Fighting cancer during a pandemic
Dr Ang Peng Tiam highlights the negative effects of the pandemic on cancer care
Cancer can also develop in the tongue
It ’ s an understatement to say that the outbreak of COVID-19 has changed the world . To date , no fewer than 150 million people have been infected and more than three million have died from the virus .
Each country has had to balance the need for controlling the spread of the disease with maintaining its economy and the livelihoods of its people . They ’ ve had to confine large populations of people to their homes , restrict inter-state travel , shut down schools and businesses , close borders , impose travel restrictions , and quarantine those infected or had possible contact with the infected .
Health care resources in some countries have been stressed to the point of collapse or near collapse . The lack of intensive care facilities and , in some countries , the lack of even basic medical resources like oxygen supply have led to innumerable deaths .
With all eyes focused on COVID-19 , it may be difficult to remember that there are still patients who suffer from many other illnesses - including cancer .
For the last 15 years , Parkway Cancer Centre has been serving the needs of cancer patients from the region , mainly from Malaysia , Indonesia , Vietnam , Philippines , India , Sri Lanka , Bangladesh , Pakistan , and the Middle East .
When COVID-19 first appeared , we were all hoping that the outbreak would be short-lived and quickly controlled , just like SARS in 2003 . Sadly , it was not to be . A year has gone by , and the pandemic continues to rage on .
In Singapore , we continue to see small numbers of infected individuals pop up in clusters within the community . This has made the government very cautious in only allowing small numbers of essential travellers to enter the country .
Each overseas patient who wants to come to Singapore for medical treatment needs to apply to the Ministry of Health ( MOH ) for an entry visa . The doctor supporting the application must justify why the patient cannot be treated in the home country and needs to come to Singapore .
One of these was Pauline ( not her real name ), a 36-year-old Chinese lady who managed to come to Singapore in March .
She first noticed a lump on the left side of her tongue in November 2020 . She saw several doctors who reassured her that it was nothing serious and treated her with some topical medication .
Over time , the lesion of the tongue became larger and increasingly painful .
She was eventually referred to an ENT ( ear , nose and throat ) specialist in her own country who carried out a biopsy on February 22 . A few days later , she was told the bad news that she suffered from squamous cell carcinoma ( SCC ) of the tongue .
She was advised to go for surgery immediately . Her surgeon tried to reassure her , saying “ you go to sleep for a few hours and by the time you wake up , the cancer will be all gone !”
What troubled her was that while the surgeon kept saying that it was a minor operation , he also said that he would need to take a piece of muscle from her body to cover the operated area .
Upon hearing the news , she contacted my clinic , and I met her through a videoconference on February 25 , but it ’ s very difficult to assess a cancer patient without the benefit of seeing and examining them .
I explained to her that surgery has conventionally been the primary treatment modality for patients with SCC of the tongue . However , there were advances in cancer management which deployed the use of upfront chemotherapy to down-size the cancer , before deciding on surgery or radiotherapy .
After hearing my explanation , Pauline was determined to come to Singapore for further assessment .
66 JUNE 2021 GlobalHealthAsiaPacific . com