Dangerous Growth - Raffles Medical Group

A PUBLICATION BY REGISTRATION No. 198901967K MITA (P) 230/12/2008 COMPLIMENTARY COPY ISSUE 02 / 2009 

Dangerous 

Growth 

Defend yourself against cancer - know what it is and 

what it does to the body 

The Life Saver 

Early detection is one of the 

best weapons we have against cancer 

Oriental Healing 

Can TCM treat cancer How does it work 

Overcoming the Odds 

Real life stories about survival and love 

10 Cancer Myths 

Let our panel of experts share their knowledge to 

demystify these common myths

CancerCentre 

CANCER RISK 

SCREENING 

Assess your risks early 

Raffles Cancer Centre offers a cancer risk screening programme that addresses the concerns of individuals. 

The programme is unique for the following reasons: 

Screening by a Cancer Centre physician 

Flexible screening packages that can be customised to suit individual risk profiles 

Genetic counselling to assess the risk of hereditary cancers 

A whole body mole examination to assess for moles with cancerous signs 

Tests and Investigations Males Only Females Only Females Only 

(All Ages) (All Ages) (Above 40 years old) 

General Assessment by Cancer Centre Physician 

Family History 

Genetic Counselling and Cancer Risk Assessment 

General Physical Examination 

Whole Body Mole Examination 

Investigations 

Full Blood Count (FBC) 

Liver Function Test (LFT) 

Faecal Occult Blood Test (FOBT) 

Urine FEME 

Chest X-Ray (for lungs) 

Pelvic Examination 

PAP Smear (for cervix) 

Mammogram (for breast) 

Cancer Marker Tests 

EBV (for nasapharynx) 

Alpha-Fetoprotein (for liver) 

CEA (for colon & rectum) 

Ca 19-9 (for pancreas) 

PSA (for prostate) 

Ca 125 (for ovary) 

Package Prices (excluding GST) S$400.00 S$450.00 S$500.00 

Hospital 

To make an appointment, please contact: 

Tel: (65) 6311 1222 | Fax: (65) 6311 2136 | Email: specialist@raffleshospital.com 

(v1.0) 03/09

Contents 

NewsRoom 4 

New Doc on the Block | Towards Better Patient Care and 

Quality Standards | New clinics | IMI Achieves BUPA Award | 

Endobutton: Mending A Broken Shoulder 

Supplements 24 

FoodNotes 28 

Q&A 29 

Promotions 30 

Features 

Dangerous Growths 7 

Worldwide, 13% of deaths are caused by cancer. Defend 

yourself against this dangerous growth - know what it is and 

what it does to the body. 

Killer Cancers 9 

Cancers kill. Find out more 

about the risk factors, the 

symptoms, and the screening 

tests recommended by 

the experts for the top five 

cancers. 

The Life Saver 14 

Successful cancer treatment can be achieved through early 

cancer screening. Early detection is one of the best weapons we 

have against cancer. Learn about the importance of screening 

and the different tests available. 

UpClose 16 

Dr Hoo Kai Meng, a Family Physician at Raffles Cancer Centre, 

underwent palliative care training recently. Find out how specialising 

in palliative care brings him closer to cancer patients. 

Overcoming the Odds 18 

Real life stories about survival and love. Two 

patients from Raffles Cancer Centre share 

their experience of overcoming cancer and 

their personal lessons from the disease. 

Winning the Battle: Nutritional 

Therapy for Cancer Patients 20 

You are what you eat. And what you eat can either hinder you or 

help you in your fight against cancer. Use nutritional therapy for 

your benefit. 

Oriental Healing 22 

Can TCM treat cancer How does it work Can it be used in 

conjunction with conventional cancer treatments Get your 

questions on TCM and its link with cancer answered. 

10 Cancer Myths 25 

The myths surrounding cancer are enough to drive anyone to the 

brink of paranoia. Our panel of experts share their knowledge to 

demystify these common myths. 

DIRECTORY 

www.rafflesmedicalgroup.com 

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* Clinics with X-ray Facilities 

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Physiotherapy Centre 

Radiology 

Regional Representative Offices / 

Liaison Centres 

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Dhaka Representative Office 88 02 8835984 

Editorial: Dr Prem Kumar Nair, Magdalene Lee, 

Clara Cai & Fann Khoo 

Creative: Edd Chua & Jenny Cheok 

The information contained in this publication should 

not be regarded as a substitute for detailed medical 

advice in individual cases. 

All rights reserved. No part of this publication may 

be reproduced in any form or by any means without 

the written permission of the publisher. 

Please address all correspondence to 

The Editor, Raffles HealthNews, 

Fax no. 6311 2378 

Email: healthnews@rafflesmedical.com 

Raffles HealthNews is published by 

Raffles Medical Group Ltd 

585 North Bridge Road, Raffles Hospital 

#11-00, Singapore 188770 

www.rafflesmedicalgroup.com 

May 09

Newsroom Raffles HealthNews 

New Doc 

on the Block 

Dr Ng Chee Keong 

Specialist in Cardiology 

Raffles Heart Centre 

Dr Wong Kutt Sing 

Specialist in General Surgery 

Raffles Surgery Centre 

Dr Janee Lim 

Specialist in Orthodontics 

Raffles Dental 

Ms Duan Qian Mei 

TCM Physician 

Raffles Chinese Medicine 

Dr Ng underwent two subspecialty 

training stints in his career, firstly 

at the Cedar-Sinai Hospital in Los 

Angeles, California studying the 

intricacies of Nuclear Cardiology 

imaging. Upon his return, he set up 

the Nuclear Cardiology service at 

Tan Tock Seng Hospital. 

Dr Ng subsequently received 

formal cardiac intervention training 

at Johns Hopkins Hospital. His 

experience included treating 

patients who required coronary 

artery intervention, closure of 

atrial septal defects, alcohol 

septal ablation for hypertrophic 

cardiomyopathy and valvotomies. 

Dr Ng’s area of expertise includes 

intervention cardiology and noninvasive 

cardiac imaging. 

Dr Wong graduated from NUS with 

MBBS under the Lim Boon Keng 

Scholarship and subsequently 

obtained his FRCS (Edin), FRCS 

(Glas) and FAMS (General Surgery). 

Dr Wong did his HMDP Fellowship in 

Advanced Colorectal Surgery at the 

Cleveland Clinic Foundation, USA 

where he was trained in minimally 

invasive (laparoscopic) colorectal 

surgery. His previous appointment 

was Director, Minimally Invasive 

Surgery, Colorectal Division, National 

University Hospital. He is an Adjunct 

Senior Lecturer with Yong Loo 

Lin School of Medicine, National 

University of Singapore and a Clinical 

Examiner in the Surgery Track 

of the Final Professional MBBS 

Examinations. 

Dr Wong’s clinical interests include 

treatment of bowel disorders and 

anorectal conditions, eg. change 

in bowel habit, abdominal pain, 

unexplained weight loss, bleeding 

per rectum, perianal pain. He has 

particular interests in laparoscopic 

colon and rectal surgery, endoscopy 

and anorectal surgery. 

Dr Lim successfully obtained 

her Masters of Dental Surgery 

FRCS (Edinburgh) in 2004 

and FAMS (Orthodontics) in 

2007. Dr Lim has served in the 

Executive Committee of the 

Association of Orthodontists 

(Singapore) and is a member 

of the World Federation of 

Orthodontists and the Singapore 

Dental Association. 

Dr Lim’s expertise includes 

comprehensive orthodontics in 

children and adults, interceptive 

treatment in children and 

combined orthognathic surgery 

and orthodontics in adults. 

She received further training 

in the use of lingual appliance, 

Damon® appliance, 3M Unitek 

Smartclip® appliance and mini 

implants. She is also accredited 

to use the Invisalign® system. 

Ms Duan’s special interests are 

in the areas of TCM Internal 

Medicine, TCM Paediatrics, TCM 

Gynaecology and Reproductive 

Health and pain management. 

She specialises in the use 

of herbal medicine and 

acupuncture in the treatment of 

allergies. She also has specialty 

interest in women’s health 

particularly in the treatment of 

gynaecological conditions such 

as irregular menstruation, premenstrual 

syndrome, cramps, 

endometriosis, fibroids, infertility 

and menopause. 

Physician Duan also provides 

treatments in internal medicine 

for conditions including gastritis, 

fatty liver, asthma, hypertension 

and diabetes. Other than treatment 

of disease conditions, she also 

provides TCM services for 

slimming and general wellness.

