SUNDAY STAR, 3 FEBRUARY 2019
CANCER AWARENESS
Never-smokers still at risk
By SRIMAYEE SEN SARMA
LUNG cancer is a diagnosis that most people
dread, and there is valid reason for this fear.
According to World Health Organization
(WHO), cancer accounted for 9.6 million
deaths worldwide last year, 1.76 million of
which were caused by lung cancer.
Datin Paduka Prof Dr Teo Soo Hwang,
chief executive of Cancer Research Malaysia
and cancer researcher/geneticist, says,
“Eighty-six per cent to 92% of male lung
cancer patients and 60% to 70% of female
lung cancer patients are smokers, suggesting
that smoking is still the most significant risk
factor for lung cancer in Malaysia.
“Lung cancer is the second most common
type of cancer among Malaysian men, fifth
most common among Malaysian women, and
third most common overall. One in 10 cancer
patients is diagnosed with lung cancer, and
smokers across all ethnicities, genders and
age groups are more likely to get lung
cancer.”
While it is true that smoking is one of the
biggest risk factors for lung cancer, non-
smokers can be in danger, too.
According to a 2009 article titled Lung
cancer in never smokers: Clinical epidemiology
and environmental risk factors published in
Clinical Cancer Research, never-smokers
account for approximately 10% to 15% of
lung cancer cases in the United States.
Even though there is no data-based
evidence on the number of lung cancer cases
in never-smokers in Malaysia, Dr Christina
Ng Van Tze, consultant medical oncologist
and the president and founder of
Empowered – a non-governmental
organisation that focuses on aiding the
underprivileged section of the society in
Malaysia with cancer treatment – says, “The
number of non-smokers developing lung
cancer is growing and becoming a concern. It
is estimated that around 15% to 20% of men
and about half the women diagnosed with
lung cancer never smoked.”
So then, what causes lung cancer in never-
smokers?
Finding answers
When a non-smoker develops lung cancer,
Harness the benefits of turmeric to fight disease
SPICES are old. They have been valued for
their ability to bring other worlds and
cultures to our tables and make food
delicious, interesting and beautiful.
Besides that, every sprinkle of spice may
add a little health bonus. Some spices have
antioxidant and anti-inflammatory
properties, especially turmeric, which
has been used for thousands of years
both as a spice and herbal medicine.
Extensive research for the past 50
years on turmeric has shown that it
can be beneficial for health.
Modern lifestyle habits such
as the drastic increase in
additives and preservatives in
food, stress and lack of sleep or
rest may be responsible for
inflammation and disturbances in
inflammation resolution in the body,
suggests a 2012 study titled Chronic
inflammatory diseases are stimulated by
current lifestyle: how diet, stress levels and
medication prevent our body from
recovering published in Nutrition &
Metabolism.
Inflammation resolution is the body’s
defence mechanism that helps protect the
body from infection and injury. It can be
it can be attributed to more than one factor,
including environmental, occupational or
genetic.
In an article published in Science Blog of
Cancer Research UK titled Science Surgery:
‘Why do never-smokers get lung cancer?’, Dr
Mariam Jamal-Hanjani, oncologist and
clinical researcher specialising in lung cancer
at University College London, mentions that
non-smokers who develop lung cancer are
more likely to have cells with a gene
abnormality called EGFR.
“If you have never smoked, you are more
likely to develop lung cancer that is driven by
a fault in one or more genes. These are not
necessarily genetic faults that you are born
with, they may be faults that develop during
the lifetime,” wrote Dr Mariam.
Environmental and occupational factors,
on the other hand, include exposure to radon,
passive smoking, aerosolised oils caused by
wok cooking, and asbestos exposure. The
article also elaborated that there is a marked
difference in the kind of lung cancer common
in smokers and non-smokers.
Surviving against adversity
Sim Siew Bee (pic) is a 55-year-old
homemaker who assists her husband in
his business. She was diagnosed with
stage four lung cancer last year but is now
in remission. As a lung cancer survivor,
she attributes her win against the disease
to her good health prior to getting
diagnosed, as well as her positivity.
She narrates her journey from diagnosis
to remission.
“I did not have typical symptoms of
lung cancer such as coughing. For a
couple of days before getting diagnosed, I
just felt tired and short of breath while
performing simple household tasks.
“When I went for a check-up, I was
diagnosed with stage four lung cancer,
which had metastasised to other parts of
my body including my throat and brain.
“My first reaction was shock because I
led a healthy lifestyle and still do. I
exercise, eat home-cooked food, avoid
fast food and have never smoked or
accompanied by symptoms such as pain,
swelling or redness, which subside within a
couple of days after the body recovers.
