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CRMY: Malaysia needs more strategies for cancer control

PETALING JAYA: Malaysia needs more strategies for cancer control from prevention to early detection, says Cancer Research Malaysia (CRMY).

This should also include better access and more effective and affordable treatments, it said.

“Today, nearly 60% of the deaths due to cancer occur in Asia. The majority of these occur in low and middle income countries.

“This is expected to increase in the next few decades,” said CRMY, a non-profit cancer research organisation, in a reply to The Star on whether there was a pattern emerging involving more young Malaysians being diagnosed with cancer.

A recent study, published in a medical journal, which analysed cancer data in the US and other industrialised countries, found a rise in cases of cancer among people under 50 years old.

However, CRMY noted that in general, cancers are more common in older individuals although the pattern is different from one cancer to another.

“For example, testicular cancer is mostly among men aged 25 years and above; and rare in men aged more than 50.

“But publicly available data is only available for three periods in Malaysia (2003-2005, 2007-2011 and 2012-2016). And these showed that over the 13-year period, there has not been dramatic changes in the age-standardised rate of cancers,” it said.

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Research by CRMY found that women who develop breast cancer at a younger age are more likely to have inherited a faulty cancer gene from their mother or father.

Genetic counselling and testing could help families work out better ways of screening for and preventing cancers, it said.

“Cancer is a term that describes nearly 200 different diseases and different solutions are required.

“It is critical that we are able to develop a comprehensive long-term approach to cancer control,” it added.

Malaysia, CRMY said, had made good efforts through the development of the National Cancer Control Plan 2016-2020.

To have more accurate data, the organisation said it would be sometimes useful to compare to Singapore, where data is available from 1968 to 2020.

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In Singapore, the age-standardised rate of cancers in men has been fairly stable at about 230 newly-diagnosed cancers per year per 100,000 individuals.

For women, the age-standardised rate of cancers has risen from 150 per year per 100,000 individuals in 1968 to 230 per year per 100,000 individuals in 2020.

This is mostly due to the rising incidence of breast cancer.

Clinical oncologist Dr Vickee Rajeswaran said compared to a decade ago, the incidence of breast cancer among young women under 40 was increasing.

Although there is no data to formally confirm this, the Malaysian Oncological Society head of public relations said this was derived from his clinical experience.

Dr Vickee attributed the early diagnosis to improved level of education, access to healthcare and better health literacy.

He spoke of certain genetic markers and lifestyle choices that could predispose someone to the development of breast cancer.

“As we continue to improve our health education and detection/screening methods, I expect this number to continue to increase.

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“While we cannot at this stage advocate for all young women to undergo routine mammograms as we do for women above 40, it is essential to educate women of all ages as well as doctors and healthcare workers that a breast lump should never be ignored,” he said.

He described breast cancer management as a “team sport” where the surgeons, oncologists, pathologists and radiologists meet to decide on the best approach in treating patients.

“The most important aspect is educating our youth on the importance of performing regular breast self-exams, and improving the health-seeking behaviour as a society,” he said.

“We still see patients who come to us later in their illness, due to fear of what may follow.

“Granted, there are challenges during treatment, but we have come a long way since the start of chemotherapy in the 60s.

“We have a much better understanding of symptom management during and after treatment.”

Dr Vickee said anyone with a strong family history of breast cancer (siblings or first relatives) should consider being screened for the BRCA mutation, as this puts them on a pathway of stricter surveillance and hopefully, earlier detection.

“Seek help early if you feel a lump in your breast.

“Take all lumps seriously, approach a doctor for the proper referral pathway if you feel anything in your breast,” he added.

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