THE STAR, TUESDAY 2 FEBRUARY 2016

special

CANCER AWARENESS
Improving access to care
By THERESA BELLE
WHEN it comes to statistics on deaths
from cancer, the numbers we see in black
and white are often far from the actual
number of cases according to the
National Cancer Registry of Malaysia,
more than 20,000 Malaysians are
currently diagnosed with cancer but
almost 10,000 cases go unregistered and
therefore unrecorded every year.
Cancer continues to ravage people of all
ages, backgrounds and lifestyles, and is
one of the leading causes of death
worldwide.
It is often a long-term burden because
patients bear significant treatment and
recovery costs on top of physical and
psychological distress.
The National Cancer Society Malaysia
(NCSM) lists breast, colorectal (bowel),
lung, cervical and nasopharyngeal
(affecting the area behind the nose and
throat) cancers as the most common types
in Malaysia.

Bearing the costs

Consultant oncologist Dr Mastura Md
Yusof of NCSM estimates that cancer
treatment can cost anywhere from
RM3,000 in a public facility to more than
RM40,000 in a private centre depending
on the stage and type of cancer and
personal fitness of the patient. This
amount covers tests, scans, surgery,
radiotherapy and chemotherapy, among
others.
Cancer has evolved and its cost
increased, so older insurance plans are
often insufficient. Some treatment
methods are not even recognised by the
insurance provider for example,

radiotherapy may not be reimbursed as it

is considered outpatient treatment, says
Dr Mastura.
Chairperson of cancer care advocacy
group Together Against Cancer (TAC)
Ranjit Kaur emphasises that this financial
burden hits those in the lower income
bracket hard, especially those in rural
areas with limited access to
comprehensive care.
We must work on improving access to
life-extending drugs especially for
advanced cancers and make expensive
life-saving drugs more readily available to
those who cannot afford them, she says.
To aid this, TAC has proposed that the
Government set up an annual RM50mil
cancer drug fund.
Last year, the group appealed to Prime
Minister Datuk Seri Najib Tun Razak to
waive the Goods and Services Tax for
cancer drugs and in Budget 2015, these
were announced as zero-rated supplies.
Change is possible through advocacy in
this way, but to what extent can it affect
policymaking?
Implications of the Trans Pacific
Partnership Agreement (TPPA) must be
considered when discussing the future of
healthcare in the country.
Besides being criticised for lack of
transparency in its dealings, the TPPA
comes under scrutiny for its regulations
on data exclusivity and patentability
standards in healthcare.
If current terms are agreed upon,
Malaysians would have restricted access
to generic drugs, having to wait a longer
period of time after novel drugs are in the
market before their generic versions can
be introduced.
This is bad news for the average citizen
because according to research published

We must work on
improving access to
life-extending drugs
especially for advanced
cancers and make
expensive life-saving
drugs more readily
available to those who
cannot afford them.
Ranjit Kaur

in 2011s Journal of Public Health,

Malaysian pharmacists recommend
generic substitution for 85% of all brand
name requests for medicines.
Without these substitutes, citizens will
have to pay a lot more for immediate
quality healthcare.
These woes have not gone unnoticed by
the authorities. Last October, Deputy
Health Minister Datuk Seri Hilmi Yahaya
spoke on behalf of the Health Ministry to
reject this TPPA proposal to extend expiry
dates as it would burden the people.

Widening the scope

Our healthcare system does not have
the capacity, infrastructure or skilled
manpower to cope with the rising number
of cancer patients.
But it is also important to note that we
as consumers must avail ourselves to pap
smears, mammograms and similar tests to
ensure cancer is found at the earliest stage

With the high costs of cancer treatment,

stakeholders must play their part in
bearing it together to promote public
health and better quality of life.