A compound in turmeric called curcumin
is widely researched for its healing
properties. A 2011 study titled Turmeric
(Curcuma longa) inhibits inflammatory
According to Dr Ng, lung cancer can be
generally divided into two groups – small
cell lung cancer (SCLC) and non-small cell
lung cancer (NSCLC). NSCLC is further
divided into three types – adenocarcinoma,
squamous cell carcinoma and large cell
carcinoma.
SCLC is the more aggressive kind of lung
cancer and is thankfully less common and
almost rare in non-smokers. Other less
common types of lung cancer are lung
carcinoid and pulmonary lymphoma. While
smokers can develop all kinds of lung
cancers, non-smokers are more prone to
developing adenocarcinoma.
Till now, lung cancer in smokers and non-
smokers have been treated in a similar
manner. However, this may change with
new research bringing to light more
differences in the characteristics of lung
cancer in smokers and non-smokers.
Lifestyle matters
Even though never-smokers can get lung
drank alcohol.
“However, I got past that initial shock
and, instead of concentrating on the
disease, I decided to focus on healing.
I got all the support from my
family and friends, which
helped me stay positive in my
fight against cancer.
“I am also fortunate to
have been able to continue
with my normal life because
even with stage four
metastasised lung cancer, I
never went through much
pain. I was active during my
treatment sessions as
well.
“I had to go
through both
chemotherapy and
radiotherapy
sessions and still
do, but the
nuclear factor (NF)-KB and NF-KB-regulated
gene products and induces death receptors
leading to suppressed proliferation, induced
chemosensitization, and suppressed
osteoclastogenesis published in Molecular
Nutrition & Food Research indicates that
turmeric inhibits certain inflammatory
products and induces death receptors
(a protein that may kill cancer cells
when bound to another protein
called TRAIL), leading to reduced
cancer cell growth and higher
chemosensitivity.
Many clinical (human) research
studies use high daily doses of
curcumin to test its effects on
different ailments and bodily
functions. This is because curcumin
absorption by the body is poor, so much
higher doses are necessary. With new
technology and innovation, however, poor
absorption of curcumin is in the past.
A curcumin formulation called
Theracurmin, which is produced via
ultrafine granulation and suspension
technology, can be rapidly absorbed within
one hour and retained for as long as 24
hours in the body.
A low dose (600mg) of Theracurmin can
cancer, the good news is that such patients
respond better to chemotherapy than
smokers according to a 2006 study titled
Smoking affects treatment outcome in
patients with advanced nonsmall cell lung
cancer, published in Cancer.
Dr Ng has a similar opinion, saying, “A
healthy lifestyle before the diagnosis of
lung cancer is one of the deciding factors of
how well someone will respond to
treatment.”
She names a patient, Sim Siew Bee, as an
example. Sim, who was diagnosed with
stage four lung cancer that had
metastasised to her throat and brain in May
last year, responded so well to treatment
that she is already in remission.
Dr Ng attributes Sim’s fast recovery to
her excellent health before her diagnosis.
She says, “Sim led a healthy lifestyle. This
helped her respond to the treatment better
than people who have health issues prior to
diagnosis.”
> TURN TO PAGE 2
frequency has reduced significantly now
that I am in remission. I am mostly on
drugs now. Many people often have the
misconception that cancer treatments are
excruciatingly painful, but I did not feel
any pain during my chemotherapy or
radiotherapy.”
She has been extremely positive
throughout her journey as a lung
cancer patient and says that her
positivity has been one of her
greatest strengths against lung
cancer.
She advises all cancer patients to
focus on living as normal a life as
possible instead of dwelling on the
disease. She also advocates
the importance of leading
a healthy lifestyle since
she believes that it was
another reason she
responded so well to
treatment.
Modern lifestyle habits such
as the drastic increase in
additives and preservatives in
food, stress and lack of sleep
or rest may be responsible
for inflammation and
disturbances in inflammation
resolution in the body.
provide more curcumin than 100 teaspoons
of turmeric powder. Theracurmin is a well-
researched curcumin powder that may be
beneficial for heart, brain, muscle and joint
health.
This article is brought to you by Cambert
(M) Sdn Bhd.
n For more information, call 03-5638 3660
(Monday to Friday, 9am to 5pm) or email
enquiry@cambert.com.my
2 Cancer Awareness
Giving back to the community
ORAL cancer, also known as mouth cancer,
is the sixth most common cancer in the
world. According to the United Kingdom’s
National Health Service (NHS),
approximately 6,800 people are diagnosed
with mouth cancer in the UK every year.
