cancer and qigong

I have heard of the benefits of qigong but did not know where to find the right class to join until I attended a talk organised by the NPC support group. I learned from the talk that high oxygen levels can kill cancer cells & gigong uses deep diaphramatic breathing technique to help strengthen the body's immune system. Coincidentally at that time, I also learned that cancer had spread to my lung. I felt that I could not afford to do nothing so I decided to give qigong a try.

And so in Nov 2008 I signed up for the qigong class which was organised specifically for NPC survivors. About 10 of us met every Sunday morning at Toa Payoh Park to learn qigong from Sifu Nicholas from Chi Dynamics. We completed our lessons in May 2009, and since then I have made an effort to practise qigong every morning for one hour.

In Oct 2009, I happened to watch a news clip on Channel News Asia which reported that a study conducted in China had shown that practising qigong can help fight cancer. I attach the news clip below, obtained from the CNA website : http://www.channelnewsasia.com/stories/health/view/1010774/1/.html

CNA news on "Some studies show practising qigong helps to fight against cancer"

SHANGHAI : The stress of modern living had prompted many around the world to learn qigong. Recent joint studies from China and the United States also show that qigong can help cancer patients live longer.

One community club in Shanghai is practising a form of qigong that has helped members recover from life-threatening illnesses over the past 20 years.

Cancer survivor Qiu Jia Ming, 65, who suffered from pancreatic cancer years ago, said: "I was diagnosed with pancreatic cancer when I was 50 years old and the doctor told me I only had three months to live. But I've survived 14 years now."

Another cancer survivor, Yin Xiao Ling, suffered from nasal malignant granulomatosis 22 years ago.

"I'm 57 and have been practising qigong for 22 years. I was diagnosed with nasal malignant granulomatosis, a very rare cancer, and doctors said I only had six months to a year to live at the most.

"So when I was discharged from hospital, I didn't go home. I went to join the Guolin Qigong Club. Doctors said it was a miracle that I survived beyond a year," said Yin.

Even the head of the cancer rehabilitation club is convinced of the benefits of qigong against cancer. Yuan Zheng Ping was diagnosed with malignant lymphoma 28 years ago and after studying Guolin qigong in Beijing, he started the Shanghai Cancer Rehabilitation Club in 1989 to teach others like him.

"It's not only a physical exercise, it is also a psychological practice of breathing using rhythmic exercises, thereby taking in a lot of oxygen. This is beneficial because it increases immunity and help fight the cancer.

"We did a survey in 1993 with 1,500 cancer patients and discovered that after five years of practising Goulin qigong, there was about 85 per cent recovery rate. In 2003, we did another comprehensive study and found that out of 7,000 cancer sufferers, more than 60 per cent of them survived for more than five years," said Yuan.

With such high success rate, there is now more attention paid to this form of exercise. Initial results from studies conducted by the University of Illinois and Shanghai University of Sports show that practising Cailin qigong can help cancer patients live longer and give them a better quality of life.

Wang Changwei is the researcher behind a new study programme sponsored by the US-based National Cancer Institute. Her first phase of research centred on those who regularly practise qigong and it showed that this group of practitioners have a lower rate of cancer reoccurrence than others.

She said: "From our current study, regardless of quality of life, exercise ability or health conditions, those who practised Guolin qigong are far better off than those who don't exercise qigong.

"We did an 11-month observation and found that oxygen intake of those who practise Guolin qigong was higher and when they are at rest, the oxygen level is the same. This means that they inhale more oxygen during their practice. Their breathing method of inhaling twice and exhaling once helped to improve their oxygen intake."

Even doctors who specialise in Western medicine believe there are benefits to practising qigong. But they said there may be other causes that are helping cancer patients recover from their illnesses.

Gao Yong, a doctor at Shanghai East Hospital, said: "Qigong can help patients forget the pain of the disease. Also, the exercise is a team activity. Practitioners encourage and support each other. There is more confidence when they see others recover. I think this is the real benefit of qigong.

"The study has only just started about two or three years ago. A large scale study is needed and should take about three to five years, or even longer, for a more detailed observation of the benefits."

China sees about 2.2 million cancer cases yearly, with one in five dying from the disease.


Notes from author :
If you wish to learn qigong, you may contact the following Chi Dynamics Centres:
1. Singapore - http://www.chidynamics.org/
2. Malaysia - http://www.chidynamics.org.my/
3. Australia & UK - email addresses are given in the Malaysian website.

