The best treatment for cancer is surgery to remove this completely. Unfortunately, in some patients this may not be possible for a number of reasons. The cancer may already have spread to distant organs and curative surgery is no longer beneficial. The tumour itself may be large and invading into surrounding organs. Or the patient may be too old or too unfit for major surgery. In all these patients, we try to offer some other treatment to relieve any symptoms due to the cancer. Such treatment may include chemotherapy, radiotherapy or endoscopic treatment. In general, the less invasive the treatment the better. Nevertheless, we may sometimes still require some sort of surgery if palliation by non-surgical means is inadequate or not possible.
Previously, most of these operations were done by conventional open surgery. For example, in patients with digestive cancers such as gastric cancer and pancreatic cancer, a long abdominal incision is required. Most patients tend to take a long time to recover after surgery due to the large incisions used. Fortunately, we can now perform these procedures by a keyhole technique called Laparoscopic Palliation for Cancer. Depending on the procedure required, 3 to 5 small incisions (2 mm to 12 mm in size) are used to insert the telescope and operating instruments into the abdominal cavity. The entire operation is done without the need for a large incision. Examples of palliative procedures we can perform this include laparoscopic stoma formation (to relieve obstructed bowel from cancer), laparoscopic palliation of pain (by a nerve block or division of the nerves conducting the pain), and laparoscopic bypass.
Cancers in the abdominal cavity can cause bowel obstruction if they are large and block the alimentary tract. Intestinal obstruction leads to abdominal distension, vomiting and inability to eat or retain food. If obstruction occurs and the cancer cannot be removed, we can offer good symptomatic relief by bypassing the obstruction surgically. For example, in gastric cancers and pancreatic cancers, the outlet of the stomach can become completely blocked. A Laparoscopic Bypass can be done to connect the healthy part of the stomach to the small intestine using a stapling device.
Most patients recover more quickly after Laparoscopic Palliation compared to conventional open surgery. There is less wound pain and the bowels return to function rapidly. For example, patients can generally start to drink and eat three days after a Laparoscopic Gastric Bypass for an obstructed stomach.
A quick post-op recovery also means that we can initiate other treatment faster. We need not delay chemotherapy and radiotherapy as we do not have to worry about healing from a long incision from conventional open surgery.
"I went for a colonoscopy, gastroscopy, and hemorrhoidectomy procedure with Dr Melvin Look. It was nerve wrecking for me to go under general anesthesia (GA) but Dr Look eased my fears with his calm and confident demeanour along with his funny disposition. Had a smooth and successful procedure with attentive pre- and post-op care from Dr Look who has been very patient with all my questions before and after the surgery!"
I met Dr Sam Peh in 2018 when I was admitted to parkway east hospital for acute unrinary retention . Subsequently in the same year I had TURP procedure .Some tissues from TURP was found to be cancerous . We just monitor the situation on 6 monthly psa reading In 2020 the psa reading spiked and am MRI scan shows 2 lesions in the prostate Dr. Peh give me the option to burn the 2 lesions using the HIFU technology. I’m glad to use HIFU as the downtime was like only a day. Dr Peh always explain the procedures to me using simple layman’s language and with drawings as illustrations. I feel safe and confident with Dr Peh as my urologist.
I was worried about my constant bloatedness , nauseous & poor appetite in eating . I was not eating well at all for 4 months. I decided to seek help from Dr Melvin Look and was scheduled very quickly for a scope - to give me a peace of mind. Nursing team was also assuring and patient with me when I had questions on insurance & costing . I was very well advised at every step of the way! Thank you Dr Look and to the nurses who attended to me at pan asia!