NEOPLASIA 1/2014

PG 39

F IF A W O R L D C U P 2 0 14 B R A Z IL MAKNA MOBILE BREAST SCREENING PROGRAMME 10 ODD THINGS TO SAY TO SOMEONE WITH BREAST CANCER PG 26 TALIAN BANTUAN BEBAS TOL KANSER MAKNA PG 33

PG 16

Content Issue 01/2014 page

06

page

08

page

16 page

33 page

13 01 From the President’s Desk News Happenings 02 Run to Survive 2014 03 #ShareYourStory / #ShareYourThoughts Video Campaign

04 MAKNA’S Commitment Towards Cancer Research 05 Engineers for MAKNA Run 2013 06 Cycle for Cancer, Colour for Cancer and Cook for Cancer!

Fundraising 07 MIX Gives Back With MAKNA Cover Story 08 World Cancer Day Volunteers 13 Terima Kasih MAKNA Feature Story 16 MAKNA Mobile Breast Screening Programme Research 20 Development of a Stool-based DNA Integrity Assay Test for Colorectal Cancer Screening

Health Focus 23 4 Reasons Your Body Loves Flax Seeds 26 10 Odds Things To Say To Someone With Breast Cancer

28 Man With Breast Cancer Says, “Don’t be embarrassed... it’s too important”

31 Overlooked Superfood Lowers Cholesterol Life Goes On 33 Talian Bantuan Bebas Tol Kanser MAKNA 36 Bantuan MAKNA Menjadi Pendorong untuk Berjaya

37 Feedback/Comments 38 Interesting Stuff 39 FIFA World Cup 2014 - Brazil 43 Klimb for Kancer 2014

page

43

EDITORIAL EDITOR Lionel Lim PENYELARAS / COORDINATOR Najmi Kamal Amir Ravivarman Prema Ramasamy PENASIHAT / ADVISORS Dato’ Mohd Farid Ariffin Farahida Mohd Farid Vemanna Appannah PENYUMBANG / CONTRIBUTORS Ann Pietrangelo Christopher Foong Diana Herrington Dr. Imran Abdul Khalid Dr. Michael Musci Michelle Schoffro Cook Muhamad Razif Ramly Nisha Sanita Md. Norha Prema Ramasamy DITERBITKAN OLEH / PUBLISHED BY National Cancer Council (MAKNA) BG 03A & 05, Ground Floor, Megan Ambassy, 225 Jalan Ampang, 50450 Kuala Lumpur.

Tel: +603-2162 9178 Fax: +603-2162 9203 Email: makna@makna.org.my www.makna.org.my www.facebook.com/maknacancer www.twitter.com/makna_malaysia DICETAK OLEH / PRINTED BY Percetakan Jiwabaru Sdn Bhd No.2 Jalan P/8, Kawasan MIEL Fasa 2, Bandar Baru Bangi, 43650 Bangi, Selangor Darul Ehsan.

Tel: +603-8925 6688 Fax: +603-8925 1688

IMPORTANT MESSAGE: In no way this newsletter be considered as offering medical advice. The content in here is general in nature, and is provided for information purpose only. Never disregard medical advise or delay in seeking it because of something you have read here.

REKACIPTA / DESIGN SG Global Support Services Sdn Bhd Level 18, Quill 7, No. 9 Jalan Stesen Sentral 5, KL Sentral, 50470 Kuala Lumpur.

Tel: +603-2260 1717 Fax: +603 2260 2211 www.sgglobalsupport.com

PRESIDENT’S DESK

On the 4th of February of every year, the world celebrates

WORLD CANCER DAY to raise awareness of cancer and to encourage its prevention, detection and treatment.

Dear Friends, World Cancer Day was founded by the Union for International Cancer Control (UICC) to support the goals of the World Cancer Declaration, written in 2008. The primary goal of the World Cancer Day is to significantly reduce illness and death caused by cancer by 2020. For some of us, it is also a day to remember loved ones we lost to the disease and celebrate those who survived.

It is hard for me to write that each year about 8 million people die from cancer. So many lives lost yet so many cancers are preventable. Research suggests that one-third of cancer deaths can be prevented. Although proven ways to prevent cancer exist, these services and technologies are not widely available in low and middle-income countries.

In a developing country like ours, those in the lower income group are the ones who will suffer the most financially if afflicted with cancer. The cost of treatment for this disease can be as debilitating as the disease itself.

I am glad to report that MAKNA’s role in helping these underserved individuals is growing. Our team of dedicated personnel and volunteers are tireless in their efforts to diversify our services, our reach and our support. It is with their diligence and persistence MAKNA grows but without our generous donors and sponsors, it will be difficult to make the best possible accessible even to the poorest.