_________________________________________________

References :

Channel News Asia
http://www.channelnewsasia.com/stories/health/view/1010774/1/.html

Chi Dynamics Singapore
http://www.chidynamics.org.sg/

Qigong & Cancer Care (to know more on how qigong can help fight cancer)
http://www.chidynamics.org/index.php?option=com_content&view=article&id=10&Itemid=9

cancer and nutrition - why is nutrition important?

Proper nutrition is important for everyone but especially so for people with cancer.

Three weeks before I underwent radiation therapy in Sep 2006, my oncologist advised me to put on as much weight as I possibly could. A doctor friend gave me the same advice too. She added that I should eat all kinds of food to help me gain weight in the shortest possible time. At that time I weighed just about 46kg. I took their advice seriously and managed to put on 4kg within 3 weeks. That was no mean feat! And it was good advice for I later lost a total of 8kg.

But why is nutrition so important to cancer patients? Below are some answers I obtained from trusted websites.

from cancer.gov
• The diet is an important part of cancer treatment.
• Eating the right kinds of foods before, during and after treatment can help the patient feel better and stay stronger.
• To ensure proper nutrition, a person has to eat and drink enough of the foods that contain key nutrients (vitamins, minerals, protein, carbohydrates, fat and water).
• Good eating habits help the patient cope with the effects of cancer and its treatment.

from a Norwegian research, “The Importance of Nutrition for Cancer Patients”
(published by National Centre for Biotechnology Information)

• Good nutrition and nutritional therapy are important for cancer patients before, during and after treatment.
• The goal for the dietary advices and the nutritional therapy is to maintain or improve the nutritional status of cancer patients.
• This seems to have beneficial effects on the oncological therapy.

from curesearch.org
• Proper nutrition is important for you while you receive cancer therapy.
• By eating well, you can stay stronger, tolerate your treatments and their side effects better, and continue to grow and thrive.
• Eating well means eating a variety of foods to get all the essential nutrients for growth, plus additional things you need to help fight your illness.
• Essential nutrients include protein, carbohydrates, fat, water, vitamins and minerals.

from cancer.ca
• Good nutrition is vital at every stage of your cancer treatment.
• Eating well gives you energy, helps you feel better and keeps your body strong so that you can cope with side effects from treatment.
• It will also help you heal and recover after treatment.

from cancer.net
• Eating well can improve your overall health & well-being and help you have more energy and less fatigue.

from a talk given by an SGH dietician at NPC Support Group
Good nutrition is important for you because it :
• helps you feel better & keeps up your strength and energy
• maintains your weight & preserves your body’s store of nutrients
• helps you tolerate treatment-related side-effects better
• decreases your risk of infection
• helps you recover faster

I hope the above has convinced you of the importance of nutrition. In subsequent weeks, I will share further tips on nutrition for people with nose cancer.

References
National Cancer Institute USA
http://www.cancer.gov/cancertopics/pdq/supportivecare/nutrition/Patient

National Centre for Biotechnology Information
http://www.ncbi.nlm.nih.gov/pubmed/9800498

CureSearch
http://www.curesearch.org/for_patients/intreatment/article.aspx?ArticleId=3316&StageId=14&TopicId=92&Level=1

Canadian Cancer Society
http://www.cancer.ca/ontario/about%20cancer/coping%20with%20cancer/nutrition.aspx?sc_lang=en

American Society of Clinical Oncology
http://www.cancer.net/patient/Library/Cancer.Net+Features/Guidance+and+Support/Grocery+Shopping+Made+Easier

cancer and health : how to prevent H1N1

A friend sent me information on H1N1 which is the most sensible advice I've ever received on H1N1 since its outbreak in May 2009. I'm reproducing it here to share with my fellow nose cancer survivors & readers.

The unknown author had this to say : "Please note that this is not an official advice, especially the one about face masks or N95." So readers, please make your own judgement & decide for yourself if this is good advice to protect you & your loved ones from the H1N1 flu virus.

N95 masks
Most N95 respirators are designed to filter 95% particulates of 0.3µ, while the size of H1N1 virus is about 0.1µ. Hence, dependence on N95 to protect against H1N1 is like protecting against rain with an umbrella made of mosquito net. (blogger : Do face masks protect us from H1N1 flu? Read the report, "Face masks seem to protect against flu" from : http://edition.cnn.com/2009/HEALTH/08/03/face.mask.flu/index.html)

Tamiflu
Tamiflu does not kill but prevents H1N1 from further proliferation till the virus limits itself in about 1-2 weeks (its natural cycle). H1N1, like other Influenza A viruses, only infects the upper respiratory tract and proliferates (only) there. The only portals of entry are the nostrils and mouth/throat. In a global epidemic of this nature, it's almost impossible not coming into contact with H1N1 in spite of all precautions.

