02-11-2016, 10:00 PM
Young cancer patients tell others to 'never give up'
By Lam Shushan Updated 11 Feb 2016 21:37
Emma (left) and Xander (right) were diagnosed with cancer in 2015. They are attending a transitional learning school to help them adjust to normal life when they return to school. (Photo: Ray Yeh)
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SINGAPORE: Eight-year-old Emma and Xander, 12, were diagnosed with different forms of cancer in 2015. While Xander has completed his chemotherapy and is preparing to go back to school in a few months, Emma is still undergoing the intensive phase of her chemotherapy. Despite the challenges they have been through, the bright-eyed duo have a message for other cancer patients: To never give up.
Every year, 250,000 adolescents below the age of 20 around the world are diagnosed with cancer. While the bulk of these cases occur in developing countries, childhood cancer is the leading non-communicable disease (NCD) cause of death in developed countries. In Singapore, it is the second major cause of death among children.
There were between 180 to 200 childhood cancer cases here in 2015 - a figure that has remained fairly constant over the years, according to Associate Professor Quah Thuan Chong, Head Consultant of the Division of Paediatric Haematology and Oncology at the National University of Singapore.
“When I first started out, a third of patients still didn’t get through. When we had patients who relapsed or didn’t do so well, the only thing we could tell the mother was ‘I’m sorry we can’t do anything more’. The only thing you could offer was yourself, your time,” said Assoc Prof Quah.
But with technological advances in understanding cancer and new treatments which are milder and more effective, Singapore has a survival rate of about 80 per cent in childhood cancer patients, as compared to 67 per cent a few decades ago.
“Now I’m glad to say that I have been seeing these kids for more than 30 years, and I can show them my other patients who are in their 40’s and are perfectly normal, married with kids, and their kids are perfectly normal too,” he said.
A poem written by one of the Children's Cancer Foundation's beneficiaries.
WHAT CAUSES CHILDHOOD CANCER
Unlike adult cancers, most childhood cancer cases are not attributable to environmental or cultural causes. Instead, Assoc Prof Quah said they are due to “genetic accidents”.
“We now understand that genes in our cells undergo mutation all the time, but very few people get cancer during the first 20 years of life because most of the mutation happens in cells which have nothing to do with cancer - it takes a chance event which is largely unpredictable,” he said.
“This mutation allows the cell to grow out of control, so over time, maybe one to two years later, the number of cells have grown large enough for us to be able to detect."
In Singapore the top five common types of cancer in children are leukaemia, brain cancers, lymphomas (cancer of white blood cells, usually in the lymph nodes), germ cell tumours (cancer of cells in the ovaries or testes), and sarcomas (soft tissue cancer).
In other cases, some children can inherit mutated genes, which can give rise to cancer, such as BRCA1 or BRCA2. The former was made famous by actress Angelina Jolie when she had a double mastectomy after discovering her faulty gene.
Through play and art therapy, children at the CCF are given an outlet to deal with any psychological or emotional trauma.
RAISING AWARENESS AND SUPPORT
One of the purposes of International Childhood Cancer Day is to raise awareness for children to receive affordable and quality care. In Singapore, most childhood cancer cases are referred to the Children’s Cancer Foundation (CCF), a non-profit organisation that offers support services to children and their families.
Some of their services include counseling, therapy, financial assistance, back-to-school support, palliative and, in some cases, bereavement support.
Still, some industry workers feel that more could be done to support the cause: “There is scope and room to give more attention to children’s cancer even though the number of diagnoses actually is not as great as the adult cases,” said Ms Lim Boon Chee, senior social worker and art therapist at CCF.
“Every year we have international childhood cancer day, but we realise that we don’t place that much emphasis on this day compared to breast cancer awareness weekend or other adult cancer days. It’s actually a very low key event,” she said.
Some of the things that she feels can be improved on include education on symptoms for early detection and making information on services that are available for children and their families more available.
“I think it’s good for families to share what they have gone through so others can understand,” Ms Lim said.
Assoc Prof Quah agreed. “(Parents) need a lot of support because these parents are mostly young parents - they just started out in life, and children need more support too because they don’t understand things," he said.
"You may ask whether their world dark or not, but it's not always dark. Sometimes they draw in their hopes and dreams," Ms Lim on the type of artwork created during art therapy sessions.
BE CAUTIOUS, NOT “KIASU”: CONSULTANT
Assoc Prof Quah has the same view that personal stories are the best way to raise awareness of childhood cancer. “The human mind is very much susceptible to stories which they can visualise and empathise with,” he said.
But he cautioned against giving too much hype to childhood cancer awareness. “There are 'kiasu' parents and kiasu doctors too. Sometimes I feel my job is to keep them out of the range of kiasu doctors. For example, many doctors know that if the child has enlarged lymph nodes in the neck, it could be cancer. But even though you may see 1,000 kids with such a presentation, maybe only two of them are cancer cases,” he said.
He shared an anecdote back in 1984 after his department had completed the second bone marrow transplant. A news report was written, giving an account of the mother’s discovery of the boy’s leukemia when she noticed unusual bruising on her child’s body.
“After that for two to three weeks, I got a lot of calls saying: ‘My son has quite a lot of bruises - do you think he has leukemia?’” he said.
Instead, Assoc Prof Quah teaches his trainee doctors to be vigilant when assessing cases, and to be alert for red herring cases - instances where potential signs or pains in the body are mistaken for injuries. “If a child has a lump that you cannot account for, and has had no history of a fall and yet there is pain, then you want to be careful,” he said.
“To me, if there is too much awareness, parents might get unnecessarily scared. So for me the solution is to work harder on the doctors so they don’t miss signs,” he said.
