Stage 4 Lung Cancer: Targeted therapy & Immunotherapy. Which to Start?

Not all lung cancers are of the same type, stage or treated similarly. In a nutshell... A. Targeted therapy For stage 4 lung adenocarcinoma (subset of NSCLC), further testing of EFGR and EML4-ALK mutation are routinely done in Malaysia. ROS1 rearranged mutation driver testing is not routinely done although targetable treatment is available. Those with …

Achieving Cure in Breast Cancer with Adjuvant Chemotherapy

Mrs Y, 38, was recently diagnosed with left breast cancer and she underwent left mastectomy and axillary clearance 3 weeks ago. HPE report: Infiltrating ductal cancer, grade 3, pT3N0M0 (stage 2), ER negative, HER2 negative, LVI positive, margin clear. She was planned for adjuvant chemotherapy and radiotherapy to left chest wall. Introduction Mrs Y wanted …

Head & Neck Cancer (HNC): Curative Treatment with Radiotherapy and Chemotherapy

A pleasant lady, 53 years old with long standing hypertension, presented with dysphagia symptom for 3 months duration. She was diagnosed with base of tongue SCC, T2N3M0. Multidisciplinary Team (MDT) Discussion Surgery or definitive concurrent chemo-radiotherapy (CRT)? Surgeon want to operate, I want definitive concurrent CRT (happened all the time during discussion) Rationale? With surgery, …

News: Chemotherapy Kill Cancer Patients. Not Cancer?

Points Across The study published in reputable The Lancet Oncology journal emphasised on proper selection of cancer patients for chemotherapy treatment, especially patients who are old or have poor performance status. importance of mortality review in order to improve clinical decision making (identifying patients who does not benefit or not suitable for chemotherapy treatment, eg. …

Living Longer: Advanced Breast Cancer (ABC) – HER2 over-expressed (1st line treatments)

Introduction HER2 over-expression constitutes around 20% of all breast cancer. Two different methods are being used to test for HER2 over-expression, immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH) Immunohistochemistry (IHC); identifies HER2 expression on the cell surface, with a grading system of 0 to 3+ positive. tumors are classed as HER2-positive if they have …