Just as the World Cancer Day aims to save as many preventable deaths each year, MAKNA does the same each day. We will continue to raise awareness and education about cancer; we will not stop until we have empowered those who are powerless to take action against the disease in one way or another.

Farid 01

NEOPLASIA { ISSUE 01/2014 }

NEWS & HAPPENINGS

1Run 1Life Kolej MASA organised “Run to Survive 2014” on 23 February 2014 in collaboration with MAKNA with the intention of helping those who are less fortunate, and in this instance, cancer patients to stand on their feet again.

The slogan of the run, “1Run 1Life” was aimed at encouraging participation, in that by running in the event, they would already be donating to the selected charity, MAKNA. By the end of the event’s closing date, 400 students had signed up for the event.

The run was officiated by Deputy Minister of Youth and Sports, Datuk M. Saravanan. As soon as the run began, both cancer survivors and volunteers of MAKNA, Ahmad Nazri Hamzah, a leg amputee and Muhamad Razif Ramly were joined by Datuk Saravanan.

The 5 km run had the participants running around the college’s vicinity areas which offered picturesque sceneries aplenty.

Hundreds of the college’s students had turned out to support the runners, cheering and clapping enthusiastically.

Many passers-by exchanged encouraging words with Nazri and the others who ran together with him.

During the prize-giving ceremony, the first 50 runners each received a medal. All participants received certificates of appreciation. Kolej MASA’s students then surprised the participants and public by performing a flash mob dance which was later followed by lucky draw giveaways.

The event managed to raise RM 3,000 for MAKNA. To the organising committee and Kolej Masa, we send them our most sincere appreciation for the kind donation and wish the college all the best in its endeavours and undertakings.

The fund raised from this event, along with various others generated through a number of projects will enable MAKNA to continue meeting its commitment to those being assisted financially or otherwise. To-date, MAKNA has helped about 450,000 cancer patient cases and currently, the non-profit organisation receives referrals from 92 government hospitals under its bursary assistance programme.

www.makna.org.my

02

NEWS & HAPPENINGS

#WorldCancerDay

#ShareYourStory / #ShareYourThoughts

Video Campaign For World Cancer Day this year, MAKNA came up with an idea to encourage people who have always wanted to speak up for cancer as patients or survivor themselves, for their loved ones, their friends or even on cancer in general. The plan was simple, it was purely for the purpose of inspiring patients or caregivers who are undergoing the same trauma battling cancer or helping others to cope with it.

We then made a video featuring our volunteers and staff where they filmed themselves asking the public to submit videos to us sharing their stories, and thoughts. We named the project “#Share Your Story/#Share Your Thoughts” and the submitted videos would serve as some form of a motivator to cancer patients everywhere.

By the end of the submission date, we did receive some videos, but it did not actually meet our target. So, what we did next was the most proactive we could think of – we went about shooting some of the videos ourselves, interviewing both cancer patients, cancer survivors and ordinary individuals about their experiences with cancer.

Yes, in the end, this worked out just fine. The videos captured have since been uploaded on YouTube, cheers! One of our videos was highlighted by the Swiss Red Cross as a favourite in a tweet. The campaign also caught the attention of Union for International Cancer Control (UICC), also on tweeter under the #WorldCancerDay. From this particular exercise, we realised it is never be easy for cancer patients to talk about their condition on camera. When someone gets cancer, most patients would rather keep this information unknown to others - this is only human nature. Not surprisingly, certain patients will go on all extent not to attract any attention unnecessarily. The fact is the stigma and lack of understanding about cancer is still pervasive among the society, and can be very undermining even for the toughest fighting the disease. We also felt that it is true that cancer survivors are more open to discussing their experiences because their intentions are more towards helping others beat the disease.

03

NEOPLASIA { ISSUE 01/2014 }

In any event, we would still like to sincerely thank all those who made this campaign as success. Also as part of the WCD celebration, MAKNA was also featured on “Selamat Pagi Malaysia”, TV1 where the opportunity was given to our Senior Volunteer, Mr. Jacob Mathews to share his experiences as a cancer survivor, and our Deputy General Manager, Mr. Vemanna to speak about MAKNA’s roles and services.

NEWS & HAPPENINGS

Support Services

MAKNA’S Commitment

Towards Cancer Research eminent scientists in the country which is coordinated by MAKNA’s partner for CRA, Academy of Science, Malaysia.

This year, three recipients were selected from a total of 15 applications. They were Dr. Yeap Swee Keong (Universiti Putra Malaysia), Dr. Ho Wan Yong (The University of Nottingham - Malaysia) and Cik Noorfaiza A. Aziz (Universiti Teknologi Mara) and were each awarded RM30,000.

