Wednesday, March 30, 2011
I am back. I mean we are back. The National Cancer Society Malaysia (NCSM) will be back with their annual Relay for Life(RFL) event. This year will see Melaka and Penang having their own relays as well. Keep our dates free.
RFL Kuala Lumpur is scheduled for 16 - 17 July 2011, Melaka on 4-5 June 2011 and Penang on 1 and 2 October 2011. All venues will be announced shortly. Get your teams ready and celebrate life with us. See you all wearing our delightful Ts.
Light a luminance for your love ones or a friend lost.
Tuesday, March 29, 2011
Dr Murali Sundram
I attended Dr Murali Sundram’s talk on 26 March 2011 at the National Cancer Society on Treatments for prostrate cancer and its complications. About 30 participants attended this frank and informative talk about the men’s only disease.
Prostrate cancer is luckily a slow growing disease, but unfortunately there are no obvious symptoms whilst it is growing inside us. It is very prominent with the Afro-blacks in the USA. And Japanese are apparently are the lowest with Prostrate cancer. The main causes for prostrate cancer are the genes in us and the environment.
Prostrate cancer also has an excellent tumour marker in the PSA (Prostrate Specific Antigen) readings. Whilst the PSA is not an absolute marker for the disease, it is significantly important to indicate the possibility of prostrate cancer, hence a biopsy is normally followed up to confirm malignancy or otherwise.
Good PSA readings vary from under 2.5 in the USA to under 5 in Europe to under 4 in Malaysia.
The three important indicators and status of the disease are the PSA reading, the stage of the cancer tumour and the Gleason’s grading. The combination of the three matrix will determine the prognosis of the patient. Generally PSA readings under 4 are good, Cancer stages under T2 are good and the Gleason grades under 4 are good. Life expectancy for majority of men with prostrate cancer is about 13.5 years. Life expectancy and prognosis are generally dependant on the patient’s age, health, fitness and lifestyle.
There are 4 type of conventional medical treatments, namely surgery, radiotherapy, chemotherapy and hormonal therapy. An active watching/surveillance (Do nothing yet) may be good for the patients in certain cases. There are also many adjunct therapies in support of the main therapies. Hormone and chemo therapies are used mostly in stage 4 cancers to control metastasis. Prostrate cancer cells generally spread to the bones if not treated early. Radiotherapy is an end game treatment whereby the patient cannot do surgery as follow up treatment.
There is always a chance of PSA recurrence in 27 to 53% of prostrate cancer patients. PSA recurrence will lead to prostrate cancer spreading within the time span of about 8 years. PSA recurrence normally starts about 2 years after surgery. And life expectancy after cancer spreading is about 5 until imminent death of the patient. We are also to note there are more prostrate cancer patients dying from other causes other that cancer, particularly from heart diseases.
There are also several new drugs for prostrate cancer namely Ketoconozole plus hydrocortisone, Provenge and Abiraterone. However these new drugs can only prolong life expectancy for very short periods only, some for only 4 months or so.
PSA doubling time is also an important indicator to recurrence of cancer and it’s spreading. PSA doubling time in more than a year is good. Prostrate cancer patients can google for the prostrate cancer prediction tool to know their possibilities of cancer recurrence and also for secondary treatments post castrate resistance disease.
As for diets for prostrate cancer patients, it is best to look for evidence based foods, nutrients and supplements. Unfortunately there are no such diets today. However eating anything well for the heart should be good for the prostrate.
A final advice for patient’s whose PSA is on the recurrence, is not to do anything hastily, as there is adequate time for the correct type of treatments.
Stay healthy and take care.
Dr Murali Sundran is the present Consultant Urologist and Head of department Hospital Kuala Lumpur.
Friday, March 25, 2011
Me and Afiq
I visited Afiq in HUKM yesterday. He was during his scheduled chemo cycle. I am pleased that Afiq has responded very well to his treatments in HUKM. Most importantly Afiq is eating well throughout his treatment session. He has also gained some weight.
