROM SURVIVORS<br />

The lessons learnt after the diagnosis of cancer are common to many who have<br />

suffered from this disease, and perhaps a few are unique to our experience.<br />

Below is a compilation of valuable lessons learnt by survivors who had gone<br />

through the cancer journey, which we would like to share with our readers.<br />

Page B3<br />

Tender Care<br />

SALUBRIS<br />

October / November 2008<br />

Lesson 1<br />

As the greatest physician, God<br />

appreciates the value of a referral.<br />

Early detection and prevention is<br />

important. We went through many months<br />

of denial and postponement that allowed<br />

the cancer to advance. This can be totally<br />

prevented. For those of us who have a<br />

religion, we believe that God has given<br />

our doctors an arsenal of treatments and<br />

the will to find a cure. Whatever faith we<br />

have embraced, our own God wants us to<br />

have faith, but at the same time God wants<br />

us to seek out earthly assistance.<br />

Lesson 2<br />

Make sure your doctor understands<br />

that hope is a vital part of the<br />

practice of medicine.<br />

We heard repeatedly from our<br />

doctors that attitude and faith had<br />

an enormous effect on healing. One<br />

wonders why more physicians are not<br />

prescribing it. It is at least as effective<br />

as some of our medications.<br />

Lesson 3<br />

<strong>Cancer</strong> is NOT an<br />

infectious disease.<br />

We will always be grateful for the<br />

overwhelming love we received from<br />

friends and family. But we are saddened<br />

by several personal and professional<br />

friends who never once responded<br />

to our most basic need to show they<br />

cared. The silence is deafening.<br />

Lesson 4<br />

Avoid doomsayers.<br />

Just as it is vitally important to hear<br />

encouragement from friends and family,<br />

it is equally important to avoid those<br />

who deliver gloom and doom. Seek out<br />

people who radiate a positive glow, and<br />

stay away from those who drain your<br />

energy and confidence.<br />

Lesson 5<br />

The way you look affects<br />

the way you feel.<br />

It is terribly painful to lose one’s hair.<br />

But if it is going to happen, get a<br />

short haircut right away. It lessens the<br />

trauma as the hair comes out. Wigs<br />

can be an opportunity to experiment<br />

with the different look you fancy.<br />

Take special care to wear clothes that<br />

make you feel attractive. Pay attention<br />

to grooming and hygiene. Look for<br />

humour and find opportunities to<br />

laugh. It is one of God’s greatest gifts.<br />

Nothing can make you feel and look<br />

better than a smile.<br />

Lesson 6<br />

<strong>Cancer</strong> does NOT mean the<br />

end of a sexual relationship.<br />

It is not easy to talk about one of the<br />

most personal aspects of life. The<br />

closeness and bond between you<br />

and your partner during this time are<br />

critically important to maintain. While<br />

the period following the diagnosis and<br />

treatment requires untold patience<br />

and understanding, normal sexual<br />

relations can and should continue. It<br />

is important to discuss this with your<br />

doctor or nurse. They may be able to<br />

offer some helpful tips or advice.<br />

Lesson 7<br />

Listen more, look more<br />

and love more.<br />

<strong>Cancer</strong> changes everything. But it<br />

does not have to change everything<br />

for the worse. Even in this terrible<br />

situation, there is opportunity. It is<br />

important to slow down and reevaluate<br />

what and who is really<br />

important in life. <strong>Cancer</strong> can bring<br />

wonderful people into your life that<br />

will give you strength, love and<br />

special kindness.<br />

Lesson 8<br />

Listen more,<br />

look more and<br />

love more.<br />

Strengthen your faith.<br />

<strong>Cancer</strong> is a lonely disease but you do<br />

not have to go through it alone. We are<br />

no longer in denial and are able to go<br />

on with our lives feeling enriched and<br />

happier than ever. For many, having faith<br />

in a religion helps and for those who do<br />

not have a specific religion, talking about<br />

your illness with your close friends and<br />

relatives will help to strengthen your<br />

hope and confidence to cope with it. We<br />

have confidence in the future and know<br />

that no matter what cancer has in store,<br />

we are prepared for it.<br />

<strong>Cancer</strong> Support<br />

Programmes<br />

The <strong>National</strong> <strong>Cancer</strong> <strong>Centre</strong><br />

<strong>Singapore</strong> conducts support<br />

programmes for patients, their<br />

families and cancer survivors to<br />

address issues of living with cancer.<br />

For more information, please call<br />

the <strong>Cancer</strong> Helpline at 6225 5655 or<br />

email: cancerhelpline@nccs.com.sg<br />

Acknowledgement:<br />

Special thanks to all cancer survivors for<br />

sharing their thoughts and experiences.


