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Tuesday, 15 October 2013

Race against cancer 2013

Running a marathon is popular among Singaporeans. There is something about running; what it does to the body and the mind. Firstly, you feel energetic and eager. More than halfway through, you begin to feel tired and wish you have not start. Then three quarter of the way, you begin to push yourself and your mind begin to encourage your body to complete the journey and to look forward to the finishing line.

The fight against cancer is the same. Although nobody expect and want to go through the cancer journey, cancer can strike anyone at anytime. Initially, one will feel eager to finish this "nightmare" and get thorough this journey as soon as possible so as to go back to normal life. Half way through the surgery, chemotherapy and radiotherapy or whatever treatment combinations that are being offered, one wish to take a rest and many just give up. It is usual to cry. It is usual to feel pain and generally unwell in the body as the body is not prepared to take on the treatments all of a sudden. But, the caregivers and bystanders (friends, relatives and health care professionals) would just give encouragement to push the runners through and help them  see the finishing line in front. Sometimes, in many cases, people that you do not know will come around and encourage you and some even offer you water and food genuinely. There are people in the society who is caring. 

The NPC support group is very much the bystander and the good people around. What is unique, is that they are cancer survivors and had been ex-runners. Cancer survivors like Dave, Peter and Carol completed their own journeys and their cancer have been cured. Yet, they came back for the sole purpose to run the cancer journey with the newly diagnosed cancer patients, as fellow runners to encourage and motivate them to carry on, to persevere towards the finishing line. I applaud them for their commitment and dedication as they have been doing this for many years. 

So, the Singapore Cancer Society Race Against Cancer 2013 has a special meaning to them. They ran as a group. They ran as a family. They ran with their own caregivers. They ran to remind themselves that they ran against cancer and finished their race successfully. Now, they are back. Stronger and more committed that the fight against cancer is a shared responsibility. Together, we are one. We are NPC One Heart Support Group.

Dr. Choo Bok Ai
Consultant Radiation Oncologist NUH/TTSH/NCIS
Assistant Professor NUS

Richard, Carol, Yvonne, Peter and Dave

We are strong as one

Hope instead of despair 

Monday, 14 October 2013

Successful head and neck public forum

A total of 196 people attended the talk. 23 staffs from NUH/TTSH/NCIS turned up to help. Overall rating for the talks were Very good (4/5). Over 83% benefited from the talk and rated the event as Very good (4/5). Only 2% said that the event did not meet their expectation.

The cancer survivors and caregivers sharing were well received. Carol and Richard came from KL to Singapore specifically to share in this forum. Such dedication!

Thanks again and well done team.

Dr. Choo Bok Ai
Organiser and chairperson
NCIS Head and Neck Public Forum 2013 NUH/TTSH
in partnership with Singapore Cancer Society

Sunday, 15 September 2013

Breaking the fear factor in cancer

A lot of my patients have fear. It is undoubtedly so since there is so much negative publicity about cancer and its treatments. Cancer can be life threatening. Cancer treatments have a high frequency of side effects and are damaging in its own ways. The time when being newly diagnosed with cancer is probably the most difficult period of time in a person's life. Many will shed tears, felt numb and alone and for the first time face their own mortality. It is very scary. It may be their breaking point. 

For these reasons, I have chosen the topic of "Breaking the Fear Factor in Cancer" to be the theme of our annual public forum. The fear in cancer does not help in the recovery or the fight against cancer. On the contrary, it cripples and destroys any hope of surviving cancer. In many instances, cancer can still be cured. It is not always terminal. I purposefully chosen 5 important talks to provide education to the public, to raise awareness and to give hope. The questions asked as illustrated by the titles of the talks are very real. I heard them before and they echoes in my daily life as an oncologist, being repeated frequently by my patients. 

On the second part of the forum, I am bringing up 5 cancer survivors and caregivers on stage with me to talk about their cancer journeys. It will be a casual interview. They are real patients previously who had battled against cancer in the past few years. Their stories will reflect how when the going gets tough, the tough gets going. Come and listen to them as they share from their hearts. It is very personal and brave for them to come up on stage in front of 300 people to talk about the most difficult time of their lives. Don't miss this opportunity. 

