A CLEAN BILL OF HEALTH
World Cancer Day – What to Know about Cancer Screening and Treatment Options
Cancer screening helps to detect cancers early, when you may not have any symptoms. The reason why it is important is because early detection and treatment of cancers result in better outcomes. In addition, pre-cancerous conditions may also be detected, and if treated, can prevent the development to cancer.
Men and women are recommended to be screened for the common cancers like colorectal cancer, while women should be screened for cervical cancer if they are sexually active, as well as for breast cancer from 40 years of age. At age 30, women should start to perform Breast SelfExamination (BSE), which can help detect changes in their breasts.
Depending on your risk factors, screening for other types of cancers is also recommended. These include lung cancer for ex-smokers, stomach cancer, liver cancer and prostate cancer.
PRINCIPLES FOR CANCER SCREENING
The World Health Organisation (WHO) recommends that screening should follow specific principles:
- Screening should be done only for an important heath problem of serious consequence;
- The screening test must be reliable enough and not cause harm; and
- There must be an acceptable and effective treatment for the disease when detected at an early stage.
TESTS FOR DIFFERENT CANCERS
While there are established tests like the mammogram, Pap smear and colonoscopy which are supported by scientific evidence, there are also many other tests which, when done, can lead to considerable physical and psychological harm to those tested. Hence, it is important to speak to a trusted physician to discuss on the types of screening that are suitable, before going ahead with the tests.
COLORECTAL CANCER SCREENING
Colorectal Cancer Screening can be performed with a stool test or a colonoscopy.
A stool test looks at a sample of your stool (faeces) to check for blood. Blood in the stool means there is possibly bleeding in the digestive tract and this may be caused by different conditions, including polyps, haemorrhoids, diverticulosis, ulcers, inflammation of the intestines and colorectal cancer. If blood is detected in your stool, your doctor may advise you on the need for a colonoscopy. Not all colorectal cancers cause bleeding, hence a negative stool test does not mean you do not have cancer.
A more sensitive test would be a colonoscopy. This is a test to check the lining of the lower digestive tract i.e., the colon and rectum. Individuals with a family history or anyone above 45 years of age are encouraged to be screened for colorectal cancer as it is the most common cancer in Singapore.
BREAST CANCER SCREENING
Breast Cancer Screening involves a mammogram and occasionally, an ultrasound scan.
A mammogram is a low-dose x-ray of the breast and is used to detect breast cancers. An ultrasound uses sound waves to produce pictures of the internal structures of the breast. It is mainly used to help identify breast lumps or other abnormalities which you may have found during a physical check, or during a mammogram.
A mammogram looks for early signs of breast cancer. It is recommended for females between the age of 40-50 years old to undergo these tests every year, and for older females to undergo the tests every two years. If picked up early, breast cancer can be treated well and cured.
CERVICAL CANCER SCREENING
Cervical Cancer Screening involves a Pap smear test, and a test to detect the human papillomavirus virus (HPV). The goal of screening for cervical cancer is to find precancerous cervical cell changes, where treatment can prevent cervical cancer from developing. The HPV/Pap test uses an HPV test and Pap test together to check for both high-risk HPV and cervical cell changes. If detected, patients will be advised to see a specialist who will advise further treatment.
Contributors:
Dr Grace Tan
Senior Consultant,
Melissa Teo Surgery
The Surgical Oncology Clinic
MBBS(London), MMED (Surgery), FRCS (Edinburgh)
Prof Melissa Teo
Senior Consultant
Melissa Teo Surgery
The Surgical Oncology Clinic
MBBS, MMED (Surgery) FRCSED, FAMS, MPH
https://www.mtsurgery.sg/
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Senior Consultant
MBBS, MMED (Surgery) FRCSED, FAMS, MPH
Melissa Teo Surgery & The Surgical Oncology Clinic
Adjunct Professor Duke-NUS Medical School
Visiting Consultant National Cancer Centre Singapore
Clinical Professor Melissa Teo graduated from the National University of Singapore and completed her general surgical training in the Singapore General Hospital and National Cancer Centre Singapore. She was awarded the Singhealth Human Manpower Development Plan Award to pursue further training in complex abdominal and pelvic surgery. With a keen interest in treating and curing cancers, she completed two fellowships in surgical oncology and in colorectal surgery at the University of Toronto, Canada in 2009. Dr. Teo remains one of few accredited surgical oncologists in the country and region and is frequently consulted for her expertise in the management of gastrointestinal cancers, sarcomas and melanomas.
Interested in health policies, she also obtained a Masters of Public Health from Johns Hopkins University, USA. She held many leadership positions whilst at the National Cancer Centre Singapore, including being the Head of the Division of Surgical Oncology. She also co-chaired the gastrointestinal oncology and was a member of the sarcoma, melanoma and cancer genetics Cancer Service Line development in SingHealth, prior to leaving the public service. Dr. Teo has authored over 130 peer-reviewed publications, 6 book chapters and won numerous teaching awards.
Dr. Teo is skilled in the management of stomach and colorectal cancers, sarcoma, melanoma and peritoneal disease. She is the first President of the Asian Peritoneal Surface Malignancy Group with her vast experience in Cytoreductive Surgery and Intraperitoneal Chemotherapy (CRS and HIPEC) for the treatment of peritoneal disease.
Dr. Teo's personal belief is that the management of cancer needs to be holistic, from early accurate detection and diagnosis to excellent surgical standards and multidisciplinary care and most importantly to being committed to caring for her patients and their families.
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Senior Consultant
MBBS(London), MMED (Surgery), FRCS (Edinburgh)
Melissa Teo Surgery & The Surgical Oncology Clinic
Visiting Consultant National Cancer Centre Singapore
Dr. Grace Tan graduated from Guy's King's and St Thomas's College of Medicine in London, UK. She returned to complete her general surgery and surgical oncology training at Singapore General Hospital and the National Cancer Centre Singapore (NCCS). She then went on to complete her subspecialty training in Cytoreductive Surgery (CRS) and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) at the NHS Peritoneal Malignancy Unit in Basingstoke, UK, and Pelvic Oncology Surgery in King Chulalongkorn Hospital in Bangkok, Thailand. The Basingstoke Peritoneal Malignancy Unit is a world-renowned institution for the treatment of peritoneal-based malignancies and has completed over 1200 CRS and HIPEC procedures. The King Chulalongkorn Hospital in Bangkok is one of the largest tertiary referral hospitals in Thailand and with internationally recognised expertise in the management of advanced pelvic cancers.
Dr. Tan is currently serving as an executive committee member for the Asian Peritoneal Surface Malignancy Group and as a member of the Gastrointestinal and Sarcoma Clinical Trial Steering Committee. She is also an examiner for both the Duke-NUS Graduate Medical School and NUS’ School of Medicine, and continues to be a speaker in the foundation course in clinical oncology at NCCS.
Dr. Tan has co-authored over 70 research papers that were published in journals such as Journal of Surgical Research and International Journal of Clinical Oncology, and is a reviewer for The Surgeon and the International Journal of Hyperthermia.
In recognition of her exceptional contributions, Dr. Tan was awarded the RISE awards for outstanding faculty in 2014, the 2017 Editor's Award for significant contribution by an investigator in the "Clinical" category, by the International Journal of Hyperthermia, and in 2019, she was awarded the Singapore Health Quality Service Gold Award.
Dr. Tan is experienced in the treatment of Gastrointestinal Cancers, Peritoneal and Pelvic malignancy, Melanoma and Sarcomas, and is passionate in providing the best holistic care for patients with cancer.
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