Raffles HealthNews Newsroom 

Raffles Hospital joined 220 healthcare 

organisations in 33 countries as a Joint 

Commission International (JCI) accredited hospital 

on 13 December 2008. JCI is currently the most 

recognised international healthcare accreditation body 

and the gold standard in the setting and monitoring of 

global healthcare standards for hospitals. 

To many Raffles’ patients, the Raffles name was all the 

accreditation they needed. However, this accreditation 

is a part of the hospital’s continuous quality improvement 

process, and a symbol of its dedication towards patient safety 

and quality standards. It also assures patients, especially first 

time patients, of the hospital’s quality of care. 

Towards 

Better Patient Care 

and Quality Standards 

“The JCI accreditation process is aligned with Raffles Hospital’s 

quality mission, and provides strategic standardisation. With 

this, the hospital will be able to effectively benchmark itself 

to the “best of class” international standards,” explained Mr 

Thomas Lee, General Manager of Raffles Hospital. 

JCI has been working with organisations and governments in 

over 80 countries since 1994. Its focus is on improving the 

safety of patient care through the provision of accreditation 

and certification services as well as advisory and 

educational services to help organisations implement 

practical and sustainable solutions. 

New Clinics 

For your convenience, Raffles’ medical services in Tampines will 

be consolidated and relocated to Tampines One, a new shopping 

mall located between the Tampines MRT Station and Tampines 

Bus Interchange. The new medical centre in Tampines One will 

offer family medicine, women, children, radiology and dental 

services under one roof. 

With this new medical centre, the Raffles Medical clinic at Blk 506 

will cease to exist. The current clinic at Tampines Junction 

will still offer GP services. 

TAMPINES ONE 

Blk 10 Tampines Central 1, #03-28 Tampines One, 

Singapore 529536 | 6260 5116 

Residents of Sembawang will be happy to know that Raffles has 

found its way into Sembawang. The spanking new clinic offers 

general family medicine services, including travel medicine, 

vaccination and management of chronic ailments such 

as diabetes and hypertension. 

SEMBAWANG 

Blk 355 Sembawang Way, #01-06 

Singapore 750355 | 6853 7703

Newsroom Raffles HealthNews 

Achieves BUPA Award 

Since International Medical Insurers tied up 

with BUPA for the IMI-BUPA International 

Health Plan, the plans have been well 

received as they provide global coverage 

benefitting multinational corporations with 

regional offices and executives who travel 

frequently or are stationed in overseas 

locations. In recognition of International 

Medical Insurers’ achievement in gaining 

the fastest growth in sales for a new market 

that BUPA entered, International Medical 

Insurers was awarded the New Market 

Pioneer Whistler in January 2009 by BUPA. 

Mending A 

Broken Shoulder 

Injuries in and around the shoulder are common, especially 

amongst athletes. Yet conventional methods of mending 

acromioclavicular joint (ACJ) dislocations and fractures 

fail to provide a long lasting solution to the problem. In 

response to this, Dr Lim Yeow Wai, Orthopaedic Surgeon, 

Raffles Orthopaedic Centre, developed a new technique, 

Triple Endobutton, to counter this. 

“The shoulder is a very complex and unstable joint which 

can get injured easily. Many types of surgeries have been 

developed in the past to repair the bone and torn ligaments, 

but outcomes are far from satisfactory,” explained Dr Lim. 

This is because current treatment methods employ fixation 

using metal implants which rigidly secure the two bones 

making up the ACJ. This often leads to failure because 

the joint is a flexible joint which can rise and rotate during 

movement. Furthermore, screws and pins are often 

ineffective because they usually work themselves loose 

after some time, due to necessary movements in and 

around the shoulder area. 

Acromion 

Clavicle 

The Triple Endobutton technique, on the other hand, is nonrigid 

and allows for normal movement of the joint. All that is 

needed are three tiny stainless steel buttons and two strands 

of Fibrewire suture. The buttons can safely stay in the body 

for life. During the operation, the suture is looped through 

the button holes and over the shoulder bone, allowing for 

fluid movements while stabilising the joint. 

The entire surgery takes just 45 minutes under general 

anesthesia. So far, Dr Lim has performed 11 such operations. 

Currently, the Triple Endobutton technique is only performed 

in Singapore. 

Where is the acromioclavicular joint 

The acromioclavicular joint is located at the top of the 

shoulder. It is made up of two bones – the clavicle 

and the acromion – and two ligaments which gives 

the joint its stability. Depending on the severity of the 

injury, a person may sprain or tear one or all of the 

ligaments. If not properly treated, ACJ injuries can lead 

to significant loss of strength in the affected limb. 

It may also cause arthritis of the joint.

Raffles HealthNews Feature 

Cancer: Dangerous Growths 

Know it, treat it 

Cancer is not a new disease. 

Worldwide, 13% of deaths are 

caused by cancer. In Singapore, one 

in three persons will contract cancer in their 

lifetime. Most of us would have had a close 

friend or relative who had cancer. Yet many 

may not have an understanding of what it is 

and what it does to the body. 

Explained Dr Gilberto Lopes, Medical 

Oncologist at Raffles Cancer Centre, 

“Cancer is a group of 100 different diseases 

characterised by the uncontrolled, abnormal 

growth of cells. These cells form a lump or 

a tumour although some, such as blood 

cancers, do not form tumours.” 

Tumours can be benign (non-cancerous) 

or malignant (cancerous). Benign tumours 

may grow, but they do not spread to other 

parts of the body and are usually not life 

threatening. Malignant tumours grow and 

invade other tissues in the body. 

Sometimes cancer will spread to the lymph 

nodes. A lymph node is a tiny, bean-shaped 

organ that filters the flow of lymph, the clear 

fluid that plays a role in the body’s immune 

system. Lymph nodes are located in clusters 

in different parts of the body, such as the 

neck, groin area, and under the arms. 

8Signs That May Scream Cancer 

Cancer kills by destroying vital tissues and 

organs, 

1. Sores 

disrupting 

that don’t 

normal 

heal 

body functions 

and 

2. A 

blocking 

lump in breast 

or compressing 

or other parts 

important 

of the body 

blood 

3. Unusual 

vessels 

bleeding 

or air passages 

4. Change in bowel habits or bladder 

Cells 

function 

from malignant tumours can also 

break 

5. Recent 

away and 

change 

move 

in 

to 

a 

other 

wart or 

parts 

mole 

of the 

body, 

6. Indigestion 

where they 

or 

continue 

difficulty in 

to 

swallowing 

grow. This 

process 

7. Nagging 

is called 

cough 

metastasis. 

or hoarseness 

Metastatic 

cancer 

8. Unexplained 

is named after 

weight 

the 

loss 

part 

or 

of 

fever 

the body

Feature Raffles HealthNews 

where it started (e.g.: if breast cancer 

spreads to the lungs, it is called metastatic 

breast cancer, not lung cancer). 

Cancer can start anywhere in the body. It 

can affect people of all ages but the risk for 

most cancers increases with age. 

Cancer Is Not Death Penalty 

Rather than to think that cancer spells 

the end of life, it is important to know that 

cancer can be treated. In cancer treatment, 

the aim is to remove or destroy the cancer 

cells. The three ways by which this can 

be done are surgery, chemotherapy and 

radiotherapy. 

Depending on the type and stage of 

the cancer and the age and health of 

the patient, treatment is administered. 

Sometimes, a complement of two or 

more treatments is used. Certain cancer 

treatments may cause side effects as 

they affect the normal cells as well. 

Surgery 

In surgery, the tumour is removed together 

with some of the surrounding tissue that 

may contain invading cells. It is most 

effective for cancers that are small, found 

in only one area of the body and located 

in parts of the body from which they can 

be easily removed. 

Chemotherapy 

Chemotherapy uses medicine to destroy 

cancer cells by interfering with their ability 

to grow and multiply. 

may experience side effects such as hair 

loss, nausea and vomiting. They are also 

more prone to infections. 

Radiotherapy 

Radiotherapy uses radiation to kill cancer 

cells. This radiation may come in the form 

of: 

• High-dose x-rays which are directed 

at the tumour 

• Some radioactive material that is 

surgically implanted into the tumour 

Radiotherapy may be used before 

surgery to reduce the size of a tumour, 

or after surgery to destroy any remaining 

cancer cells in that area. Side effects from 

radiotherapy include tiredness and skin 

rashes over the treated area. 