Noorfaiza, Dr. Yeap, and Dr. Ho receiving mock cheques from ASM Secretary General, Dato’ Dr. Samsudin (left) and MAKNA President, Dato’ Mohd Farid Ariffin.

One of MAKNA’s core commitments is to provide opportunities to promising cancer research work to receive part of the funding needed to turn it into a “viable” treatment for cancer.

Since 2001, through Cancer Research Award (CRA), young researchers have been invited by MAKNA to submit their applications for funding for their on going projects.

Assessment will then be made by a panel comprising

MAKNA President, Dato’ Mohd Farid Ariffin said, “The Award signifies our strong and unwavering commitment towards what we have set out to do since our inception in helping cancer patients. More importantly, it underscores our effort to find a potential curative treatment for cancer as a whole or any individual type of cancer.”

“Every year, our hope is renewed and we are re-energised with the initial findings of these researches. Any person who is passionate about helping cancer patients will fully understand what MAKNA has pledged to do, that our fight towards cancer is over the long haul, and by how best we can fulfill this responsibility,” continued Dato’ Farid.

Aside from CRA, MAKNA has been collaborating with local universities and research institutes in Malaysia. Currently, there are 18 collaborative projects.

www.makna.org.my

04

NEWS & HAPPENINGS

Support Services

Engineers For

MAKNA Run 2013 Another Community Service Event for Cancer Patients

“Engineers for MAKNA Run” was organised the second time late last year as a worthy revisit, after the first run organised in 2012 was a success.

05

The organiser, The Institution of Engineers Malaysia-Society of Ingenieurs (IEM-SIR) Student Chapter of Universiti Tenaga Nasional (UNITEN), Putrajaya held the event to fulfill their CSR programme as a students service to the community and again selected MAKNA as the beneficiary this year.

On the event day, 22 December 2013, more than 700 runners were flagged off by IEM president, Mr. Choo Kok Beng and after it had been officiated by Datuk N. Siva Subramaniam, Special Implementation Task Force of the Cabinet Committee on the Indian Community Chief Coordinator.

The run was held at The Loop, UNITEN and received patronage and support from Yayasan Canselor UNITEN, SUNQUICK, Gardenia Bakeries (KL) Sdn Bhd, and College of Engineering UNITEN, Malaysia Youth College (MYC) and United Power Engineering Sdn. Bhd.

The race course was 12 km around and within UNITEN and the adjacent Jalan Ayer Hitam. The event raised a total of RM3,000 and was handed over to MAKNA’s representative during the prize-giving session.

NEOPLASIA { ISSUE 01/2014 }

NEWS & HAPPENINGS

3Cs

Cycle for Cancer, Colour for Cancer and Cook for Cancer!

By Hospital Jerantut Director & MAKNA Volunteer Leader, Dr Hj Muhd Siv Azhar Merican

Jerantut District Hospital, led by Dr Hj Muhd Siv Azhar Merican and his working committee came up with a unique idea for a cancer cause which they themed it as the 3Cs – “Cycle for Cancer, Colour for Cancer and Cook for Cancer,” all at the same time with the help of the Malaysian Medical Association (MMA) of Pahang and MAKNA.

Two trailers were parked at the compound for the event, one of which was MAKNA’s mobile mammogram unit, which managed to conduct 173 screenings, thus comfortably exceeding the initial target of 150 cases. The MAKNA team also performed 87 breast clinical examinations. The other trailer organised was a hearing assessment unit from Universiti Islam Antarabangsa Malaysia (UIAM).

Dr Hj Muhd Siv (left) handing a token to MAKNA Deputy General Manager, Vemanna Appannah

The event was held on 23 March 2014 and its goals were to educate the public on cancer, promote healthy living and perform cancer screening at the National Park, Pahang.

It was officiated by the Jerantut Member of Parliament, YB Tn Hj Ahmad Nazlan who flagged off 155 cyclists of various age groups with bicycles of all types taking on a 25 km challenge.

He then visited a colouring contest where it was participated by 100 pre-school children and held concurrently with a cooking competition. The latter programme featured 5 pairs of contestants trying their best to prepare a healthy meal which had to adhere to the calories set and the use of a slice of chicken as the main dish. The judges for these 2 events were from other agencies including District Education Office, District Health Office, Bank Rakyat and Unity Department.

The other activities and services that benefited the local folks came in the form were PAP smears (37 cases), Hepatitis B screenings, dental examinations, a blood donation drive, organ donor pledging (8 new registrations), lucky draws, general health screening and medical consultations with MMA specialists comprising a general physician and an opthalmologist. A total of 148 patients gained from this particular exercise (a standard government out-patient clinic attendance).

