Rare cancer takes more aggressive form in Asians

When Ms Hilmy Chung suffered long bouts of diarrhoea, constipation, lethargy and bone pain in 2010, neither she nor her doctors could pin down the cause.

By the time her rare cancer was diagnosed the following year, it had spread to other parts of her body.

Experts have found that her disease – gastroenteropancreatic neuroendocrine tumours (GEP NET) – takes a more aggressive form in Asians than in people elsewhere in the world.

The new data from the GEP NET Registry suggests that Asians may require closer monitoring and more intensive treatment for this hard-to-detect cancer, which arises from cells of the hormonal and nervous systems.

More than half of GEP NET cases showed up in the pancreas for Asians. For non-Asians, only 30 per cent had tumours in the same organ, the registry found.

Although the disease can crop up in the stomach, small and large intestines and appendix, it is more threatening when located in the pancreas, said oncologist Lim Hwee Yong of the National Cancer Centre Singapore.

He said people with neuroendocrine tumours of the pancreas who do not have treatment are given about 27 months to live. When the tumour is in the intestinal area, the figure is about 70 to 80 months without treatment.

The GEP NET database has enrolled 252 ethnic Asians – including Singaporeans – and another 356 from other regions since it started in 2009.

The ongoing project aims to fill a gap in knowledge of neuroendocrine tumours. Dr Lim, who presented the findings on the existing pool of patients last June, said Asian patients should be “observed more closely” and have more scans, given that they are prone to the deadlier pancreatic form of the cancer.

“Overall, treatment should be more aggressive, including chemotherapy,” said Dr Lim, adding that more data must be collected before a firmer conclusion can be made.

In Singapore, the disease is said to affect five to seven people out of every 100,000.

Dr Lim stressed the importance of public awareness, especially since the symptoms can be vague. These include abdominal pain, weight loss and diarrhoea – so the disease can be mistaken for other minor ailments.

Ms Chung, 41, was once suspected of having dengue fever. Recalling an episode of “paralysing” bone pain that prompted her to seek specialist care in early 2011, she said: “Anyone would think that I was exaggerating.”

But her cancer went undiscovered until June that year when she went to Tan Tock Seng Hospital after symptoms intensified – including bleeding in her stools.

Ms Chung, who quit her investment banking job during this “harrowing” period, fell into depression and resorted to popping Panadol pills and laxatives before undergoing seven months of chemotherapy.

Her cancer is now very advanced at stage four, and she is managing it “like a chronic illness” with medication. Yet, she is considering getting a job.

Ms Chung hopes the public can become more aware of the disease, urging: “Pay attention to your health. Don’t take it for granted – that was what happened to me.”

SOurce: The Straits Times

Category: Health alert