NCCS to establish centre for peritoneal and pelvic cancers
Wednesday, 24 Nov 2010
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Peritonectomy and infusion of heated intra-peritoneal will be offered to selected patients with advanced abdominal cancers to improve survival rate |
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Many research projects on better treatment options based on genetic profiling will be conducted |
Singapore, 24 Nov 2010 –
NCCS sets up new centre to treat patients with advanced abdominal and pelvic cancers. The centre will also conduct research in the disease to further improve the survival of patients with such disease.
Patients with advanced abdominal and pelvic cancers, who previously had six to twelve months survival, now have a vastly improved chance to live due to a surgical procedure pioneered in the region by NCCS.
The procedure, otherwise known as Peritonectomy, seeks to remove all visible tumours in the lining of the abdominal cavity for patients with disease such as colorectal and ovarian cancers.
About 80 patients have undergone Peritonectomy since NCCS introduced it ten years ago. A recent analysis of results has shown that the procedure offers more than 65 per cent overall survival rate at three years. The first patient who underwent the procedure at NCCS is still alive today. That marks the longest survival at ten years to date. Previously, patients depending on conventional chemotherapy seldom survive beyond a year.
With such encouraging results, the NCCS has trained a team of doctors, nurses and paramedical staff to focus on management of such cancer patients.
Patients who may be suitable for this procedure are presented at a multidisciplinary tumour board for discussion by an expert panel specializing in the disease.
The new centre which also seeks to collaborate with other institutions like KKH, will be headed by Dr Melissa Teo, Consultant, Department of Surgical Oncology, NCCS, together with Dr Chia Yin Nin, Head of Gynaecological Oncology Unit, KKH.
The establishment of this centre will also allow the development of a strong research programme. Research projects lined up include using animal models that mimic the pattern of human abdominal cancer, allowing the testing of chemotherapy agents.
With the well equipped facility available at NCCS, it will also do genetic profiling of the cancer tumour to explain their biological behaviour. This will then allow personalized treatment for patients with such disease in the future.
The research programme will come under the stewardship of Professor Teh Bin Tean, Director of NCCS-VARI Translational Research Laboratory.
NCCS is also in discussion with Australian National University to explore using nano compounds to deliver radioactive particles in treating the disease.
Prof Soo Khee Chee, Director, NCCS said that the centre is a timely enterprise. “With greater understanding of patient selection and the return of more doctors who have specialized training and considerable exposure to this technique, we feel that it is important to set up such a centre which aims to help patients who are otherwise considered seemingly incurable.”
Please see Annex A for more information on Peritonectomy.
About NCCS
NCCS is the national cancer centre dedicated to providing a comprehensive, multidisciplinary and holistic approach to cancer treatment and care for its patients. As a hub for the best cancer professionals, patients can receive the best in treatment and care through the exceptional site-specific sub-specialization of its oncology specialists. The NCCS is also the institutional home for among the best clinician scientists and researchers who are actively engaged in cutting-edge clinical and translational research. Its patients benefit from the close collaboration between NCCS physicians and scientists working to discover the best in treatment options, besides the full range of support services such as palliative care and psychosocial counseling.
Today NCCS, which was established in 1997, sees almost 70 per cent of the public sector oncology cases. NCCS also actively promotes anti-cancer advocacy through its wide range of community outreach and public education programmes. It also offers a range of specialist training programmes to other medical institutions in Singapore and the region.
Through its innovation and worldwide collaboration, NCCS is set to be a global leading cancer institution. In September 2010, it has successfully obtained accreditation from Joint Commission International for achieving excellence in implementing quality patient care and safety processes.
For further information please contact the Corporate Communications Department:
Ms Veronica Lee
Senior Executive, Corporate Communications
Tel: 6236 9429 / 9450 4017
Email: Veronica.Lee.H.E@nccs.com.sg
Ms Chua Hwee Leng
Senior Executive, Corporate Communications
Tel: 6236 9424 / 9191 2957
Email: Chua.Hwee.Leng@nccs.com.sg
Annex A
About Peritonectomy
Cancer remains as the number one killer in Singapore, with many cancers diagnosed at a late stage. Patients who have advanced disease may have spread of the disease to other organs, including the lung, liver, bone and the peritoneum. Previously, the prognosis for all patients with advanced disease was uniformly fatal but the advent of new surgical techniques and procedures, coupled with better chemotherapeutic options, have allowed some patients to enjoy improved survival rates.
The peritoneum is the lining covering the inside of the abdominal cavity and is often the site of disease for many cancers that originate in the abdomen. These include colorectal, ovarian, gastric and pancreatic cancers, as well as a condition known as pseudomyxoma peritonei, PMP. In selected patients, an aggressive surgical procedure known as peritonectomy originally designed to treat PMP, coupled with the infusion of heated chemotherapy (HIPEC) into the abdominal cavity after the procedure, can be performed to improve survival rates significantly. Complete removal of all the disease is the surgical aim, and one of the most important factors to determine prognosis. Chemotherapy that is heated, allowing it to have greater efficacy, then eliminates any residual cancer cells. As the chemotherapy is given in a locoregional fashion, as opposed to the traditional intravenous method, the dosages administered can be significantly higher, without many of the usual side effects of chemotherapy.
This combined procedure has been offered at the National Cancer Centre of Singapore for the past 10 years but has been increasingly more common over the past 5 years, as more patients and their physicians become aware of the evidence and indications for this procedure, with a 10-20% increase in numbers of patients every year. All patients who may be suitable for the peritonectomy and HIPEC procedure are presented at a multidisciplinary tumour board for discussion by a panel that comprises of surgical, medical and radiation oncologists and radiologists.
To date, NCCS has performed approximately 80 of such cases, with the longest survivor being 10 years from the date of surgery. Whilst there are possible complications from such an extensive procedure, the results have been most encouraging. The NCCS sent a team of doctors, nurses and para-clinical staff to visit and exchange experiences with Dr Sugarbaker, the surgeon who pioneered this procedure, at the Washington Cancer Institute, benefiting from this experience.
Coupled with this clinical experience and expertise, the NCCS also has a team of researchers who have been able to replicate the growth of human cell lines for each of these cancer types in the abdominal cavity of mice. Molecular profiling of each tumour to identify tissue- specific targets conveys the possibilities of personalized medicine delivery. Administering the appropriate chemotherapy to the patient, knowing that it has been shown to work for his/ her particular tumour would render improved results, whilst eliminating the time wastage of trying different chemotherapeutic regimes on each patient.
The establishment of the Centre for Peritoneal and Pelvic Cancers at the NCCS is timely, as its experience in this area allows the patients to enjoy both protocolised efficiency and personalized treatment from its high clinical throughput and research capabilities. The Centre can bring about all specialists interested in the complex management of such diseases to combine their experiences in order to render better treatment for patients. There remain many research opportunities in this field, and the NCCS is leading with multiple projects, focused on molecular profiling of tumours, testing of chemotherapeutic options on animals, prior to the administration of efficacious chemotherapy to the patients.
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