This equates to almost 2% of the total
number of cancers diagnosed worldwide.
Oral cancer is a condition where a tumour
begins to develop in the lining of the mouth.
The tumour can be anywhere in the mouth,
such as the surface of the tongue, inner
cheeks, roof of the mouth, lips or gums.
NHS states that oral cancer commonly
affects older adults in the age range of 50 to
74. Only an eighth of oral cancer cases
involve people aged below 50. It is also more
prevalent in men than women. This may be
due to the higher alcohol consumption rate
among men in general.
The symptoms of oral cancer may
resemble ordinary mouth infections, which
is why mouth infections should not be taken
lightly. Common symptoms may include
mouth ulcers that persist for several weeks,
unexplained and persistent lumps in the
mouth or neck, looseness of teeth or sockets
that remain unhealed after extractions,
persistent numbness or an odd feeling on
the lip or tongue, changes in speech where
none had been apparent such as lisps, and
white or red patches on the lining of the
mouth or tongue.
The type of oral cancer an individual has
can be identified based on the type of cell
where the cancer starts. Squamous cell
carcinoma is the most common type of oral
cancer and occurs in nine out of 10 cases.
Other, less common types include
adenocarcinoma, which develops in the
salivary glands, sarcoma, which refers to
abnormal growth in bones, cartilage,
muscles and other tissues, oral malignant
melanoma, a cancer that starts in
NUMed emphasises increasing the local community's awareness of oral cancer.
melanocytes, and lymphoma, a type of
cancer that grows in the lymph glands and
can sometimes develop in the mouth.
Treatments for oral cancer are broadly
similar to treatments for other common
cancers. These include surgery, radiation
therapy, chemotherapy and targeted drug
therapy. Oral surgery aims to completely
remove the tumour from the mouth.
Radiation therapies, such as external beam
radiation therapy and brachytherapy, are
carried out to treat cancerous tissues of the
mouth through selected radiation
technology.
Chemotherapy is another common
technique and seeks to destroy cancer cells
in the body using anticancer drugs. These
are combined to attack cancer cells at
different stages of growth while decreasing
the chances of drug resistance. Lastly,
targeted drug therapy is a specific treatment
that aims to interfere with cell growth on a
molecular level. Under certain conditions,
this treatment may be combined with
chemotherapy and radiation therapy.
Over time, a sizeable body of research
has been accumulated to improve the
treatments of oral cancer. Newcastle
University, a world-class medical school in
the UK renowned for its research excellence,
has made remarkable contributions towards
oral cancer research.
“Newcastle University is ranked among
the top in the world for research. We are
bringing that capability to our Newcastle
University Medicine (NUMed) campus in
Controlling what we can
> FROM PAGE 1
Malaysians beware
Prof Teo raises concern that most new
treatment costs for cancer far exceed the
average income of many individuals living
even in high-income countries, and the same
could be said of Malaysia as cancer
treatment is not affordable to most people
here, even to those who are insured or live
on an upper-middle income.
“However, the Government is doing all the
right things to reduce the burden of lung
cancer on the Malaysian public by increasing
tobacco tax, tightening regulations for
tobacco advertisement and promotion, and
Staying strong and supportive
Sim Siew Bee’s husband, Tan Wan
Chuan (pic), talks about what it was like
to have a loved one diagnosed with stage
four lung cancer.
“I was in shock and denial when I
found out that my wife had stage four
cancer that had metastasised to her
throat and brain. I was scared that she
would not make it, and expected it to be
a difficult journey.
“However, she surprised us and
proved us all wrong, emerging a strong,
SUNDAY STAR, 3 FEBRUARY 2019
Dr Michaela Goodson.
Malaysia. One of the key focus areas is to
encourage students to undertake research
projects that not only help to enhance their
knowledge, but also have a direct and
positive impact on the local community,”
says Dr Michaela Goodson, dean of research
at NUMed.
“A dedicated research laboratory is being
opened on the campus, which will allow
students and faculty members to undertake
laboratory-based research projects on
molecular mechanisms and determinants of
disease in Malaysia,” she adds.
Located in Johor, NUMed is the
international campus of Newcastle
University. With a solid foundation in
research excellence, the university is
dedicated to not only seeking advancements
in oral cancer treatments but also promoting
awareness of the disease among the local
community.
n For more information, call 07-555 3800,
WhatsApp 011-1231 5411/012-784 9456,
email admissions@newcastle.edu.my or
visit www.ncl.ac.uk/numed/
increasing the coverage of smoking bans in
public places,” she adds.
