Dr Grace Yang, Consultant, Division of Supportive and Palliative Care at National Cancer Centre Singapore (NCCS), answers your questions about palliative care.
What is palliative care? Is it only for the terminally ill?
Dr Grace Yang, Consultant,
Division of Supportive and Palliative Care at
National Cancer Centre Singapore (NCCS), a member of the
SingHealth group, answers questions
on facts and myths surrounding cancer survivorship, supportive and palliative care.
Posted by GohLM (Republished by Forum Admin)
Dear Dr Grace Yang, my father has stage 2 lung cancer (he’s been a heavy smoker all his life).
What is the survival rate?
I hear the term ‘palliative care’ being mentioned frequently these days, what exactly does it entail? Is it only for the patient or does it also include family members?
Answered by Dr Grace Yang, Consultant, Division of Supportive and Palliative Care at National Cancer Centre Singapore.
Dear GohLM,
Sorry to hear that your father has lung cancer – must be a stressful time for the whole family. There is a good chance of cure for stage 2 lung cancer if he is able to get through the treatment. You will be able to find various 5-year survival rates online but these are just estimates and it is best to talk to your doctor about your individual situation.
“Palliative care” is an approach that focuses on quality of life for patients with serious illnesses such as cancer, and for their families. Palliative care includes checking and treating for symptom problems such as pain, breathlessness and nausea. It also includes providing a listening ear and journeying with patients. Some general palliative care is provided by your cancer doctors and nurses. There is also specialist palliative care for those with more complex problems, and these specialist palliative care services may be based in the hospital, community or hospices. You can read more at
https://singaporehospice.org.sg/
Posted by Tim (Republished by Forum Admin)
Dear Dr Yang,
I’m an only child and my parents are in their mid and late seventies. No serious condition with their health so far, thankfully. But we all know, no one stays in perfect health forever. So to prepare myself for that day, is palliative care beneficial for me and my family?
If it is, how do you suggest I go about broaching the idea to my parents (they’re old-fashioned)? Or is it more applicable only when they’re approaching end of life?
Answered by Dr Grace Yang, Consultant, Division of Supportive and Palliative Care at National Cancer Centre Singapore.
Palliative care is for patients with serious life-threatening illnesses and their families. Nonetheless, it is good to be prepared. You can start by having conversations. Conversations about their life story, about what is important to them, about what they look forward to in life. Then go ahead and make time for things that matter. There are some events for the month of October in various public libraries around Singapore. You can also check out
https://singaporehospice.org.sg/events/ Going together to an exhibition or talk near you could be one way of broaching the idea.
Posted by Erna Republished by Forum Admin)
Hi,
What is Carcinoma Papiler ?
I just got the Thyroid test result.
How is the medication?
Does it need surgery?
Thank you.
Answered by Dr Grace Yang, Consultant, Division of Supportive and Palliative Care at National Cancer Centre Singapore.
Dear Erna,
Please consult your doctor as I am not able to give specific medical advice in the forum. If you would like to make an appointment to see a doctor in the National Cancer Centre of Singapore, you may call 6436 8000.
Posted by Alvin Koh (Republished by Forum Admin)
Hi Dr Yang,
How are you? Low white blood cell count does it indicate the probability of breast cancer relapses is higher? Currently patient is thinking to commit suicide. Please advise any solutions.
Answered by Dr Grace Yang, Consultant, Division of Supportive and Palliative Care at National Cancer Centre Singapore.
Dear Alvin Koh,
There is no evidence that low white blood cell counts indicate a higher breast cancer relapse rate.
I am sorry to hear that the patient is thinking of committing suicide. I am unable to give specific medical advice – please consult the patient’s doctor as soon as possible. You mean read more about how to help someone who expresses suicidal thoughts here
https://www.sos.org.sg/get-help/helping-someone-in-crisis. One of the best ways you can help is providing a listening ear and being available.
Posted by Ng Ah Huan (Republished by Forum Admin)
Dear Dr,
I had NPC in 1992, followed by 34 doses of radio therapy on the throat, nose, left and right side under the ear.
I suffered from progressive side effects after the radiation.
I do not need Chemotherapy as mine is 1st stage.
About 12 years ago, my throat started to give problems. My voice started to deteriorate.
In 2016 Jan, I could not eat and drink. My doctor from NTFGH (Dr. Soon Yu) opened a hole in my tummy and inserted a tube so that I could feed milk.
The problem did not end here, my windpipe could not close, thus saliva enters and I always cough very hard to remove it.
Is there anything that can be done to alleviate the sufferings?
Answered by Dr Grace Yang, Consultant, Division of Supportive and Palliative Care at National Cancer Centre Singapore.
Dear Ng Ah Huan,
I am sorry to hear about the problems and suffering that you have. Indeed, cancer treatment is really tough and can have long term effects on quality of life. Joining a support group may help – there is an NPC support group for cancer patients and survivors and caregivers. You may find more information about this here:
https://www.healthxchange.sg/forums/support-groups/nose-cancer/Pages/nose-cancer-support.aspx We may be able to help with some of the symptom problems that you are experiencing – if you would like specific medical advice, do call 6436 8000 to make appointment with a Palliative Medicine doctor.
Posted by Kmk Mdy (Republished by Forum Admin)
NSCLC ,Stage III A patient
66 yrs, F, non-smoker
Successful Treatment =
Pre-op Chemotherapy (carboplatin + Pemetrexide)
Lobectomy + removal of lymph nodes near tumor
Post-op chemotherapy (carboplatin + Anzatax) + RT
EGFR +ALK + PDL 1 are all negative.
The present X-ray, CT shows normal and no metastasis.
Blood tumor marker test shows with normal.
My Questions are:
Is it necessary immunotherapy (anti-PDL 1) with negative PDL1 result?
What are the best further managements for no recurrence and no metastasis?
Answered by Dr Grace Yang, Consultant, Division of Supportive and Palliative Care at National Cancer Centre Singapore.
Dear KmK Mdy,
Well done for completing the treatment. It’s not easy to get through all that, and you have now given yourself the best chance of no recurrence and no metastasis. The best thing you can do now is eat healthily and stay active. Importantly, live well – do things that you enjoy, do things that are important to you.
If the PDL1 result is negative, we do not give PDL1-inhibitors (a form of immunotherapy).
See previous page for
information on Dr Grace Yang.
Ref: N18