Contact with H1N1 is not so much of a problem as proliferation is. While you are still healthy and not showing any symptoms of H1N1 infection, in order to prevent proliferation, aggravation of symptoms and development of secondary infections, some very simple steps - not fully highlighted in most official communications - can be practised (instead of focusing on how to stock N95 or Tamiflu).

The 6 do's
1. Frequent hand-washing (well highlighted in all official communications).

2. "Hands-off-the-face" approach. Resist all temptations to touch any part of face (unless you want to eat or bathe).

3. Gargle twice a day with warm salt water (use Listerine if you don't trust salt). H1N1 takes 2-3 days after initial infection in the throat/ nasal cavity to proliferate and show characteristic symptoms. Simple gargling prevents proliferation. In a way, gargling with salt water has the same effect on a healthy individual that Tamiflu has on an infected one. Don't underestimate this simple, inexpensive and powerful preventative method.

4. Clean your nostrils at least once every day with warm salt water. Not everybody may be good at Jala Neti or Sutra Neti (very good Yoga asanas to clean nasal cavities), but blowing the nose hard once a day and swabbing both nostrils with cotton buds dipped in warm salt water is very effective in bringing down viral population.

5. Boost your natural immunity with foods that are rich in Vitamin C (Amla and other citrus fruits). If you have to supplement with Vitamin C tablets, make sure that it also has Zinc to boost absorption.

6. Drink as much of warm liquids as you can. Drinking warm liquids has the same effect as gargling, but in the reverse direction. They wash off proliferating viruses from the throat into the stomach where they cannot survive, proliferate or do any harm.

The above 6 "do's" are simple ways to prevent, within means of most households, and certainly much less painful than to wait in long queues outside public hospitals.

blogger : As prevention is better than cure, do your utmost best to maintain your overall well-being by eating healthily, resting sufficiently & exercising regularly.

the advice above is given by : author unknown

understanding nose cancer : treatment options

I was diagnosed with Stage 2 NPC and was treated with radiation therapy. Other Stage 2 NPC survivors I had met told me they underwent both radiation & chemotherapy. Why is that so? What determines the treatment of NPC?

This is what I found out from the American Society of Clinical Oncology website (www.cancer.net) and the American National Cancer Institute website (www.cancer.gov).

Treatment options

The treatment of NPC consists of the following options :

• Radiation therapy
• Chemotherapy
• Surgery

The treatment of NPC depends on the size & location of the tumour, whether the cancer has spread and the patient's overall health. Most cancers of the nasopharynx can be cured, especially if found early.

Treatment by stages

Stage 1

Treatment is usually radiation therapy to the tumour & lymph nodes in the neck.

Stage 2

Treatment usually includes the following :

• chemotherapy combined with radiation therapy
• radiation therapy to the tumour & lymph nodes in the neck

Stage 3

Treatment usually includes the following :

• chemotherapy combined with radiation therapy
• radiation therapy to the tumour & lymph nodes in the neck
• radiation therapy followed by surgery to remove cancerous lymph nodes in the neck that remain or come back after radiation therapy

Stage 4

Treatment usually includes the following :

• chemotherapy combined with radiation therapy
• radiation therapy to the tumour & lymph nodes in the neck
• radiation therapy followed by surgery to remove cancerous lymph nodes in the neck that remain or come back after radiation therapy
• chemotherapy for cancer that has metastasised (spread) to other parts of the body

References

American Society of Clinical Oncology (http://www.cancer.net/)

American National Cancer Institute (http://www.cancer.org/)

understanding nose cancer : survival rates

People often equate cancer with death. This is not surprising as cancer is the Number One killer in Singapore, with heart diseases in second place. Out of 17,140 deaths reported in Singapore in 2007, 27.7% died of cancer while 19.8% died of heart diseases (source : Ministry of Health Singapore).

The good news is that with recent advances in cancer research, the survival rates for cancer have improved over the years.

Survival by stage
The 5-year survival rate refers to the percentage of patients who live at least 5 years after their cancer is diagnosed. Many of these patients live much longer than 5 years after diagnosis. 5-year rates are used to produce a standard way of discussing prognosis (chance of recovery). (http://www.cancer.org/)

Survival tends to worsen as the stage increases. The 5-year survival rates* for nose cancer patients in Singapore are believed to be as follows :

Stage 1 : 90-95%
Stage 2 : 80%
Stage 3 : 70%
Stage 4 : 50-60%

5-year survival rates are based on patients diagnosed and initially treated more than 5 years ago. So the statistics may no longer be accurate as improvements in cancer treatment may have resulted in a more favourable outlook for recently diagnosed patients.