Afiq had checked into the ward the previous night for his day care treatment. He was sleeping soundly when I visited him at 10.00am yesterday. I managed to speak to Afiq’s parents for awhile. When Afiq woke up he was immediately cheerful when he saw me. We high- fived and exchanged tons of smiles. Inspite of his cheerfulness Afiq was initially somewhat shy. I am not sure of the reason but with a bit of cheering he soon warmed up and responded well to my queries about his health and activities. We had nasi lemak banana leaf for mid morning breakfast.
Treatment for Leukemia is a long haul task. I am pleased that the Oncology Pediatric Ward HUKM is almost empty. This hopefully means that most of the kids warded before have been discharged and are happily on the road to full recovery. Thanks for the dedicated doctors and staff of HUKM.
Wednesday, March 9, 2011
I had actually wanted to write this post for some time. Insurance cover is indeed very important and essential, particularly in the escalation of costs, and cost of living. Typical medical / health cover in insurance may not be sufficient now, in times when a person is down with some form of critical illness.
Whilst medical and health covers pays most of your hospitalization and treatments per hospital billings, insurance for critical illness actually pays you directly the full sum insured. This is all fine, but then there is a real downside to insurance for critical illness. The policy is very specific and well defined in the small prints. The cue now is that who reads the small print?
I have being reading into insurance for critical illness and also had spoken to several insurance agents about it. My conclusion is that whilst it is good and essential we must always take time to read the small prints and clauses therein.
I quote Malaysia Insurance Portal giving ten reasons for taking up insurance for critical illness:
1 A lump sum CASH payment will be payable.
2 Able to seek immediate treatment in any hospital of your choice.
3 Pay for prescription drugs or treatment not covered by government or private plans.
4 Family able to maintain current standard of living
(care for your aging parents, children education and your love ones)
5 Protect your mortgages or settle all your loans.
(Most MRTA policies do not cover critical illnesses)
6 Extra home nursing care during recovery stage.
(minimise the burden on your family members)
7 Premium starts from RM 100 a month for a RM 240,000 protection.
(depending on your age, gender and health condition)
8 Cash back .
(total cash back value is subject to age and insurer's performance)
9 Many people are diagnosed with Critical Illnesses each year.
(thanks to medical advances, many survive). But don't let the medical cost be a burden.
10 Peace of mind.
First and foremost we must know and understand the definitions of the standard critical illnesses. They include: (and I specifically highlight definitions into cancers)
1. Heart Attack.
3. Coronary Artery Disease Requiring Surgery.
Cancer is defined as the uncontrollable growth and spread of malignant cells and the invasion and destruction of normal tissue for which major interventionist treatment or surgery (excluding endoscopic procedures alone) is considered necessary. The cancer must be confirmed by histological evidence of malignancy.
The following conditions are excluded:- (a) Carcinoma in situ including of the cervix (b) Ductal Carcinoma in situ of the breast (c) Papillary Carcinoma of the bladder and Stage 1 Prostate Cancer (d) All skin cancers except malignant melanoma (e) Stage I Hodgkinâ’s disease (f) Tumors manifesting as complications of Acquired Immune Deficiency Syndrome.
5. Kidney Failure.
6. Fulminant Viral Hepatitis.
7. Major Organ Transplant.
8. Paralysis / Paraplegia.
9. Multiple Sclerosis.
10. Primary Pulmonary Arterial Hypertension.
12. Heart Valve Replacement.
13. Loss Of Hearing / Deafness.
14. Surgery To Aorta.
15. Loss of Speech.
16. Alzheimerâ’s Disease / Irreversible Organic Degenerative Brain Disorders.
17. Major Burns.
19. Terminal Illness.
The Life Assured must be suffering from a condition, which in the opinion of an appropriate Medical Practitioner is highly likely to lead to death within 12 months. The Life Assured must no longer be receiving active treatment other than that for pain relief.