possible, says Dr Saunthari

Somasundram, chairperson of NCSM.
She proposes that a Cancer
Control Plan be set up to ensure
all stakeholders work together to improve
on the healthcare system and services.
This will encourage a wide-scope
involvement of the Government and
society, including health professionals
and cancer bodies.
According to Dr Ednin Hamzah, medical
director and chief executive officer of
Hospis Malaysia, this comprehensive
approach should include palliative care to
a greater extent as it is not fully utilised in
cancer care, in which pain management is
crucial.
A lot of healthcare planning revolves
around future care, that is, prevention to
reduce disease burden, but we must also
consider those suffering from advanced
and life-limiting illnesses, he says.
Most patients dealing with such
illnesses prefer to spend their final days
at home, but there is little healthcare
support. This is where community
palliative care comes in.
Dr Ednin explains that the current
oncology care structure is no longer
efficient in providing satisfactory cancer
care, since many locally trained
oncologists are unfamiliar with pain
treatment the way palliative care
physicians are.
If Malaysia is to become a leading
medical hub, it needs to start from within
by strengthening public healthcare
offerings and access to treatment.
Cancer treatment costs are a hefty
burden, which is why stakeholders must
play their part in bearing it together in the
name of public health and better quality
of life.

2 cancer awareness

THE STAR, TUESDAY 2 FEBRUARY 2016

With proper treatment at the early stage of cervical cancer, patients have a high survival rate.

Surviving
cervical cancer

CERVICAL cancer makes up 12.9% of all

incidences of female cancer in Malaysia.
This may not seem like a large number, but
cervical cancer is actually the second most
common cancer among women in Malaysia
after breast cancer.
Health Ministry statistics put admissions
into hospitals for late stage cervical cancer
cases at about between 2,000 and 3,000
per year.
According to Dr Sanjeev Chandra Joshi,
resident radiotherapy and oncology
consultant at Mahkota Medical Centre, the
high incidences of late-stage admissions and
treatments are because of non-detection at
early stages due to women not attending
regular screenings and check-ups.
Dr Joshi says that though most of the
cervical cancer patients he sees are above
40 years old, more and more women are
suffering from late stages of the disease
before the age of 40.
Sometimes, even if the woman was
diagnosed with cervical cancer at an early
stage, she refuses proper treatment and
chooses traditional or alternative treatment
instead, which does not work.
These women then seek proper
treatment when the disease progresses into
the later stages, at which point it may be too
late for survival, he says.
This is a deplorable state of affairs as
cervical cancer is eminently curable if
diagnosed and treated early.

Awareness and screenings

There are several common symptoms of
cervical cancer, including abnormal vaginal
bleeding, watery and strong-smelling vaginal
discharge, abdominal pain and back pain,
and frequent menses after menopause.
Women often mistake prolonged or
irregular vaginal bleeding for an unusual

Dr Sanjeev
Chandra Joshi.

menses and dont do anything about it until

the symptoms worsen. It is important to be
aware of what is happening to your body
and to see an oncologist for a screening
when you have these symptoms, says
Dr Joshi.
Some of the factors that prevent women
from attending regular screenings are the
lack of awareness about the disease and
screenings, social factors such as the fear of
stigma, and misguided attitudes about
screenings fear of them or doubt of their
efficacy.
Many women do not have enough
knowledge about cervical cancer, which
affects their compliance to screenings and
tests such as the pap smear. Some women
are even afraid to ask their doctors about
the disease and of what the doctor might tell
them, says Dr Joshi.

Risks and preventions

Risk factors for cervical cancer can easily
be mitigated or altogether eliminated.
For example, a major risk factor is having
multiple sexual partners the human
papillomavirus (HPV), which causes cervical
cancer, is sexually transmitted. Sexual
abstinence is therefore the ideal
preventative measure.
A more practical primary prevention is
vaccination. Along with leading an overall
healthy lifestyle and secondary preventative
measures, such as regular screenings and
early detection of precancerous cells and
treatment, it can almost guarantee complete
prevention of the disease occurring or a
very high survival rate if it does.
Families play an important role in
ensuring women do not get cervical cancer.
Parents should ensure their daughters get
the HPV vaccination at the ideal age
between 11 and 13 years old and families
should encourage women to go for regular
screenings and tests, says Dr Joshi.
Detection and treatment with surgery,
radiotherapy or chemotherapy at stage 1
of the disease usually results in a 90%
survival rate.
At stage 2, the survival rate is about 70%
and between 40% and 50% at stage 3. At
stage 4, the chances of survival are quite
low as the disease would have spread to
other areas in the body.
Your options for treatment and
possibility of recovery are extremely limited
at the later stages. Early detection and
proper medical treatment are the keys to
survival, says Dr Joshi.

n For more information, contact

Mahkota Medical Centre.