No statistics can tell you what will happen to you. Your cancer is unique. The same type of cancer can grow at different rates in different people. Survival statistics are useful as a general guide, but they may not accurately represent any one person's prognosis. A number of other factors, including other tumour characteristics and a person's age and general health, can also affect the prognosis (chance of recovery).

References

* Figures obtained from talk given at NPC support group in Apr 2009.

Ministry of Health, Singapore
http://www.moh.gov.sg/mohcorp/statistics.aspx?id=5526

World Health Organisation
http://www.who.int/mediacentre/factsheets/fs310/en/index.html

American Cancer Society
http://www.cancer.org/docroot/CRI/content/CRI_2_4_3X_How_is_nasal_cavity_and_paranasal_cancer_staged.asp

Cancer Research UK
http://www.cancerhelp.org.uk/help/default.asp?page=17370#stage

understanding nose cancer : grading

I did a nasal biopsy in Aug 2006. The histopathology report says : "undifferentiated carcinoma". Two years later in Dec 2008, I underwent a wedge resection (a cut) on my right lung. The histopathology report says : "metastatic undifferentiated nasopharyngeal carcinoma". Do you know the difference between "differentiated" and "undifferentiated" carcinoma? (carcinoma means malignant cancer)

Cancer terminology can be rather daunting to the non-medically trained. I like to share what I found out about cancer grading from the internet library. (http://www.cancerhelp.org.uk/)

The grade of a cancer tells you how much the cancer cells look like normal cells. There are 3 grades of nose cancer.

• Grade 1 (low grade) – the cancer cells look very much like the normal nasal cavity cells
• Grade 2 (intermediate grade) – the cancer cells look slightly like normal nasal cavity cells
• Grade 3 (high grade) – the cancer cells look very abnormal and very little like normal nasal cavity cells

The word "differentiated" means how developed or mature a cell is. So you may hear your oncologist describe grade 1 cancer cells as 'well differentiated'. Grade 2 cancer cells are 'moderately differentiated'. Grade 3 cancer cells are 'poorly differentiated'.

In "undifferentiated cancer", the cancer cells are very immature and "primitive" and do not look like cells in the tissue from which it arose. As a rule, an undifferentiated cancer is more malignant than a cancer of that type which is well differentiated. Undifferentiated cells are said to be anaplastic. This is a cancer which does not appear to resemble the tissue of origin.

Differentiated cancers tend to be decidedly less aggressive than undifferentiated cancers. But undifferentiated cancer is known to respond better to radiotherapy and chemotherapy.

The grade of the cancer gives your oncologist a guide as to how the cancer is likely to behave. Low grade cancers are usually slower growing and less likely to spread. High grade cancers are likely to be faster growing and are more likely to spread. And undifferentiated cancers often grow & spread quickly.

This is only a guide. Your oncologist will consider all your test results when deciding which treatment is best for you.

References

Cancer Research UK
http://www.cancerhelp.org.uk/help/default.asp?page=13830#grade

MedicineNet
http://www.medterms.com/script/main/art.asp?articlekey=20476

understanding nose cancer : staging

When the MRI results came out, my oncologist told me the tumour was Stage "T2N0" NPC. Do you know what it means? At that time, I didn't quite understand the staging process for NPC. I will share what I've learned from the internet library. What is staging & why is staging necessary?

Staging is the process used to find out whether cancer has spread within the nasopharynx or to other parts of the body. The information gathered from the staging process determines the stage of the disease. The results of the tests used to diagnose NPC are often used to stage the disease. It is important to know the stage in order for your oncologist to plan your treatment. (http://www.medicinenet.com/)

I believe that in Singapore, we use the AJCC TNM staging system. I obtain information about this system from the American Cancer Society website. (http://www.cancer.org/)

The American Joint Committee on Cancer (AJCC) TNM system
A staging system is a standardized way for members of the cancer care team to summarize the extent of a cancer's spread. The most common system used to describe the spread of NPC is the TNM system created by the American Joint Committee on Cancer (AJCC). This system contains 3 key pieces of information :

• T describes whether the primary tumor has invaded other organs or tissues near the nasopharynx.
• N describes whether the cancer has spread to nearby (regional) lymph nodes (bean-sized collections of immune system cells located throughout the body).
• M indicates whether the cancer has metastasized (spread) to other organs of the body. (The most common sites of distant nasopharyngeal cancer spread are the lungs, liver, and bones.)