Understanding Staging 

A common term used when we talk about 

cancer is cancer stages. Simply put, the 

higher the stage, the more advanced 

the cancer. Cancers caught at an earlier 

stage have a higher chance of recovery 

while those at a later stage would be far 

more life-threatening. 

“Still, although cancers are easier to 

treat at an earlier stage,” said Dr Lopes, 

“you should seek treatment; no matter 

how advanced the cancer is, as soon as 

possible, to contain the disease.” HN 

Different types of medicine are used for 

different cancers. Some medicines are oral 

(take by mouth). Others work better when 

injected into the blood vessels. 

Chemotherapy works mainly on cancer 

cells but it also affects normal cells that grow 

rapidly, like hair cells or cells lining the gut. 

As a result, patients receiving chemotherapy 

Stage 

Description 

0 Cancer in situ (in place), meaning that cancer has not become invasive and does not have the capacity to 

spread. These cancers are highly curable. 

I 

II / III 

IV 

Generally indicates a cancer that is small, has not invaded deeply into the surrounding tissues, and has not 

spread either to lymph nodes or other parts of the body. 

Stage II and III cancers have increasing degrees of size, invasion, and spread to lymph nodes, but have not 

spread in amounts that can be detected in other parts of the body. 

Stage IV means that the cancer has spread to other organs or parts of the body, and may be referred to as 

advanced cancer.

Raffles HealthNews Feature 

KILLER Cancers 

Hidden In The Depths 

Colorectal cancer is the leading 

cancer in Singapore. Worldwide, 

655,000 people die from colorectal 

cancer each year. Many colorectal cancers 

are thought to arise from adenomatous 

polyps in the colon. These mushroom-like 

growths are usually benign, but some may 

develop into cancer over time. Diagnosis 

of colon cancer is currently done through 

a combination of blood test, stool test and 

colonoscopy. 

“It is important to diagnose colon cancer 

early,” said Dr Ng Chin, General Surgeon 

of Raffles Surgery Centre, “as up to 95% 

of early cancers can be cured with an 

operation. Early diagnosis can also halt 

the progression of cancer.” 

Treatment of colorectal cancer is stagedependent. 

Early-stage colorectal cancer 

is potentially curable. When colorectal 

cancer has spread to other organs, 

the cancer is less likely to be curable. 

Surgery is the mainstay of treatment. 

Chemotherapy and radiotherapy may be 

required, depending on the staging. 

“The aim of curative surgery,” explained 

Dr Wong Kutt Sing, General Sungeon, 

Raffles Surgery Centre, “is to completely 

remove the cancer-bearing segment of 

the bowel with adequate margins and 

radical en-bloc resection of its mesentery 

and lymph nodes.” 

Laparoscopic colectomy is a minimally 

invasive (keyhole) surgical technique to 

treat colorectal cancer. Potential benefits 

of this technique include smaller incisions, 

less postoperative pain, earlier return of 

bowel function, earlier resumption of oral 

intake, shorter hospital stay and earlier 

return to normal activities. The main 

disadvantage of laparoscopic colectomy 

is increased operating time. 

Long-term studies comparing laparoscopic 

and open colectomy have demonstrated 

equivalent survival rates between the 

2 techniques. One study from Spain 

showed better survival in Stage 3 colon 

cancer in patients who have undergone 

laparoscopic colectomy. 

Although it may be hidden in the depths 

of your bowels, colorectal cancer can be 

prevented through regular screening and 

the removal of polyps. 

“Early diagnosis means a better chance 

of successful treatment,” advised 

Dr Wong. “Screening should begin at age 

50 for all average risk individuals or sooner 

if you have a family history of colorectal 

cancer, symptoms, or a personal history 

of inflammatory bowel disease.” 

Risk Factors Symptoms Screening Tests 

• 

• 

• 

• 

• 

• 

• 

• 

• 

Polyps 

Age 

Inflammatory bowel disease (IBD) 

Diet high in saturated fats, such as 

red meat 

Personal or family history of cancer 

Obesity 

Smoking 

Race 

Other 

• Change in bowel habits: diarrhoea, 

constipation, or a feeling that the 

bowel does not empty completely 

• Bright red or dark blood in stool 

• Stools appear narrower or thinner 

than usual 

• Discomfort in the abdomen, 

including frequent gas pains, 

bloating, fullness, and cramps 

• Unexplained weight loss, constant 

tiredness, or unexplained anaemia 

• Colonoscopy 

• Virtual colonography 

• Sigmoidoscopy 

• Fecal occult blood test 

• Double contrast barium enema 

• Stool DNA test

10 Feature Raffles HealthNews 


Not Just A Woman’s Problem 

Some people may think breast 

cancer is something that only 

affects women. However, do you 

know that men are not spared 

According to Prof Walter Tan, Plastic 

Surgeon and General Surgeon, Raffles 

Surgery Centre, “men can also get 

breast cancer though it is one hundred 

times more frequent among women 

than men. The prognosis in males with 

breast cancer however, is generally 

worse than in females. This is because 

of the small size of the male breast and 

the tendency of the cancer to spread 

beyond the breast more easily.” 

Breast cancer is the number 1 cancer 

affecting women globally and in 

Singapore. It is considered to be the 

final outcome of multiple environmental 

and hereditary factors. 

While surgery remains the mainstay 

for breast cancer treatment, breast 

cancer patients who need to undergo 

mastectomy often have to bear with the 

emotional and physical trauma of losing 

one’s breast(s). 

Raffles Hospital offers immediate 

reconstruction surgery that is done 

at the same time as the mastectomy, 

when the entire breast is removed. A 

benefit of immediate reconstruction, 

explained Prof Tan, is that chest 

tissues are undamaged by radiation 

therapy or scarring. Also, immediate 

reconstruction means one less surgery, 

which results in cost savings. Most 

importantly, it is psychologically less 

traumatising for patients as they need 

not undergo a period of loss. 


• 

• 

• 

• 

• 

• 

Age, race 

Individual or family history of breast 

cancer 

Individual history of ovarian cancer 

Genetic predisposition 

Estrogen exposure 

Abnormal proliferation of cells in 

the breast 

Lifestyle factors: obesity, lack of 

exercise, alcohol use 

Radiation exposure 

• 

• 

• New lumps or thickening in the 

breast or under the arm 

• Nipple tenderness, discharge, or 

physical changes 

• Skin irritation or changes 

• Warm, red, swollen breast with 

a rash resembling the skin of an 

orange 

• Pain in the breast (usually not 

a symptom of breast cancer, but 

should be reported to a doctor) 

• No visible or obvious symptoms 

(asymptomatic) 

• Mammography 

• Ultrasound 

• MRI scan 

• Biopsy to confirm a diagnosis 

• Blood tests to determine if the 

cancer has spread outside the 

breast 

• Additional tests may be used to 

determine stage

Raffles HealthNews Feature 11 


Liver And Let Live 

The liver can be characterised as 

the largest organ within the body. 

Located below the right lung and 

under the ribcage, the liver is divided 

into two lobes. Multiple types of tumours 

can develop in the liver because the 

liver has rich blood supply. Liver cancer 

patients can be divided into two types, 

primary and secondary (or metastatic). 

“Primary liver cancer is the result of 

liver cells turning cancerous usually 

from chronic inflammation of the 

liver,” explained Dr Law Ngai Moh, 

Gastroenterologist at Raffles Internal 

Medicine Centre. “Therefore it is 

commonly associated with chronic 

hepatitis B and C infection or heavy 

alcohol consumption. As early primary 

liver cancer has no signs and symptoms, 

individuals with risk factors mentioned 

above should go for regular liver blood 

tests and scanning of the liver, so that 

early detection leading to complete 

cure is possible.” 

“In contrast,” added Dr Law, “secondary 

liver cancer refers to the spread of cancer 

from other organs to the liver. Usually, 

in such cases, affected individuals will 

be in advanced stages of cancer with 

poor prognosis. The only exception is 

that of colorectal cancer with limited 

liver spread, whereby removal of tumour 

spread and the original cancer in the 

colon by surgery may still be possible in 

some patients.” 