Page B4<br />

SALUBRIS<br />

October / November 2008


Page B5<br />

SALUBRIS<br />

October / November 2008


Page B6<br />

SALUBRIS<br />

October / November 2008


Page B7<br />

SALUBRIS<br />

October / November 2008


Page B8<br />

Outreach<br />

SALUBRIS<br />

October / November 2008<br />

Upcoming <strong>Public</strong> Education<br />

activities / Programmes<br />

Event Name Date, Time, Venue Registration Details<br />

English Forum & Workshop –<br />

Understanding Arm<br />

Swelling in Breast <strong>Cancer</strong><br />

For breast cancer patients & healthcare<br />

professionals.<br />

Topics:<br />

i) Reducing the Risk of Lymphoedema<br />

ii) Non-surgical Treatment of Lymphoedema<br />

iii) Surgical Treatment of Lymphoedema<br />

18 Oct 2008, Saturday<br />

12pm to 5pm (English)<br />

Lecture Hall / Function Room, Level 4<br />

<strong>National</strong> <strong>Cancer</strong> <strong>Centre</strong> ;<strong>Singapore</strong><br />

11 Hospital Drive, <strong>Singapore</strong> 169610<br />

$5 per Person<br />

Call: 6225 5655 / 6236 9434 / 6236 9432<br />

Pink Bridges –<br />

Walk for the Women<br />

in Our Lives<br />

For breast cancer survivors & healthcare<br />

professionals.<br />

The Breast <strong>Cancer</strong> Awareness Month closes<br />

with a walk along the Southern Ridges Trail,<br />

from Mount Faber to HortPark.<br />

25 Oct 2008, Saturday<br />

4pm to 9pm<br />

HortPark, Hyderabad Road<br />

$10 for Adults<br />

$5 for Children (3 to 12 years)<br />

Dinner & goodie bag included<br />

Call: 6436 8294 / 6436 8283 for enquiries<br />

on the event. Registration by phone will not<br />

be accepted.<br />

<strong>Cancer</strong>Wise Workshop –<br />

DIET & FITNESS IN CANCER<br />

PREVENTION<br />

Speaker: Ms Hozaidah Hosain<br />

Principal Physiotherapist & Chief<br />

Lymphoedema Management<br />

SGH<br />

TOPICS:<br />

Mr Philip Chia<br />

Private Chef & Consultant<br />

Rice Cooking Studio, <strong>Singapore</strong><br />

i) The Role of Fitness in <strong>Cancer</strong> Prevention:<br />

Achieving Your Ideal Weight • Make<br />

Fitness Work for You – Choosing the<br />

Right Exercise • Benefits of Exercise &<br />

Fitness • Role of the Physiotherapist •<br />

Getting Fit After <strong>Cancer</strong><br />

ii) The Role of Diet in <strong>Cancer</strong> Prevention:<br />

Types of Diet to Reduce <strong>Cancer</strong> Risk •<br />

Dietary Myths and Misconceptions •<br />

Nutrition for <strong>Cancer</strong> Patients • Simple<br />

Healthy Cooking Tips, Rice Cooking<br />

Demonstration<br />

22 Nov 2008, Saturday<br />

1pm to 4.30pm (English)<br />

Function Room, Level 4<br />

<strong>National</strong> <strong>Cancer</strong> <strong>Centre</strong> <strong>Singapore</strong><br />