Nevertheless, the fact remains that
nothing will work unless there is awareness
among people and they consciously choose
what is best for themselves as well as
others. While quitting smoking is the first
step towards reducing the high incidence
rate of lung cancer worldwide, the next step
would be understanding and avoiding
environmental hazards.
Being diagnosed with lung cancer caused
by genetic factors is not in our hands, but
we can at least work on reducing
modifiable external risk factors such as
lifestyle and the environments we choose to
expose ourselves to.
positive person who took the disease
head on and triumphed. People ask me
how I took care of her, but the truth is
that I never had to since she is still taking
care of me, the household and our
business exactly as she used to before
getting diagnosed and did all through her
treatment as well.
“It may seem like an exaggeration, but
she still outruns me when we go jogging
in the morning, even when she is
undergoing chemotherapy and
radiotherapy.”
According to him, it is her strength that
helped him combat his negativity about
the disease and not the other way
around. Since he experienced it at first
hand, he agrees with Sim that positivity
and a healthy lifestyle can have a good
impact on the success of cancer
treatment.
He suggests that family members and
friends of a cancer patient provide
support to ensure the patient leads a
normal life that focuses on the healing
process, not the disease.
SUNDAY STAR, 3 FEBRUARY 2019 3
4 Cancer Awareness
Preparing for the unexpected
THESE are trying times. Because of
the high inflation rate and slowing
economy, many Malaysians have to
work tirelessly to make ends meet
every month. However, even if one
earns a comfortable salary, one’s
world can still be turned
completely upside down if he or
she were ever to hear the words
“You have cancer”.
When a person, particularly the
main breadwinner of the family, is
diagnosed with cancer, that family
is very likely to lose a stable source
of income and may have to scrape
by on their savings.
Unfortunately, escalating
medical fees for cancer treatment
adds on to this financial burden,
which can further cripple and
devastate a family’s financial
situation.
According to the article Cancer
and financial catastrophe,
published by University of Malaya
in 2017, Assoc Prof Nirmala Bhoo
Pathy suggests that half of
Malaysians face financial
catastrophe within the first year of
a cancer diagnosis, with lower- and
middle-income families being more
adversely affected.
This finding rings particularly
true when Cancer Cure Malaysia
presented the general costs as of
2017 for the treatment of common
cancers in Malaysia.
l Breast cancer – Up to
RM395,000
l Colon cancer – Up to
RM85,000
l Lung cancer – Up to RM56,000
l Nasopharyngeal cancer – Up
to 70,000
l Cervical cancer – Up to
RM60,000
These numbers do not account
for other related costs such as loss
of income, hiring a professional
caretaker or domestic help, as well
as follow-up, alternative and
overseas treatments.
Therefore, wouldn’t it be nice to
have a safety net to give you peace
of mind should you find yourself in
turbulent times like these?
Making informed
decisions
In response to these issues,
financial protection plans have
stepped up to help ease the
financial burden of cancer on
patients. In the case of a person
being diagnosed with cancer, some
financial relief is given depending
on the insurance package bought.
Having a backup plan when cancer strikes can affect your treatment and
recovery experience.
PRUCancer X provides peace of mind to the cancer patient and his family by providing a lump sum payout to support their finances.
Eric Wong, chief customer and
marketing officer of Prudential
Assurance Malaysia Berhad
(Prudential) says that there has
been growing awareness among
the public on the necessity of
having a cancer protection plan.
“More people are purchasing
health insurance because they can
now see how it relates to their
daily lives. Medical insurance,
hospital admission and outpatient
treatment are all real-life needs.”
Nevertheless, because of high
medical fees, the coverage
provided by these plans are rarely
enough to cover cancer treatment
as well as other miscellaneous
costs.
“Thus, in line with Prudential’s
mission to provide financial
freedom to all Malaysians, we have
introduced a cancer protection
plan that does not just cover
cancer treatment expenses, but
also the potential income loss if
one has to stop work to focus on
the recovery, as well as other
additional costs such as specialised
home care, health supplements
and alternative treatments,” Wong
adds.
With the recent launch of its
PRUCancer X protection plan,
Prudential hopes to provide a
holistic and comprehensive cancer
protection plan to ensure that
Malaysians are financially
prepared and protected in the
event of a cancer diagnosis.
