Answers to Cancer Symposium Questions

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Department Question Answer
Ear, Nose, Throat (ENT)  When a child has inflamed tonsils quite often, should he remove the tonsils?  The tonsils should be removed if the inflammed tonsil episodes is happening frequently (>4-5 times per year) and affecting the child's growth or causing them to miss school.
Ear, Nose, Throat (ENT)  What are the chances of thyroid or throat cancer resulting from inflamed tonsils? There is no relationship between the 2.
Ear, Nose, Throat (ENT)  Are the chances of thyroid cancer higher in people who suffer from hypothyroidism?  In general this is not true but specific conditions like Hashimoto's disease which can cause wither hyper or hypo thyroidism can be associated with higher risk of higher risk of thyroid lymphoma. 
Ear, Nose, Throat (ENT)  If a person with nose cancer has been treated and cured, is there a chance that the cancer can spread to other parts of the body like the liver, etc? It is still possible that after treatment of the nose cancer that the cancer cells that have already spread (though not detectable at the time of treatment) may manifest as cancer in other organs like the liver and bones. Generally the chance of this happening is low.
Ear, Nose, Throat (ENT)  If a person with allergic rhinitis constantly experiences blocked nose due to runny nose, backflow of mucus and saliva irritation in the throat or nose, does this increase his/her risk of getting cancer in the nose, tongue and throat? No, it does not.
Ear, Nose, Throat (ENT)  As mentioned in the presentation slides, a patient can live 5-10 years after treatment, but what about after that? What are the chances of survival subsequent to the 5-10 years? Once a person survives 5 years after treatment with no recurrence, he is unlikely to have further recurrence in general. However, exceptions can occur. We advise the patient to discuss with his/her doctor to decide on the best follow-up strategy.
Ear, Nose, Throat (ENT)  I enjoy eating my food hot and fast. Will this increase my risk of cancer in the tongue and thyroid? No, it does not.
Ear, Nose, Throat (ENT)  Does biopsy aggravate cancer or cause cancer? No, it does not.
Ear, Nose, Throat (ENT)  What are the chances of unknown causes of goiter after biopsy is done if it is not cancer? If the biopsy does not show cancer, it is likely that the nodule is benign and this may be part of a goitre, which has many thyroid nodules.
Ear, Nose, Throat (ENT)  Due to blockage of the lymph node, it will swell when  food is eaten hot/spicy or even when drinking water. Will it cause cancer in future and are there any ways to treat it? If a lump in the neck swells with food, it is possible this is a blocked salivary gland rather than a lymph node. This does not cause cancer. Please get your doctor to check this out.
Ear, Nose, Throat (ENT)  What is the risk of getting mouth/throat cancers with regular use of alcohol-based mouth washes? No risk.
Ear, Nose, Throat (ENT)  I usually wake up in the morning to find a white patch on my tongue. I am able to scrap the white patch off  with a  tongue scraper. Is this white patch related to thyroid/tongue cancer? If this can be scraped off it is not related to tongue cancer or thyroid cancer.
Ear, Nose, Throat (ENT)  Understand that betel nut is a common food carcinogen. Are there other food carcinogens that are commonly eaten/chewed in this region (besides tobacco)? Tobacco and betel nuts are the main ones we see in this region.
Ear, Nose, Throat (ENT)  Why are Cantonese more prone to contracting nasopharyx cancer? This is down to genetics, as well as possibly due to the food they consume (preserved food has higher chance of resulting in NPC).
General Surgery  I am a lung cancer patient. My recent cough seem to time in with the sharp pain that I experience on the right side of my body (i.e. from the back to the front of my breast). Is this pain brought about by the constant coughing or is this a sign that my cancer has worsened? Pain can be related to a number of factors in someone suffering from cancer. You should consult your doctor to help you determine the cause of this.
General Surgery  Is chemotherapy required after lobectomy? If yes, when is it best to start the treatment ? The need for chemotherapy after lobectomy is determined by a number of factors (size of tumour, spread to lypmh nodes for example). The best time to start treatment will be discussed between the surgeon and the oncologist as it is based on factors such as the patient's general health and recovery from surgery (lobectomy). 
General Surgery  If a family member has been diagnosed with lung cancer which is not related to smoking, what are the available screening tests for the patient's family members? Currently, there are no screening programs in Singapore for lung cancer. However, please discuss your concerns with your doctor who can advise you on this.
General Surgery  What types of cancers have a higher tendency to spread to the lungs in general? Almost any cancer can spread to the lungs. Cancers that commonly spread to the lung include colorectal cancer, breast cancer and prostate cancer.
General Surgery  What are the typical symptoms of secondary lung cancer? The typical symptoms of secondary lung cancer are similar to primary lung cancer. Some patients can develop cough, chest pain or shortness of breath. Some patients may have no symptoms and the secondary lung cancer is only detected during their follow up.