11 Hospital Drive, <strong>Singapore</strong> 169610<br />

$10 for <strong>Public</strong><br />

$5 for Healthcare Professionals<br />

CALL: 6225 5655<br />

EMAIL: cancerhelpline@nccs.com.sg


NCCS Activities In and<br />

Around the Community<br />

Page A5<br />

Community<br />

SALUBRIS<br />

October / November 2008<br />

<strong>Public</strong> Forum<br />

Advances in <strong>Cancer</strong> Research and Treatment<br />

28th June 2008<br />

HDB Convention <strong>Centre</strong> (HDB Hub), Auditorium<br />

A well-attended forum where<br />

NCCS medical oncologists, Dr Toh<br />

Han Chong and Dr Tan Min-Han,<br />

together with research scientist,<br />

Mr Johnson Ng, of Biochip<br />

Devises Pte Ltd, shared with<br />

audiences on the cancer research<br />

and treatment advancements.<br />

The forum, which was conducted in<br />

two sessions (Mandarin and English),<br />

highlighted topics such as:<br />

• Importance of Research in State-ofthe-Art-<strong>Cancer</strong><br />

Treatments<br />

• New Experimental Therapies<br />

• Converting Research to Bedside<br />

Treatment<br />

LIVER CANCER AWARENESS MONTH<br />

Liver cancer is the 4th most common cancer among men and ranks number two in terms of fatality.<br />

“Even so, there is potential hope for cure if individuals go for early detection and appropriate intervention,” said<br />

Prof London Lucien Ooi, Chairman of Liver <strong>Cancer</strong> Awareness Month (Liver CAM) also Deputy Director and Senior<br />

Surgical Oncologist at NCCS.<br />

Thus, to educate and update the public, general practitioners (GPs) and specialists on the disease, treatment<br />

options and prevention, NCCS held a public forum and sharing sessions with the medical professionals in<br />

conjunction with the 1st Liver CAM held in September 2008.<br />

<strong>Public</strong> Forum<br />

Liver <strong>Cancer</strong> and You ~<br />

Prevention and Treatment<br />

6th September 2008<br />

HDB Convention <strong>Centre</strong> (HDB Hub), Auditorium<br />

About 850 participants<br />

attended the English and<br />

Mandarin forum and found<br />

out more about liver cancer<br />

and related issues such as<br />

hepatitis B, which may lead<br />

to liver cancer.<br />

MEDICAL FORUM<br />

LIVER CANCER AND GPS ~ TREATMENT<br />

OPTIONS AND CASE STUDIES<br />

20th September 2008<br />

MAKING SENSE OF LIVER<br />

CANCER MANAGEMENT<br />

27th September 2008<br />

Some 60 GPs benefited from a medical update on liver cancer<br />

when they attended the special forum organised as part of this<br />

year’s Liver CAM. A roundtable discussion session was also held<br />

with specialists in the field.


Page A6<br />

People<br />

SALUBRIS<br />

October / November 2008<br />

Award Winners, New<br />

Appointments and More...<br />

NCCS Shares Limelight at<br />

Scientific Meeting<br />

Pictured below, from left to right:<br />

Dr Joanne Ngeow (right), Dr Ang<br />

Mei-Kim, Dr Ho Gay Hui (right) and<br />

Mr William Chin Wei Lim (left).<br />

Three doctors and a Research Officer from <strong>National</strong> <strong>Cancer</strong><br />

<strong>Centre</strong> <strong>Singapore</strong> (NCCS) each walked away as winners at the<br />

<strong>Singapore</strong> General Hospital (SGH) 17th Annual Scientific<br />

Meeting which was held from 25th to 26th April 2008 at the<br />

College of Medicine Building.<br />

Staff from Outram Campus, namely,<br />

SGH, NCCS, <strong>National</strong> Dental<br />

<strong>Centre</strong>, <strong>National</strong> Heart <strong>Centre</strong>,<br />

