 | Dr Gurcharan Singh Khera, Consultant Clinical Oncologist |  | Prof Dr Looi Lai Meng, Senior Consultant Histopathologist |  | Dr Ednin Hamzah, CEO/Medical Director of Hospis Malaysia |
Standard of Care in Breast Cancer Workshop Goes to Penang – 19 Aug 2006
By Dr Evelyn Ho The Malaysian Oncological Society and the University of Malaya Medical Centre has organised a “Standard of Care” programme using a holistic approach to increase awareness and to provide continuing medical education to medical professionals. This programme provides doctors with an understanding of the perspectives and role of each breast cancer management team member. This impacts the level of care and ultimately the public and the breast cancer patient benefits directly from such initiatives.
This has been made possible through an unlimited grant from AstraZeneca. The organisers and AstraZeneca must be congratulated for this effort to put together this standard of care programme.
The first in the series of workshops was held on 22 July 2006 in the Dewan Sekapur Sirih (Auditorium) of the Trauma Centre of the University Malaya Medical Centre. About 60 participants (excluding the speakers) attended the workshop which began at about 9am and ended at 5pm. The audience was made up mostly of doctors in the surgical and oncology units from Putrajaya Hospital, Hospital Kuala Lumpur, Kajang Hospital, Hospital Universiti Kebangsaan Malaysia and University Malaya Medical Centre. The second workshop of this nature has already been scheduled for August in Penang.
In the opening remarks by the President of the Malaysian Oncological Society (MOS), Dr Gurcharan Singh Khera, early detection and access to care was mentioned. The levels of care available in Malaysia was varied due to availability of services between urban/rural areas, and even between various states in Malaysia, what more the difference between public and private sector care.
The level of resources can be classified as basic, limited, enhanced and maximal. At the basic level, the detection methods were through breast health awareness (with or without self examination) and clinical breast examination. The limited level involved targeted outreach and education for clinical breast examination for at-risk groups and this included diagnostic ultrasound and diagnostic mammography. Diagnostic mammography and opportunistic mammographic screening would be the resources available in enhanced access to care. Finally, maximal access to care would be when population based mammography screening and other imaging technologies as appropriate were available. The participants were reminded to be aware of differences in delivering standard of care to the best of their ability and that they may have to be within the scope of available resources. The other topics covered included Epidemiology and Clinical Assessment of Breast Cancer (Prof Dr Yip Cheng Har); Radiological Investigations (Dr Evelyn Ho); Pathology (Prof Dr Looi Lai Meng); Surgical Oncology (Dr Noor Hisham); Radiotherapy (Dr Ahmad Kamal); Chemotherapy (Dr Matin Mellor); Hormonal & Targeted Therapy (Dr Lam Kai Seng); Supportive Care (How do you break the news to the patient?) (Ms Ranjit Kaur) and Palliative Care (Dr Ednin Hamzah). In addition, there were 2 interactive case studies with audience participation.  | L to R: Part of the multidisciplinary team: Prof Dr Looi Lai Meng (Sr Consultant Histopathologist), Prof Dr Yip Cheng Har (Surgeon), Dr Noor Hisham (Breast and Endocrine Surgeon), Dr Evelyn Ho (Radiologist) |  | L to R: The group of clinical oncologists: Dr Lam Kai Seng, Dr Ahmad Kamal and Dr Matin Mellor |
The inclusion of the psychosocial aspects including palliative care, pain management and end of life care was to introduce to the doctors the importance of these aspects of care. The patient should be treated with respect and certain communication skills as well as skills beyond just operating and giving drugs or radiation therapy were essential for the well being of the patient. Breaking the “bad news” itself was the first critical step in ensuring the person with breast cancer (patient) would eventually make the right decisions with regards her own management. Good rapport and communications have been known to help the patient arrive at the “right” choices with regards to the treatment recommended by her team of doctors.
Once again, the organisers and their speakers as well as the sponsor, AstraZeneca and venue host should be applauded for this initiative to start a series of workshops on Standard of Care in Breast Cancer. All in all, it was a day well spent!
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