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Fixing cancerous limbs is all in a day’s work for orthopaedic surgeon Tan Mann Hong. Joan Chew reports
I specialise in limb sarcomas involving bone and soft tissues because...
No one wants to lose their limbs and limb salvage surgery allows patients to retain, recover and regain most of their limb functions after surgery. Most of my patients tend to be schoolchildren or young adults who have the rest of their lives ahead of them, so it makes sense to try and help them keep their limbs.
The bones in the limbs are fascinating because...
Bones start off mostly as small cartilage tissues in the foetus and develop into large, long and hard bones with joints at each end to move with each other. Each bone is unique and serves specific functions to hold the body upright and move the limbs together with the muscles, tendons and ligaments. They can even heal on their own when broken.
If I were to give an analogy for what I do, I would be a...
Ship-in-a bottle craftsman. I take out the tumour from the bone (which is like the ship), remove the broken parts of the bone, re-assemble and rebuild it with bone grafts or metallic implants, and then introduce the reconstructed bone back into the body (which is like the bottle).
A typical day for me starts...
At 7am with teaching sessions or departmental meetings, followed by ward rounds at 8am, then clinic sessions which last from 9am to as late as 7.30pm. I perform surgery 1 1/2 days each week. It can begin at 8.30am and end late in the evening. I also have teaching commitments with postgraduate trainees and undergraduate students. After work, it’s family time with my wife, 44, a general practitioner, and two sons, aged 10 and 13. I also try to squeeze in a little exercise on the elliptical machine. My only indulgence in my free time is reading graphic novels by the likes of James Robinson and Brian Michael Bendis as well as New York Times non-fiction bestsellers.
I have come across cases...
That have amazed me. Recently, I met the husband of a former patient. My patient’s limb cancer has been in remission for more than 10 years, but unfortunately, she developed a second white blood cell malignancy which required a bone marrow transplant. A week before that, the couple found out that their only son, who is six years old, had to undergo heart valve surgery. In spite of all this, the couple remained upbeat. I was amazed by their resilience.
I love patients who...
Play an active role in understanding the treatment of their illnesses, as well as those who stay resilient when undergoing chemotherapy, surgery and rehabilitation. Patients who get my goat are... Those who are impatient. Fortunately, they are few and far between. Most patients understand that doctors are trying their best to see and attend to them. However, a few are indignant when their appointment times have passed and they have not seen the doctor. They would give the clinic assistants and nurses a hard time in the consultation rooms.
Things that put a smile on my face are...
The relief on my patient’s and their family's faces after the former has recovered from treatment. And patients who come up to me and tell me they can walk again after successful limb salvage surgery. It breaks my heart when... A young child or adult with cancer turns up at the hospital at an advanced stage with a very poor prognosis. I know that he is not going to live till his next birthday.
I wouldn’t trade places for the world because...
My job gives me tremendous satisfaction in helping people through surgery. At the same time, I teach and mentor junior surgeons and trainees, conduct research and interact with people locally and overseas who share similar academic interests.
One little known fact about musculo-skeletal tumours is...
Malignant bone tumours such as osteosarcomas occur in human bones undergoing rapid growth, such as during adolescence. Interestingly, these forms of cancer occur in animals as well, especially in large-breed dogs such as the Great Danes and German Shepherds. This is related to the greater bone growth of these large animals.
My best tip is...
Stick to a regular family doctor and have him see you for general health issues. That way, you build up a strong rapport and, if any new health issues crop up, you would already have someone who knows you well enough to advise you and, if necessary, re-direct you to the appropriate specialists. Too often, Singaporeans tend to consult a specialist straightaway when their health issues could have been handled by primary health-care doctors.
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