<strong>National</strong> Neuroscience Institute SGH<br />

Campus, <strong>Singapore</strong> <strong>National</strong> Eye <strong>Centre</strong><br />

and Duke-NUS Graduate Medical School<br />

were invited to submit an abstract of their<br />

work to compete in 13 award categories.<br />

Dr Joanne Ngeow, Registrar of the<br />

Medical Oncology Department<br />

clinched the Young Investigator’s<br />

Award (Clinical) with her paper on<br />

“PET/CT versus Conventional CT<br />

Scans and Bone Marrow Biopsy in the<br />

Initial Staging of Lymphoma Patients:<br />

A Comparative Analysis”.<br />

Her department colleague, Dr Ang<br />

Mei-Kim, an Associate Consultant,<br />

won the Best Poster (Clinical) prize<br />

for her work which featured “A<br />

Promising New Chemoimmunotherapy<br />

Regimen for Advanced Hepatocellular<br />

Carcinoma”.<br />

Dr Ho Gay Hui, Senior Consultant of<br />

the Surgical Oncology Department,<br />

took home the second prize in<br />

the Best Oral Paper (Clinical). Her<br />

winning paper “<strong>Cancer</strong> Miss Rate in<br />

Women Under 30 Who Undergone<br />

Excision Biopsy of Clinically Benign<br />

Breast Lumps without Preoperative<br />

Ultrasonography”.<br />

The Best Oral Paper (Scientist) prize<br />

was awarded to Mr William Chin<br />

Wei Lim, Research Officer of the<br />

Laboratory of Photodynamic Diagnosis<br />

and Treatment in the Medical Sciences<br />

Division, for his paper on “Membrane<br />

Transport Enhancement of Chlorin<br />

e6 – Polyvinylpyrrolidone and its<br />

Photodynamic Efficacy on the Chick<br />

Chorioallantoic Model”.


