Head & Neck Cancer (HNC): Curative Treatment with Radiotherapy and Chemotherapy

A pleasant lady, 53 years old with long standing hypertension, presented with dysphagia symptom for 3 months duration. She was diagnosed with base of tongue SCC, T2N2M0. Discussion in multidisciplinary team (MDT) meetings Surgery or definitive concurrent chemo-radiotherapy (CRT)? Surgeon want to operate, I want definitive concurrent CRT (happen all the time, ha3) Rationale? With…… Continue reading Head & Neck Cancer (HNC): Curative Treatment with Radiotherapy and Chemotherapy

News: Chemotherapy Kill Cancer Patients, Not Cancer?

The good intentions: The study published in reputable The Lancet Oncology journal emphasised the importance of proper selection of cancer patients for chemotherapy treatment, especially patients who are old or have poor performance status. The study also stressed on the importance of mortality review in order to improve clinical decision making (identifying patients who does…… Continue reading News: Chemotherapy Kill Cancer Patients, Not Cancer?

Living Longer: Advanced Breast Cancer (ABC) – HER2 over-expressed (I)

Introduction HER2 over-expression constitutes 20% of all breast cancer. Two different methods are being used to test for HER2 over-expression, immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH) Immunohistochemistry (IHC); identifies HER2 expression on the cell surface, with a grading system of 0 to 3+ positive. tumors are classed as HER2-positive if they have a…… Continue reading Living Longer: Advanced Breast Cancer (ABC) – HER2 over-expressed (I)

Living Longer: Advanced Breast Cancer (ABC) – Triple Negatives; ER/PR/HER2 (-ve)

Introduction Breast cancer is not a single disease but comprised of distinct biological subtypes with different prognosis and treatment options: Luminal A: ER/PR+ve, Her2-ve Luminal B: ER/PR+ve, Her2+ve HER2 over-expressed: Her2+ve Triple negatives/ basal-like: ER/PR-ve, Her2−ve Among the different subtypes above, triple negative breast cancer (TNBC) accounts for 10%-15% of breast cancer diagnosed. TNBC carries the worst prognosis and…… Continue reading Living Longer: Advanced Breast Cancer (ABC) – Triple Negatives; ER/PR/HER2 (-ve)

Living Longer: Stage 4 Lung Adenocarcinoma EGFR Mutation positive

Introduction Firstly, with optimal palliative chemotherapy treatment for stage 4 lung cancer, the average survival is slightly under a year; 7.4 months – 8.1 months (Schiller JH, 2002), which doubled the average survival with just best supportive care, 3.9 months. Although improvement in survival was achieved with chemotherapy, it seemed like chemotherapy alone had reached…… Continue reading Living Longer: Stage 4 Lung Adenocarcinoma EGFR Mutation positive