To protect yourself from liver cancer, you 

can: 

• 

• 

• 

• 

• 

Vaccinate yourself from hepatitis B 

Avoid intravenous (IV) drug use 

(commonly associated with the 

transmission of hepatitis C) 

Avoid alcohol abuse (increases the 

risk of cirrhosis) 

Take certain medications to control 

hepatitis B or C infection, decreasing 

the risk of liver cancer 

Screen for liver cancer if you have 

cirrhosis of the liver or chronic viral 

hepatitis 


• 

• 

• 

• 

• 

Chronic viral hepatitis 

Cirrhosis of the liver, often caused 

by excessive alcohol consumption 

Age & gender 

Chemical exposure 

Eating foods contaminated with the 

mould aflatoxin 

• Pain at the top right side of the 

abdominal area, near the right 

shoulder blade or in the back 

• Unexplained weight loss 

• Weakness or fatigue 

• Hard lump under ribs on the right 

side of the body 

• 

• 

• 

• 

• 

• 

• 

• 

• 

Confirmed with a biopsy 

Sometimes confirmed with blood or 

imaging tests 

Physical examination 

Blood test for elevated alphafetoprotein 

(AFP) levels 

Ultrasound of the abdomen 

Computed tomography (CT) scan 

Magnetic resonance imaging (MRI) 

Angiogram 

Laparoscopy



Clearing The Air About Lung Cancer 

As the second top cancer for 

men and, third for women, lung 

cancer kills 1.3 million people 

worldwide annually. One out of every 

five persons who died from cancer had 

lung cancer. The lung is a common 

place for metastasis from tumours in 

other parts of the body. 

The risk of lung cancer for the smoker 

is 15 to 25 times more than that of a 

non-smoker. When the smoker stops 

smoking, the risk of lung cancer drops 

to two times the risk of a non-smoker 

after 10 to 15 years. The best safeguard 

against lung cancer is still to never 

smoke; and if you smoke, you should 

stop now. 

Surgery, radiation and chemotherapy 

are the three main methods of cancer 

treatment. The type of treatment depends 

on the size, extent of the disease, the type 

of lung cancer and the general health of 

the patient. 

Part of a lung or a whole lung may 

be removed in the treatment of lung 

cancer. Before surgery, the patient will 

undergo a lung function test to assess 

the functional capacity of the existing 

lung. After surgery, these patients may 

require assisted ventilation for a short 

period. Physical activities may also be 

limited for a short period. If the remaining 

lung function is good, the patient will be 

able to continue a normal life. 

Certain types of lung cancer are sensitive 

to chemotherapy treatment. This form 

of treatment is increasingly being used 

in combination with surgery or with 

radiation. As newer drugs are discovered 

and their range of efficacy increases, 

the use of chemotherapy will increase. 

Side-effects of chemotherapy such as 

nausea, vomiting and diarrhoea can be 

overcome with medications. 

Radiation or the use of x-rays to treat lung 

cancer may be in conjunction with surgery 

or as a palliative treatment to relieve the 

pressure symptoms or pain caused by 

the lung cancer. Side-effects of radiation 

such as tiredness, skin rash or sore throat 

are transient. 


• Tobacco and second-hand smoke 

• Asbestos (mineral fibre) 

• Radon (gas) 

• Some people who develop lung 

cancer today have either stopped 

smoking years earlier or have 

never smoked 

• Fatigue (tiredness) 

• Cough 

• Shortness of breath 

• Chest pain 

• Loss of appetite 

• Coughing up phlegm 

• Haemoptysis (coughing up blood) 

• If cancer has spread, symptoms 

include bone pain, difficulty 

breathing, abdominal or back pain, 

headache, weakness, and speech 

difficulties 

• Chest x-ray or CT scan of the 

chest 

• Confirmed with a biopsy 

• The location(s) of all sites of 

cancer is determined by additional 

CT scans, PET (positron emission 

tomography) scans, and MRI 

(magnetic resonance imaging) 

• Tests to determine if cancer 

started in the lung or somewhere 

else in the body



Manhood Under Siege 

Prostate cancer is a malignant tumour 

of the prostate gland, located below 

the bladder and surrounds the top 

part of the urethra. 

“When cancer develops in the prostate, 

it may spread through the lymphatic 

system to other parts of the body such as 

the bones and lungs. It is the third most 

common cancer in Singaporean men,” 

said Dr Fong Yan Kit, Urologist at Raffles 

Surgery Centre. 

Early prostate cancer has no symptoms 

but is highly curable. As such early 

detection of prostate cancer is critical. 

To reduce risk of prostate cancer, 

patients are encouraged to stay fit 

and lose weight as obesity is linked 

to higher prostate cancer mentality. In 

addition, certain drugs and food have 

been shown to reduce the risk. These 

include Proscar, Vitamin E, Selenium, 

tomatoes and Soy products. 

Other than surgery, radiation therapy and 

chemotherapy, hormonal therapy can also 

be used to treat prostate cancer that has 

grown after surgery and radiation therapy 

or to shrink large tumours before surgery 

and radiation therapy. 

“The reduction in the level of male sex 

hormones slows the growth of cancer,” said 

Dr Gilberto Lopes, Medical Oncologist, Raffles 

Cancer Centre. “Hormonal therapy can be 

done surgically or through medication but it 

may also cause a variety of side effects.” 

Mr Wu Yue, Senior TCM Physician 

from Raffles Chinese Medicine manages 

prostate cancer patients by using herbs 

as an adjunct to ongoing biomedical 

treatment for prostate cancer. This can 

be done using any or all of three main 

approaches: 

1) Offset the damaging side-effects of 

radiation and chemotherapy 

2) Strengthen the patient’s immune 

system that has been weakened by 

the biomedical treatment 

3) Aid in tumour reduction, potentially 

shortening the length of time the 

patient needs to receive radiation 

and/or chemotherapy. HN 


• Age 

• Race/ethnicity (Americans & Indians) 

• Family history 

• Diet 

• Hormones 

• Frequent urination, or weak or 

interrupted urine flow. Pain or 

burning during urination or blood in 

the urine 

• The urge to urinate frequently 

during the night 

• Different symptoms if the cancer 

has spread: pain in the back, weight 

loss, fatigue 

Note: Symptoms are not specific to 

prostate cancer and could be caused 

by an enlarged prostate 

• Prostate-specific antigen (PSA) 

test 

• Digital rectal examination (DRE) 

• Discuss screening with your doctor


The Life Saver 

Early detection is one of the best weapons we have against cancer. For this reason, 

cancer screening is recommended for all individuals, even those without any 

symptoms. Beyond the possibility of avoiding death, screening may reduce cancer 

morbidity as it increases the chances of detecting cancers at their early stages. 

“The chance of successful treatment 

and cure is better when the cancer is 

treated in the early stages. This can 

only be achieved through early cancer 

screening, provided early, effective 

screening methods are available” says 

Dr Benjamin Ng, an Occupational 

Physician at Raffles HealthScreeners. 

Dr Ng adds that many cancers do not 

display obvious symptoms until the 

advanced stages. These include lung 

cancer, brain cancer, stomach and colon 

cancer, prostate cancer, and liver cancer. 

It is important to note that none of us is 

immune to the risk of cancer even if we 

do not have any family history or if we 

are meticulous in our lifestyle. That said, 

we can gain an edge against the illness 

through health screenings. Detecting 

cancer at an early stage improves our 

chance of survival and cure. 

However, many people remain hesitant 

about going for screening. “There will 

always be a few patients who are fearful 

of being diagnosed with cancer because 

they feel that it is the end for them. 

They sometimes fear that they will be 

a burden to their closed ones and think 

that there is no hope. Sometimes they 

are in denial and hence delay seeing 

a doctor. Some of them, especially the 

elderly, are ignorant,” shares Dr Hoo 

Kai Meng, a Family Physician at Raffles 

Cancer Centre. 

A substantial number of people also 

have a fear of the treatments (e.g. 

surgery and chemotherapy) that may 

be required. For some, the possible 

costs of investigations and treatments 

weigh upon them and stop them from 

seeking a doctor’s opinion even when 

they exhibit symptoms that may be 

related to cancer. 

Currently, there are many advances in 

cancer treatment which improve the 

survival rate of patients with cancer and 

they do not cause too many severe side 

effects. Indeed, advances in cancer 

treatment such as newer chemotherapy 

regimens, monoclonal antibodies, 

targeted therapy and hormonal therapy


Are you unsure of what the various screening 

tests are about Here is what you can expect 

from some of the common screening tests. 

Colonoscopy 

What to expect: The doctor inserts a colonoscope (a long, thin, flexible 

tube) into the anus. Pain medication and a sedative (medication that 

causes drowsiness) are given to help reduce discomfort. 