THE STAR, TUESDAY 2 FEBRUARY 2016

cancer awareness 3

Herb for
joint relief
IF you experience pain and stiffness in your
body for more than an hour, especially in
the morning or after a long rest, you may
have rheumatoid arthritis (RA).
RA does not only affect the elderly but
can begin at any age, even in childhood. It
is more common in women than men but
men tend to display more severe symptoms.
RA is a progressive inflammatory
autoimmune disease where the bodys
immune system attacks the synovium, a
thin membrane that lines the joints.
It commonly affects hand, wrist and knee
joints. Symptoms include pain, stiffness,
swelling, warmth and redness.
Flare-ups come and go and symptoms
progress over time, making daily physical
activities difficult and exhausting.
If left untreated, it can cause damage to
tendons, cartilage, ligaments and eventually
results in bone erosion and joint deformity.
The exact cause of RA is unknown
it has been attributed to genetics and
environmental and hormonal factors.
Dietary choices play an important role in
the inflammatory response in RA. Sugar
and high-glycaemic foods increase blood
sugar levels and trigger the release of
insulin, which result in a pro-inflammatory
response, leading to chronic joint pain.
Obesity, an inactive lifestyle, lack of sleep,
smoking, recreational drug use and

excessive alcohol intake are also possible

factors in affecting our immune response.
Over-the-counter non-steroidal antiinflammatory drugs (NSAIDs) such as
aspirin and ibuprofen offer relief to joint
pain and inflammation. However, the
results are often temporary and these drugs
may cause stomach ulcers or intestinal
bleeding.
Hence, more people are turning to
natural alternatives for joint relief, which
include making proper lifestyle and dietary
changes and consuming medicinal herbs.
Most people know turmeric as the
culinary spice that gives curry its colour
and flavour. However, besides its culinary
uses, turmeric offers great medicinal value.
Curcumin, the active compound in
turmeric, not only reduces inflammation
but also addresses the underlying causes
and strengthens the body as a whole.
As obtaining curcumin from food sources
such as curry powder may be insufficient,
look out for a curcumin supplement
formulated with C3 Curcumin Complex
extract and piperine extract. The C3
Curcumin Complex contains 95% total
curcuminoids, including curcumin,
bisdemethoxy curcumin and demethoxy
curcumin.

n For more information, contact VitaHealth.

The raw food benefits

I HAD several health problems and went
through three medical treatments. I was
diagnosed with colon cancer and underwent
chemotherapy. I also underwent angioplasty
treatment as I had five blocked arteries.
Seven years later, I had bone tuberculosis
(TB) due to a slipped disc problem. I had to
consume as many as 18 TB tablets, two
painkiller pills and three antibiotic pills
every day, says David Lim.
When taking these medications became
too difficult, I decided to supplement my
treatment with natural raw foods. I
consumed two tablespoons of BarleyGreen,
two tablespoons of Beta Carrot, one
tablespoon of Beta Beet and two capsules
of Probio+Plus three times a day, he says.
After the second month, I was back on my
feet again with a greater passion to live.

l Benefits of BarleyGreen
BarleyGreen is processed from organic
young barley grass and is 20 times more
concentrated than ordinary wheatgrass.
It is rich with essential nutrients such as
16 vitamins, 17 minerals and more than 300
types of live enzymes to help strengthen the
bodys immune system. It also contains the
potent antioxidants 2-O-GIV, P4O1 and
superoxide dismutase (SOD).
Research has found that 2-O-GIVs
protection is more potent than vitamin E.
P4D1 promotes the restoration of damaged
DNA in the cells nucleus and SOD helps
eliminate the devastating effects of
superoxides, which is a host for free radicals.

l Organic Beta Beet

One of the powerful phytonutrients in

Beta Beet is flavonoids. It prevents the

growth of tumours by boosting respiration
of struggling cells.
Moreover, iron, vitamin 12 and folic acid
are the required precursors to form red
blood cells, which help to transfer oxygen
throughout the body. Once the oxygen level
increases, cellular respiration improves.
Beta Beet also plays a significant role in
liver detoxification.

l Organic Beta Carrot

Carrots are good not only for your vision
but also for boosting your immune system.
Beta Carrot contains two potent antioxidants
beta-carotene and vitamin C which can
help fight against free radicals.

l Organic Beta Lemon

Beta Lemon contains flavonoids,
vitamin C and vitamin E, which are
powerful antioxidants. These nutrients help
to eliminate free radicals and potentially
harmful particles from our body, ultimately
strengthening our immune system.
Beta Lemon contains two naturally
occurring substances modified citrus
pectin and limonoids.

n For more
information,
contact
Wellness
Concept (M) Sdn
Bhd.
Cancer survivor David Lim
stays healthy with raw
food supplements.

