Shiloh
Editor, Senior Moderator
Source: http://health.asiaone.com/Health/News/Story/A1Story20091231-188956.html
Thu, Dec 31, 2009
S'pore's cancer treat a breakthrough
By Dawn Tay
WITHOUT warning, a mystery illness struck Ms Dewi Hermawati, then 24, in 2007.
Hour-long seizures, fits and memory loss left the customer service officer unresponsive for four months.
Doctors were initially unable to make a diagnosis, leading her family to fear that she had been possessed.
Nearly a month after she had been in a coma, she was diagnosed with a rare disease, called paraneoplastic encephalitis - an inflammation of the brain associated with cancer or tumours in the ovaries or rest of the body .
But she has made a full recovery, thanks to Singapore doctors who came up with an unconventional approach to treat the disease.
They are now recommending that the procedure be used as a standard treatment worldwide.
The National Cancer Centre Singapore (NCCS) specialists published their findings in Nordic medical journal Acta Oncologica this year, detailing their use of aggressive chemotherapy to successfully treat two patients here with the disease.
There was no standard treatment for the rare malady, which was discovered only in 2007.
Past attempts worldwide to surgically remove the cancer or tumours, so as to stop brain inflammation, resulted in success only half of the time, said Dr Tan Min-Han, an oncologist at NCCS.
In a few cases, chemotherapy was combined with surgery. Ms Dewi's case is a landmark as it is the first time chemotherapy alone had successfully stopped the brain inflammation, after surgery to remove the tumour in the patient's ovary failed to improve her condition.
Stressing the importance of prompt and aggressive chemotherapy in treatment, Dr Tan said: "It is important to diagnose this disease correctly, as it is easy to mistakenly attribute the neurological symptoms to other causes rather than ovarian tumours or cysts."
Its exact prevalence worldwide is not known. NCCS doctors are aware of only five to six cases here since 2007.
As this is a newly discovered disease, it is likely that many cases have gone unreported, doctors said.
They expect the number of cases to increase, along with growing awareness. Since Ms Dewi's case, NCCS doctors have used chemotherapy on three other patients with similar conditions.
One has also fully recovered, while the other two are "doing well", said Dr Tan.
He admitted that the initial decision to treat Ms Dewi with chemotherapy - in which drugs are used to kill cancer cells - was difficult, because of potential side effects such as infertility and a compromised immune system.
He said: "We had reached a point where we could either watch and hope for the best, or do something more unusual." He thinks that the chemotherapy may prevent the body's immune system from attacking the brain, while destroying the cancer at the same time.
In future, surgery will still be carried out first for patients with tumours, because these have to be removed to prevent the cancer from spreading.
If the brain inflammation does not subside, chemotherapy will then be used.
For about 40 per cent of patients who do not have apparent cancer symptoms, chemotherapy will be used immediately.
Initially clueless about what Ms Dewi was suffering from, her family felt helpless. They thought she had become "a guinea pig" when the new treatment was proposed, said her sister, Ms Linde Nurhayati, 22, a nursing student who broke down and cried at the recollection.
Their despair turned into joy when she regained consciousness 20 days after chemotherapy was administered.
Ms Dewi said: "I initially thought I wouldn't make it. But I'm glad that I did, and that the doctors and my family didn't give up."
dawnt@sph.com.sg
Thu, Dec 31, 2009
S'pore's cancer treat a breakthrough
By Dawn Tay
WITHOUT warning, a mystery illness struck Ms Dewi Hermawati, then 24, in 2007.
Hour-long seizures, fits and memory loss left the customer service officer unresponsive for four months.
Doctors were initially unable to make a diagnosis, leading her family to fear that she had been possessed.
Nearly a month after she had been in a coma, she was diagnosed with a rare disease, called paraneoplastic encephalitis - an inflammation of the brain associated with cancer or tumours in the ovaries or rest of the body .
But she has made a full recovery, thanks to Singapore doctors who came up with an unconventional approach to treat the disease.
They are now recommending that the procedure be used as a standard treatment worldwide.
The National Cancer Centre Singapore (NCCS) specialists published their findings in Nordic medical journal Acta Oncologica this year, detailing their use of aggressive chemotherapy to successfully treat two patients here with the disease.
There was no standard treatment for the rare malady, which was discovered only in 2007.
Past attempts worldwide to surgically remove the cancer or tumours, so as to stop brain inflammation, resulted in success only half of the time, said Dr Tan Min-Han, an oncologist at NCCS.
In a few cases, chemotherapy was combined with surgery. Ms Dewi's case is a landmark as it is the first time chemotherapy alone had successfully stopped the brain inflammation, after surgery to remove the tumour in the patient's ovary failed to improve her condition.
Stressing the importance of prompt and aggressive chemotherapy in treatment, Dr Tan said: "It is important to diagnose this disease correctly, as it is easy to mistakenly attribute the neurological symptoms to other causes rather than ovarian tumours or cysts."
Its exact prevalence worldwide is not known. NCCS doctors are aware of only five to six cases here since 2007.
As this is a newly discovered disease, it is likely that many cases have gone unreported, doctors said.
They expect the number of cases to increase, along with growing awareness. Since Ms Dewi's case, NCCS doctors have used chemotherapy on three other patients with similar conditions.
One has also fully recovered, while the other two are "doing well", said Dr Tan.
He admitted that the initial decision to treat Ms Dewi with chemotherapy - in which drugs are used to kill cancer cells - was difficult, because of potential side effects such as infertility and a compromised immune system.
He said: "We had reached a point where we could either watch and hope for the best, or do something more unusual." He thinks that the chemotherapy may prevent the body's immune system from attacking the brain, while destroying the cancer at the same time.
In future, surgery will still be carried out first for patients with tumours, because these have to be removed to prevent the cancer from spreading.
If the brain inflammation does not subside, chemotherapy will then be used.
For about 40 per cent of patients who do not have apparent cancer symptoms, chemotherapy will be used immediately.
Initially clueless about what Ms Dewi was suffering from, her family felt helpless. They thought she had become "a guinea pig" when the new treatment was proposed, said her sister, Ms Linde Nurhayati, 22, a nursing student who broke down and cried at the recollection.
Their despair turned into joy when she regained consciousness 20 days after chemotherapy was administered.
Ms Dewi said: "I initially thought I wouldn't make it. But I'm glad that I did, and that the doctors and my family didn't give up."
dawnt@sph.com.sg