Preparation guidelines: 

• As your colon must be empty, you will need to be on a diet of clear 

liquids for one to three days before the procedure. 

• In addition to the liquid diet, you will need to take a laxative or 

give yourself an enema the day or night before the colonoscopy. 

Digital rectal examination 

What to expect: In this test, a doctor inserts a gloved finger into the 

rectum to feel for anything abnormal. This takes only a few minutes to 

complete and is performed without sedation. 


No advance preparation required. 

Mammography 

What to expect: This is basically an x-ray of the breast. Generally, 

mammography is uncomfortable but rarely painful. Some women do find 

the procedure painful, as the x-ray plates are compressed firmly. 

are in place to offer patients options 

that were previously unavailable.” said 

Dr Hoo. 

“Early screening is important if you 

have a higher than average risk of 

getting cancer, such as having a strong 

family history of breast cancer or colon 

cancer. Screening is also important 

if your occupation exposes you to 

radiation or cancer causing chemicals,” 

said Dr Hoo. 

Healthy individuals may put off going 

for screening, as they may not see a 

need for it. However, the choice should 

be clear as finding cancer at an early 

manageable stage improves survival 

rates. 

HN 


• On the day of your mammogram, do not use deodorant, 

anti-perspirant, powder, lotion, or perfume on your breasts or under 

your arms. 

• Avoiding caffeine for a week prior to the examination and taking an 

over-the-counter pain medication the day of the examination may 

also reduce breast sensitivity and make the examination more 

comfortable. 

Pap smear 

What to expect: Cells are gently scraped from the outside of a woman’s 

cervix and vagina and examined. This only takes a few minutes. The test 

can be uncomfortable, but it is not usually painful. 


• To ensure that the Pap test results are as clear as possible, do not 

have sexual intercourse for two to three days before the test. 

• Do not use tampons, birth-control foams, vaginal medicines, douches, 

or vaginal creams or powders for two to three days before the test. 

These products may wash away abnormal cells.

16 UpClose Raffles HealthNews

Raffles HealthNews UpClose 17 

UpClose 

with 

Dr Hoo Kai Meng 

Deputy Clinical Director, Raffles Medical 

Family Physician, Raffles Cancer Centre 

A 

familiar face at Raffles Medical clinics, Dr Hoo Kai Meng is now a Family Physician at Raffles Cancer Centre. UpClose 

finds out from Dr Hoo on how specialising in palliative care brings him closer to cancer patients, who needs his help 

and support. 

I understand that you just moved 

into Raffles Cancer Centre. How long 

have you been working at Raffles 

Medical Group 

Come June this year, I would have 

been with Raffles Medical Group for 

approximately 15 years. I moved into 

Raffles Cancer Centre, as a family 

physician who specialises in palliative 

care, in January this year. 

What made you decide to focus on 

palliative care 

I felt that there was not much emphasis 

on palliative care in general and that 

more could be done for patients who 

are nearing the end of their life. Many 

times, the patient and their relatives 

are left to cope on their own. Having 

experienced this personally, I wanted 

to do more. 

I have been attending some palliative 

courses and was very fortunate to be 

attached to a home care hospice. I was 

heartened by their care of terminally ill 

patients and could see the difference 

they made to the patients and their 

loved ones. 

To be a GP specialising in pallative 

care, are there any specific skills or 

interests that you need to have 

There are and I am still learning. I will 

be attending a course on palliative care 

conducted by National Cancer Centre and 

Flinders University in Australia. In addition 

to skills, I believe that compassion and a 

good listening ear are important. 

What’s a typical day like for you 

This is currently a new set up for me. 

I usually visit inpatients in the morning. 

In the afternoon, I will be stationed at 

the Cancer Centre to attend to walk-in 

patients. I also conduct cancer screening 

for patients and I will be around to attend 

to any emergencies that may occur 

during chemotherapy sessions. 

What do you enjoy most about your 

work 

I am really happy when patients and 

their families come together and make 

the final days of the patient comfortable 

and happy. 

Do you have any fulfilling moments 

in your work that you can share 

with us 

There was a patient with terminal cancer 

who, initially, was not ready to let go 

because he was awaiting his son’s 

graduation from university. He was a 

deeply religious man, who gradually 

accepted his fate. This was after much 

counselling and due to his faith. The good 

thing was that he managed to live long 

enough, not only to see his son graduate 

but also see his son land his first job. 

That’s quite a story. You often have 

to work with and interact with people 

who are terminally ill. Any secrets 

on how you handle them and their 

loved ones 

There are no secrets. However, be 

truthful, supportive and empathetic. 

Always do your best to help. 

Patients have mentioned that you 

are very kind and patient. Can you 

share some tips on how to deal with 

the pressures of having to manage 

patients that are ill and may not be in 

the best emotional state 

I would say that it is important to remain 

calm and do a lot of listening. I always 

try to understand my patients’ concerns 

and work with them to resolve it. 

Seeing so many patients undergo 

treatments, do you feel pressured to 

keep fit and stay healthy 

I do not really feel pressured. 

Nonetheless, keeping fit does help me 

in managing the long working hours. 

I try to cycle for 30 mins a day, five days 

a week at home, usually after work. I 

try really hard not to take chocolates 

and ice cream, which are some foods 

that I love. My diet consists of two to 

three helpings of vegetable a day with 

small portions of either chicken or fish. 

However, I do enjoy the usual chicken 

rice and fried hokkien mee. HN


Fiona and her supportive family 

I could never have done it 

without the support of 

my family. 

It all started strangely with a cramp in her 

breasts in August. 

Fiona Loh, 45, felt a tugging ache from 

her left breast but decided to brush it 

aside until the end of her vacation. Upon 

her return to Singapore, she saw Dr Ng 

Bee Lim, General Surgeon, who quickly 

proceeded to do an ultrasound and found 

an abnormal growth in her right breast. 

“Dr Ng asked me if any friends or relatives 

are here with me for the appointment. 

Suspicious of something serious, I told 

her to just tell me what’s wrong. When she 

did, I broke down. I had breast cancer.” 

The biopsy later confirmed that Fiona had 

Stage I breast cancer. For a few weeks, 

Fiona was shocked and could not accept 

it. She has always been an active woman, 

leading a healthy lifestyle. 

“It was like a nightmare. I remember talking 

to my husband and family about it. For a 

while, I was hesitant about treatment but 

once I gave Dr Ng the go ahead to start 

sometime in October, everything moved 

so fast, I had no time to worry at all.” 

For Fiona, the support of her loving 

husband was crucial. “He made sure I 

would lead life as per normal even during 

my treatment. His quiet watchful eyes 

gave me much encouragement during 

the treatment. I was feeling tired and he 

encouraged me. I was throwing tantrums 

but he just beared with me.” 

“Chemotherapy was not as bad as I 

thought. It is at least not as invasive as 

an operation. The only discomfort was 

the needle poking but there was no 

pain. However, the hair loss made me 

contemplate stopping my chemotherapy.” 

Fiona’s three daughters, aged 8, and a 

pair of twins aged 7, did not react well to 

her hair loss. They pointed often at her 

and squealed when they saw Fiona’s 

thick lovely tresses fall by the bunch. 

That broke her heart. It was only after her 

husband explained the situation to the 

girls that they became more concerned 

and caring. 

Each time Fiona comes by the Raffles 

Cancer Centre for chemotherapy, her 

husband and brothers would accompany 

her. The acceptance by her family helped 

her to persevere despite the discomfort. 

Life went on almost normally for Fiona 

who continued with her life with very few 

adjustments, such as avoiding crowded 

places. She also shared openly with her 

friends about her condition, earning much 

admiration from them for her strong will. 

Fiona was full of praise for the staff at 

Raffles Cancer Centre. Particularly, her 

oncologist Dr Lopes and Dr Ng. “I am 

very grateful to them and the nurses who 

were very kind and gave me lots of good 

advice. The Clinic Coordinator, Soherni 

advised me to take 10 or more egg whites 

everyday for five months to replace my 

white blood cells. She also recommended 

that I take beetroot, dragonfruit and lean 

pork to replace the red blood cells. I also 

had to abstain from spicy food which I 

love. I have not had spicy food for more 

than five months,” declared Fiona. 

Fiona’s Tips 

1. Cancer is not that scary, so you 

should not be afraid to talk about it. 

2. Be strong and prepare yourself 

mentally. 

3. Rather than coop yourself up at 

home, air the issue with your family. 

