Patients with Rare Neurological Complications of Cancer Successfully Treated by NCCS Specialists
Wednesday, 30 Dec 2009
Singapore, 30 Dec 2009 –
The National Cancer Centre Singapore (NCCS) has reported the successful treatment of two young patients suffering from paraneoplastic encephalitis, an inflammation of the brain associated with ovarian tumours, using aggressive chemotherapy. This was an exciting outcome, with the oncologists choosing an unconventional approach proving eventually successful in curing the two patients.
Paraneoplastic encephalitis is an acute inflammation of the brain as a result of the presence of cancer in the body causing the immune system to mistakenly attack the brain through an antibody called the anti-NMDA antibody. In the case of the two patients, both of whom were referred to NCCS, the cause was tumours in the ovaries.
One of the grateful patients was Ms Dewi Hermawati. Three years ago, then 24-year-old Ms Dewi came down with a bout of fits, fever and confusion, which persisted even after one month of investigation and therapy for multiple possible causes. She was agitated, unable to respond to external verbal or visual cues amongst other symptoms she displayed. After a cyst in the left ovary was found, a possible association was considered by the attending doctors, and a presumptive diagnosis of encephalitis related to the ovarian cyst was made. Surgery was recommended based on this presumption and performed in the hope of resolving the encephalitis.
However, two weeks after the surgery, Ms. Dewi’s confusion persisted and the doctors were in a dilemma. Dr Tan Min-Han, Associate Consultant in the Department of Medical Oncology at NCCS, decided to proceed with aggressive chemotherapy as a treatment for Ms Dewi’s unresponsive condition, even though all tumours had already been removed by surgery.
“It was a challenging decision then to guess whether aggressive chemotherapy would have been the correct course of action, but we balanced the data and evidence available, the family trusted in us, and so we decided to do what we thought was best for Ms Dewi,” shared Dr Tan. “The decision to administer chemotherapy was made as it was the best and probably only hope for the patient.”
Dr Tan’s decision paid off as her condition improved rapidly upon administering the first cycle. Twenty days after the start of her chemotherapy, Ms Dewi regained orientation and responded appropriately to questions. In fact she was well enough to return to work four months after completion of chemotherapy. Today, she is completely cured of her condition and living life to the fullest.
In managing these two cases, NCCS has highlighted in the world literature the importance of prompt and aggressive chemotherapy in treating this unusual, disabling but potentially completely reversible problem in young women, in addition to conventional surgery. In Dr Tan’s view, it is possible that the chemotherapy may have prevented the immune system from attacking the brain, while destroying cancer in the body.
Dr Tan summarised “It is important to recognise this unusually severe inflammation of the brain in young women, where the neurological symptoms can be easily mistakenly attributed to many other causes rather than ovarian tumours or cysts. Prompt treatment is essential to a complete recovery, the chance of which is high.”
About (NCCS)
The National Cancer Centre Singapore (NCCS) is the premier cancer research and treatment facility in Singapore and in the region. It was established in 1997 and sees about 68 per cent of the public sector medical oncology cases and about 65 per cent of radiation oncology cases. NCCS not only houses the most number of oncologists in Singapore but is also equipped with the largest number of equipment to provide the latest radiation oncology care in Singapore.
For further information, please contact :
Ms Veronica Lee
Senior Executive, Corporate Communications
Tel:
6236 9429 / 9450 4017
Email:
Veronica.Lee.H.E.@nccs.com.sg
Ms Carol Ang
Executive, Corporate Communications
Tel:
6236 9424 / 9845 5354
Email:
Carol.Ang.S.Y@nccs.com.sg
Mr Sunny Wee
Community and Media Relations Advisor
Tel: 9274 6922
Email: Sunny.Wee@nccs.com.sg
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