The numbers or letters that appear after T, N, and M provide more details about each of these factors :

• The numbers 0 through 4 indicate increasing severity.
• The letter X means "cannot be assessed" because the information is not available.
• The letters "is" after the T stand for "in situ," which means the tumor is still only in the layer of cells where it started and has not yet invaded deeper.

T groups for nasopharyngeal cancer
TX: Primary tumor cannot be assessed due to incomplete information.
T0: No evidence of a primary tumor.
Tis: Carcinoma in situ (cancer cells are present only in the surface layer of the nasopharynx but have not invaded into deeper layers).
T1: Tumor is limited to the nasopharynx.
T2: Tumor extends to tissues (but not bone) near the nasopharynx.

• T2a: Cancer extends to the oropharynx (the back of the mouth, where the throat begins) and/or nasal cavity but no farther.
• T2b: Cancer has also extended to the left or right sides of the upper part of the throat.

T3: Tumor extends to the sinuses and/or the bones near the nasopharynx.
T4: Tumor extends into the skull and/or cranial nerves (nerves in the head that lie near the nasopharynx and have special functions such as vision, smell, and eye movement), the hypopharynx (lower part of the throat), or the eye or its nearby tissues.

N groups for nasopharyngeal cancer
NX: Nearby lymph nodes cannot be assessed due to incomplete information.
N0: No spread to nearby lymph nodes.
N1: Spread to 1 or more lymph nodes, not larger than 6 cm (about 2½ inches) across, on one side of the neck.
N2: Spread to lymph nodes, not larger than 6 cm across, on both sides of the neck.
N3: Spread to 1 or more lymph nodes that are either :

• larger than 6 cm across (N3a), or
• are located just above the collarbone (N3b)

M groups for nasopharyngeal cancer
MX: Distant spread (metastasis) cannot be assessed.
M0: The cancer has not spread to tissues or organs far away from the nasopharynx.
M1: The cancer has spread to tissues or organs far away from the nasopharynx.

TNM stage grouping
Once the T, N, and M categories have been determined, this information is combined in a process called stage grouping. The stage is expressed in Roman numerals from stage 0 (the least advanced) to stage IV (the most advanced). Some stages are subdivided with letters.

Stage 0
Tis, N0, M0 : The cancer is "in situ." It has not yet invaded into deeper layers of nasopharyngeal tissue and has not spread to nearby lymph nodes or distant sites.

Stage I
T1, N0, M0 : The tumor is only in the nasopharynx and has not spread to nearby lymph nodes or distant sites.

Stage IIA
T2a, N0, M0: The tumor has spread to soft tissues of the nasal cavity and/or the oropharynx but no farther. It has not spread to nearby lymph nodes or distant sites.

Stage IIB
There are 2 combinations of categories that make up this stage.

T2b, N0, M0 : The tumor has extended to the soft tissues of the nasal cavity and/or the oropharynx and has also extended to the left or right sides of the upper part of the throat. It has not spread to nearby lymph nodes or distant sites.

T1-T2b, N1, M0: The tumor may still be confined to the nasopharynx, or it may have extended to the soft tissues of the nasal cavity and the oropharynx and/or the left or right sides of the upper part of the throat. It has spread to one or more nearby lymph nodes, not larger than 6 cm (about 2½ inches) across, on only one side of the neck. The cancer has not spread to distant sites.

Stage III
There are 2 combinations of categories that make up this stage.

T3, N0-N1, M0 : The tumor has spread to the sinuses or the bones near the nasopharynx. It may or may not have spread to nearby lymph nodes (not larger than 6 cm across and on only one side of the neck). It has not spread to distant sites.

T1-T3, N2, M0 : The tumor may still be confined to the nasopharynx, or it may have extended to the soft tissues of the nasal cavity, the oropharynx, the left or right sides of the upper part of the throat, the sinuses, or the bones near the nasopharynx. The tumor has spread nearby lymph nodes on both sides of the neck, and none are larger than 6 cm across. The cancer has not spread to distant sites.

Stage IVA
T4, N0-N2, M0 : The tumor has extended to the skull and/or cranial nerves, the hypopharynx, the eye, or its nearby tissues. It may or may not have spread to nearby lymph nodes in the neck (none of which are larger than 6 cm across). It has not spread to distant sites.

Stage IVB
Any T, N3, M0 : The tumor may or may not have extended into nearby soft tissues or bones. It has spread to lymph nodes that are larger than 6 cm across and/or are located above the collarbone area. The cancer has not spread to distant sites.