Through considerable research
and its own efforts at data
collection, Prudential has identified
the needs of its consumers and
come out with targeted solutions
that solidly addresses their pain
points.
l High cost of cancer
treatment – Taking into
consideration the types of cancer
treatment and recovery period of a
patient, PRUCancer X offers
benefits of up to RM2mil to ensure
the patient can be presented with
the best possible treatment option,
in addition to adequate recovery
assistance and care.
l Affordable insurance –
Prudential recognises that some
people do not have the budget to
prioritise cancer protection,
especially young working adults.
However, it also understands that
cancer is a disease that does not
discriminate.
Therefore, PRUCancer X is very
affordable, with premiums from as
low as RM34 per month to ensure
it can deliver peace of mind
without burning their consumer’s
pockets.
l Early diagnosis – In cases
where a patient is diagnosed with
specific types of cancer in the early
stages, PRUCancer X pays out 10%
of the coverage for the patient to
receive treatment. The remaining
coverage will be paid out in the
unfortunate case of a recurrence
or if the cancer has spread to its
later stages.
l Family financials – Prudential
also takes note of the possibility of
a patient succumbing to the cancer.
In the event of death, the plan will
Eric Wong.
provide a lump sum
compassionate benefit to assist
the family with funeral expenses
in addition to livelihood support
until they can get back on their
feet.
l Enrolment process –
Enrolling in an insurance plan
may be complex, but PRUCancer X
has stripped its application
process of unnecessary questions,
instead focussing entirely on
cancer risks questions only.
Giving people control
Looking at the array of costs
needed to fund a cancer patient’s
recovery, it is crucial for a cancer
patient to have a comprehensive
cancer protection plan that takes
into account the extra costs that
can follow a successful cancer
treatment.
According to statistics published
by World Health Organization,
one out of four people will be
diagnosed with cancer by the age
of 75. The Malaysian Study on
Cancer Survival 2018 also brands
cancer as the fourth most
common cause of death in
Malaysia, with 12.6% incidences
of death in government hospitals
SUNDAY STAR, 3 FEBRUARY 2019
People have the
tendency to purchase
health insurance
because they can now
see how it relates
to their daily lives.
Medical insurance,
hospital admission
and outpatient
treatment are all
real-life needs.
and 26.7% in private hospitals.
There is a higher chance for
anyone to be diagnosed with
cancer, and most people have
families to support and other
responsibilities to manage.
Therefore, there is no time to be
complacent when dealing with
the repercussions of cancer. Take
control and learn how insurance
plans work to support you and
your loved ones in the face of
cancer. Make informed decisions
so you can keep yourself and your
loved ones safe physically,
mentally and financially in the
worst-case scenario.
All in all, Prudential hopes to
continue servicing the public by
providing them financial freedom
and peace of mind even during
their most challenging periods.
Wong says, “We listen to the
market and try to allay its
concerns with actions such as
addressing the affordability of our
insurance packages and ease of
enrolment. Therefore, I hope that
people will be able to recognise
the importance of getting a cancer
protection plan.”
n For more information, visit
www.prudential.com.my
SUNDAY STAR, 3 FEBRUARY 2019 5
6 Cancer Awareness
Say yes to life
ALTHOUGH non-smokers are also at risk of
getting lung cancer, smokers are by far the
most at risk. According to the Lung Cancer
Fact Sheet published by the American Lung
Association, 80% and 90% of lung cancer
deaths in women and men respectively are
attributable to smoking.
The fact sheet also states that in terms of
risk, male smokers are 23 times more likely
and female smokers are 13 times more
likely to develop lung cancer, compared
with people who never smoke.
Additionally, active smoking is
responsible for close to 90% of lung cancer
cases. Radon exposure accounts for 10% of
all patients, occupational exposure to
carcinogens (9% to 15%) and outdoor air
pollution (1% to 2%). Because of the
interactions between exposures, the
combined attributable risk for lung cancer
can exceed 100%.
According to Dr Murallitharan Munisamy,
medical director of National Cancer Society
of Malaysia, occupational exposure,
including to asbestos, uranium and coke (an
important fuel in the manufacture of iron in
smelters, blast furnaces and foundries) is
almost non-existent in Malaysia. So is
exposure to radon.
“As is evident from the statistics, the risk
attributable to smoking is so great that it
outweighs all other factors.
“In some countries, air pollution is high,
which might increase the risk of getting
lung cancer, but even that is only by a few
percentage points. Hence, giving up
smoking is the largest risk-reduction
strategy for lung cancer.”
He says that smokers not only harm
themselves, but others too, including people
who are within their immediate vicinity
when they smoke.
“The percentage risk of impact on actual
SUNDAY STAR, 3 FEBRUARY 2019
The percentage risk of
impact on actual exposure
to second-hand smoke
is clear. Non-smokers
have a 20% to 30% greater
chance of developing lung
cancer if they are exposed
to passive smoking, at
home or work.
exposure to second-hand smoke is clear.