4. Think positively and life will be easier. 

5. Take precautions; do not neglect your 

annual check-ups. 

6. Family members should be accepting 

and encouraging.


Overcoming 

The Odds 

Cancer survivor stories always inspire us. Three patients from 

Raffles Cancer Centre share their experience of overcoming 

the odds and their personal lessons from the disease. 

I thought I was pregnant, 

then I found out it was a 

tumour. 

Newly-wed Ms Aye Phyu San Myint Than, 

25, first noticed something was amiss in 

early 2008 when her menstruation stopped 

and she was displaying pregnancy-like 

symptoms. She had been trying for a child 

but to no avail. These symptoms worried 

her so that she went to her gynaecologist 

in Myanmar who did an ultrasound for her. 

As the gynaecologist noticed a growth in her 

uterus, she was advised to do a dilatation 

and curettage (D&C) in order to diagnose 

the pathology of the tumour. It turned out 

to be a molar pregnancy, an anomalous 

pregnancy related growth that is precancerous 

in nature. 

The news of the tumour in her uterus 

shocked her. “I was crying and so afraid of 

what this all meant. My mother was also 

shocked as she has never heard of this 

disease before. We have no family history 

of cancer and none of our friends have ever 

had the same disease.” 

Between March and May 2008, Ms Aye 

saw her oncologist in Myanmar for three 

sessions of D&C to determine if it was 

in any way cancerous. After that, she 

underwent four cycles of chemotherapy. 

Rather than reducing in size, the size of the 

tumour gradually increased until it was 4 cm 

in diameter. 

“This was a very difficult time for me. 

I vomited a lot and bled through the 

vagina. Although it was not painful, 

I felt very uncomfortable. I also lost 10 

pounds. We were then referred by our 

neighbour to seek treatment in Raffles 

Hospital.” 

The difference in treatment was 

something that surprised the family. 

Unlike the simple injection administered 

in Myanmar, Ms Aye had to be admitted 

to the hospital for a day and given two 

infusions. The next morning, she was 

given more medications. 

“I could feel the side effects. I felt 

nauseous, lost my appetite and had 

constipation. I also lost hair just before I 

went for my second cycle and by the end 

of my second cycle, almost all my hair 

had dropped off.” 

“I wasn’t too worried though 

as the nurses and doctors 

had all warned me about the 

side effects. In fact, I was very 

glad when I got the results 

after treatment - my baseline 

hormone has dropped by more 

than 50% from 1800 to 300 in 

just one cycle!” 

The speed by which she is seeing 

results in the treatment surprised her. 

By September 2008, after six cycles of 

treatment in Raffles Hospital, the size 

of the tumour has been brought down 

further to 2 cm in diameter. 

Ms Aye looked totally like a new person 

when she recently came back for her 

check up. Sporting a spunky new hairdo, 

she has also gained 30 pounds. In her 

latest review, the doctors have given her 

the all clear sign. 

“I am so thankful to everybody in Raffles 

Hospital, especially the doctors and nurses 

for their care and treatment. I am looking 

forward to the future where my husband 

and I can carry our baby and its all thanks 

to the treatment in Raffles.” HN 

Ms Aye and mother with the staff of Raffles


Winning the Battle 

Nutritional therapy for cancer patients 

Everyone can benefit from a healthy diet. For cancer patients, good nutrition is 

even more important as the illness and its treatment may affect your appetite. 

They may also alter your body’s ability to tolerate certain foods and to use certain 

nutrients. 

Ms Nehal Kamdar, a dietician at Raffles Internal Medicine Centre, answers some of the 

common questions on diet for cancer patients.

What are some nutrients that are integral in a cancer patient’s diet 


1. Iron 

Low iron can lead to anaemia as well 

as low resistance to infections. Meat, 

chicken and liver are good sources 

of iron. Vegetarian sources of protein 

like soybean products, legumes and 

nuts provide adequate iron. Ending 

your meals with a fruit can enhance 

iron absorption. 

2. Calcium 

Milk and dairy products like cheese 

and yoghurt provide calcium which is 

essential for healthy bones and teeth. 

Yoghurt drinks may be included in 

your diet as they contain beneficial 

bacteria helpful for maintaining healthy 

intestines. 

3. Fluids/water 

Water and fluids are vital to our health. 

If you do not take enough fluids or if you 

are vomiting or have diarrhoea, you may 

become dehydrated. In general, a person 

should drink about eight glasses of water 

per day. 

4. Vitamins and minerals 

Vitamins and minerals allow the body to 

use the energy supplied in food. It can 

be hard to eat a balanced diet when 

you are being treated for cancer and 

have treatment side effects that last 

for long periods of time. When that is 

the case, your doctor or dietician may 

suggest a daily multivitamin and mineral 

supplement. 

If you are thinking of taking a vitamin or 

supplement, be sure to discuss this with 

your doctor first. Large doses of some 

vitamins and minerals may reduce the 

effectiveness of chemotherapy and 

radiation therapy. 

5. Antioxidants 

Antioxidants are substances that protect 

the body’s cells from damage caused by 

free radicals. Health experts recommend 

eating a variety of fruits and vegetables, 

which are good sources of antioxidants. 

Taking large doses of antioxidant 

supplements is not recommended 

while undergoing treatment. Therefore, 

talk to your doctor to determine the best 

time to take antioxidant supplements. 

Are special foods necessary 

Currently, there is no substantial evidence 

that certain foods can improve your health 

during cancer treatment. Therefore there 

is no need to eat special foods or to avoid 

particular foods. 

However, you may modify your existing 

diet to make sure that you get proper and 

adequate nutrition to help you overcome 

some of the nutrition related problems 

that may occur during the treatment, 

e.g. constipation, nausea, vomiting, loss 

of appetite, taste changes, bloatedness 

/wind and mouth/throat problems. 

S hould I take bird’s nest or ginseng to improve my body’s constitution 

There is no harm in taking traditional 

foods like bird’s nest, red dates, fish 

essence or ginseng in moderation, in 

addition to a balanced diet. However 

it is important to check with your 

doctor before taking medicinal herbs 

or traditional medicines as these may 

interfere with your treatment. 

I have heard of some unconventional nutrition therapies that 

are supposedly beneficial for my condition. Should I try it out 

You may have read or heard about 

“special” nutrition therapies that can cure 

cancer or improve your nutritional status 

during cancer treatment. 

Examples of these therapies include: 

• Detoxification and metabolic therapy 

• Macrobiotic diet 

• Raw food diet 

Although these therapies promise 

spectacular results, there are many 

drawbacks. There is no conclusive 

medical evidence that they are 

successful. They may result in nutritional 

deficiencies due to food restrictions. 

Should you wish to try any of these 

therapies or other special diets, it is 

important to keep your doctor informed, 

continue with the conventional treatment 

prescribed by your doctor and discuss 

your nutritional needs with your dietician. 

It is important to eat well during your cancer 

treatment so as to enhance your health and 

body resistance to infections. Try to make 

food your ally so that you don’t lose weight. 

You can then cope better with the side 

effects of your treatment. 

HN


Oriental Healing 

T C M A p p r o a c h t o C a n c e r 

The use of Traditional Chinese Medicine (TCM) as a complementary therapy to 

conventional treatments such as chemotherapy and radiotherapy is increasingly 

prevalent.


Ms Miao Meng, a TCM Physician from 

Raffles Chinese Medicine Centre, shares 

with us the TCM approach to cancer 

treatment in a holistic and non-invasive 

manner. TCM treatments seek to prevent 

or slow down cancer development, manage 

symptoms and side effects, improve 

patient’s quality of life and prevent cancer 

recurrence. 

According to the TCM perspective, cancer 

is basically due to a weakened constitution 

that makes one susceptible to different 

carcinogens. The prolonged internal 

disharmony and organ dysfunction cause 

an accumulation of pathological waste 

products that then induces growth in certain 

places. 

Depending on the patient’s constitution 

and the type and stage of cancer, TCM 

physicians will design a comprehensive 

programme that is carefully balanced 

between preserving health and correcting 

imbalances brought about by the abnormal 

growth. 

Common treatment 

principles: 

1. Building-up physical resilience 

Taking suitable tonics can improve the 

body’s ability to fight cancer, relieve 

complex symptoms and control cancer 

progression. 

Some common herbs used include 

astragalus (huang qi), ginseng (ren 

sheng), rehmannia (di huang), liqorice 

(gan cao) and angelica sinensis (dang 

gui). 

