Learn more about this innovative treatment from the Department of Nuclear Medicine and PET at the Singapore General Hospital (SGH)
‘Nuclear strike’ helps destroy rare cancer
A new procedure helps doctors save patients from a disease that is often detected too late for treatment.
For about a year following her diagnosis of stage IV cancer, she underwent chemotherapy and took expensive drugs. The arduous treatment sapped her strength and spirit.
And just when she thought she couldn’t take any more, her doctors threw her a lifeline: a promising new radioactive treatment had just become available at
Singapore General Hospital (SGH), a member of the
Today, the dark clouds that hung over the 41-year-old former banker appear to be fading. Thanks to three cycles of the new treatment, the woman – who wants to be known as Ms Zhang – now faces a more hopeful future as she undergoes tests in the coming weeks to assess her condition.
“I feel well. The treatment doesn’t give me side effects and I feel encouraged physically, mentally and emotionally,” she said. “The treatment does not provide a cure but, if I’m lucky, I may be able to stay free from symptoms and be almost as good as normal, for as long as I can.”
Ms Zhang suffers from a rare disease known as neuroendocrine cancer. Unusually, she has a combination of aggressive and slow-growing cancer cells.
Ms Zhang went through 10 rounds of chemotherapy, and took a daily dose of an expensive drug, which made her bleed internally.
Then, her oncologist at a private hospital stumbled upon peptide receptor radionuclide therapy. The treatment involves injecting the patient with a radiopharmaceutical drug called Lutetium-177 DOTA-TATE.
A part of the drug seeks out and binds itself to cancer cells. After that, the radioactive part of the drug delivers a high-dose of radiation that kills the cancer cells.
However, not every patient suffering from neuroendocrine cancer will benefit from the radioactive treatment – the cancer cells must have the right receptors to attract the radioactive material in the drug. A patient will have to undergo a PET (positron emission tomography) scan to see if he can benefit from the treatment.
Ms Zhang turned out to be one such patient and, in May last year, became one of the first patients to undergo the treatment at SGH – one of the very first hospitals in the Asia-Pacific to offer the procedure.
Mini nuclear bombs
Dr Anthony Goh Soon Whatt, Senior Consultant and Head,
Department of Nuclear Medicine and PET, SGH, said: “The substance is like a mini nuclear bomb that targets (cancer cells). The procedure is actually a very elegant way of killing the cancer cells.”
In 2011, Dr Goh led a team of nuclearmedicine doctors, oncologists, nurses, scientists and laboratory specialists to Germany and Austria to learn about the treatment at hospitals there. The treatment has been available in those countries for eight to 10 years.
The team learnt about the equipment needed, the chemicals used and their side effects, and recovery care. For example, because the chemical used can damage the kidneys and cause nausea and vomiting, patients have to be given preventive treatments before the radioactive treatment can be administered.
As of early January, more than 10 patients have undergone the radioactive treatment at SGH. Some have had more than one cycle of treatment and all of them have experienced a better quality of life, said
Dr David Ng, Senior Consultant, Department of Nuclear Medicine and PET, SGH.
As neuroendocrine cancer cells tend to grow slowly, regular treatment will kill the cells as they surface. That means patients like Ms Zhang can enjoy a normal life without the ill effects from some forms of cancer treatments, said Dr Ng.
Ms Zhang said: “I’ve undergone three cycles of treatment and experienced almost no side effects. Chemotherapy wears me down but, with this treatment, I’ve been able to go swimming or shopping the day after.”
The long-term effects of the new treatment are still unknown, but Ms Zhang is taking this in her stride. She said: “If I live long enough to experience the longer-term side effects, it’ll still be a bonus, because it means I’ve already enjoyed that much more extra time.”
An elusive disease
- Neuroendocrine cancer affects five to seven people out of every 100,000. It is most commonly found in organs along the gastrointestinal tract, such as the small intestines.
- Some people with the disease might feel discomfort, diarrhoea, constipation, flushing and excessive sweating, which can be mistaken for symptoms of more common conditions, such as irritable bowel syndrome, menopause or allergies.