General Surgery  What are the chances of cancer arising from gastritis that is treated for Helicobacter Pylori? H pylori infection is found to be associated with gastric cancer and mucosa associated lymphoid tissue lymphoma (MALToma) in stomach.   Eradication of H pylori infection can significantly reduce the life long risk of H pylori associated gastric malignancy.  However patients with any upper gastrointestinal tract symptoms are still recommended to consult doctors for further evaluation even after successful eradication of H pylori infection.
General Surgery   I have experienced discomfort in the abdomen day and night and bloatedness for one year plus. There are times when I suffer from cramps and indigestion as well.  Why do we experience persistent bloatedness and burp often? Are these symptoms of colon or stomach cancer? Abdominal bloating is a common problem and is often related to dietary fibre. However if the symptoms are persistent, it would be advisable to be seen by a specialist and conduct further investigations.
General Surgery   I  have received the all clear when I underwent colonoscopy, and CT scan previously. However I am still experiencing bloatedness after meals and also constipation. May I know why? Bloatedness after meals can be caused by many things and is often related to the types of food and in particular the amount of fibre consumed. Constipation is often related to the amount of fibre in the diet as well as inadequate water consumption. In the situation where colonoscopy and CT scan have already been done and are normal, then that is reassuring but you should speak to your doctor as there may be other investigations that can be done to evaluate the constipation further.
General Surgery   Noted that reduction of cancer risk can be achieved by avoidance of postmenopausal weight. Please explain how so and if regular exercise would help? I am gaining post-menopausal weight and I am seeing a breast surgeon regularly for lumpy breasts ( next appointment scheduled at end Mar 2016).  With regard to breast cancer, we advice to avoid post menopausal weight gain. The reason is that our fat tissue is responsible for the production of estrogen (female sex hormone) after menopause. Since majority of breast cancers are stimulated by estrogen. lowering the estrogen level in the body will reduce the development of breast cancer. Exercise helps reduce breast cancer risk not only by reducing fat tissue but also by lowering the estrogen level in the body. It may also stimulate our immue system to defend against cancer.
General Surgery   Is fibrosis in the breast and womb a cause for concern? No.
General Surgery   Why is there swelling in the upper arm after a mastectomy? Mastectomy per se will not cause swelling of the arm or water retention (lymphedema). However, if the lymph nodes in the underarm area are also removed then it interrupts the flow of lymph fluid from the arm to the body and this may therefore result in water retention in the arm.
General Surgery   What is the likelihood that a breast cancer patient's children may contract breast cancer? Hereditary breast cancer is not common - occuring in 10% of all breast cancer. The risk depends on the age of onset of the family member (younger than 40 years old more risk), closeness of family member (ie mother, grandmother, sister), multiple occurences of breast/ovarian cancer in the family or in  one member. Whilst the most accurate way is to go for gene testing for BRCA gene, only women with the above mentioned family history need to consider gene testing.
General Surgery   Can a male get breast cancer? Yes, male:female is 1:100.
General Surgery   Is duck meat red or white meat? White.
General Surgery   I have some friends who have got lumps in their breasts but they are not malignant in nature. Does occasional bleeding from the nipple constitute a symptom of cancer? Lumps in the breast are common and majority are not cancerous. Bleeding from the nipple may be due to benign growths, infection and sometimes breast cancer. It is best to get it checked  by a doctor.
General Surgery  What happens to a newborn baby who is breastfed by her mum, who might have breast cancer without realising it? No issues as cancer is not spread through ingestion.
Neurosurgery  Is it true that a brain cancer patient cannot live longer than 5 years?  The term ‘brain cancer’ is very broad, and encompasses a large number of tumour types. Brain tumours can be caused by overgrowth of the cells that are part of the brain and, or skull; or cells from other parts of the body that get deposited in the brain as part of a disease process. The prognosis of each brain tumour depends on firstly, the type of cells that make up the growth; and next, how extensive the disease has spread to other body parts. In addition, it also depends on how responsive the brain tumour is to treatment, which can be in the form of surgery, chemotherapy, radiation, or a combination of such modalities. Some brain tumours have very good prognosis and affected patients go on to lead normal lives after treatment. However, there are others that are very aggressive and may cause the patient to have a poorer prognosis.
Neurosurgery  How does an individual know if he has a tumour in the brain? Symptoms and signs of brain tumours may be very vague. They may present as persistent headaches, memory loss or non-specific nausea and, or vomiting episodes. If the brain tumour is large enough, it may cause stroke-like symptoms such as limb weakness, speech difficulties or drowsiness. If there are worrying, persistent symptoms to an individual, he or she should seek advice from a doctor who may recommend a brain scan to exclude a brain pathology. Currently, the best modality for brain tumour imaging is an MRI scan of the brain.