Understanding Cancer Screening and Treatment

Contributed by: Dr Zee Ying Kiat

The word ‘cancer’ is one that strikes fear in the hearts of those who hear it. However, a better understanding of the various prevention, screening and treatment options available can help dispel common myths and misconceptions about this disease.

Cancer is a condition that arises when normal cells develop an ability to divide uncontrollably, invade nearby non-cancerous tissues, and spread to distant parts of the body.

Worldwide, it is estimated that 1 in 5 individuals may develop cancer before the age of 75. The top three cancers in Singaporean men are those of the colon, lung and prostate, while the top three cancers in Singaporean women are those of the breast, colon and lung.

It is estimated that 1 in 3 cancers are possibly preventable. Adopting basic dietary and lifestyle changes can significantly reduce one's risk of developing cancer as well as other chronic illnesses. These measures include consuming more fruits and vegetables, consuming less processed foods and red meat, smoking cessation, limiting alcohol intake, keeping physically active and maintaining a healthy weight. Dr Zee Ying Kiat, Senior Consultant, Medical Oncology at Parkway Cancer Centre, also highlighted some less well-known preventive measures such as protecting oneself against sexually transmitted infections and regular cancer screening.

Cancer screening – how it can save lives

Cancer screening is a means of checking for cancer or conditions that may lead to cancer in individuals who show no symptoms. Types of cancer screening include physical examinations, laboratory tests and imaging. But what are the benefits of screening?

Using cervical cancer as an example, Dr Zee explained how screening can save lives. As the development of cervical cancer takes years, Pap smears help detect precancerous cells so that treatment can be rendered to prevent invasive cancers from developing.

Pap smears have been largely responsible for the dramatic decline in incidence of cervical cancer in countries that have implemented comprehensive screening programmes, such as Singapore, where cervical cancer is currently the tenth most common cancer in women.

However, Dr Zee emphasised that not all cancers have suitable screening tests available.

Screening for breast cancer – why should I go for it?

According to Dr Andrew Lee, Breast Surgeon, Gleneagles Medical Centre, screening allows for early detection of certain cancers and therefore greater chances of survival and cure.

Better understanding of the biology of breast cancer, improvements in breast cancer detection and treatment have led to an improvement of overall breast cancer survival from 40% in 1970–1971 to almost 80% in 2010–2011. These improvements are in part due to the ever-increasing breast cancer awareness worldwide. With early stage breast cancer offering a 10-year survival rate of 75–95%, breast cancer is by no means a death sentence today.

Breast self-examination is no rocket science—it is a highly accessible form of screening that anyone can do at home. Mammograms are also more accessible with established screening programmes that can be done affordably. Generally in Singapore, yearly mammograms begin at age 40–50, and once every 2 years from age 50 onwards. Although the risk of breast cancer increases with age, mammograms become more accurate with age as women’s breasts become less dense.

Today, imaging is advanced and sophisticated, offering better quality imaging that can improve the accuracy of diagnosis. 3D mammograms for instance, can address the issue of dense breasts, providing better visualisation of the breasts.

Contrary to common myths about mammograms, the procedure is not painful for most women and the amount of radiation used is low dose and equivalent to 5 return flights to Europe from Singapore. Furthermore, the benefits of early detection outweigh any risks as it not only increases the chance of cure, but can also lead to early recovery, preservation of the breast, less aggressive treatment for some, and better quality of life—therefore there is no reason to be afraid of screening.

Treating cancer - no one-fits-all approach

Recent advances in medicine and medical technologies have led to a plethora of treatment options available for cancer. Doctors may combine different treatments for greater effect, taking into account other factors like the patient's overall health.

Generally, the main types of cancer treatment are surgery, chemotherapy, hormonal therapy, targeted therapy, immunotherapy and radiation therapy.

Main Types of Cancer Treatment

SurgeryIn which doctors physically remove the cancer and its surrounding tissue. Today, some operations are carried out using keyhole surgery or robotic surgery, offering more precise treatment with shorter recovery time and reduced pain.
ChemotherapyThe use of drugs to kill cancer cells by interfering with their ability to divide, with the aim of maximising chance of cure (curative) or prolong survival and/or reduce symptoms (palliative).
Hormonal TherapyBy adjusting hormone levels with drugs, doctors can stop some cancers and even kill the cancer cells.
Targeted TherapyTargeted therapy interferes with, or ‘targets’, specific molecules involved in cancer growth and spread.
ImmunotherapyThis breakthrough treatment harnesses the patient’s immune system to fight cancer by reactivating the body’s immune response.
Radiation TherapyUses high energy X-rays or other types of radiation to destroy cancer cells.

Cancer is a critical disease in Singapore and worldwide. However, advances in imaging technologies and treatment, as well as better understanding of cancer, have improved how we prevent and treat the disease. Lifestyle modifications and screening can help prevent and detect the cancer early, saving lives. With many treatment options available, treatment is also now personalised to an individual and their cancer, offering a more holistic approach with better outcomes and quality of life.


POSTED IN Cancer Prevention, Cancer Treatments
TAGS breast cancer, cancer quality of life, cancer screening, cancer self-examination, cervical cancer, chemotherapy, immunotherapy, mammogram, misconceptions, pap smears, prevent cancer, radiotherapy (radiation therapy), robotic surgery, targeted therapy, women (gynaecological) cancer
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