See all of you next Sunday - 22 September between 130pm-5pm. Register now if you have not done so. As of today, we have only about 80 seats left. It is free. Refreshment and goodie bags provided. There will be questions and answers time to you to post questions to our speakers during the session. 

If you have Facebook, please log in and share through the National Cancer Institute Singapore Facebook page:

Dr. Choo Bok Ai
Medical Adviser of NPC OneHeart Support Group
Consultant Radiation Oncologist
Assistant Professor in Medicine
Organiser of "Breaking the Fear Factor in Cancer" 2013 Public Forum.

Sunday, 4 August 2013

September 2013 Head and Neck Cancer Public Forum

·       In Singapore, September is Head & Neck Cancer Awareness Month. During this month, we try to raise awareness of Head & Neck Cancer through our annual public forum, which cover topics like prevention, surgery, radiotherapy, chemotherapy and supportive care. There will also be an interactive session with cancer survivors and their caregivers where the audience can learn and be encouraged from real life experiences.

·  Last year, the forum was oversubscribed (300 people maximum capacity) and many participants found the topics covered useful and informative.
     This year our forum will be on the 22nd of September (Sunday) from 1.30pm to 5.00pm. It will be held at the NUHS Tower Block Auditorium on Level 1 (1E Kent Ridge Road, NUHS Tower Block, Singapore 119228). The forum is free so that all can attend and is held in partnership with Singapore Cancer Society. The title of the forum is “Breaking the Fear Factor in Cancer”. 

Tuesday, 2 July 2013

NPC Talk July 2013 on Nutrition for Cancer - Focusing on Organic and healthy eating.

I remembered that whenever anyone in my family had tummy upset, my mother would recommend ginger . She staunchly believes that the ginger effectively  purged out the “ wind “ and enhances the digestion as well .  On the other hand my mother in law maintained that there was little that garlic soup with pepper could not cure . I remembered poignantly, when I was about ten years old and having high fever that did not subside even after medication, my grandmother brewed a bowl of medicine for me . She came into the room beckoning me to get up and insisted that I drank the medicine. As I raised the bowl to my lips I let out a loud scream . There floating on  the “  yellowish soup of leaves“   was the  head of a cockroach with its horrendous eyes looking at me . I rebelled. She coaxed. I protested she cajoled .  Closing  my eyes, I drank the soup with grandma’s arms caressing me. Being the first grandson I was the apple of her eyes and she would do anything to protect and love me. If there is a Fear Factor for kids I believe I would have won it.

Of course, I do not give this cockroach broth to my kids but I do  swear by another broth –the “yellow ginger/pandan/lemon grass “ broth which is not only cheap but also very palatable and potently high in antioxidant. Like my mum and my mother in law these "ginger /garlic/lemon grass" therapy has become the panacea to life’s upsets and illnesses.

Below is a testimony taken from a blog of a  cancer survivor (".) . We too have asked ourselves the same questions.

I am one who strongly believes & faithfully practises good nutrition in the years before cancer. I have a whole library of books on health & nutrition. I even invested $1000 on a good fruit juicer from the USA. I exercised daily & did everything the books say to avoid getting cancer but in the end, I still get cancer. So what went wrong? I had always been healthy, never fell sick, never on MC. Even my siblings used to laugh at the way I eat (this cannot eat, that cannot eat), but guess who has the last laugh? They eat anything without controlling their diet, yet they don’t get cancer. I practise what the books say & I am the one who gets cancer. The conclusion I draw from all the talks this year is, “Eat everything in moderation.”  This seems to be what most of the speakers said in their talks.

You know, on a scale of 0 to 50,000+, my antioxidant score was 48,000, which is considered VERY HIGH. I took this test after I completed my treatment, at a time when I was still unable to eat well. Most books say that people with low antioxidant level are more prone to getting cancer. But my case proves this theory wrong. If my antioxidant level is so high, how come I still get cancer? I remember my oncologist once told me that the cause of cancer is genetics, environment, lifestyle, in this order. I tend to agree with him.