The attendees were very pleased with the presence of specialists examining them and hoped such activities would be organised again in future. The exhibitions for the day covered cancer awareness, organ donation and Hospital Mesra Ibadah itself.

Prizes were sponsored by Bank Rakyat (colouring contest) and ADABI (cooking competition). Fifty lucky numbers were drawn for the cycling participants and public, with a mountain bike worth RM 2,000.00 being the main prize. www.makna.org.my

06

FUNDRAISING

MIX Gives Back With MAKNA

One for the Kids!

MIX fm and MAKNA worked together on a fundraising campaign, “MIX fm Gives Back with MAKNA” in late January to raise funds for children with cancer under MAKNA’s assistance.

On 22 January 2014, Rod Monteiro, the host of MIX Breakfast Show visited one of the children, Francis Chang, 10, who was about to undergo his 10th chemotherapy session at the hospital.

At the hospital, Rod also met Francis’ father, Mr Chang Kok Yong, a chef with a local hotel. Mr Chang explained that according to the doctors, Francis’ condition known as peritoneum tumour was said to the first of its kind in Malaysia.

Rod also found out that Francis was receiving monthly bursary assistance from MAKNA. Together with his colleagues, the then set up a meeting with MAKNA’s staff to discuss raising funds for children with cancer including Francis, all of whom are located in the Klang Valley. The appeals for donation would be made via MIX Fm’s morning 07

NEOPLASIA { ISSUE 01/2014 }

show where listeners wanting to donate can click on a banner on the radio station’s website which will be then redirected to dedicated page for the campaign on www.peoplegiving. org.my.

By the end of the campaign, RM35,750 had been raised, surpassing its initial target of RM20,000 by 79%. In this campaign, Malaysians from all walks of life from various parts of the country really came through with their generosity, donating as well as leaving well-meaning messages on the page to Francis and the other children.

MAKNA cannot thank these donors enough for such an incredible show of kind-heartedness who wanted more than anything to do something within their means to ease the children’s pains and sufferings.

To our partner for the campaign, MIX fm, our deepest gratitude to you for your great example as a caring corporate entity for showing the way and lighting the path for the children to continue their journey in their fight against cancer.

COVER STORY

WE DON’T NEED TO TALK ABOUT CANCER

On 4 February 2014, the Union for International Cancer Control (UICC) celebrated World Cancer Day hand-in-hand with its members, partners and supporters around the world.

In the last couple of years the World Cancer Day campaign saw a breakthrough in recognition and visibility with the levels of public and media interest growing exponentially in 2013 and seeing an even bigger step-up in 2014.

According to UICC, this year’s campaign achieved 8.7 billion opportunities to see, hear or read about World Cancer Day. These results have led to this international awareness day becoming a firm and significant fixture in calendars around the globe.

The 2014 campaign focused on reducing stigma and dispelling myths about cancer (Target 5 of the World Cancer Declaration) under the tagline “Debunk the Myths!” to improve general knowledge and challenge misconceptions about the disease.

The campaign was articulated around four key myths that are found in cultures and countries around the globe: • • • •

We don’t need to talk about cancer There are no signs or symptoms of cancer There is nothing I can do about cancer I don’t have the right to cancer care

Truth: Whilst cancer can be a difficult topic to address, particularly in some cultures and settings, dealing with the disease openly can improve outcomes at an individual, community and policy level.

WHEN YOU OR SOMEONE YOU KNOW HAS CANCER Talking about Cancer Evidence: • For most people, a diagnosis of cancer is a lifechanging event commonly evoking feelings of shock, fear, anger, sadness, loneliness and anxiety. Talking about cancer to partners, family members, friends and colleagues can help to alleviate these feelings, and yet many people find it difficult.

• In most settings, cancer remains taboo and people with cancer are even subject to stigma and discrimination that may stop them from seeking care.

• Negative public perception of cancer can stifle informed public discussion and perpetuate a cycle of fear and misinformation that hinders raising awareness about cancer prevention and the importance of early detection. Countering cultural barriers against speaking about cancer and contesting misinformation is therefore essential.

• Even within highly engaged communities, the level of knowledge of cancer and the willingness to talk about it with friends and family can be low. www.makna.org.my

08

COVER STORY • There are campaigns that specifically challenge the taboos and embarrassment surrounding some male cancers (prostate, testicular and colorectal cancers) and create awareness of early signs and symptoms.

Global Advocacy Message Talking about cancer can help to challenge negative beliefs, attitudes and behaviours that perpetuate myths, cause fear and stigma, and prevent people from seeking early detection and treatment.

