Dr Wong Siew Wei was a speaker at Gleneagles Hospital’s Annual Medical Seminar on 20 Aug 22. Dr Wong is a medical oncologist in Singapore, at Parkway Cancer Centre. He has expertise and interest in prostate, kidney, bladder, upper gastrointestinal and lung cancers. Dr Wong is also a member of our Expert Advisory Board. During the seminar, Dr Wong shared his expertise with the medical community in Singapore on the topic of treatment of advanced prostate cancer in his talk on “Advancing the Care of Prostate Cancer”.
Below is an abstract of his address.
Prostate Cancer in Singapore
Prostate cancer is the second most common cancer among men in Singapore. Furthermore, the incidence has been rising.
Late Diagnosis of Prostate Cancer
Prostate specific antigen (PSA) screening for prostate cancer is controversial* as it detects cancers ranging from low-grade indolent cancers that many never manifest clinically to aggressive high-grade cancer that cause early mortality. In Singapore and in the regional, a large proportion of prostate cancer cases are diagnosed in advanced stage.
Treatment Of Advanced Prostate Cancer in Singapore
On the topic of treatment of advanced prostate cancer in Singapore, Dr Wong shared that androgen deprivation therapy (ADT) is the cornerstone treatment. Early intensification of treatment by adding novel hormonal agent and/or chemotherapy is increasingly being used to treat patients with metastatic castration-sensitive prostate cancer (mCSPC). Most patients will however, progress to metastatic castration-resistant prostate cancer (mCRPC)**.
Dr Wong shared that up to 1 in 5 patients with mCRPC may harbour somatic DNA repair pathway alterations. Poly (ADP-ribose) polymerase (PARP) inhibition is becoming an important treatment for this cohort of patients who have failed one novel hormonal agent. He suggested that testing for DNA repair pathway alterations be offered to all patients with mCRPC ***.
Understanding The Cost Of Cancer Drug Treatment in Singapore And How To Protect Ourselves Against The Cost Of Cancer
The cost of cancer treatment in Singapore for late stage cancer can be $100,000-$200,000 or more per year. In an upcoming webinar organised by health365.sg (on 30 Sep 22, 8pm), Dr Wong Siew Wei will share his insights on the cost of cancer drug treatment. Ms Pamela Chong, Associate Manager from TN Advisory Group (a part of Legacy FA Pte Ltd) will share on how we can protect ourselves against the financial impact caused by cancer. Register here for free.
Notes By health365.sg
* Health experts explain that PSA screening is controversial because while they often alert doctors to the presence of cancer, there is however no precise way to definitively determine whether the cancers detected would cause symptoms or harm during the patient’s lifetime.
** Metastatic cancers are cancers that have spread beyond the site of origin. Castration-sensitive prostate cancer is prostate cancer that can be controlled by keeping the patient’s testosterone level as low as would be expected if his testicles were removed i.e. the “castrate” level. On the other hand, castration-resistant prostate cancer (CRPC) is an advanced prostate cancer which does not completely respond to treatments that lower testosterone. Such cancer still shows signs of growth, even with lowered testosterone levels.
*** PARP is an enzyme found in our cells. It is an important part of DNA repair pathways and they help damaged cells to repair themselves. PARP inhibitors fight cancer by stopping the PARP from repairing cancer cells, thereby allowing the cancer cells to die.
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This article is informative only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment, and should never be relied upon for specific medical advice.