Terminal cancer patients living longer

Advances in medicine have changed the definition of 'terminal' for breast cancer patients.

The statement "The terminal may still be many stations away" is not a snippet from a conversation on a train, but a doctor's reply to a patient with advanced breast cancer.

The patient, a young woman in her 30s working as a senior executive in the hospitality industry, had her cancer labelled "terminal" by many and she was asking Dr Wong Seng Weng, a consultant medical oncologies and physician at The Cancer Centre, Paragon Medical, how many more days she had to live. That conversation took place more than two years ago.

Today, she continues to pursue her career full-time, juggling work with the responsibilities of looking after her family.

Having terminal cancer used to imply a short survival of perhaps a few months, but chemotherapy treatment of breast cancer has made important breakthroughs in recent years. With advances in medicine, the definition of "terminal" is changing.

A two pronged strategy in breast treatment involves, first, the local treatment of the affected breast and its surrounding areas and, second, the whole-body treatment to purge the body of remnant cancer cells that may still be hiding in other parts of the body and which may trigger a relapse in future, said Dr Wong.

The local strategy relies on surgery to remove the cancer and it is aided by the use of radiation to destroy the cancer cells in the immediate surrounding areas. The whole-body strategy uses chemotherapy and hormonal therapy. In chemotherapy, drugs that kill cancer cells are used. Hormonal treatment works by depriving the body of hormones that stimulate the growth of breast cancer.

Modern treatment approaches to potentially curable cancer lean towards being more conservative in surgery but more aggressive in chemotherapy as the latter reduces the chance of a relapse, said Dr Wong.

Breast cancer is the most common cancer for women in Singapore. More than 1,000 women are diagnosed with breast cancer annually here, said Dr Yap Yoon Sim, a consultant at the National Cancer Centre.

If you are a woman over 40 years old, a yearly mammogram (special X-ray of the breast) is recommended.

Dr Yap said that some women seek medical attention only after the cancer has spread to other organs such as the bones, lungs, liver or brain. Cure is no longer possible once the cancer has spread to other organs.