Governments, communities, employers and media all have a role to play in changing perceptions about cancer to create a culture where the physical and mental health and wellbeing of cancer survivors and their careers are addressed and people are empowered to access quality cancer prevention and care.

MYTH

warning signs and symptoms of cancer is essential to reduce the likelihood of misdiagnosis and ensure prompt referral to specialist medical care at an early stage of the disease.

• Strategies for help-seeking behaviour should be encouraged.

• Recognition of early warning signs of some cancers is particularly relevant in low resource settings – it is cost-effective and in some cases does not require any specialist diagnostic technologies. E.g. clinical breast examination (CBE) performed by primary healthcare workers has the potential to detect cancers earlier, particularly in areas where the majority of breast cancers are diagnosed at an advanced stage.

Global Advocacy Message The success of early detection programmes can be measured by a reduction in the stage of the cancer at diagnosis with earlier diagnosis associated with a reduction in the risk of dying from cancer.

02

THERE ARE NO SIGNS OR SYMPTOMS OF CANCER

MYTH

03

THERE IS NOTHING I CAN DO ABOUT CANCER Truth: For many cancers, there are warning signs and symptoms and the benefits of early detection are indisputable.

RECOGNISE SIGNS AND SYMPTOMS Evidence: • It is true that early signs and symptoms are not known for all cancers, but for many cancers, including breast, cervical, skin, oral and colorectal cancers, and some childhood cancers, the benefits of early detection are indisputable.

• Awareness is the first step to early detection and improving cancer outcomes. Whilst some of the cancers with the poorest survival rates, such as ovarian and pancreatic cancers, rarely show early warning signs, cancer researchers globally are seeking innovative ways to improve early detection and develop new tests for early diagnosis for these cancers.

• With few exceptions, early stage cancers are more treatable than late stage cancers.

• Equipping primary healthcare workers with the appropriate knowledge and tools to recognise the 09

NEOPLASIA { ISSUE 01/2014 }

Truth: There is a lot that can be done at an individual, community and policy level, and with the right strategies, a third of the most common cancers can be prevented.

PROMOTING HEALTHY LIFESTYLES The conditions in which people live and work, and their lifestyles, influence their health and quality of life.

Evidence: • Global, regional and national policies and programmes that promote healthy lifestyles are essential to reducing cancers that are caused by factors such as harmful use of alcohol, unhealthy diet and lack of physical activity.

• Tobacco use, the most common risk factor, is linked to 71% of lung cancer deaths and accounts for at least 22% of all cancer deaths. Based on current trends, tobacco use is estimated to kill one billion people in the 21st century.

COVER STORY • Alcohol is a known risk factor for cancer. It is strongly linked with an increased risk of cancers of the mouth, pharynx, larynx, oesophagus, bowel and breast, and may also increase the risk of liver cancer and bowel cancer in women.

• Overweight and obesity is increasing globally at an alarming rate, including among children and adolescents. Also of concern is the high proportion of overweight people living in low resource settings (two-thirds of the global total). Overweight and obesity is also strongly linked to increased risks of bowel, breast, uterine, pancreatic, oesophagus, kidney and gallbladder cancers.

• Rising rates of obesity will lead to increased cancer rates unless policies and actions are taken to improve people’s diets and levels of physical activity.

Global Advocacy Message The implementation of policies and programmes that support a life-course approach to prevention, and strengthen the capacity of individuals to adopt healthy lifestyles choices can bring about behavioural change, which can help prevent cancer.

Prevention is the most cost-effective and sustainable way of reducing the global cancer burden in the longterm. Effective cancer prevention at the national level begins with a national cancer control plan (NCCP) that responds to a country’s cancer burden and cancer risk factor prevalence. NCCPs should include evidencebased resource-appropriate policies and programmes that reduce the level of exposure to risk factors for cancer and strengthen the capacity of individuals to adopt lifestyle choices that promote good health for life.

I DON’T HAVE THE RIGHT TO CANCER CARE Truth: All people have the right to access proven and effective cancer treatments and services on equal terms, and without suffering hardship as a consequence.

ACCESS TO CANCER CARE IS A MATTER OF SOCIAL JUSTICE

Disparities in cancer outcomes exist between the developed and developing world for most cancers.

Evidence • Patients in low resource settings whose cancer may be curable in the developed world, often suffer and die unnecessarily due to a lack of awareness, resources and access to affordable and quality cancer services.

• Gender inequities in power, resources, culture and inadequate investment at a primary healthcare level restrict women in low resource settings from accessing essential cancer services, e.g. cancer prevention and early detection programmes.