Common herbs include rhizome 

curcumae (e shu), radix salviae 

miltiorrhizae (dan shen) and flos campsis 

(ling xiao hua). 

4. Dissolving phlegm 

Accumulation of phlegm in the body 

presents a series of complex problems 

such as abdominal distention, nausea, 

vomiting and water retention. 

Some common herbs used include 

rhizoma pinelliae (ban xia), fructus 

trichosanthis (gua lou), pleione 

bulbocadioides (shan ci gu) and 

spica prunellae (xia ku cao). 

Widely known as a powerful tool for 

general pain control, acupuncture can 

also be used to reduce cancer-related 

pain. 

Studies have been done on the effect of 

acupuncture on chemotherapy-induced 

nausea and vomiting, dry mouth, weight 

loss, cough, night sweats, poor appetite, 

dizziness, fatigue, anxiety and depression. 

The positive results of the studies on 

chemotherapy-induced nausea and 

vomiting are the most convincing. 

There is preliminary evidence that 

combined use of conventional medicine 

and TCM may extend the life of patients. 

However, patients who wish to adopt 

an integrated approach should always 

communicate with their doctors to 

ensure that they receive safe and 

coordinated care. 

HN 

2. Purging ‘toxic’ heat 

In the study of TCM, toxic heat is a major 

cause for cancer progression especially 

in middle and late stage patients. 

Herbs like hedyotis diffusa (bai hua she 

she cao), herba scuttellariae barbatae 

(ban zhi lian) and rhizoma paridis (qi ye 

yi zhi hua) are often used to purge the 

‘toxic’ heat within the body. 

3. Dissipating blood stasis 

Blood stasis can promote growth of 

tumour and surrounding connective 

tissues. It is thus important to dissipate 

blood stasis and ensure good blood 

circulation within the body.

24 Supplements Raffles HealthNews 

Reducing 

Cancer Risks 

The chain of events leading to cancer is very complex. Many experts believe that damage from 

free radicals is an important factor in causing the uncontrolled cellular growth that is characteristic 

of cancer. 

Other factors that increase the risk of cancer include genetics, smoking, poor dietary habits and 

stress. While most researchers do not think stress brings on cancer directly, they do believe that 

it weakens the immune system, impairing the body’s ability to destroy pre-cancerous cells which 

can develop into cancer. 

There is increasing scientific evidence to show that certain supplements and foods can reduce 

cancer risks. For instance, some studies found that a high-fat diet increases the risk of cancer, while 

a low-fat diet that is rich in fibre actually helps the body in preventing cancer. Several supplements 

have been shown in clinical trials to be associated with the reduction of cancer risks. 

Essential 

Antioxidants 

Essential Antioxidants are 

present naturally in a variety 

of foods and in the form 

of supplements. Important 

antioxidants include betacarotene, 

vitamins C and E, zinc, 

and selenium. Antioxidants 

are believed to protect cells 

from free radicals, i.e. harmful 

oxygen molecules thought to 

damage cells that result in 

cancer. 

CoEnzyme Q10 

Coenzyme Q10 is a fatsoluble 

antioxidant that is 

uniquely able to protect 

the cells’ power sources, 

known as mitochondria, 

from free radical damage. 

CoQ10 improves cellular 

oxygenation and also boosts 

the immune system. 

Vitamin C 

Vitamin C is a powerful anticancer 

agent that promotes 

the production of interferon 

in the body. Interferons are 

natural proteins produced by 

the cells of the immune system 

in response to challenges 

by foreign agents such as 

viruses, parasites and tumour 

cells. Several studies have 

shown that vitamin C reduces 

the risk of several cancers, 

including colon, bladder and 

breast cancer. 

Promotions for the month 

of April/May 2009 

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* 2nd bottle has to be of the same or lower price


10 Cancer Myths 

Misinformation is contagious. The number of cancer myths are enough to 

drive anybody to the brink of paranoia. Our experts verify the top 10 

cancer myths that you should not be losing sleep over. 

Panel of Experts 

from Raffles Cancer Centre 

Prof Alex Chang 

Medical Oncologist 

Dr Gilberto Lopes 


Dr Choo Dee Peng 

Family Physician 

Dr Lavina Bharwani 


Dr Hoo Kai Meng 

Family Physician


1Using indoor tanning beds 

does not cause skin cancer. 

Some people think that getting 

an artificial tan means that they 

will not be at risk of skin cancer. However, 

the truth is: any tan, no matter how you get 

it, is a sign of skin damage. Tanning beds 

produce the same ultraviolet radiation 

as the sun. To prevent skin cancer, you 

should limit your exposure to ultraviolet 

radiation. 

2If your mom or dad had 

cancer, you will have it too. 

It is true that you may have 

higher risks of developing certain 

types of cancer if an immediate relative 

has it. Yet this does not mean that one 

will definitely develop cancer because of 

one’s genes. 

Many factors can help determine if the 

cancer in a family is hereditary. These 

include: 

• The presence of certain types of 

cancer occurring in the same family 

(for e.g. breast, ovarian, colon and 

uterine cancers); 

• The age of onset of cancer 

(particularly with breast cancer and 

colon cancer, cancer diagnosed 

before age 50 is considered more 

significant); and 

• The number of relatives with cancer 

and how they are related to each 

other. 

3Cancer causes hair loss. 

Cancer does not cause hair loss. 

Hair loss is a side effect of cancer 

treatments such as chemotherapy 

and radiation therapy. The severity and 

symptoms of hair loss can vary amongst 

individuals. Therefore, not everyone who 

underwent these treatments would lose 

his or her hair. 

4Only women get breast cancer. 

This is one of the biggest cancer 

myths of all. Men do get breast 

cancer, although it is rare. Less 

than 1% of the total breast cancer cases 

are male. If a man discovers a lump in 

the breast, he should immediately see an 

oncologist to exclude breast cancer. 

5Some injuries can cause 

cancer later in life. 

This is an outdated belief that 

probably dates back to the 1800s. 

A fall, bruise or any other injury is almost 

never the cause of cancer. Sometimes a 

person might visit the doctor for an injury 

and find a tumour during consultation. The 

tumour is already present to begin with 

and not a result of the injury. People may 

also pay more attention to an injured part 

of their body, and some people discovered 

tumours while rubbing a painful area. 

In some rare cases, long-standing and/or 

severe injuries can increase cancer risk. 

However, these account for only a small 

fraction of cancer cases. For example, 

skin cancer risk is somewhat increased 

in scars caused by thermal or chemical 

burns.


6Cancer is always fatal. 

Yes, cancer can cause death. 

However, due to the new breakthroughs 

in early detection of 

cancer, the risks of dying from cancer 

have decreased since the early 1990s. 

Routine screening has clearly led to 

an impressive decrease in death from 

several cancers, including cervical, breast 

and colon cancers. 

More people with cancer live longer with 

a better quality of life. This is due to early 

diagnosis, lifestyle changes and better 

treatment options. 

7Cancer is always painful. 

This is not always true. Cancers 

are usually not painful during 

the early stages. Some cancers 

never cause pain, though many advanced 

cancers do. Pain from cancer may be 

due to a number of reasons. For e.g., 

the tumour may be pressing on a nerve. 

However, there are many treatments 

available to manage cancer pain. 

8Surgery causes cancer to 

spread throughout the body. 

Specialists in cancer surgery 

have the expertise to take biopsy 

samples and to remove tumours without 

causing spread of the cancer. In many 

cases, surgery is a necessary part of the 

cancer treatment plan. 

Surgeons take extra precautions to prevent 

any chance of the cancer spreading. Doctors 

who perform surgery for cancer are specialists 

and are highly trained in the intricacies of 

cancer and the anatomy. Cancer patients 

should not let misconceptions of this nature 

deter them from seeking early treatments. 

9Older women don’t need 

Pap Smears 

All women should go for regular 

Pap smear until her doctor 

advises that they are no longer necessary. 

This usually happens when a woman 

turns 65 and hasn’t had an abnormal Pap 

smear within the last 10 years. You should 

consult your doctor if you are unsure of 

when you should stop getting regular Pap 

smears. 

10 

for the treatment of cancer. 

Some people may be too 

old for cancer treatment. 

Contrary to what some people 

think, there is no age limitation 

There are side effects involved in all cancer 

treatments. Therefore, every individual should 

receive the treatment that is best suited for 

his or her condition. 

