Lung cancer can be caused by different
genetic mutations, each of
which responds to only a handful
of drugs.
Not much is known about these
mutations, but a team of doctors at
the National Cancer Centre Singapore (NCCS)and Singapore General Hospital (SGH) are hoping to change this.
From next year, they will be conducting
an in-depth study of what
mutations are common among patients
in Singapore, in the hope of
giving them treatment that is tailored
to their needs.
It is not enough to rely on data
from patients in other countries because
Asian patients have different
problems, said Dr Toh Chee Keong,
a senior consultant medical oncologist
at NCCS and a member of the
team doing the study. “We know
that the lung cancer in Asia – Singapore
included – is quite distinct
from that in the West,”he said.
For instance, a particular mutation
known as EGFR was found in
nearly half the lung cancers in Singapore,
but only in 11 per cent of
cancers in the United States.
Lung cancer is among the top
three most common cancers in
both women and men in Singapore,
with nearly 7,000 cases diagnosed
between 2010 and 2014.
It is also one of the top killer cancers,
and accounted for 5,732
deaths in that time period.
The team has already completed
a pilot project involving 83 patients,
in which 16 different mutations were
found.
Each of these mutations represents
a new target that doctors can
use to treat this aggressive cancer,
which is often discovered late.
“Overall, there is an increased
need to try and comprehensively
capture all these characteristics of
lung cancers,” said Dr Daniel Tan,
who is a senior consultant medical
oncologist at NCCS and also amember
of the study team.
One of his patients is Madam Jamilah
Tan, 47, who was found to be in
the advanced stages of lung cancer
in August last year. She was not responding
to chemotherapy, and
doctors found that she had a gene
mutation known as ALK.
She was prescribed a drug that targeted
the effects of the mutation
and given immunotherapy treatment.
She is now doing much better.
“Previously I couldn’t walk very
well, I lost weight and I had no energy
all the time,” the housewife said.
She added that, at the time, people
would notice immediately that
she was not well.
“But now, I’ve put on weight, and
nobody would know that I have
lung cancer,” she said.
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