• Over 85% of the 275,000 women who die every year from cervical cancer are from developing countries.

• More than 70% of the 160,000 newly diagnosed cases of childhood cancer worldwide each year lack access to effective treatment. The result is an unacceptably low survival rate of ~10% in some low- and middleincome countries compared to ~90% in some highincome countries.

• Poor and vulnerable populations are unable to afford expensive cancer medicines and treatments, which must often be paid by patients out-of-pocket, pushing families further into poverty.

Global Advocacy Message Cost-effective interventions must be made available in an equitable manner through access to information and education about cancer at the primary health care level, as well as early detection programmes and affordable, quality medicines, vaccines and technologies, delivered as part of national cancer control plans.

Social protection measures, including universal health coverage, are essential to ensure that all individuals and families have full access to healthcare and opportunities to prevent and control cancer.

“The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being.”

- The Universal Declaration of Human Rights

www.makna.org.my

10

Activities Organised Around the World in conjunction with World Cancer Day 2014 According to UICC, coinciding with WCD 2014, a total of 674 events were organised in 123 countries around the world this year.

Below are some of the more interesting events organised in different parts of the world:

20 Colours / 20 Hours Cancer Support Community Central Texas & ColorCancer, Austin, Texas, USA 20 Colours / 20 Hours was a 20-hour indoor cycling fundraiser that invited beginner riders, competitive cyclists, fitness enthusiasts, cancer patients, survivors, and everyone in between to hop on a stationary bike and raise funds to help Austin area cancer patients and their support network.

This first time fundraising event was hosted by Cancer Support Community Central Texas (CSCCT) and ColorCancer, two Austin-based non-profit organisations that strive to support cancer patients, survivors and their families.

Teams of up to 20 were assembled and challenged to ride relay-style from 7.00 pm on 7 February through 3.00 pm on February 8 at PureRyde RealRyder® Indoor Cycling in downtown Austin. In the spirit of the event name, each bike and each hour represented a different colour of cancer, totalling 20 colours and hours. Participants benefited from raising money for an important and widespread cause, but they also got an amazing cardio workout, while having fun!

“Donate Balloons” Campaign ABRALE (Brazilian Association of Lymphoma and Leukemia), Sao Paulo, Brazil The campaign was launched on 4 February, with videos and stories of cancer patients survivors sharing the importance that faith and hope had during their treatment. The patients had recorded a message of hope to total strangers, and after that the crew would select random people on the streets to watch the video. These selected people could also return the message to the patient if they wanted to.

The result was simply incredible!

Volunteers also distributed balloons on the streets to raise awareness about cancer in a different and creative way.

11

NEOPLASIA { ISSUE 01/2014 }

COVER STORY

78 Paintings Against Cancer As part of WCD 2014, yourPainting supported the fight against cancer together with 65 Instagram photographers and their 78 unique designs, known as Instapainting.

Each 100% painted in oil on canvas. An Instapainting costs exactly USD$200. All receipts went to the Union for International Cancer Control (UICC). Together with 65 photographers, 78 photographs, more than 8 million followers and the artists, unique art was created to “save lives.” As part of the Instagram success story, so many ideas have arisen on what we can do with Instagram pictures.

The result – Instapainting in 2012. Anyone who owns an Instagram profile can easily get a painting of his favourite picture via yourPainting. yourPainting was founded in Berlin in 2010. The company is the largest provider worldwide of personalised photo art.

“The Big War Against Cancer in Nigeria” Community Encouraging Corporate Philanthropy (CECP-NIGERIA), Lagos, Nigeria To mark World Cancer Day, a new phase of a campaign by CCEP-Nigeria was unveiled where the flag off of “The Big War against Cancer in Nigeria” took place.

The current focus of CECP-Nigeria is “Taking Cancer Prevention to the Grassroots.” This campaign involved raising funds to acquire thirty-seven Mobile Cancer Centres (MCCs). The MCCs will facilitate the ongoing nation-wide cancer screening/treatment campaign of the National Cancer Prevention Programme (NCPP), a non-governmental initiative.

A mobile cancer centre is a clinic on wheels, in which screening, follow-up and some treatment (including surgeries), can take place. It includes facilities for mammography, colonoscopy, cryotherapy, and sonology.

The mobile units will also deliver preventive care against other common diseases which are known to increase the risk of cancer, including malaria, diabetes, hepatitis, kidney disease, hypertension and HIV/AIDS.

www.makna.org.my

12

VOLUNTEERS

VOLUNTEERS

Terima Kasih

MAKNA Oleh sukarelawan MAKNA dan pendidik di SK. Saliku, Cikgu Christopher Foong

Pada 17 Februari 2014, Penyelaras Sukarelawan MAKNA, En. Faizal dan sukarelawan kanan MAKNA dari Sabah, Pn. Zariana membuat satu lawatan ke Sekolah Kebangsaan Saliku, Nabawan, Sabah yang terletak di kawasan yang sangat di pedalaman dan berdekatan dengan sempadan Malaysia-Indonesia.