There are cases where older patients 

have other illnesses that may limit the use 

of certain treatments. It is thus important 

for all patients to talk to their doctor with 

regards to the best approach of towards 

treating cancer. 

HN

28 FoodNotes Raffles HealthNews 

Bok Choy 

with Sautéed Mushrooms 

and Shallots Servings per recipe: 4 

Ingredients 

• 

• 

• 

• 

• 

• 

• 

• 

2 tsp canola or olive oil 

1½ pounds bok choy, rinsed and chopped into 

1-inch pieces 

1 package (8oz) sliced mushrooms 

2 tsp light soy sauce 

1 tsp lemon zest 

2 shallots, minced 

1 garlic clove, minced 

Salt & freshly ground pepper, to taste 

Preparation 

1. In large skillet or wok, heat oil over mediumhigh 

heat. Add mushrooms, shallots and garlic 

and stir-fry until mushrooms darken, for about 

five minutes. 

2. Add bok choy and stir-fry for about 8-10 minutes 

until tender. Sprinkle with soy sauce, lemon 

zest, salt and pepper. 

3. Ready to serve. 

Nutritional breakdown per serving 

• 

• 

• 

• 

• 

• 

65 calories 

3g fat < (1g saturated fat) 

8g carbs 

4g protein 

2g fiber 

213mg sodium 

“Bok Choy is low in calories and it is a good source of 

calcium. It is also low in sodium and rich in vitamins 

C and A and phytonutrients. On a nutritional scale of 

1 to 5, I would rate this dish as 4.5.” 

Ms Nehal Kamdar, Dietician, Raffles Hospital 

Ease of preparation: 

Nutritional level:

Raffles HealthNews Q&A 29 

I have stomach cancer, and have been told by my doctor 

that I may need to remove my stomach. Is it really necessary 

and how can I survive without a stomach Are there any 

lifestyle adjustments that I may need to make 

This is a necessary procedure especially when the tumour is 

large, involving the whole stomach and nearby areas including 

lymph nodes. In order to improve the cure rate, radical surgery 

with complete clearance of the tumour is needed. 

The stomach is needed mainly for grinding of food and minor 

initial digestion. The main digestion and absorption take place 

in the small intestine. Therefore, in patients without a stomach, 

i.e. having a direct connection of the oesophagus to the small 

intestine, digestion and absorption are still possible with cautious 

intake of food. 

With the loss of capacity and grinding function of the stomach, 

finely minced diet in small and frequent portions is recommended. 

In addition, indigestive fibres in certain food must be reduced 

to avoid bloating. High calories and fatty food should also be 

avoided to prevent overloading the small intestine resulting 

in diarrhoea and absorption disturbance. Finally, protein and 

nutrient supplements in liquid or semi-solid forms may be needed 

if affected individuals are having problem with weight gain. 

My husband has been recently diagnosed with prostate 

cancer Stage II. I am worried for him as he seems very 

depressed. What can I do to encourage him during these 

times 

Cancer has a significant impact on those closest to them -- most 

often spouses. Most spouses take an active role in their husbands' 

experience and agree that the disease brought them closer. 

In your case, let your husband know you're there for him while he 

battles prostate cancer. Without prying, give him the opportunity 

to share his fears and concerns. Listen to him, and avoid making 

him think it is his fault that he is ill. Don't nag at him to do the 

things he normally does. Remind him that while he has an illness, 

he can get better no matter how hopeless he feels. 

Show interest in what your husband is going through and 

encourage him to find out more about his condition. You can offer 

to accompany him on his doctor visits as it is the best way to learn 

about his health, treatment decisions and other important issues 

related to the disease. You may also want to seek advice and 

support from the hospital’s counselling team who are specially 

trained to counsel families of patients. 

To help him cope with depression, get him to simplify his lifestyle, 

set reasonable schedules and structure his time. Try to get him 

to participate in normal activities and get together with family or 

friends regularly. Encourage him to eat healthily and get sufficient 

sleep. Recovery from depression is an ongoing process and he 

may want to try stress reduction techniques such as meditation, 

yoga or tai chi. 

Dr Law Ngai Moh, 

Gastroenterologist, 

Raffles Internal Medicine Centre 

Dr Lim Yun Chin, 

Psychiatrist, 

Raffles Counselling Centre

30 MarketPlace Raffles HealthNews 

PROMOTIONS 

Health Supplements 

Take charge of your health 

May 

June 

July 

12% off 

12% off 

Women’s Multis, Golden Multis & 

Bone Calcium 

Adult Multis, Golden Multis & 

Glucosamine 1500mg 

12% off Essential Antioxidant 

Prices exclusive to all 

Raffles Medical clinics. 

Call 6311 1111 to locate a clinic 

near to you. 

EXPRESS 

2009 

A comprehensive blood profile package, comprising 

essential blood tests to screen for major health risks 

• Haematology 

• 

• 

• Liver Function Test 

• Kidney Function Test 

• Lipid/Cholesterol Profile 

• Blood Glucose 

• Thyroid Function 

• Uric Acid 

• Calcium 

• Phosphate 

• Cardiac Risk Assessment 

• 

• 

Complete blood count 

Erythrocyte Sedimentation Rate 

Lipoprotein A 

High Sensitivity CRP 

• Serology 

• Anti HAV Total 

• HBs Ag 

• HBs Ab 

(Choice of 3 out of 7 Cancer Markers) 

1. Cancer Marker – Liver 

2. Cancer Market – Colon 

3. Cancer Marker – Intestine 

4. Cancer Marker – Lung 

5. Cancer Marker – Prostate 

6. Cancer Marker – Breasts 

7. Cancer Marker – Ovary 

• 

• 

Urine FEME 

Medical review on results 

For more information, please call Raffles HealthScreeners at 6311 1222. 

Raffles HealthScreeners | 585 North Bridge Road | Level 2, Raffles Hospital | Singapore 188770

PROMOTIONS 

Raffles HealthNews MarketPlace 31 

Raffles Dental is offering a Braces Package for fulltime 

students.* 

Braces are used in Orthodontic treatment to 

“straighten” teeth that are displaced or misaligned. 

Brace yourself for a future of great smiles. 

Braces for student at 

$3,888 ($4160.16 

Inclusive of GST) 

Call 63112360/2365 for 

an appointment 

• No waiting list 

• Treatment by registered specialists 

• Saturday clinics 

• Progressive payment plan 

Email dental@raffleshospital.com 

* Excludes consultation fees and X-Rays 

* Present your matriculation or student card upon registration 

* Terms and conditions apply 

T3 HealthScreening 

In celebration of our 1st Anniversary 

at Changi Airport Terminal 3, the 

following health screening packages 

are available at our centre: 

Raffles Lifestyle Package 2009 S$229 

Raffles Deluxe Package 2009 S$329 

Raffles Ladies’ Deluxe Package 2009 S$399 

Raffles Executive Package 2009 S$589 

Raffles Ladies’ Executive Package 2009 S$699 

65 Airport Boulevard | Singapore Changi Airport Terminal 3 | B2-MS-15 | Singapore 819663 

Please call 6241 9900 for more information or to make an appointment.

To Our Patients Our Best 

Raffles Medical Group provides a comprehensive range of wellness and medical services that is focused 

on your needs. 

With an islandwide network of 65 multi-disciplinary clinics and a tertiary hospital, we always offer you the 

highest quality medical care and services. 

Situated at the heart of the city, Raffles Hospital is a one-stop tertiary hospital that offers services in 

35 medical specialties. Experience the personalised care of our medical team and a patient centric 

service tailored to your needs. 

For your general medical needs, there is always a Raffles Medical Clinic situated near you. Should you 

feel too sick to visit the doctor, house/hotel call services are available. 

We are also the exclusive medical service provider at the Singapore Changi International Airport. Beyond 

basic medical services, our medical centre at Terminal 3 provides health screening, aesthetics, O&G 

and dental services. 

With us, your health is in good hands. That is our promise. 

Services 

International Patient Services • 24 Hour Emergency • Aesthetics • Cancer • Children • Chinese Medicine 

Counselling • Dental • Corporate Healthcare • Ear, Nose & Throat • Executive Medical • Eye • Family Medicine 

Fertility • Health Screeners • Heart • Internal Medicine • Japanese • Orthopaedic • Physiotherapy 

Skin • Surgery • Travel Health • Women 

For more information on our services or for an appointment, please call +65 6311 1111 (24 hour) 

www.rafflesmedicalgroup.com

Dangerous Growth - Raffles Medical Group

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