Official Opening Of The Cancer Institute

22 Feb 2003

By Dr Balaji Sadasivan

Venue: Tan Tock Seng Hospital

Introduction

I am very happy to join you today to witness the opening of The Cancer Institute at Tan Tock Seng Hospital.

History Of Cancer

Cancer is a major scourge of humanity in the 21st Century. Cancer is not a disease of modernity. It has afflicted mankind throughout recorded history. Evidence of cancer has even been found in the human mummies of ancient Egypt. The earliest description of cancer was in 1600 BC, in an Egyptian papyrus, which described 8 cases of tumours in the breast which were treated by cauterisation.

The word 'cancer' itself is credited to Hippocrates, the famous Greek physician, and widely considered the 'father of Western medicine'. Cancer comes from the Greek word 'Karkinos', which refers to the crab, and is a reference to the finger-like projections of a spreading cancer which call to mind the shape of a crab.

In recent times, cancer has become a disease of epidemic proportion. It is estimated that half of all men and one-third of all women in the US will develop cancer in their lifetimes. In Singapore, cancer has been the leading cause of death since 1991, and it accounted for 28.2% of all deaths in 2001.

Researchers from National University of Singapore report that the incidence of cancer is rising. In 1970, there were 2,500 reported cases of cancer. In recent years, the number is about 6,400 cases a year. The trend is especially noticeable in females among whom the overall cancer numbers have risen sharply from 154.5 to 198.8 per 100,000. The most rapidly rising cancer is breast cancer. Women in Singapore tend to be diagnosed with breast cancer at an earlier age than those in the West. The reason for this is unclear. The incidence of colon cancer has also almost doubled over the last 30 years. However, all is not gloom and doom. The incidence of some cancers has come down. The incidence of liver cancer has shown a downward movement as a result of the government's effort to immunise the population against Hepatitis B, which is linked to this cancer. Cancers of the nasopharyx, oesophagus and cervix have also declined

In the 19th Century and early 20th Century, the most greatly feared disease was Tuberculosis. In the mid 20th Century, drugs that could cure tuberculosis were discovered. Perhaps the 21st Century will herald a similar cure for cancer. In the 21st century, doctors look to newer methods. Researchers are investigating the use of biologic response modifiers to spur the body into fighting cancer, for example through the development of cancer vaccines, and the use of biologic agents such as cytokines. The advent of the Century of the Gene has also augured the possibility of finding the 'magic bullet', a quest that doctors have embarked on since time immemorial, and one which has continued to elude us today.

At the same time, researchers have devised safer and more effective ways to use the arsenal that we already possess. For example by combining different methods of treatment, such as in adjuvant or neo-adjuvant therapy, doctors have been able to achieve better survival rates for breast and colorectal cancers.

MOH's response to cancer

My Ministry is acutely aware of the heavy burden that cancer imposes on Singaporeans. We have set a target to reduce premature deaths from cancer by 10% from 124 deaths per 100,000 population aged 35-64 years in 1997 to 112 deaths per 100,000 in 2010.

To this end, my Ministry has intensified existing programmes, and started new initiatives to meet the challenge of cancer head-on. We started the BreastScreen programme for all women aged 40 to 64 years of age in 2001. This permits early detection of breast cancer, which is the commonest cancer among women in Singapore.

It is well-recognised that lifestyle factors play a role in the development of cancer. Smoking in particular has been identified as a major cause of lung cancer and cancer of the upper airways. It is imperative that we educate Singaporeans on the need to develop healthy habits so as to reduce their risk of cancer. We will continue our work in longstanding health promotion programmes such as the National Healthy Lifestyle Campaign and the National Smoking Control Programme.

The treatment of cancer is rapidly evolving, with new discoveries being made on an almost daily basis. My Ministry is committed to introducing new technologies of proven value into Singapore for the benefit of all Singaporeans. Over the last 2 years, we have funded projects to investigate the use of new technologies in the treatment of cancer, such as non-myeloablative bone marrow transplants for the treatment of haemotologic malignancies and solid tumours, and Intensity-Modulated Radiotherapy for the treatment of nasopharyngeal carcinoma. These state-of-the-art technologies hold great promise in being able to improve survival and quality of life for cancer patients.

My Ministry also produces Clinical Practice Guidelines to aid doctors in their management of cancer. These guidelines are based on the best available clinical and scientific evidence. We published a guideline on prostate cancer in 2000. Over the next 2 years, we will be producing 3 more guidelines on breast, cervical and colorectal cancer. It is hoped that doctors will use the guidance offered by these guidelines, and, by practising evidence-based medicine, give cancer patients the best treatment available.

The Cancer Institute at Tan Tock Seng Hospital

As a healthcare provider, and a partner, the National Healthcare Group plays an essential role in our struggle against cancer. NHG set up The Cancer Institute in 2000 to provide a comprehensive disease management programme that co-ordinates all the different aspects of cancer care, from prevention and early detection, to treatment and long-term health maintenance. The Cancer Institute allows NHG to integrate and co-ordinate care by linking up the various institutions in NHG and streamlining the care process across these institutions.

With the opening of The Cancer Institute, Tan Tock Seng Hospital will now be able to offer a one-stop cancer service to its patients, permitting the delivery of chemotherapy and radiotherapy on its premises. It will also gain access to the pool of specialised manpower available in NHG, such as medical oncologists, radiation therapists and medical physicists.

I congratulate the National Healthcare Group on the opening of The Cancer Institute at Tan Tock Seng Hospital. I believe that it is with incremental steps like this that we would ultimately win the war against cancer.

Thank you.