13

NEOPLASIA { ISSUE 01/2014 }

MAKNA adalah badan bukan kerajaan yang pertama sekali sampai di S.K. Saliku sejak 4 tahun yang lalu.

VOLUNTEERS

Tujuan lawatan rombongan MAKNA ini adalah untuk memberi ceramah tentang penyakit kanser kepada murid-murid serta penduduk kampung yang menetap di perkampungan sekeliling walaupun mereka terpaksa mengharungi keadaan jalan raya yang agak mencabar untuk mencapai destinasi mereka.

MAKNA adalah badan bukan kerajaan yang pertama sekali sampai di S.K. Saliku sejak 4 tahun yang lalu dan ia adalah bukan mudah untuk MAKNA sampai ke sini untuk menyampaikan maklumat yang amat berguna kepada penduduk-penduduk di kawasan ini.

Kampung Saliku dan Kampung Sibuah terletak berdekatan dengan sempadan Malaysia-Indonesia, dan kedua-dua kampung adalah setakat beberapa jam sahaja dari sempadan tersebut. Pekan yang terdekat pula merupakan Pekan Nabawan iaitu lebih kurang 3 jam dari perkampungan ini dan hanya boleh diakses dengan menggunakan kereta pacuan empat roda. Pekan Nabawan pula adalah lebih kurang 4 jam dari Bandaraya Kota Kinabalu.

Untuk tiba ke kawasan ini, kenderaan dikehendaki melalui jalan tanah merah yang berbatu-batu. Sebuah jambatan buatan sendiri oleh penduduk kampung akan ditemui sejenak selepas itu. Jambatan ini terpaksa dbina oleh orang kampung kerana tiada pihak yang sanggup datang untuk melakukannya. Sebelum ini, mereka terpaksa mengambil risiko jatuh ke dalam sungai setiap kali keluar ke pekan untuk membeli keperluan harian.

Sepanjang aktiviti tersebut, semua pelajar, ibu bapa dan guru-guru S.K. Saliku serta semua penduduk Kg. Saliku dan Kg. Sibuah telah dijemput untuk menghadiri ceramah tesebut. Sambutan yang ditunjukkan amat mengalakkan.

Malah, pihak tentera Malaysia-Indonesia yang mempunyai markas tidak jauh dari SK. Saliku telah bersama-sama hadir dalam acara tersebut.

Pelajar-pelajar dan pihak tentera Malaysia dan Indonesia.

www.makna.org.my

14

VOLUNTEERS

Kedatangan MAKNA ke S.K. Saliku ini amat dialu-alukan dan rata-rata penduduk kampung tidak pernah mendengar atau mengetahui mengenai kewujudan MAKNA sebelum ini. Tidak hairanlah kalau para hadirin juga tidak terdedah kepada bahaya penyakit kanser. Penduduk-penduduk kampung menunjukkan penerimaan mereka terhadap bahan yang dikongsi semasa sesi penerangan dan mereka menyertai segala aktiviti yang dijalankan oleh MAKNA. Ditambah pula dengan tayangan gambar dan video yang jelas dan menarik, ia terus menggamit hati semua yang terlibat. Para hadirin juga tidak melepaskan peluang untuk bertanya persoalan atau keraguan mengenai kanser melalui perbincangan kumpulan dan perkongsian sesi soal jawab.

Pada keesokan hari, semua murid telah didedahkan dengan program tambahan mengenai kanser yang didampingkan dengan aktiviti seperti senam robik, kuiz dan perbincangan dalam kumpulan.

Warga sekolah S.K.Saliku, Nabawan, Sabah amat berterima kasih kepada pihak MAKNA kerana sudi datang ke tempat yang terpencil ini untuk menyampaikan maklumat tentang kanser dengan warga sekolah dan penduduk kampung. Murid-murid telah sedikit sebanyak mendapat maklumat yang dapat dipraktikkan seperti cara pencegahan kanser dan amalan pemakanan seimbang untuk kesihatan secara umum.

Sekali lagi, bagi pihak sekolah dan penduduk Kg. Saliku dan Kg. Sibuah, saya mengucapkan terima kasih kepada MAKNA kerana sanggup mengambil risiko untuk datang ke tempat kami.

Lawatan ke rumah pesakit di Nabawan.