Non-smokers have a 20% to 30% greater
chance of developing lung cancer if they are
exposed to passive smoking, at home or
work.”
The good news is that Dr Murallitharan
believes awareness of smoking and lung
cancer correlation is high among
Malaysians. Quit smoking to
“However, there is still a lack of self- reduce the risk
motivation for smokers to quit, as many of lung cancer.
perceive that they can quit before they get
cancer. This is a particular area of specific
self-awareness that needs to be improved.”
To help addicts stop smoking, Dr l Stay away – Stay as far as you can from meditate/silently contemplate.
Murallitharan provides useful tips in the those who smoke l Pray – Say a quiet prayer wherever
form of the 12M method. l Avoid – Avoid places in which people you are.
When you crave a cigarette, do the smoke.
following. l Chew – Chew gum or any kind of fruit Although the Government is taking a
l Wait – Wait 5 minutes. Tell yourself “I to keep your mouth moving. step in the right direction by banning
will wait”. l Wash – Wash your hands frequently. public smoking, the onus of doing what is
l Breathe – Take deep breaths. l Bathe – Take frequent baths. good for ourselves lies on us. If you want
l Drink – Drink a glass of warm water l Stretch – Every now and then, do some to quit smoking but did not find the above
slowly. muscle stretches. tips useful, you can always consider
l Busy – Keep yourself busy. l Meditate – Take a few minutes to seeking professional help.
SUNDAY STAR, 3 FEBRUARY 2019 Cancer Awareness 7

Clearing Probiotics for bowel movement

A QUOTE from father of modern plant-based, fibre-rich diet, movement frequency, according to a

the air on
medicine Hipprocrates, “all disease
begins in the gut,” still holds true
today. Diets low in fibre but high in
red meat, colon inflammation
triggered by bacterial infection,
exercising regularly and ensuring
regular bowel movement.
Biogrow ProGut is made from
natural Swedish oat fibre formulated
with dual action from the well-
2015 study titled Effect of the
probiotic strain Bifidobacterium
animalis subsp. lactis, BB-12®, on
defecation frequency in healthy
subjects with low defecation frequency

lung cancer
LACK of awareness has caused
many misconceptions about
lung cancer. These myths can
lead to people not getting
diagnosed in time or neglecting
treatment post diagnosis.
physical inactivity, alcohol abuse
and chronic laxative use are
common causes of poor gut health.
Irregular bowel movement or
constipation affects nearly a
quarter of the world population,
according to Epidemiology of
constipation in North America: a
systematic review, a 2004 study
published in The American Journal
of Gastroenterology.
Besides that, a 2012 study titled
It is not easy to Bifidobacteria for Life Betterment
detect lung cancer. published in World Applied Sciences
Journal shows that people with
researched Oat BG22 fibre powder
and Bifidobacterium lactis BB-12
probiotic strain from Denmark – a
strain of Bifidobacterium with more
than 300 scientific publications and
over 130 clinical studies carried out
on it.
One sachet daily provides a
synergistic effect for improved
intestinal function and balanced gut
microbiota. To consume, mix one
sachet (≈7g) with cold water, fruit
juice, cereal or yoghurt. One to two
sachets a day after meals or
whenever convenient is
and abdominal discomfort: a
randomised, double-blind, placebo-
controlled, parallel-group trial
published in British Journal of
Nutrition.
Biogrow ProGut is available at all
pharmacies nationwide.
This article is brought to you by
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n For more information, call 03-7956
2220 (9am to 5pm) or email info@
biogrow.com.my

It is thus imperative to discern
myth from fact. Listed below are
a few such false perceptions that
many people have about this
disease, along with the facts.
Myth Lung cancer cannot be
1 prevented
TRUTH While it is partially true
lung cancer cannot entirely be
prevented, staying away from
smoking and other
environmental risk factors such
as exposure to radon, asbestos
and aerosolised oil can
significantly reduce the
possibility of getting the disease.
Myth It is a disease
2 of men
TRUTH Although it is true that
lung cancer is the top cancer
affecting the male population, a
high number of women get it,
too. It is, in fact, the third most
common cancer in women after
breast and colorectal cancer.
Myth I am too young to
3 get lung cancer
It could be a long constipation have lower levels of recommended.
time before any Bifidobacteria in the large intestine.