With the above in mind, I would like to pose the following questions to the nutritionist :
(1) To what extent does nutrition play in the prevention & recurrence of cancer?
(2) Should we eat EVERYTHING in moderation? Or are there foods that cancer survivors should avoid?
(3) What role do free radicals & antioxidants play in cancer prevention? Is it possible for a person with a high level of antioxidants to get cancer?
(4) If genetics & the environment play a major role in causing cancer, how can nutrition help in avoiding the occurrence of cancer?
(5) Are food supplements necessary?

Dear members I am happy to announce that for the coming talk in July I have invited a Herbalist Max Liao JM to speak on a topic that is close to our hearts : Can we eat to starve cancer cells? During the talk,  Max will be bringing his own organic herbs  and vegetables for live demonstration and sampling. There will be a small charge of $2/pax for registration of the talk to cover the costs of the herbs and vegetables for all to share. 

His CV and working experience is in the attachment above.

Details of the Talk :

Date : 20th July Saturday
Time : 130-5pm
Venue : NUHS Tower Block Level 7
Seminar Room T07-03/04
Topic : Starving Cancer Cells with Good Nutrition – Myth or Fact    
Speaker : Herbalist Max JM

If you have any questions about nutrition please email them to me so that I can forward them to the speaker. Please register with me early .

Let me end on a personal note :

After grandma’s broth the fever subsided. I am always thankful for  her.

Grandma if you are looking down and see your grandson   volunteering this cancer work I believe you would be be proud of him right ? :)

I missed you grandma  !

Peter Tang

Saturday, 1 June 2013

NPC June 2013 meeting

Dear Members

20 years after treatment I had an extraction of my right molar tooth this month . A test confirmed that the nerves below the tooth were dead and and xray exposed  a crack at the base of the tooth and was advised to have the tooth removed. My Dental Doctor next suggested to have me refer for further treatment.

For all head and neck survivors and patients the management or Oral hygiene is of paramount important because there are common oral problems occurring after radiotherapy and chemotherapy treatment . Some of these problems include : “mucositis (an inflammation of the mucous membranes in the mouth), infection, pain, and bleeding. Dehydration and malnutrition, commonly brought on by difficulties in swallowing (dysphagia). injuring the glands that produce saliva, or damage  muscles and joints of the jaw and neck (trismus),  reduction in blood vessels and blood supply of the bones of the mouth. In addition, treatments may affect other forms of dental disease (caries, or soft tissue complications), or even cause bone death

An internet article (revised) explained it succinctly  :

“ … Radiation treatment for head and neck tumors can cause reduction in normal tissue blood flow and a variety of side effects. The mucous membranes of the mouth and salivary glands are especially sensitive. The damage to these tissues and glands can varies,  depending on the amount and kind of radiation used (IMRT is usually least damaging compared to the conventional 3D conformal technique), the total dose, and the area irradiated. Damage caused by radiation therapy can be life long. It is of great importance that the patient's dentist is aware and educated in the issues regarding radiation therapy. The special dental considerations surrounding post-treatment care last forever. “

The last sentence that “  post treatment oral care last forever”  is not something that all of us will like take lightly.

The coming talk “ Management of Oral Hygeine of Head and Neck Survivors “ is an important talk for all of us . And even though I have attended the talk  many times, I have always learnt new points and for the  new oral  problems that I am experiencing that I would seek medical advice for the speaker. Dr Shawn Goh was invited again because from the feedback received most of those who have attended have benefited much.  Sales Representatives from Oral 7 will be sharing about  their various  products and how they will be able to assist us in the management of oral hygiene problems.

The details of the talk at in the attachment above.

There will be survivors who will be sharing about their post cancer journey  Please register with me early for the talk.

Peter Tang or

Monday, 27 May 2013

Stretching exercise on 19 May 2013

It was a good day. I woke up at 5am as my 5 month old baby girl woke up to feed. After that, I went back to sleep. But at the back of my mind, I remembered that this was not an ordinary Sunday. I needed to wake up at 7am to get ready to go to Bishan for exercise and do my first group Tai-chi.

The weather was good. The sun was bright and hot and there were a lot of people at the park. When I arrived, the group had started stretching exercises and after 15-20 minutes, we did some Tai-chi. I felt slimmer after the exercises so decided to buy some McDonalds as a reward and also to cool down in the air-con outlet. It was my first McDonalds in a year. I hope we can have more social outings and events in the future.