Stage IVC
Any T, any N, M1 : The tumor may or may not have extended into nearby soft tissues or bones. It may or may not have spread to nearby lymph nodes. It has spread to distant sites.

References :
American Cancer Society
http://www.cancer.org/docroot/CRI/content/CRI_2_4_3X_How_is_nasopharyngeal_cancer_staged_17.asp

understanding nose cancer : risk factors

Most people react with shock & disbelief when told they have cancer. This initial denial is a normal reaction which for some people, can last minutes, while for others days or weeks.

Cancer runs in my family. My second sister succumbed to metastatic breast cancer & died at the young age of 32, just 9 months after diagnosis. My maternal grandma died of nose cancer back in the 1960's after surviving 5 years. After my sister's death, I became more aware of cancer & immersed myself with health books to help me change my lifestyle so I would not get cancer. But I still ended up with cancer.

When I was diagnosed with nose cancer in Aug 2006, my first reaction was of disbelief. How could it be cancer? How could I have succumbed to the very disease I had worked so hard to avoid all these years? I didn't understand. I was confused. The healthy lifestyle as prescribed by health books had helped me to be in the pink of health for almost 20 years. I hardly suffered from common ailments such as colds or flus or sore throats. But I found myself suffering from the same deadly disease that had taken the lives of two of my loved ones. What went wrong?

The first question cancer patients often ask is, "How did I get cancer?" Your doctor probably gave this standard answer, "Cancer can be caused by genetic, environmental and lifestyle factors." Cancer is still a mystery disease to this day. There is no answer to the many questions many of us have.

I learn from online resources that there are risk factors for different types of cancer. A risk factor is anything that increases your risk of getting a disease. Different cancers have different risk factors. For example, unprotected exposure to strong sunlight is a risk factor for skin cancer. Smoking is a risk factor for many kinds of cancer.

But risk factors don't tell us everything. Having a risk factor, or even several risk factors, does not mean that you will get the disease. Although scientists have found several risk factors that make a person more likely to develop nose cancer, many people with this cancer have no known risk factors. Even if a patient has one or more of these risk factors, it is difficult to know whether that factor actually caused the cancer.

Unlike other squamous cell cancers of the head and neck, nose cancer does not appear to be linked to excess use of tobacco and alcohol. Scientists have found several risk factors that make a person more likely to develop nose or nasopharyngeal cancer (NPC).

Ethnic background. NPC is more common in people of Chinese or Asian ancestry. For some unknown reasons, NPC is relatively rare among Caucasians, Indians & Japanese.

Exposure to the Epstein-Barr virus. EBV is a common virus that remains dormant in most people. EBV has been associated with certain cancers, including NPC & some lymphomas. But the link between EBV infection and NPC is complex and not yet completely understood. EBV infection alone is not enough to cause NPC since infection with this virus is very common. Other factors such as a person's genes may affect how the body deals with EBV, which in turn may affect how EBV contributes to the development of NPC.

Genetic factors. A person's genes may affect their risk for NPC. For example, just as people have different blood types, they also have different tissue types. Studies have found that people with certain inherited tissue types have an increased risk of developing NPC. Tissue types affect immune responses, so this may be related to how a person's body reacts to EBV infection.

Family history. If someone in your family has nose cancer, you have a 15% to 20% risk of developing the cancer. It is not known if this is because of inherited genes, shared environmental factors (such as the same diet or living quarters) or some combination of these.

Diet. A diet high in salted fish and nitrosamines, and eating a lot of fermented food.

References :

American Cancer Society http://www.cancer.org/docroot/CRI/content/CRI_2_4_2X_What_are_the_risk_factors_for_nasopharyngeal_cancer_17.asp?sitearea=

MedicineNet
http://www.medicinenet.com/nasopharyngeal_cancer/article.htm

Centre for Ear Nose Throat
http://www.entdoctor.com.sg/articles/nose-cancer.html

understanding nose cancer : signs & symptoms

For me, it all started with an innocent ringing tone (tinnitus) in my left ear after 2 weeks of swimming lessons. I gradually experienced blocked ear. A biopsy later confirmed I had nose or nasopharyngeal cancer (NPC). All this took place within a month.

Possible signs of nasopharyngeal cancer include trouble breathing, speaking or hearing. These and other symptoms may be caused by nasopharyngeal cancer. Other conditions may cause the same symptoms. A doctor should be consulted if any of the following problems occur :

• A lump in the nose or neck
• A sore throat
• Trouble breathing or speaking
• Nosebleeds
• Trouble hearing
• Pain or ringing in the ear
• Headaches

References :

National Cancer Institute, USA http://www.cancer.gov/cancertopics/pdq/treatment/nasopharyngeal/Patient/page1

cantonese cancer

At my first consultation with my NPC oncologist at the National Cancer Centre in Aug 2006, the first question he asked me was, "Are you Cantonese?" "No, I'm Hokkien," I replied, surprised at his question.

