Sunday, November 11, 2012

Singapore - Kidney cancer: A rising trend in a fast-ageing Singapore

SINGAPORE - Kidney cancer has now entered the list of top ten of cancers among males in Singapore for the first time.

There's been a prominent rise in the number of cases in the last ten years.

From 1993 to 1997, there were 60 to 70 cases of kidney cancer a year in Singapore. From 2006 to 2010, the number has gone up to an alarming 160 to 200 cases a year.

According to Dr Tay Miah Hiang, Consultant Medical Oncologist of OncoCare Cancer Centre, the rise could be attributed to Singapore’s ageing population.

In addition, as Singapore develops economically and becomes more westernised, it is seeing higher rates of smoking and a growing obesity problem.

These are well-known risk factors for cancer and contributes to the rising number of kidney cancer cases, he told YourHealth.

Of these, renal cell carcinoma (RCC) is the most common type of kidney cancer in adults, accounting for 85 per cent of all kidney cancer cases.

RCC is a type of kidney cancer that starts in the lining of very small tubes in the kidney, and is known to be highly resistant to radiotherapy and chemotherapy.

About 20 per cent of patients at present are in the advanced stage, where patients generally face a poor prognosis and survival rates are low.

Advanced kidney cancer is curable if it is detected at early stage and it can be removed via surgery in its entirety. Even if it reaches the later stages where the disease is no longer curable, it is treatable and life expectancy can be prolonged.

Am I at risk?

According to the National Cancer Registry, it has a peak incidence at 60 to 70 years of age, with men one and a half times as likely to develop the cancer as women.

"The group of people that are classified to be in the high risk zone includes chronic smokers, or those who have high blood pressure or have under gone long-term dialysis," said Dr Tay.

Other risk factors include smoking and those whose families have had a history of genetic syndromes.

What are the symptoms?

Dr Tay said that Singaporeans are generally not aware of the prevalency of kidney cancer, and one of the main reasons is because renal cancers are not easily detectable through physical examinations until the later stages.

In addition, the symptoms of RCC are generally non-specific.

They can include fatigue, weight loss, anaemia, pain, mass on the side or lower back and blood in the urine.
The good news is that with the new treatment options available today, patients are able to maintain their quality of life and live their lives to the fullest without being crippled by dehibilitating side effetcs.

Dr Tay explained that there is a new targeted therapy for RCC used as a first-line treatment option to inhibit the key protein (tyrosine kinases) involved in tumour growth.

The latest drug in this class is Pazopanib. This treatment helps prevent the formation of new blood vessels by blocking the growth of kidney cancer tumours, which depend on blood vessels to survive, he said.

In doing so, it prevents cancer progression and the spread of cancer cells.

It's used to treat cases of advanced RCC and for patients who have received prior cytokine therapy for advanced disease.

Unlike earlier treatment options which have severe side effects such as mucositis/stomatitis (inflammation of the mouth) and fatigue, this option offers a low incidence of side effects, thus improving the overall quality of life.

Ultimately, living a healthy lifestyle and having a nutritious diet is the most effective way to minimise all forms of diseases, including cancer.

Dr Tay said that for example, it's been proven that simple lifestyle changes like avoiding carcinogenic foods as well and cutting down smoking can reduce a person's risk of cancer.

For the rest of Singapore’s ageing population who remain at risk, early diagnosis is advised.

Kei Yamada

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