News & Articles

In a special episode of CNA Health Matters, Dr Ang Peng Tiam, Medical Director and Senior Consultant, Medical Oncology, and Dr Richard Quek , Senior Consultant, Medical Oncology, explain how cancer care has evolved over the years.

“When I first started practicing oncology in 1986, chemotherapy was the only option for patients in advanced stages of cancer,” shared Dr Ang.

The veteran cancer specialist founded Parkway Cancer Centre (PCC) 16 years ago, and has since seen how the understanding of cancer as a disease and its treatment has become more complex compared to the past.

“Over the past three decades, we have seen a growing armamentarium of new therapies, which are more effective in killing cancer cells, and also have lesser side effects.”

Novel treatments in cancer care

Some of the novel therapies used to treat cancer include:

• Monoclonal antibodies – laboratory produced antibodies that disrupt the signaling pathways driving cancer cell growth
• Targeted therapy – drugs that target specific genes and proteins to destroy cancer cells, without affecting healthy cells
• Immunotherapy – medicine that raises the immune system of the patient, allowing the immune system to recognise the cancer and destroy it

Immunotherapy, in particular, is effective in a broad range of cancers. This is because the treatment is specific to one’s immune system and not specific to any individual cancer.

“The first cancer which immunotherapy was shown to be effective was a form of skin cancer called melanoma,” explained Dr Quek, whose subspecialties include the management of melanomas.

“Since then, it has been tested and approved in a wide variety of cancers including lung, breast, liver, kidney, gynaecological cancers and lymphomas amongst others.”

Are new treatments effective?

In the past, treatment options for many cancers, including melanoma, were poor and sometimes toxic.

These days, with immunotherapy, side effects are much more tolerable, allowing patients to receive treatment for longer periods of time. Some patients can even stop treatment indefinitely, without the risk of the cancer getting worse. This translates to longer survival and good quality of life.

“With the success of immunotherapy in advanced stages of cancer, we have now moved treatment to earlier stages,” Dr Quek pointed out. “A case in point is the success we see in patients with Stage 3 resected melanoma and high risk resected kidney cancer.”

Like immunotherapy, treatments using monoclonal antibodies and targeted therapy drugs can be used over long periods of time. This means patients can enjoy a better quality of life for extended periods with minor side effects.

The targeted nature of these treatments also mean that treatment is more personalised to each patient in their individual cancer. “We study each patient and their cancer closely, and then offer the most appropriate targeted therapy,” Dr Ang explained.

Is chemotherapy obsolete then? The answer is no, Dr Ang shared. “Chemotherapy can be used alone or in combination with these new treatments to achieve better treatment results.”

A multidisciplinary approach to cancer care

With many developments in this fast-changing field, treating cancer today involves a multidisciplinary team approach. The members of this team include the pathologist and radiologist to diagnose and locate the cancer; the medical oncologist, surgeon and radiation oncologist to plan out the treatment and deliver it; as well as nurses and allied health professionals to support patients on their cancer journey.

“When we formed PCC, we decided to bring together subspecialists who possess expertise in the different cancer types,” explained Dr Ang. “Over the years, we have developed a good understanding of each other’s respective roles and capabilities. This allows us to collaborate and plan what is best for each individual patient.”

Strength in depth is what sets PCC apart in its patient care, shared Dr Quek. “This allows us to be at the forefront of cancer treatment and provide state-of-the-art care to our patients.

“Even with the growth of technology for cancer treatment, caring for a cancer patient is not just a matter of science, it’s also a matter of the heart.”