- CNA/ss
By Lam Shushan Updated 11 Feb 2016 21:37
Emma (left) and Xander (right) were diagnosed with cancer in 2015. They are attending a transitional learning school to help them adjust to normal life when they return to school. (Photo: Ray Yeh)
148 Email More
A A
SINGAPORE: Eight-year-old Emma and Xander, 12, were diagnosed with different forms of cancer in 2015. While Xander has completed his chemotherapy and is preparing to go back to school in a few months, Emma is still undergoing the intensive phase of her chemotherapy. Despite the challenges they have been through, the bright-eyed duo have a message for other cancer patients: To never give up.
Every year, 250,000 adolescents below the age of 20 around the world are diagnosed with cancer. While the bulk of these cases occur in developing countries, childhood cancer is the leading non-communicable disease (NCD) cause of death in developed countries. In Singapore, it is the second major cause of death among children.
There were between 180 to 200 childhood cancer cases here in 2015 - a figure that has remained fairly constant over the years, according to Associate Professor Quah Thuan Chong, Head Consultant of the Division of Paediatric Haematology and Oncology at the National University of Singapore.
“When I first started out, a third of patients still didn’t get through. When we had patients who relapsed or didn’t do so well, the only thing we could tell the mother was ‘I’m sorry we can’t do anything more’. The only thing you could offer was yourself, your time,” said Assoc Prof Quah.
But with technological advances in understanding cancer and new treatments which are milder and more effective, Singapore has a survival rate of about 80 per cent in childhood cancer patients, as compared to 67 per cent a few decades ago.
“Now I’m glad to say that I have been seeing these kids for more than 30 years, and I can show them my other patients who are in their 40’s and are perfectly normal, married with kids, and their kids are perfectly normal too,” he said.
A poem written by one of the Children's Cancer Foundation's beneficiaries.
WHAT CAUSES CHILDHOOD CANCER
Unlike adult cancers, most childhood cancer cases are not attributable to environmental or cultural causes. Instead, Assoc Prof Quah said they are due to “genetic accidents”.
“We now understand that genes in our cells undergo mutation all the time, but very few people get cancer during the first 20 years of life because most of the mutation happens in cells which have nothing to do with cancer - it takes a chance event which is largely unpredictable,” he said.
“This mutation allows the cell to grow out of control, so over time, maybe one to two years later, the number of cells have grown large enough for us to be able to detect."
In Singapore the top five common types of cancer in children are leukaemia, brain cancers, lymphomas (cancer of white blood cells, usually in the lymph nodes), germ cell tumours (cancer of cells in the ovaries or testes), and sarcomas (soft tissue cancer).
In other cases, some children can inherit mutated genes, which can give rise to cancer, such as BRCA1 or BRCA2. The former was made famous by actress Angelina Jolie when she had a double mastectomy after discovering her faulty gene.
Through play and art therapy, children at the CCF are given an outlet to deal with any psychological or emotional trauma.
RAISING AWARENESS AND SUPPORT
One of the purposes of International Childhood Cancer Day is to raise awareness for children to receive affordable and quality care. In Singapore, most childhood cancer cases are referred to the Children’s Cancer Foundation (CCF), a non-profit organisation that offers support services to children and their families.
Some of their services include counseling, therapy, financial assistance, back-to-school support, palliative and, in some cases, bereavement support.
Still, some industry workers feel that more could be done to support the cause: “There is scope and room to give more attention to children’s cancer even though the number of diagnoses actually is not as great as the adult cases,” said Ms Lim Boon Chee, senior social worker and art therapist at CCF.
“Every year we have international childhood cancer day, but we realise that we don’t place that much emphasis on this day compared to breast cancer awareness weekend or other adult cancer days. It’s actually a very low key event,” she said.
Some of the things that she feels can be improved on include education on symptoms for early detection and making information on services that are available for children and their families more available.
“I think it’s good for families to share what they have gone through so others can understand,” Ms Lim said.
Assoc Prof Quah agreed. “(Parents) need a lot of support because these parents are mostly young parents - they just started out in life, and children need more support too because they don’t understand things," he said.
"You may ask whether their world dark or not, but it's not always dark. Sometimes they draw in their hopes and dreams," Ms Lim on the type of artwork created during art therapy sessions.
BE CAUTIOUS, NOT “KIASU”: CONSULTANT
Assoc Prof Quah has the same view that personal stories are the best way to raise awareness of childhood cancer. “The human mind is very much susceptible to stories which they can visualise and empathise with,” he said.
But he cautioned against giving too much hype to childhood cancer awareness. “There are 'kiasu' parents and kiasu doctors too. Sometimes I feel my job is to keep them out of the range of kiasu doctors. For example, many doctors know that if the child has enlarged lymph nodes in the neck, it could be cancer. But even though you may see 1,000 kids with such a presentation, maybe only two of them are cancer cases,” he said.
He shared an anecdote back in 1984 after his department had completed the second bone marrow transplant. A news report was written, giving an account of the mother’s discovery of the boy’s leukemia when she noticed unusual bruising on her child’s body.
“After that for two to three weeks, I got a lot of calls saying: ‘My son has quite a lot of bruises - do you think he has leukemia?’” he said.
Instead, Assoc Prof Quah teaches his trainee doctors to be vigilant when assessing cases, and to be alert for red herring cases - instances where potential signs or pains in the body are mistaken for injuries. “If a child has a lump that you cannot account for, and has had no history of a fall and yet there is pain, then you want to be careful,” he said.
“To me, if there is too much awareness, parents might get unnecessarily scared. So for me the solution is to work harder on the doctors so they don’t miss signs,” he said.
- CNA/ss