The levels of these good bacteria
Each sachet contains
2.4g soluble and
symptoms appear. decrease with age. insoluble fibres with
It is also easy In addition, a study titled How
many cancer cases and deaths are
one billion colony-
forming units (CFUs) of
to mistake the potentially preventable? Estimates live probiotic cultures.
symptoms of lung for Australia in 2013 published in The dose of one
International Journal of Cancer billion CFUs of BB-12
cancer with other suggests that almost 40% of deaths has been clinically
respiratory caused by cancer, including colon tested and shown to
problems. cancer, are preventable with
lifestyle changes such as adopting a
have benefits on
defaecation and bowel
available, including surgery,
chemotherapy, radiotherapy and
targeted therapy. These
treatments are often used in
combination to remove
cancerous cells, prevent relapses
and increase patients’ life
expectancy.
Side effects are part of the
treatment process and can
include nausea, vomiting, hair
loss and fatigue. However, these
side effects are nothing
compared to the outcome of not
getting treatment for cancer,
which can lead to great pain,
suffering and eventual death.

TRUTH This is one disease that Myth Being diagnosed with

can affect people of any age. The
fact is there are a huge number
of young lung cancer survivors
as well as people who are living
with it worldwide. Even if you
do not smoke, you may live in a
polluted area or be genetically
at risk.
Myth I don’t have any
4 symptoms, which means
I am healthy
TRUTH It is not easy to detect
lung cancer. It could be a long
time before any symptoms
appear. It is also easy to mistake
the symptoms of lung cancer
with other respiratory problems.
Approximately 25% of people
with lung cancer display no
symptoms and are only
diagnosed when they undergo a
routine X-ray or CT scan.
Myth Cancer treatment kills
5 off good cells along with
cancerous ones
TRUTH There are different
kinds of cancer treatments
6 lung cancer is equal to a
death sentence
TRUTH The survival rate of lung
cancer is certainly not as high as
researchers and doctors would
like to see. One reason for this
may be the absence of symptoms
in the initial stages, which
causes late diagnosis when the
disease is already beyond the
curable stage.
However, even if it is beyond
the curable stage, it is still
treatable. With the latest cancer
therapies and medications, lung
cancer at every stage can be
effectively treated, increasing
the life expectancy of the patient
and reducing symptoms
significantly.
Learn about lung cancer and
help spread awareness about it.
Someone with lung cancer who
is refusing treatment and
believes that she will die anyway
or someone who believes herself
to be healthy since she does not
have any symptoms may benefit
from your initiative.
8 Cancer Awareness
WHILE lung cancer shares the
stage with colon cancer as the most
common form of cancer in men,
lung cancer has a higher mortality
rate because it is often detected
too late, says Dr Anand
Sachithanandan, consultant
cardiothoracic surgeon at Subang
Jaya Medical Centre.
“In Malaysia, at initial
presentation and diagnosis of lung
cancer, only 3% of people are in
stage one and 7% in stage two. The
remaining 90% of lung cancer
patients were diagnosed in either
stages three or four.”
He adds, “According to the
Malaysian Study on Cancer Survival
2018, the five-year relative survival
rate for lung cancer across all
stages is 11%. Hence, lung cancer is
the worst performing of all
cancers, and the median time of
survival after being diagnosed is
only 6.8 months.”
Spreading the word
“From the results of several local
surveys, it was noted that around
90% of people know that smoking
causes lung cancer, which is good.
However, 50% to 60% of
participants mistakenly think only
men get lung cancer, and about
70% think that lung cancer is a
communicable disease,” says Dr
Anand.
“These results tell us that
awareness on lung cancer in
Malaysia is still quite low. We need
to help the public be more aware
of the disease, so they are better
informed to self-refer earlier on to
medical professionals should they
feel something is wrong.”
For primary care doctors, Dr
Anand has some advice, “Signs and
symptoms of lung cancer are non-
specific, such as coughing, losing
weight, chest pains or shortness of
breath, and most symptoms are
not apparent in the early stages.
“These doctors see many patients
with various ailments daily, hence
some may overlook the differential
diagnosis of lung cancer and
provide patients with ‘normal’
treatments such as cough mixture
or antibiotics. Doctors need to be
more aware and think more about
the possibility of lung cancer so
they can do thorough checks and
refer their patients to a specialist.”
Receive the right care
When it comes to treatment, Dr
Anand emphasises the need for
early detection of lung cancer.
“There are two goals when treating
lung cancer. The goal of treatment
for early stage cancer is curative,
where we hope to cure the patient.
