Screening & Prevention is Better Than Cure
Recent Radio Interview with Gold 90.5fm, DJ Jamie Yeo on Gastroscopy and Cancer Genomic by Dr Melvin Look.
[Part 1] – What is Gastroscopy
Jamie: In Asked the Expert for this week is Dr. Melvin Look from PanAsia Surgery Singapore at Mount Elizabeth Novena. Hi Dr. Look. I feel very close to Dr. Look because I just went to him for a gastroscopy. So this doctor has seen my insides like I never have, and in fact, I’ve pictures and shown to my daughter, you know she was like “eeee~”. But Dr. Look why did you persuade me to go for a gastroscopy? Tell us what exactly a gastroscopy is.
Dr. Look: It’s one of the best way to examine the stomach, the esophagus, and the duodenum which is the first part of the small intestine. There are two reasons why we do gastroscopy: one is to have an accurate diagnosis of people with symptoms and the other is to do screening; screening for cancer and also for precancerous changes in the stomach.
Jamie: So we’re talking about stomach cancer of course and Dr. Look, stomach cancers are quite prevalent among Asian people right. Why is that so?
Dr. Look: It’s far more prevalent in Asians than in among Caucasians. We don’t really know the reason why. It is partly genetic and also partly lifestyle – the diet we eat. Also these bacteria in the stomach which is very common in Asia especially Southeast Asia. These bacteria are called Helicobacter pylori, it’s something that stays in the stomach chronically; it causes chronic inflammation in the stomach.
Jamie: So that’s kind of bacteria that can cause cancer?
Dr. Look: Yes, it is actually the only bacteria known to cause cancer in men. So it’s a type one carcinogen. It’s directly related to stomach cancer. It causes the stomach to undergo transformation which can lead to stomach cancer.
Jamie: So when you perform a gastroscopy, you are essentially looking out for this certain bacteria as well. In my case, you didn’t find any but what if you had found these kind of bacteria?
Dr. Look: When we do the scope, there are three things that we look for. Firstly, any pathology, anything abnormal. Secondly, we do biopsies to look for any precancerous transformations that we cannot detect by the naked eye. And thirdly we look for these bacteria. These bacteria were found; we can eradicate it easily with a short course of antibiotics. The thing about Helicobacter pylori is particularly common in Asia and it can be passed from person to person because we like to share food and sometimes standards of hygiene in Asia are not so good especially food that are badly prepared: vegetables, raw and not properly cooked, also human fertiliser.
Jamie: Well I’m glad my stomach is free of that certain bacteria. You know I was a bit nervous before I went in for my gastroscopy because I’m not forty yet. So I haven’t done any of these screenings just yet and it took me a while to actually say yes to this test. I’m going to come back again and talk about the process. It was actually really simple. So for those of you who have never gone for any screenings like a gastroscopy or colonoscopy, maybe we can talk about that in just a bit. Once again Dr. Melvin Look is our expert today on Ask the Expert, he’s from PanAsia Surgery Singapore. We will be back for more.
[Part 2] – The Gastroscopy Procedures
Jamie: We’ve been speaking to Dr. Melvin Look from PanAsia Surgery Singapore at Mt Elizabeth Novena. Dr. Look and I were just talking about screenings we can do to prevent major illnesses and why wait till we catch something or have something. You’re right, let’s try to prevent it. I totally believe prevention is better than cure. We have been talking about gastroscopy just little while ago in the first part of Ask the Expert. I mentioned that I was persuaded to do it. Dr. Look, firstly gastroscopy is the screening of the stomach and we’re talking about the bacteria as well – the Helicobacter pylori. The screening actually catches these bacteria and then when it’s found, we just take medication right?
Dr. Look: Yes, if you take medication to eradicate the bacteria, most patients, 90% of them will be eradicated with a single course of medication. But these bacteria, besides living in the stomach, it can cause symptoms. So people that recurrent, we called dyspepsia which similar to gastric pain or discomfort; it can be due to these bacteria. And also eradicating these bacteria can reduce your risk of getting stomach cancer. I strongly recommend that you’re checked for these bacteria and also to do an endoscopy or gastroscopy to look for precancerous changes. Because if you do have the precancerous changes then we will want to put you on the surveillance program to detect any early cancer which can be treated with the endoscope that means we can actually remove it with a scope without you having to undergo major surgery.