The medical name for nose cancer is nasopharyngeal cancer or NPC. Do you know that nose cancer is also referred to as "Cantonese cancer"? No wonder my oncologist asked if I was Cantonese.

Nose cancer is very common in Asia, predominantly in southern China & Hong Kong where the majority are Cantonese. That was how the nickname "Cantonese cancer" came about. Nose cancer is also prevalent in Taiwan and the Chinese communities in South-East Asia & other parts of the world. For some unknown reasons, nose cancer is relatively rare in Caucasians, Indians and Japanese.

There are approximately 300 new cases of NPC diagnosed in Singapore each year. Men are more prone to get nose cancer than women, in the ratio of 2.8 : 1. That is, almost 3 out of every 4 nose cancer cases are men. In simple language, it means that out of every 100 people with nose cancer, 75 are men & 25 are women. No wonder nose cancer is sometimes referred to as "men's cancer".

I obtained the following statistics from the respective countries' cancer register :

• Nose cancer is ranked 6th in Singapore, 2nd in Malaysia, 5th in Hong Kong & 10th in Taiwan among the most common cancers in men.
• However, nose cancer is nowhere among the Top 10 cancers for women in these countries. Breast cancer is unanimously the No.1 cancer affecting women not only in Asia but also in the world.

References :

Singapore Cancer Registry
http://www.hpb.gov.sg/uploadedFiles/HPB_Online/Publications/CancerTrends2002-2006.pdf

National Cancer Registry, Ministry of Health Malaysia
http://www.radiologymalaysia.org/Archive/NCR/2ndNCR.pdf

Hong Kong Cancer Registry, HK Hospital Authority
http://www3.ha.org.hk/cancereg/

Taiwan Cancer Registry
http://crs.cph.ntu.edu.tw/uploadimages/Leading_10.pdf

what is nasopharyngeal cancer?

At first, I did not even know that the medical name for nose cancer is nasopharyngeal cancer or NPC. I did not know anything about NPC either. Thanks to internet, I started to read up on NPC to learn more about this disease. So what exactly is NPC?


Nasopharyngeal cancer or NPC is a disease in which malignant (cancer) cells form in the tissues of the nasopharynx.


The nasopharynx is the upper part of the pharynx (throat) behind the nose. The pharynx is a hollow tube about 5 inches long that starts behind the nose and ends at the top of the trachea (windpipe) and esophagus (the tube that goes from the throat to the stomach). Air and food pass through the pharynx on the way to the trachea or the esophagus. The nostrils lead into the nasopharynx. An opening on each side of the nasopharynx leads into an ear. Nasopharyngeal cancer most commonly starts in the squamous cells* that line the nasopharynx.

* squamous cells = flat cell that looks like a fish scale under a microscope. These cells cover inside and outside surfaces of the body. They are found in the tissues that form the surface of the skin, the lining of the hollow organs of the body (such as the bladder, kidney, and uterus), and the passages of the respiratory and digestive tracts.

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References :
National Cancer Institute, USA
http://www.cancer.gov/cancertopics/pdq/treatment/nasopharyngeal/patient/

an experience I can never forget

I went to collect my biopsy result at a local hospital on 16 Aug 2006 but was made to wait more than an hour. Patients who were behind me in the queue were called in first. I had an inkling the biopsy result would turn out to be bad news.

I was now the only patient left in the clinic. The ENT doctor finally called for me. I walked nervously into her room. I noticed her eyes were avoiding mine as she quietly held the door for me. I looked at her & asked, "It's cancer, right?" She did not answer but asked me to take a seat.

After what seemed like ages, she finally spoke, "I'm sorry, you have nose cancer." Her voice was not steady. It seemed to me like she was trying to hold back her tears. It was not tears of sorrow, but tears of regret.


In the last one month, the ENT team in that hospital had persistently dismissed my blocked ear as nothing serious. They kept insisting there was nothing wrong with my ear, even when I told them many times, almost with tears, that my ear had become worse. The biopsy was finally done at my insistence, and only after I had made a lot of noise & warned them that I would go to another hospital. The biopsy result proved I was right after all.


