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11I can get through themost trying of times, aslong as I focus on myfirst love, which is makingmy patients better.there are many patients who need help. Surgery in thisfield has also evolved a lot over the last 15 years, fromopen surgery to keyhole surgery in the last eight years,and then surgical robots in the last four,” Dr Tsangexplains. “The field is quite ‘young’ compared to otherdisciplines, but it is a constantly evolving field, with newinnovations to help doctors treat patients better.”Over the years, the most memorable case Dr Tsanghas seen was an emergency surgery that he had toperform on an elderly patient from Malaysia.“The patient was very sick when I saw him – a largepart of his intestine had died, and there was gangreneon his bowels. In addition, he was coughing up phlegm– it was in his phlegm that we found a worm, whichwas something usually only found in animals,”he recounts.“After we found the cause of the illness, we found outthat we couldn’t administer the deworming medicineorally because his body couldn’t absorb it through thebowels. So we had to apply for approval to fly in aninjectable version of the medication that was usuallyonly used by vets – we administered the medicationthrough an IV and the patient made a dramaticrecovery,” he smiles. “He walked into my clinic a monthlater, which was amazing.”recent developmentsIn recent years, a large proportion of cases Dr Tsanghas seen has involved colorectal cancer, whichaccording to the Health Promotion Board, is the mostcommon cancer in Singapore.“The most common symptoms of colorectal cancerwould include blood in the stools or a change inbowel movements, and later abdominal pain anddistension in the tummy. But these are consideredlate symptoms – patients with these symptoms mostlikely already have late stage colorectal cancer,” DrTsang says.“Currently, the emphasis is on screening patients whoare 50 years of age and above for the condition, even ifyou feel absolutely fine and have no such symptoms.Large population studies have found that screeningimproves one’s chances of survival of colorectalcancer,” he adds.These recent developments form part of the reason whyDr Tsang decided to play his part and “walk the talk”,recently undergoing a colonoscopy on camera as part ofan initiative to promote screening for colorectal cancer.“As a doctor, if you want to be passionate about a causeand spread the message on the importance of screening,you have to practise what you preach. Since I turn 50this year and I hadn’t done my screening, when theopportunity came up for me to do the video, I agreed.”While other doctors may have found it awkward toundergo such a procedure on camera for the world tosee, Dr Tsang chose to look at it as a chance to identifywith his patients. “I narrated my experience as if Iwas talking to a patient, explaining what I was goingthrough,” he reveals. “And now that I’ve actually gonethrough it, I can share it with any patient who walksinto my clinic and actually be a credible source ofinformation. I feel that my patients can identify betterwith me, and I can also be a role model for colleagueswho have not had the procedure.”So how did he find his “performance” on camera? “It’sso strange watching yourself on television!” he laughs.“But friends and family members who have seen thevideo have been very encouraging and have said thatI did okay.”worthy sacrificesThe road to becoming a successful colorectal surgeonhas not been an easy one for Dr Tsang. He has mademany sacrifices for his career, especially in the amountof time he is unable to spend with his family members– his wife, two daughters and son. Even family holidaysare sometimes spent “on the job”, when he visits lessdeveloped countries to see what their medical systemsare like. “They are used to the lifestyle, and they see itas a commitment that I have made to my patients andprofession,” he shares.