Question: Do we have enough cancer treatment centers to cope with the bulk of cancer in Malaysia? Answer:
No. There are only 30 oncologists in Malaysia. We need at least 100. There are 4 states in Malaysia without any cancer treatment facilities. Question: How well equipped are our cancer centers? Answer:
Our cancer treatment centers are up-to-date and comparable with many hospitals in the western countries. Some of the centers in KL have the best and latest equipment in the world. We have almost all of the treatment facilities that some of the top US or European Cancer Centres can offer. We have access to the latest drugs from US & Europe. Hence there is no need for any Malaysian to go overseas to seek treatment; except if they want to try new untested research drugs or treatment in US or Europe. Question: What is radiotherapy? Answer:
Radiotherapy is the treatment of tumours or cancer using high energy x-rays to kill the cells. The treatment is targeted precisely to cancer cells. Normal tissues are usually spared or slightly affected as they are shielded during treatment. Radiotherapy is given daily (except on weekends) in a set course of 5 to 35 treatments over a period of 1 to 7 weeks. The general side effect is tiredness and the specific side effects will depend on the area of treatment. Question: What is chemotherapy? Answer:
Chemotherapy is a treatment using anti cancer drugs which are usually given by injection (occasionally oral). The drugs can penetrate the cancer cells and interfere with the cell division or growth. The treatment is systemic- meaning it gets into the circulation and treats the “whole body”. The side effects usually include nausea, vomiting, hair loss, bone marrow depression. These effects are transient and reversible. Chemotherapy is given in weekly, every 2 weeks or every 3-week cycles for a period of 4 to 6 months. Question: Does chemotherapy kill all the good cells as well
as bad cells and eventually the patient? Answer:
This is a misguided believe. All drugs have side effects, which are well documented and can be controlled with proper medications. However the fear of chemotherapy and refusal to have this treatment may detrimental for patients who have high risks features. However, we are continuously making great improvement in the development of new drugs, which can target the cancer cells in a more specific way with fewer side effects. Question: What are the high risk features? Answer:
Some features seen in the biopsy specimen like tumour size greater than 1.5 cm, lymphatic or vascular invasion by the cancer cells, high tumor grade, many positive axillary (armpit) nodes and oestrogen receptor status negative are features considered as high risk. Question: Why do patients with early stage breast cancer require chemotherapy? Answer:
The need to give chemotherapy will depends on the high risk factors mentioned above. In the US the use of chemotherapy in early staged cancers did improve the cure rates and reduced the risk of recurrence for some of these patients. Better results were seen with the latest drugs in some of the newer treatment regimes. Each year we see better outcome and progress being made in breast cancer therapy. Question: There are so many types of chemotherapy. How do I know which is the best? Answer:
The oncologists’ job is to advice patients on appropriate drugs to use based on the features of the cancer and the stage. These drugs are fairly standard, well documented and commonly used in all centers worldwide. Doctors will only use the chemotherapy regimes that are well tried and tested. The oncologists will have to keep up to date as new treatment regimes become available so the patients can be advised accordingly. Question: The oncologist says that I have a high risks factor and needed chemotherapy. What if I refuse chemotherapy? Answer:
The risk of recurrence or relapse is high. Once the cancer comes back cure may no longer be possible. The aim of early therapy is to maximize cure rate and prevent recurrence.
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