Fast forward one year, after my cancer treatment, I wrote to that hospital's CEO to tell him my story. He called to apologise for the undue stress his ENT team had caused me & promised to investigate. I hope the hospital has taken steps to ensure the same mistakes do not happen to other patients. And I also hope that all doctors would learn from this unfortunate incident and make an effort to listen more to their patients.

For the record, I asked to be transferred to the National Cancer Centre at Singapore General Hospital for follow-up cancer treatment. NCC is a premier medical institution in Singapore in the treatment of cancer (http://www.nccs.com.sg/).

Valuable Advice (for the benefit of future NPC sufferers)
1. Always choose a hospital you can trust (based on what you have heard from family & friends).
2. If you prefer to be treated in a restructured hospital* as a subsidised patient, you will first need to get a referral letter from a polyclinic.
3. If your polyclinic doctor refers you to a restructured* hospital "because that hospital has no queue" but you don't feel comfortable going to that hospital, please raise your concerns with your doctor.
4. If the doctor refuses to refer you to the hospital of your choice, I suggest that you go to your preferred hospital's Accident & Emergency (A&E) dept. It may cost more (S$80 at the time of writing) but it may save you your life. 

useful notes :
In Singapore, if you intend to consult a medical specialist in a restructured hospital & be treated as a subsidised** patient, you will need to obtain a referral letter from a government-owned polyclinic or the A&E dept of a restructured hospital.

* A restructured hospital is a public hospital.

** As a subsidised patient, your medical bill will be subsidised by the Ministry of Health (the government), so you will not have to pay the full medical bill. If you are hospitalised, you can choose to stay in a Class B2 or C ward. A "private" patient, however, will have to pay the full medical bill and can choose to stay in a Class A or B1 ward.

10 killer facts on cancer

• There are more than 100 types of cancer; any part of the body can be affected.
• Cancer accounted for 7.9 million deaths worldwide (around 13% of all deaths) in 2007.
• Deaths from cancer are projected to rise to 12 million worldwide by 2030.
• The 5 most common types of cancer that kill men worldwide are lung, stomach, liver, colorectal and esophagus.
• The 5 most common types of cancer that kill women are breast, lung, stomach, colorectal and cervical.
• About 72% of all cancer deaths in 2007 occurred in low- and middle-income countries.
• WHO estimates that 30% of cancers can be prevented, mainly by not using tobacco, having a healthy diet and being physically active.
• Tobacco use is the single largest preventable cause of cancer in the world.
• A third of cancers could be cured if detected early and treated adequately.
• A fifth of all cancers in the world are caused by chronic infection, eg human papillomavirus (HPV) causes cervical cancer & hepatitis B virus (HBV) causes liver cancer.

References :

http://edition.cnn.com/2009/HEALTH/01/29/cancer.facts/

updated as at 29 Jan 2009

why I started this blog

I read the CT Scan report again and again. The report was two-pages long but only these few words kept staring back at me : "suspicious of pulmonary metastases.”

It was March 2008. I was with my oncologist who had gone through the results with me. I wished there was a mistake but the report was right before me. Yes, it seemed like I had suffered a cancer recurrence. Yes, it looked like the nasopharyngeal cancer I was diagnosed with in Aug 2006 had spread to my right lung. My cancer had returned.

Many questions went through my mind. Did I do anything wrong? What should I have done or not done to prevent this relapse? Was there any part in my life I needed to change to make sure I will win this battle against cancer?

This unexpected relapse was a wake up call. I started to reflect on what I had done or not done over the past one-and-a-half years. For the most part of my post-recovery period, I had turned to TCM (Traditional Chinese Medicine) to help me regain my lost strength and immunity. I had made an effort to drink fresh vegetable juices daily with the belief that they could help detoxify my body of toxins. And I had tried to follow dietary advice given by professional nutritionists and cancer survivors.

Despite having done all these, I still felt lost and confused. I was not sure if I was doing the right thing. It seemed that everyone had their own views on what was good or bad for cancer. I had also received many viral emails that made recommendations on what to eat or what not to eat, with some emails even claiming that a certain food could cure cancer. In this internet age, how would we know what is true and what is fake information?

This unexpected cancer recurrence prompted me to do my own serious research. I was determined to find out for myself what I should do or not do to prevent another cancer recurrence. I was determined to search for “true and reliable” information from reliable sources. I will record all this information and share it with all cancer sufferers, in particular those with nasopharyngeal or nose cancer (NPC).

And so this blog was born out of this desire to share. It is free. It is easily accessible by anyone, anywhere, anytime. And if God should decide to take me home one day, this blog can live on as a legacy for future cancer sufferers.

your fellow NPC survivor,
shuqin