Tailored and potent treatments enhances survival and quality of life for breast cancer patients

For 59-year-old grandmother and ex-teacher Mrs Vasuki Raman, her wake up call came in 2002 when she discovered lumps on her breast. What followed was six months of undergoing tests and checks, mastectomy and chemotherapy.

After that, Mrs Raman went on aromatase inhibitors. These drugs inhibit aromatase, an enzyme. Aromatase converts testosterone and related hormones into oestrogen which acts as a fuel to 60 per cent of breast cancers that are oestrogen sensitive. So one approach to breast cancer treatment is to stem the oestrogen causing the cancer.

Not everyone is an eligible candidate for these drugs. “These drugs are only appropriate for postmenopausal women,” said Dr Wong Nan Soon, a consultant medical oncologist at the National Cancer Centre Singapore (NCCS). There are costs and side effects which need to be considered. “For instance, anastrozole is more likely than tamoxifen to cause bone fractures and osteoporosis but is less likely to trigger potentially deadly endometrial cancer and blood clots,” said Dr Wong.

For Mrs Raman, besides water retention and swollen ankles, the other side effects are by and large bearable.

The five-year survival rate for Singaporean women with such early stage breast is likely already in excess of 90%. But the trend towards more tailored and more potent treatments will mean Asia gets closer, and will eventually match this success rate, added Dr Wong.

Besides swimming and dancing, Mrs Raman joined the breast cancer support group. She said: “It’s great that you meet up with breast cancer survivors. Others have been through your journey and the support reinforces my sense self worth. By sharing at the support group I can also help others.”

Mr Gilbert Fan, Manager psychosocial oncology, NCCS, said: “This psychosocial support through the groups is essential – cancer management is more than treating the disease. “