“For later stages when the
cancer has spread, we can no
longer cure the disease. Therefore,
the goal of treatment is palliative,
Take a deep breath
Dr Anand Sachithanandan.
where we try to improve their
quality of life and alleviate
associated pain or discomfort. We
may get them to live a little longer,
too, but ultimately they will still die
from the cancer.”
For curative treatment, Dr
Anand recommends surgery as the
best treatment option if the patient
is fit enough, as it will remove the
cancerous part of the lung.
“It is the best chance to cure the
disease, and it presents the patient
with his best chance for long-term
survival.”
After surgery, follow-up
screenings are done for a
minimum of five years to ensure
total eradication of the cancer from
the body. Multimodality in
treatment is practised, as some
patients require further treatment
before or after surgery such as
chemotherapy and radiotherapy to
ensure complete tumour clearance
and minimise the chances of
recurrence.
Patients with later stages of lung
cancer will usually be treated with
palliative or symptomatic intent,
where treatment focuses on
controlling the tumour. Rarely is
surgery performed to relieve the
patients of their pain or distressing
symptoms, such as if the tumour is
eroding into the chest wall, they
are coughing up blood, and they
have fluid around their lungs.
Changing minds, changing
lives
Recent policy changes passed by
the Government to ban smoking
from eateries and restaurants
show that efforts are being made
towards increasing public
awareness on the dangers of
smoking.
Dr Anand also provides some
advice to reduce the risks of lung
cancer, as listed below.
l Non-smokers should know
that they have the right to inhale
smoke-free fresh air.
l Make a sincere and concerted
effort to quit smoking. Better still,
don’t start smoking in the first
place.
l Eat in moderation and
exercise regularly.
l Go for health screenings.
However, he recognises that
prevention itself is not enough as
there is still a problem with stigma
and misconceptions relating to
lung cancer, which affects the way
the public and even doctors view
lung cancer patients.
“The problem is that there is a
lack of empathy even among us
doctors towards people with lung
cancer rather than, say, breast
cancer. A lot of effort has been
made to increase awareness for
breast cancer, but not much for
lung cancer,” says Dr Anand.
He explains, “There is the
common assumption that all lung
cancer patients are smokers, and
that they have brought it upon
Early detection saves lives
Dr Anand Sachithanandan,
consultant cardiothoracic
surgeon at Subang Jaya Medical
Centre, advocates screening for
people at high risk of
developing lung cancer.
To identify people at high
risk, he cites two major clinical
trials – the United States’ 2011
National Lung Screening Trial
published in New England
Journal of Medicine and the
2017 ES 02.01 The Dutch-Belgian
Lung Cancer Screening Trial
(NELSON) published in Journal
of Thoracic Oncology, both of
which demonstrated significant
survival benefits for people at
high risk of developing lung
cancer who received targeted
screenings with low-dose CT
lung scans. People in high-risk
categories include:
SUNDAY STAR, 3 FEBRUARY 2019
These results tell us
that awareness on
lung cancer in Malaysia
is still quite low. We
need to help the
public be more aware
of the disease, so they
are better informed
to self-refer early to
medical professionals
should they feel
something is wrong.
Dr Anand Sachithanandan.
themselves. Our role is not to judge
but to treat these people. While we
can advise them against smoking,
this is not the right time to chastise
them for smoking.”
Dr Anand adds that people have
to realise that lung cancer is
multifactorial and an increasing
number of non-smokers and
women are getting lung cancer.
Some factors include:
l Cooking with a wok –
Cooking fumes at high
temperatures in a confined space
may contribute to lung cancer.
l Second-hand smoke – Long-
term exposure to second-hand
smoke inadvertently makes people
passive smokers.
l Third-hand smoke – Cigarette
residue on furniture and
surroundings may also cause lung
cancer.
He continues, “Different people
have different triggers or
thresholds towards the
development of lung cancer. Some
are genetic, while ethnicity,
gender, family history and diet
may also affect your risk of lung
cancer.
“Therefore, we should not be
complacent because anyone could
get lung cancer depending on our
lifestyle choices or genetic
predisposition. The only things you
can do is to not smoke, live a
healthy lifestyle, and go for
screening if you are in a high-risk
group.”
n For more information, call
03-5639 1212.
l Smokers or former
smokers between 45 and 75
years old
l Individuals with a family
history of lung cancer (first-
degree relative)
l Personal history of any
cancer
However, Dr Anand warns
that screening is not perfect as
it can only determine the
condition of the lungs at the
time of the screening.
“There is no guarantee that
one will not develop lung
cancer in later years. Therefore,
depending on the screening
results and your clinical profile,
doctors will recommend a
follow-up screening anywhere
from between a few months up
to approximately five years.”