The Health | November , 2020
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Knowing lung cancer
In conjunction with World Lung Cancer Awareness Month this Blue November , Lung Cancer Network Malaysia ( LCNM ) cofounders cardiothoracic surgeon Dr Anand Sachithanandan and clinical oncologist Dr Tho Lye Mun share their aspirations for the Knowing Lung Cancer ( KLC ) campaign and provide an update on lung cancer care in Malaysia amidst the Covid-19 pandemic
The disease burden of lung cancer
remains high in Malaysia . It is the second most common cancer in men and fourth in women . In terms of mortality , lung cancer is the leading cancer killer in Malaysian men , and only breast cancer accounts for more cancer-related deaths in women .
The overwhelming majority ( almost 95 per cent ) of cases are detected too late due to poor awareness and understanding . The KLC campaign aims to address this awareness gap and enhance earlier self-referral by the public to their general practitioner or relevant lung specialist .
People need to be aware of the common signs and symptoms that must not be ignored . Similarly , high-risk groups ( chronic smokers and former smokers ) should discuss with their doctors the merits of screening with a low dose CT scan . LCNM is collaborating with several leading private hospitals to provide free scans this November .
Due to the pandemic , we conducted this campaign exclusively digitally on various social media platforms to educate the public and raise much-needed awareness . The campaign is led by LCNM working in close collaboration with the Malaysian Oncological Society and National Cancer Society Malaysia .
Ultimately , we hope a sustained campaign like this over several years will result in a true stage shift such that more Malaysians with lung cancer are diagnosed at an earlier stage which is more amenable to treatments with curative intent .
This will result in better clinical outcomes and be emotionally and financially far better for the individual patient , their caregivers and society at large .
The campaign also highlights the importance of a multi-disciplinary “ team ” approach and modern multimodal therapy to provide optimal care for patients . We hope to empower patients and their families to be able to make informed health choices and better navigate their treatment journey . The campaign also seeks to destigmatise lung cancer and increase empathy for victims .
Impact of Covid-19 on lung cancer care
Travel restrictions and a genuine fear of contracting the virus during a hospital visit or admission has resulted in reduced patient visits . With regards to lung cancer , whilst local data is lacking , there is a concern this may result in more advanced stage disease cases from delayed referrals , misdiagnosis and late detection .
In the United Kingdom , lung cancer referrals have declined by 40 per cent due
Dr Anand and Dr Tho .
Ultimately we hope a sustained campaign like this over several years will result in a true stage shift such that more Malaysians with lung cancer are diagnosed at an earlier stage which is more amenable to treatments with curative intent .”
– Dr Anand Sachithanandan to Covid-19 . It is likely to be similar here .
We , unfortunately , anticipate seeing more cases of Stage 3 or 4 lung cancer in the next year due to curtailed health screenings . Data from China and Europe show cancer patients may have a higher mortality rate compared to the general population of a similar age and demographic .
A similar increased mortality trend is also seen with patients with diabetes , hypertension and chronic respiratory illnesses . However , unlike chronic conditions , cancer can be life-threatening if not treated in a timely fashion .
A delay in treating Stage 1 and 2 lung cancer , which has a cure rate of 60-90 per cent , may result in metastatic spread leading to inevitable death . In Malaysia , the death rate from Covid-19 stands at about one per cent with few cancer-associated casualties reported .
Lung cancer treatment , including surgery , is genuinely life-saving and can be performed safely despite the ongoing pandemic . It should not be deferred without careful consideration . The risk of tumour growth or cancer progression is real and will negatively impact on the patient ’ s prognosis or survival .
Patients are meticulously screened pre-treatment , and only Covid-19 negative patients proceed to surgery . Other measures to mitigate risks include the routine use of N95 respirator facemasks and Personal Protective Equipment ( PPE ) where necessary .
Challenges and plans for LCNM
LCNM has been quick to embrace virtual technology , moving away from our traditional face-to-face educational forums for the public and General Practitioners ( GPs ). We have conducted numerous webinars online and on social media this year .
As we advance , securing funding may be more challenging given the economic repercussions of the Covid-19 pandemic . Despite tremendous clinical advances which have resulted in better outcomes for patients , early detection remains the key to achieve the best chance of a cure and long term survival .
Use of Artificial Intelligence ( AI ) technology will enhance earlier detection , especially in the less urban or rural communities . Next year , LCNM will pilot an AI project utilising deep learning algorithms to assist GPs in the community with rapid expert interpretation of the chest radiograph ( X-ray ) in the hope this will expedite the referral and earlier investigation of suspicious findings . — The Health