Jamie: I was saying earlier I was actually quite nervous about going for this test screening because you need to be sedated and then you get to insert the camera down to your throat but I have to say it’s actually very easy.
Dr. Look: Tell us what you remember about it.
Jamie: I remember right before the screening, you came in and say “hey don’t worry about it…”. The nurse spray something on my throat. I guess to numb my throat. And then they you know had like an I.V. line through my veins to administer the Dormicum.
Dr. Look: We gave you a little shot which is not a general anesthetic, it’s just sedation similar to sleeping tablet that we inject in to let you sleep very fast, awake very fast and you remember nothing about it.
Jamie: I do remember nothing because apparently after everything, Dr. Look came in to tell me about my appointment and I don’t remember at all.
Dr. Look: Some people are awake in the period that you know you are awake and you’re conscious but when you go home, you’re totally forget. So that’s the best thing about doing this procedure because it’s done as a day surgery. You can just come in the morning; you’d have no unpleasant memory about it, that’s really great right?
Jamie: And it didn’t hurt. It’s not like when I woke up, my throat felt sore or anything, no pain, no tenderness.
Dr. Look: It’s a very gentle, simple and a very safe examination.
Jamie: And it’s also not expensive. Everything was less than a thousand dollars which I think is a good price to pay if you’re looking to prevent a major illness like stomach cancer. There you go, if you have a stomach cancer running in your family, it is something that you should definitely do. Prevention is better than cure, that’s what we’re here to preach today. Our expert today is Dr. Melvin Look from PanAsia Surgery Singapore. Would come back with something that’s very interesting that you could also take if you’re worried about cancer in general in the meantime though Ask the Expert on Radio Gold.
[Part 3] – Cancer Genomics
Jamie: Our guest today is Dr. Melvin Look from PanAsia Surgery Singapore and we have been talking about what we can do to prevent major illnesses. Namely stomach cancer because we were talking about gastroscopy – the screening of our stomach. But we’ve done with that. So, Dr. Look there is something that’s quite futuristic that’s only come about in the last five years. It’s very interesting. Tell us about it.
Dr. Look: OK. When we say screening, we usually looking for precancerous or early cancer. But if you have a very strong family history of cancer and you want to know your risk of cancer, we can now actually do a genomic test for you to see whether you are at risk of developing these cancers. Looking at the D.N.A. , we look for all the known cancer genes that can be inherited from your family. So this test is not for everyone. It is for people with a strong family history of cancer, particularly cancers of the same type, cancers occurring in young relatives or cancers that are quite unusual. So this will sort of instigate us to wonder whether there’s a cancer family gene that runs within your relatives and you.
Jamie: So for example if you had a cousin who stage two breast cancer at age 40. It’s something that you might want to take up?
Dr. Look: If you just have one family member with cancer and that might be what we call the usual kind of sporadic cancer which is just by genetic accident or bad luck. But if more than one case with and within your family you might want to wonder whether there is actually a cancer family gene that runs.
Jamie: So this cancer genomics has a test for more than one cancer?
Dr. Look: It’s a simple blood test, you can go to the clinic. There are different panels. If you suspect, let’s say breast cancer syndrome in your family then we do a breast cancer panel or prostate panel or colon cancer panel. Or if there are funny type of cancers that we don’t really see a pattern, you might want to do the what we call the“whole package”. It probably cost a little bit more. You can actually detect 49 to 50 kinds of common inherited genes that can cause cancer. The good thing about knowing that you have this cancer family gene is like knowing that you have a time bomb. But at least you know where that time bomb is and we can look for that time bomb. We can survey the place with a time bomb and we can also do prophylactic treatments. For example, if you are or you have a very strong chance of having breast cancer with BRCA genes. Then you might want to consider a prophylactic surgery to remove the breasts.
Jamie: Like what Angelina Jolie did right? OK, very interesting stuff. So if you want to know more about cancer genomics testing. Dr. Melvin Look is the person to look to. He’s from PanAsia Surgery Singapore at Mount Elizabeth Novena. Thank you very much once again for coming on the show here.
Find out more about PanAsia’s Gastroscopy / Colonoscopy Services.