Advanced and rare cancers are a spectrum of cancers

Those with the condition would benefit from the prompt referral to a specialist tertiary unit with a multidisciplinary team that has a rich experience and expertise in the treatment of rare conditions to provide the best patient outcomes.

Advanced and rare cancers include:

  • Sarcoma

  • Peritoneal surface malignancies and

  • Rare tumours including but not limited to melanoma and extramammary paget disease (EMPD)

Sarcomas are a group of rare and heterogeneous malignant soft tissue tumours that can present in almost any part of the body. Symptoms include pain, unexplained weight loss or presence of a lump that may be painless and increases in size over time. Treatment is dependent on the location and type of sarcoma, cancer grade and whether it has spread to other body parts.

Peritoneal surface malignancies is often a late-stage development of cancers that arise from the spread from an intra-abdominal organ including stomach, colon and ovaries to the peritoneal cavity. It can also develop from the peritoneum such as primary peritoneal cancer. Symptoms often present late including bloating, abdominal pain, unexplained weight loss or gain and loss of appetite. In highly selected patients, cure can be achieved through cytoreductive surgery and hyperthermic intraperitoneal chemotherapy. Palliative options are also available to manage symptoms and preserve quality of life such as pressurized intraperitoneal aerosol chemotherapy.

Conditions such as melanoma, advanced squamous cell carcinoma, gastrointestinal stromal tumours (GIST), EMPD and dermatofibrosarcoma protuberans are examples of rare tumours. Due to their rarity, diagnosis is the critical first step for treatment. Treatment options are directed by tumour biology and discussion by a multidisciplinary team built upon the latest international guidelines and research advances. 

If you have questions about advanced and rare cancers, take this chance to ask Clinical Associate Professor Claramae Chia, Senior Consultant for the Department of Sarcoma, Peritoneal and Rare Tumours (SPRinT), Division of Surgery & Surgical Oncology, National Cancer Centre Singapore (NCCS) and Singapore General Hospital (SGH). Both SGH and NCCS are members of the SingHealth group.

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About Clin Assoc Prof Claramae Chia

Dr Claramae Chia is the Head and Senior Consultant in the Department of Sarcoma, Peritoneal and Rare Tumours (SPRinT), Division of Surgery and Surgical Oncology, National Cancer Centre Singapore. She graduated from the National University of Singapore in 2005. She obtained her membership diploma for surgery in 2008 from the Royal College of Surgeons of Edinburgh. In May 2013, she completed her advanced surgical training and joined as a Fellow of the Royal College of Surgeons of Edinburgh. She continued on to her subspecialty training in surgical oncology with a focus on peritoneal surface malignancies.

In 2013, she was awarded the SingHealth Health Manpower Development Plan - Peritoneal Surface Malignancy Surgical Oncology Programme. She trained at the Centre Hospitalier Lyon Sud in Lyon, France with Professor Olivier Glehen. Under her leadership, the SPRinT department was formed in 2019 in recognition of the advanced oncological work that the team had been performing. Dr Chia and the SPRinT department continue to push clinical boundaries by introducing new services and initiatives. Examples of this include the introduction of Pressurised Intraperitoneal Aerolised Chemotherapy (PIPAC) and a focus of palliative surgical care.

On the research front, Dr Chia has been actively involved in clinical as well as basic science research since her basic surgical training. She has had publications in several peer reviewed journals. In 2008, she joined the Wee Kim Wee Laboratory of Surgical Oncology at the National Cancer Centre as a clinical research fellow and won the Singapore Millennium Foundation Grant for Associate Investigator for her translational work in nasopharyngeal carcinoma.

In SPRinT, Dr Chia continues to remain actively involved in research with the focus on peritoneal surface malignancies, retroperitoneal sarcoma and advanced/pelvic malignancies. She has published more than 70 manuscripts over the course of her research. The department also runs several clinical trials in peritoneal surface malignancies. Dr Chia is also a strong advocate of teaching the next generation of surgeons and doctors. She contributes to the General Surgical Residency Program and is actively involved in teaching medical students from all 3 local medical schools. She is also the first and only mentor in an Asian institute under the European School of Peritoneal Surface Oncology (ESPSO).

Ref: J22