Congratulations to All!<br />

Page A7<br />

People<br />

SALUBRIS<br />

October / November 2008<br />

SINGAPORE<br />

YOUTH AWARDS<br />

2008<br />

On 6th July 2008,<br />

Dr Tan Min-Han received<br />

the <strong>Singapore</strong> Youth<br />

Award (SYA), Science and<br />

Technology category, from<br />

Deputy Prime Minister Prof<br />

S. Jayakumar at the Istana.<br />

The SYA recognises and commends<br />

contributions by youths who excelled<br />

in their respective fields and served<br />

the community in one way or the other.<br />

Dr Tan Min-Han, an Associate Consultant<br />

of the Medical Oncology Department,<br />

NCCS, is also a dedicated researcher whose<br />

work focuses on kidney cancer. He shuttles<br />

between the laboratory and clinic where<br />

he hopes the knowledge gained about<br />

the disease can be translated to treating<br />

his patients. Despite his busy schedule,<br />

he would still spend time with the junior<br />

doctors, medical students and even junior<br />

college students to give them guidance.<br />

Healthcare Humanity Award<br />

Given out in year 2003 as the<br />

Courage Award after the SARS<br />

(Severe Acute Respiratory<br />

Syndrome) outbreak in <strong>Singapore</strong>, the<br />

Healthcare Humanity Award, as it is now<br />

known, recognises outstanding healthcare<br />

workers who go the extra mile in caring<br />

and comforting the sick and the infirmed.<br />

Dr Joanne Ngeow, Registrar of the Medical Oncology<br />

Department, NCCS, is one of the six doctors, to receive the<br />

award from President S.R. Nathan at a presentation ceremony<br />

held on 26th May 2008 at the NTUC <strong>Centre</strong> Auditorium.<br />

Winners of the award are recognised for demonstrating values<br />

such as courage, extraordinary dedication, selflessness,<br />

steadfastness in ethics, compassion as well as humanity.<br />

PROMOTIONS<br />

Name<br />

Dr Chua Eu Tiong<br />

A/Prof Koong Heng Nung<br />

Dr Fong Kam Weng<br />

Dr Tan Yu Meng<br />

Dr Wong Zee Wan<br />

Dr Preetha Madhukumar<br />

Dr Teo Ching Ching Melissa<br />

Dr Quek Hong Hui Richard<br />

Dr Ng Chee Hui Raymond<br />

Dr Soong Yoke Lim<br />

Dr N. Gopalakrishna Iyer<br />

Dr Ang Mei-Kim<br />

Dr Tan Min-Han<br />

Dr Ngo Su-Mien Lynette<br />

Title<br />

Head, Radiation Oncology<br />

Head, Surgical Oncology<br />

Deputy Head, Radiation Oncology<br />

Senior Consultant, Surgical Oncology<br />

Senior Consultant, Medical Oncology<br />

Consultant, Surgical Oncology<br />

Consultant, Surgical Oncology<br />

Consultant, Medical Oncology<br />

Consultant, Medical Oncology<br />

Associate Consultant, Radiation Oncology<br />

Associate Consultant, Surgical Oncology<br />

Associate Consultant, Medical Oncology<br />

Associate Consultant, Medical Oncology<br />

Associate Consultant, Medical Oncology


Page A8<br />

NCC Foundation<br />

SALUBRIS<br />

October / November 2008<br />

NCC Foundation:<br />

Why We Do What We Do<br />

A leader once asked a<br />

group of executives during<br />

a corporate retreat: How do<br />

you make this organisation an<br />

interesting place?<br />

This is an established company<br />

in the service sector striving to<br />

renew itself. Someone replied:<br />

To be interesting, you have to<br />

be interested.<br />

In present terms, the primary functions of the NCC Foundation are to raise and manage<br />

funds for the NCC Research Fund (NCCRF), the <strong>Centre</strong>’s registered charity and its<br />

flagship fundraising and grant-making channel. NCCRF provides seeding and bridging<br />

funds for strategic research needs at the institution. Fundraising and grant making are<br />

thus the operative functions of the Foundation. Yet it is not just about money.<br />

The NCC Foundation will be<br />

celebrating its first birthday soon.<br />

You may have seen our posters<br />

around – in the lifts, beside the business<br />

office, by the clinics; you may have<br />

heard of or even participated in our<br />

fundraising and outreach events –<br />

‘Circle of Life’, ‘Light of Life’, ‘Muffins<br />

Monday’ and our national event, the<br />

‘Run For Hope’ in October. You sensed<br />

our interest, but how does one define<br />

this Foundation?<br />

It is really about the idea of giving. Essentially, the Foundation hopes to facilitate giving<br />

as part of <strong>National</strong> <strong>Cancer</strong> <strong>Centre</strong> <strong>Singapore</strong>’s (NCCS) cultural fabric. Giving can come<br />

in various forms – of treasures, talents and time. There are grateful patients who donate<br />

regularly, and there are others who leave significant bequeathment; there is a painter who<br />

shares her talent in support of our cause; there is a warmhearted baker who donates fresh<br />

pastries regularly; and there are staff who volunteer their time and efforts in our events.<br />

These are all actual examples of giving which took place, and the Foundation hopes to<br />

provide a holistically meaningful platform for all such practical and symbolic gifts.<br />

Moving ahead, the Foundation will consolidate its bedrock and put in place programme<br />

structures where different forms of giving can benefit the myriad areas of research, education<br />

and patient welfare. Naturally, we work alongside the crucial support of various departments.<br />

At this juncture, as the Foundation’s first birthday meets the 10th year anniversary of NCCS,<br />

we would like to say a big ‘Thank You’ to one and all who have guided us in our modest<br />

beginning. We look forward to your continuous goodwill in our journey ahead.<br />

By Eugene Sng<br />

Programme Director, NCC Foundation<br />

Editorial Advisors<br />

Dr Kon Oi Lian<br />

Prof Soo Khee Chee<br />

Executive Editors<br />

Ms Carol Ang<br />

Ms Adeline Teo<br />

Mr Sunny Wee<br />

Contributing Editors<br />

Dr Lim Soon Thye<br />

Dr Wong Nan Soon<br />

Members, Editorial Board<br />

Ms Audrey-Anne Oei<br />

Ms Sharon Leow<br />

Ms Flora Yong<br />

Salubris<br />

is produced with you in mind. If there are other topics related to cancer<br />

that you would like to read about or if you would like to provide some<br />

feedback on the articles covered, please email to salubris@nccs.com.sg.<br />

<strong>National</strong> <strong>Cancer</strong> <strong>Centre</strong> <strong>Singapore</strong><br />

11 Hospital Drive <strong>Singapore</strong> 169610<br />

Tel: (65) 6436 8000 Fax: (65) 6225 6283<br />

www.nccs.com.sg Reg No 199801562Z

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