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Over 25,000 deaths in Singapore due to this!

We are of course talking about cancer.

Despite improving survival rates, cancer remains the single biggest cause of death in Singapore and the numbers are really quite shocking!

25,731 people died from cancer in Singapore from 2010 to 2014 and presently the rate is about 15 deaths per day due to cancer.

Approximately 39 people are diagnosed with cancer daily and one in four of us may develop cancer in our lifetimes!

Cancer is basically when our cells start to go out of control, often for reasons unknown, multiplying and growing abnormally, destroying surrounding tissue and spreading to other body parts, causing destruction there too! It’s like a devastating plague within our bodies!

Patients often experience unexpected weight loss, as the cancer eats away at your calories to grow and spread, leaving the rest of you to waste away, until you die!

Now it’s not all doom and gloom, cancer treatments are always improving and becoming more accessible but early diagnosis and treatment are needed for the best outcomes.

We’re going to give you a rundown of some of the symptoms associated with the most common cancers, to help you stay one step ahead of these killers!

The most common cancers are slightly different for men and women.

Top Cancers Amongst Women:

1. Breast Cancer – 29.2%

2. Colorectal Cancer – 13.3%

3. Lung Cancer – 7.6%

Top Cancers Amongst Men:

1. Colorectal Cancer – 17.1%

2. Lung Cancer – 15.1%

3. Prostate Cancer – 12.4%

Breast Cancer

This is the most common cancer amongst Singaporean women and the chances of developing this cancer increases with age, especially if you are 50 years old or more and have a mother, sister or daughter that’s had breast cancer.

There are some common misconceptions about breast cancer that women should be aware of. Although breast cancer has a hereditary component, often there is actually no family history and having large breasts, using deodorant sprays, wearing bras or having a breast injury does not increase breast cancer risk.

Symptoms of breast cancer include:

· A painless breast lump

· Bleeding or unusual discharge from the nipple

· A persistent rash around the nipple

· A newly retracted or inverted nipple

· Certain skin changes on the breasts, such as dimpling, swelling and thickening.

If you have any of these symptoms, see your doctor urgently for a referral to see a breast surgeon.

Now don’t forget, in the early stages of breast cancer there may not be any symptoms and this is why monthly self-examination and screening is so important.

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Screening is done via a special type of x-ray called a mammogram and is recommended yearly for some women between the ages of 40-49 years and once every two years for women aged 50 years and above.

If you are under 40, please do not request your doctor send you for a mammogram as breast tissue in younger women is denser meaning mammograms are not accurate.

Remember, a mammogram is a screening test for women with no symptoms.

If you have discovered a lump or develop any of the symptoms listed above, you don’t need a mammogram, you need to see a specialist who will perform more advanced investigations such as an ultrasound scan and fine needle aspiration.

Nine out of ten breast lumps actually turn out to be non-cancerous, as are most breast lumps in women under the age of 30, so don’t immediately worry if you discover a lump but do see your doctor to discuss further.

Having breast cancer is not a terminal diagnosis and does not guarantee that you will need to have a mastectomy (breast removal).

Certain breast cancers, if detected early, can be treated with non-surgical measures such as radiotherapy, chemotherapy and hormonal treatments.

Survival from breast cancer in Singapore is improving - thanks to the increased awareness of Singaporean women, early detection of cancer and in turn early treatment.

Be healthy, exercise, eat plenty of fruit and vegetables, limit your alcohol intake and finally be breast aware to give yourself the best chance you can.*

Colorectal Cancer

This is the number one cancer in Singapore, affecting over 1200 people every year.

Again, the cancer is seen more commonly in those over 50 years of age and where there is a family history of colorectal cancer.

Smoking is also a known risk factor.

Symptoms of colorectal cancer include:

· New onset frequent diarrhoea or constipation, medically referred to as a change in bowel habit.

· Passing blood in your stools.

· Frequent abdominal pains, gas or bloating.

· Unexpected weight loss.

If you have any of these symptoms, see your doctor urgently for investigations or referral to see a colorectal surgeon.

Again, in the early stages of the disease, there may be no symptoms.

Screening for low risk patients who have no symptoms, begins at 50 years of age with annual stool tests to check for microscopic traces of blood that ooze out of tumours into the colon but are not visible to the naked eye.

Lung Cancer

There are quite a few different types of lung cancer and of course smoking is a significant risk factor, however, it’s not the only risk factor.

Exposure to certain chemicals such as asbestos (previously used in housing in some parts of the world), arsenic, chromium, nickel, tar and soot, are all risk factors.

Family history can also be a significant factor.

In terms of smoking, women who smoke the same amount as men, have a higher risk of developing lung cancer and don’t forget, secondhand smoke is a significant risk factor too!

Symptoms of lung cancer include:

· Persistent cough.

· Coughing up blood.

· Breathlessness.

· Occasionally chest pains, wheezing and hoarseness.

· Unexpected weight loss.

If you have any of these symptoms, see your doctor urgently for a chest x-ray and maybe an urgent referral to see a specialist.

Again, in the early stages, there may be no symptoms.


Prostate Cancer

The prostate gland is a small gland men have just below the bladder and is considered part of the male reproductive system.

The cause is not clear and appears to be multi-factorial.

Like many cancers, the risk of developing prostate cancer increases after 50 years of age and if there is significant family history.

Being part of the male reproductive system, there is emerging evidence that men who ejaculate more frequently have a lower risk of developing prostate cancer.

Symptoms of prostate cancer include:

· Passing urine frequently, especially in the nighttime.

· Difficulty passing urine, weak flow or slow speed of urine flow.

· Pains or burning feeling on passing urine.

· Blood or semen in your urine.

· Bone pains.

· Loss of appetite.

· Unexpected weight loss.

Some of these symptoms may be due to a simple urinary tract infection (UTI) or Benign Prostatic Hyperplasia (BPH), this is the natural enlargement of the prostate gland as men get older. So if you have any of these symptoms, don’t immediately fear the worst! See your doctor urgently to discuss further for investigation or referral to a Urology Specialist as necessary.

As always, in the early stages there may be no symptoms.

Unexpected Weight Loss

As you will have no doubt seen, the symptom of unexpected weight loss has appeared a number of times above.

Unfortunately, we often get calls from patients and families who attribute weight loss to things like ageing! They will say their mother or father is losing weight but proclaim it’s okay because it’s due to ageing!

Sorry folks, it’s not okay!

Unexpected weight loss is more often than not a sign of something serious like cancer and if you ignore it and just say it’s due to ageing, well you might be throwing away the opportunity to treat it!

It is not normal for a healthy person to start losing weight for no reason, no matter how old they are!

If you’re worried about the treatments and suffering, let us tell you, no cancer treatment causes as much suffering and misery as untreated cancer itself.

We’ve seen patients in their 60s and 70s, who we would consider still very young, suffering strokes, cancers and other illnesses but no medical attention was sought, often as the family thought it was just a normal part of ageing that their loved one can no longer speak, move their arm, remember things or have loss of appetite and are losing weight unexpectedly!

Anytime you see unexpected weight loss, it’s worrying! See your doctor ASAP to discuss further!

We see patients in their 90s who are more physically active and on the ball mentally than many of us in our 20s and 30s!

Don’t ‘anyhow’ attribute things to age, please!

We hope this post was a useful eye opener.

Cancer is a significant cause of suffering but with a little knowledge and attention, you might be able to pick up the cues to detect it and treat it early!

Stay safe and healthy, friends.

Kindest regards,

Dr. Bobby Stryker

*Certain portions of this post are repeated from Dr. Bobby Stryker’s guest post on

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