THE STAR, TUESDAY 2 FEBRUARY 2016

4 cancer awareness

THERE is more to cancer recovery

than medical treatment. Catherine
Lee, senior manager at Subang
Jaya Medical Centres (SJMC)
Cancer and Radiosurgery Centre,
says this is why it is crucial that a
comprehensive approach be
applied in cancer management
from screening and diagnosis to
treatment, supportive care and
cancer survivorship.

Essential care, support

Equipped and ready

Targeted radiotherapy is a
treatment method that has proven
to not only be effective in a
multipronged approach with
surgical and medical oncology, but
also less severe on patients.
The process includes scanning to
accurately identify the size and
area of the cancerous tumour, then
treatment planning to target
radiation to that area alone
ensuring a focused beam of
radiation directly to the tumour
while minimising exposure to
surrounding healthy tissue.
This targeted radiotherapy
improves cancer treatment to
ensure patients of all ages can
recover while minimising the
common side effects such as
irritation or damage to the skin
near the treatment site and
fatigue, says Lee.
SJMCs Cancer and Radiosurgery
Centre has had a good success rate
in patient recovery, thanks to a
combination of latest technology,
medication and procedures, which

The Cancer and Radiosurgery Centre team provides treatment and support
to patients in line with the World Cancer Day 2016-2018 tagline We Can. I
Can.

when combined with a balanced

diet and lifestyle, are able to
greatly improve the quality of life
of cancer patients.
Come May, the centre will be
providing non-invasive, fast and
accurate radiotherapy using the
latest Varian Trubeam Linear
Accelerator system.
All procedures are carried out in
ways that ensure the safety and
comfort of patients. To further
enhance comprehensive care to
the patients, the centre has chemo
daycare where adults and children
are provided with medical
oncology services, nuclear

medicine and PET/CT services,

counselling services and performs
crucial laboratory tests such as
tumour markers and molecular
genetic testing to help identify
targeted cancer medicine for
personalised treatment.

Educating,
understanding
Beyond treatment, a lot of care
goes into aiding cancer patients,
survivors and family members in
their fight against the disease.
According to Lee, every patient
and family is provided support

based on their physical, emotional

and psychological needs.
It is common for patients and
caregivers to go through emotional
and psychological distress, which is
why nurses, educators and doctors
at the centre offer a listening ear
and support at every touch point.
They can now better advise
patients on what to expect with
treatment and prepare patients
well when it comes to managing
side effects of treatment, she says.
More importantly, though, these
patients also find a space for
sharing within their cancer
support groups. The centre hosts
support groups for patients of
many types of cancer and their
caregivers and sees many
survivors coming back to
contribute to these groups by
leading activities such as cooking
classes, yoga, art and drama
classes.
Nasopharyngeal cancer (NPC)
survivor Jim Kow attests to the
importance of support groups in
overcoming cancer fellow
survivors know best what others
with their condition are going
through, making them able to offer
support in an effective way.
A large part of managing cancer
is overcoming the fear of the
unknown, which is why besides

having an understanding doctor

who is able to communicate with
you on your condition, it also helps
to surround yourself with others
who can offer advice on what lies
ahead, he says.
Having lived with cancer for
many years, Kow now often leads
the NPC support group. He notes
that SJMCs centre is now more
focused on facilitating peer support
as the staff understands its role in
cancer care.
SJMCs Cancer and Radiosurgery
Centre will educate the public on
cancer prevention during World
Cancer Day 2016 campaign from
Feb 4 to March 5.
Three key aspects of cancer
prevention will be highlighted to
the public vaccination, smoking
and healthy living so that the
public is empowered to take action
in keeping themselves cancer-free.
There will also be a public forum
on March 5 where medical
professionals will give talks on the
latest cancer care, treatment and
prevention. It will be held at SJMCs
conference room and is open to all
members of the public who
register beforehand.

n For more information about the

World Cancer Day 2016 campaign,
call 03-5639 1537.