Cancer survivorship programme shows promise
A standardised post treatment programme developed and implemented by researchers from NUS Pharmacy has eased breast cancersurvivors’ transition to normalcy in Singapore, a first for the country. The research was presented at the 2016 American Society of Clinical Oncology Annual Meeting in Chicago, US on 6 June.
Led by Associate Professor Alexandre Chan, the NUS research team consisted of Year 4 Pharmacy student Oh Suan Kai, PhD students Terence Ng and Tewodros Eyob Woldehaimanot, as well as Research Assistants Dr Maung Shwe and Ms Gan Yan Xiang. The team conducted the research with National Cancer Centre Singapore (NCCS) in collaboration with the Department of Psychosocial Oncology at NCCS.
Currently in Singapore, there is a lack of standardised multidisciplinary programmes to help cancer survivors, who had completed treatment, integrate back to their pre-cancer lives. High-risk patients, defined as those who had undergone chemotherapy, surgery and radiation, were also not taking part in the post-treatment initiatives provided by local hospitals. As a result, many breast cancer patients who have completed treatment continue to suffer from physical and psychological distress such as fatigue, cognitive impairment and other toxicities that are associated with their treatment. The US Institute of Medicine recommends routine post-cancer treatment care for all survivors, involving aspects such as fertility counselling, management of long-term physical effects, exercise and diet assessments, health and finance counselling, among others.
The team conducted a rigorously designed randomised controlled trial between August 2015 and January 2016 which offered a holistic multidisciplinary programme for close to 40 breast cancer survivors. Spanning three sessions, the comprehensive programme featured speakers and facilitators from various disciplines, such as dietetic, neuropsychology, medical social work, pharmacy, nursing, physiotherapy, and even a breast cancer survivor, who reinforced ideas of living well and coping with post-treatment worries. The researchers adapted the Institute’s recommendations to the local cultural context, with Assoc Prof Chan advising survivors on using medications and complementary and alternative medicines post-treatment, and the dietician fielding questions on whether local dishes such as char kway teow and chicken rice could be consumed.
The results from an analysis of 72 participants were encouraging. Assoc Prof Chan said, “After you enrol these people into the programme, you can observe a higher reduction of the symptoms than those who are in the control arm. And when we compare that, that is statistically significant.” Survivors from the intervention group also reported a drastic improvement in fatigue levels. In the area of psychological distress, the difference between the two groups was not statistically significant, but the trend indicated that the participants in the intervention group demonstrated a higher reduction of psychological distress.
Mdm Lily Lee, who was diagnosed with breast cancer in August 2014, participated in the structured programme in November 2015. She found that being able to connect with fellow cancer survivors was particularly beneficial.
Moving forward, the team will explore how the programme can be adapted for wider implementation, possibly through involving partners such as community pharmacists and general practitioners. More research with Asian-specific perspectives also need to be carried out, noted Assoc Prof Chan.
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