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.

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     This year our forum will be on the 22^nd 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”. 

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 (  sockkim.blogspot.com".) . 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

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 npconeheart@gmail.com

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.

Helping My Wife Battle Cancer

I will forever remember November 21, 2005 as the most devastating day of my life. On that terrible day, my beloved wife, Heather, and I found out that she had mesothelioma, a cancer of the lining of the lungs caused by asbestos exposure. That was also when I started my job as her primary caregiver, something I could have never been prepared for. Just a few months before, we'd been elated about having had our first and only child, a girl named Lily. We were positively overjoyed at the prospect of our baby's first Christmas. However, as fate would have it, things don't always turn out the way you planned them to.

Even before we left the doctor's office, what it meant to be my wife's caregiver really started to sink in. Heather's doctor provided us with some information on mesothelioma and recommended that we seek the services of a specialist. One option would let us stay near home and go to a university hospital. Another was to go to an excellent regional hospital which unfortunately lacked an established mesothelioma program. The last option would require a trip to Boston to see Dr. David Sugarbaker, a foremost expert in the field.

I looked over to my wife, waiting for her to speak or choose an option, but she just looked devastated, like she wanted someone to pull her from a nightmare. I guess it probably wasn't far from the truth. I knew she needed help, so I decided that we should go to Boston. They said that Dr. Sugarbaker was the best, and now I could only pray that he would be able to save my wife.

The two months following that were pure chaos. We had no routine to speak of. We both used to work full time, but Heather quit so she could focus on healing. I started working part time so I could help out as much as I could. I had to balance care for my wife, my infant daughter and my job. It was my task to arrange travel, appointments and help care for our child. I was overwhelmed. I grappled with the fear that I'd end up a broke, homeless single dad raising a baby. Several times, I broke down on the kitchen floor in my misery. Thankfully, we had a wonderful support system that helped us through these tough times.

Everybody was so willing to help us and they gave us everything ranging from moral support to financial relief. We will never be capable of properly thanking them for the help that they gave us. One of the most important pieces of advice that I can give to people who are struggling through a similar situation is this: big or small, accept the help that you're being offered. That's one less thing on your plate that you have to deal with. Loved ones, friends and even strangers will want to help you.

There is no way to avoid the fact that it's very hard to take care of somebody who's suffering from cancer. It's perfectly normal to feel like you're being overcome with grief and it will likely be the hardest time of your life. Like many other parts of life, however, it's not like you can just ignore it and have it go away. You can't allow your fear to consume you and you can't let the uncertainty run your life. It's healthy and natural to experience hard times on occasion, but you can't let it suck the hope out of you. Take advantage of every resource that you have that enables you to maintain your sanity in the darkest hours.

A couple of years passed before things regained a sense of normality. Heather's odds of beating cancer were very poor, but despite those odds, she emerged victorious over the illness. After months of difficult mesothelioma treatment, she remains happy, healthy and cancer free seven years later.

The biggest lesson that I took from this entire incident is that my stubbornness could be used to my advantage. Furthermore, the limited amount of time that we have on this Earth is precious and should be savored. With these lessons in mind, even though I was tasked with a job and the care of my wife and daughter, I had the determination to go back to school to earn my degree in Information Technology.

After being required to manage multiple responsibilities during Heather’s battle, I believed that I was well-equipped to pursue this dream of mine. I completed college with high honors and was asked to give a speech during graduation. I spoke at length about my wife's battle with cancer and told everyone that just a few years earlier, hearing that my wife could die in a matter of months, I never imagined my life would turn out the way it did. Heather taught me that as long as we never give up hope, and always keep fighting for the ones we love, we are capable of achieving incredible things. 

Mr. Cameron Von St. James

PS: I am very grateful to Cameron for his honest and heartfelt sharing. It is never easy to face cancer and even more difficult when dealing with a cancer like mesothelioma that is associated with a poor prognosis. But, they have came out victorious and we share their happiness. I hope that this sharing will encourage you if you are fighting your cancer and motivate you to persevere if you are a caregiver. There is light at the end of the tunnel although it may be dim at times. Do not look too far ahead. Focus on the spotlight at your feet below and take one step at a time. Looking ahead and not downwards at your current steps may cause you to stumble. Life is indeed precious. Cherish it and live it out, one day at a time. 

Dr. Choo 

NPC Group Stretching Exercise 19 May 2013

This month, we will come together to do some stretching exercise in a park. The teacher is a Master in Taiji and he will demonstrate some gentle exercise that can be practiced daily. Do come and join us. All are welcome. Bring your family and friends. 

The Park is located at Bishan Road and Ang Mo Kio Ave 1 junction. 

Getting There:

Bus Services 132, 133, 136, 165, 166, 169 and 262 from Ang Mo Kio Interchange.

Bus Service 410 from Bishan MRT Station

If you are driving, you may park at the Bishan-Ang Mo Kio Park’s open car park entering from Ang Mo Kio Ave 1 or HDB open car park between Block 238 and Block 241 entering from Bishan Street 22 (nearest to standalone MacDonald’s outlet).

We will gather at Grand Lawn 1 of the Bishan-Ang Mo Kio Park

More people in Singapore joining cancer support groups

Recently, I was interviewed by the Straits Times regarding cancer support groups in my hospital.

The website link :

http://www.sgh.com.sg/about-us/newsroom/News-Articles-Reports/Documents/Year%202013/03-Mar/20130316-STHT-FrontPage-B01%20-%20More%20people%20joining%20cancer%20support%20groups.jpg

There are currently 4 active groups namely in Breast cancer, Gynecology cancer (ovary, womb and cervical), Bone marrow transplant and the NPC OneHeart. The Upper GI support group has also being recently formed this year and there is also a Stoma support group (in colon cancer) as well.

In our own public forum, we found that those who join us are also non cancer patients or caregivers, but general public who want to increase their knowledge of the cancer.

The need for cancer support groups is increasing as more people try to find help in coping with cancer and the best form of support could be found from those who have gone thorough the cancer journey themselves. This group therapy program has been found to be beneficial in improving the coping strategy while facing cancer and more importantly provide a 1-1 peer support in all aspects.

Last week, I met with Becky, a staff member from the US based Imerman Angel group. This group provides 1-1 support, linking newly diagnosed cancer patients to cancer survivors and similar to our Befriender's program. Their founder, Johnny Imerman has been featured in the CNN Heroes series.

The websites link :

http://www.imermanangels.org
http://edition.cnn.com/2012/08/23/health/cnnheroes-imerman-cancer

Peter and Dave have volunteered to join this group as an "angel" and be a mentor. NPC is more prevalent in Asia and both of them will good mentors in an otherwise rare cancer in the Western population. But with migrants to US from the Asia countries, there could be rising cases.

Dr. Choo
Medical Adviser to NPC One Heart