20. Motor Neurone Disease.
21. AIDS Due To Blood Transfusion.
22. Parkinsona’s Disease.
23. Chronic Liver Disease.
24. Chronic Lung Disease.
25. Major Head Trauma.
26. Aplastic Anaemia
27. Muscular Dystrophy.
28. Benign Brain Tumor.
A life-threatening, non-cancerous tumor in the brain giving rise to characteristic signs of increased intra-cranial pressure such as papilloedema, mental symptoms, seizures and sensory impairment. The presence of the underlying tumor must be confirmed by imaging studies such as CT Scan or MRI. Cysts, granulomas, malformations in or of the arteries or veins of the brain, haematomas, tumors in the pituitary gland or spine and tumors of the acoustic nerve are excluded.
31. Brain Surgery.
32. Bacterial Meningitis.
33. Other Serious Coronary Artery Disease.
34. Apallic Syndrome.
35. AIDS Cover of Medical Staff.
36. Full Blown AIDS.
I herewith include extracts of some typical small prints.
A. There will be no coverage for:
2. Critical Illness
i) disease (s) resulting from acquired Immuno Deficiency Syndrome (AIDS), AIDS – related complex or infection by Human Immuno Deficiency Virus (HIV) unless the condition of the disease or infection arose as a result of blood transfusion in accordance with the critical illness definitions of the policy.
ii) Pre – existing Illness which existed before the Policy Date of Reinstatement of the policy, where pre – existed Illness shall mean disabilities that the Life Insured has reasonable knowledge of. A Life Insured may be considered to have reasonable knowledge of a pre – existing condition where the condition is one for which:-
1. The Life Insured had received or is receiving treatment; or
2. Medical advice, diagnosis, care or treatment has been recommended; or
3. Clear and distinct symptoms are or were evident; or
4. Its existence would have been apparent to a reasonable person in the circumstances.
iii)Angioplasty, cancer, coronary artherectomy, heart attack, other serious coronary artery disease and/or surgery for coronary arterial disease occurring within sixty (60) days after the Policy Date or Date of Reinstatement of the Policy.
iv) Diseases other than those specified in 2 (iii) above occurring within thirty (30) days after the Policy Date of Reinstatement of the Policy.
v) Critical Illness claim/s resulting directly or indirectly from any Congenital Conditions for lives with age of entry of two (2) years or less where such disorder is known to the Policy Owner. Congenital Conditions shall mean any medical or physical abnormalities existing at the time of birth as well as neo – natal physical abnormalities developing within 6 months from the time of birth. They will include hernias of all types and epilepsy except when caused by a trauma which occurred after the date that the insured was continuously covered under this Policy.
vi) Critical Illness resulting from all or any self – inflicted injury while sane or insane.
C. Sum Insured for child below the age of four (4) years is reduced upon death, TPD or diagnosis of any of the Critical Illness or actual undergoing of Surgery covered by this policy of the child. The sum insured payable will be according to a scheduled table.
Friday, March 4, 2011
NCSM’s Empowerment Programme has organized a talk on prostrate cancer treatments and its complications, by Dr Murali Sundram, Head of the Urulogy Department HKL on Saturday 26 March 2011from 12.00 to 2 pm in NCSM’s premise. All cancer patients and care givers are cordially invited. Light lunch will be served.
I would personally recommend all gentlemen above 45 years old, irrespective of whether they are cancer patients or not, to attend this important talk. Prostrate cancer strikes silently and without any direct symptoms to the disease. I was perfectly healthy, fit and normal except for symptoms of a normal enlarged prostrate, that I was diagnosed with prostrate cancer at stage three local advanced. I was lucky that I was just in time, as early treatment is the key to good prognosis. Be wiser than me, know your prostrate as early as possible.
Do call up for a reservation for the limited seats. Call Adeline at 0326987300.
Thank you NCSM for the talk.