Having recently celebrated our 40th anniversary, Bangkok Hospital looks at the progress made in the fight against cancer in the past four decades.
In 2006, Bangkok Hospital established the first private cancer hospital in Thailand. Its name, bestowed by H.R.H. Princess Maha Chakri Sirindhorn, is Wattanosoth, which means ‘the hospital for advanced medicine’. Since then, through collaborative research with international institutions and multidisciplinary teams of specialized physicians, the hospital has utilized cutting-edge technologies to provide innovative treatment methods that have pioneered advanced cancer treatment in the country.
Progress, sometimes revolutionary progress, has been made in the fight against cancer since Bangkok Hospital first opened its doors:
- Today, two out of three patients live at least five years after their diagnosis, up from roughly one out of two in the 1970s.
- Today, highly tailored and more effective treatments target the genetics of each cancer, and each patient.
- Today, better ways of managing nausea and other side-effects are enabling patients to live better and more fulfilling lives.
- Today, five-year survival rates for breast cancer, testicular cancer and childhood leukemia are over 90%.
Treatment – 40 Years of Breakthroughs
- From: a limited understanding of how to target chemotherapy to each cancer type or how drugs can be combined most effectively, and side-effects that often require hospitalization.
- To: chemotherapy that is tailored to cancer type, stage, response to previous treatments, and often to specific subtype, with dozens of combinations proven to lengthen lives and shrink tumors, and treatment that is often given on an out-patient basis, with effective ways to manage side-effects.
- From: standard external beam radiation that destroys both cancer cells and nearby healthy tissue, with the potential for long-term health problems such as heart disease in some patients.
- To: highly targeted radiation that s tailored to a patient’s precise tumor type, size and location to minimize the risk of damage to healthy tissue as well as side-effects, and shorter courses of radiation for some cancer types.
- From: radical surgery that removes tumors as well as surrounding tissue and muscle, long hospital stays and severe cosmetic effects
- To: numerous conservative, less invasive surgical approaches, including breast conservation surgery and nerve-sparing prostatectomy to preserve sexual function and continence, as well as sophisticated reconstructive surgery options.
- From: none.
- To: the rapid development of treatments targeted to the unique genetics of the patient and the tumor, and more effective drugs, with fewer side effects, than standard therapies.
- From: none.
- To: an emerging field that examines agents that boost the immune system to attack cancer cells, and proven – or at least promising – immunotherapies developed for prostate cancer, melanoma, bladder cancer, lymphoma and others.
Quality of Life
- From: severe side-effects from cancer and its treatment, including pain, nausea and weakness that frequently require hospitalization, and few options available to relieve patient discomfort.
- To: effective supportive drugs to ease pain and nausea and boost white cell counts to reduce fatigue, allowing many patients to work and live otherwise normal lives, and the growing use of integrative approaches like supplements and exercise to improve patients’ sleep and energy, and minimize treatment side-effects.
Screening increases the chances of detecting certain cancers early, when they are most likely to be curable.
Fact: screening tests to detect cancers early allow patients to get more effective treatment with fewer side effects. Patients whose cancers are found early and treated in a timely manner are more likely to survive these cancers than are those whose cancers are not found until symptoms appear.
- Breast Cancer Screening
Regular mammograms, followed by timely treatment when breast cancer is diagnosed, can help reduce the chances of dying from breast cancer. For women between the ages of 50 and 69, there is strong evidence that screening lowers this risk by 30%, for women in their 40s, the risk can be reduced by about 17%, and for women aged 70 and older, mammography can still be helpful.
- Cervical Cancer Screening
Regular use of the Pap test followed by appropriate and timely treatment reduces deaths from cervical cancer. Women who have never been screened or who have not been screened in the past five years face a greater risk of developing invasive cervical cancer.
- Colorectal Cancer Screening
The fecal occult blood test (FOBT), done every one to two years using home test kits by people aged 50 to 80, can decrease the number of deaths due to colorectal cancer, and a regular sigmoidoscopy can reduce colorectal cancer deaths.
A Note on Prevention
Cancer can be caused by a variety of factors and may develop over a number of years, but some risk factors can be controlled.
Scientists estimate that as many as 50-75% of cancer deaths are caused by smoking, poor diet and physical inactivity. Smoking causes about 30% of all deaths from cancer, and avoiding tobacco use is the single most important step anybody can take to reduce the risk.
Other factors include weight, fruit and vegetable consumption, red meat and fat consumption, alcohol consumption and, yes, secondhand smoke.