Bersama murid-murid, guru-guru dan ibu bapa.

15

NEOPLASIA { ISSUE 01/2014 }

FEATURE STORY

Q: What were the initial objectives of setting up the MAKNA Mobile Mammogram service/programme?

We are pleased to report that up till 31 December 2013, a total of 5,509 women nationwide have had access to our mammogram service.

A:

The underlying reason for its setting up is to reduce deaths caused by breast cancer as mammograms are able to help in its detection even at the early stage. Inevitably, this will help reduce the overall treatment cost with the patient not having to go for advanced treatment. This will also result in the boosting of the overall cure rate for breast cancer.

www.makna.org.my

16

FEATURE STORY In some advanced countries, this particular service was already being offered sometime ago. Realising a mobile unit that houses a mammogram machine was able to improve women’s access to this important screening service, MAKNA went about studying its feasibility with the purpose of introducing it here in this country. Over in those countries, the service is sometimes referred to as “mammograms on wheels.”

Somewhere in later part of 2000’s, with the objective to deliver nationwide screenings for early detection of pre-symptomatic breast cancer to communities all over Malaysia from districts to cities, rural to urban dwellings, we took upon ourselves to put together the nuts and bolts of this undertaking, seeing it gradually into full fruition.

Also, the initial plan was to provide these screenings at no cost or at least to cover cost, which meant prioritising the provision of accessibility of the mammograms to those in the lower income bracket. But as we went on, the targeted audience was expanded to cover women in other groups as well. Understandably, with this goal in mind, the project would provide some form of challenges knowing that there were all kinds of setup and operational costs to contend with, and to overcome this, we were ready to continuously endeavour to raise funds from corporate entities, foundations and also, prepared to work with the government as well.

As mammograms are purpose-driven for early detections of breast cancer, the idea of introducing this service where early stages of cancerous developments in the breasts can be checked early and even prevented was the driving force for its coming into being.

At the same time, we also wanted to increase awareness of cancer alongside the services provided by this mobile unit where people who come for screenings will be exposed to information and exhibition that will be beneficial to them.

Q: What are some of the initial challenges faced and how were they solved?

A:

Some of the processes that were necessary for us to go through to bring the idea to actualisation were more complex than had been earlier imagined. Some of its more challenging aspects involved the intricate layers of approvals needed, being the first project of its kind in the country. As such, there were always various kinks that had to be ironed out, and all the necessary and proper checking, screenings, vetting, authentication and certification for the mobile unit, the mammogram machine and its complementary equipment had to be addressed or obtained for the project. This required working with various relevant ministries and government agencies in an integrated and concerted basis.

Before proceeding, it was agreed that it was to be a turnkey project and the appointed company should handle the design, fabrication, installation, testing, commissioning and delivering the mobile mammogram unit. The contractor was also responsible for the transporter’s equipment and related regulatory and statutory requirements and maintenance of the same.

Besides these, there were a myriad of other challenges in the form of technical issues but they were taken care of through time, and with a lot of patience, wisdom and common sense, the project finally saw the light of day.

All in all, we have benefited immensely from the learning experiences gained from the various facets and stages of the programme.

Q: What has the progress been since its launching?

At the MAKNA’s Mobile Mammogram launching ceremony – From left, MAKNA President, Dato’ Mohd Farid Ariffin, Deputy Prime Minister’s spouse, Puan Sri Datuk Seri Hajjah Noorainee Abdul Rahman, and MAKNA Radiographer, Malathi Alagu.

17

NEOPLASIA { ISSUE 01/2014 }

A: In the past three years, there have been numerous opportunities that were presented

FEATURE STORY

to the team to work with various communities.

Most of the time, the experiences have been mostly to do with bringing the service right to the doorstep of communities in the rural areas.

Below is the breakdown of the number of programmes organised with corporations and rural sites from 2011 till 2013.

Along with this, we have also worked with corporate entities and the demand from this group is growing through time. With an already established working relationship with Social Security Organisation or Perkeso, women in various organisations have been able to benefit from the mammogram services.

Year

Corporate

Rural

Total

2011

1

6

7

2012

8

8

16

2013

12

19

31

GRAND TOTAL

21

33

54

Also, in terms of the number of screenings conducted for all states in the Peninsular Malaysia last year:

We are pleased to report that up till 31 December 2013, a total of 5,509 women have had access to our mammogram service.

Number of Mammograms Performed (2011 – 2013)

2011

YEAR

2012

2013

TOTAL

Classification

Corporate

Rural

Total

Corporate

Rural

Total

Corporate

Rural

Total

Corporate

Rural

Mammogram

42

573

615

318

1,216

1,534

666

2,694

3,360

1,026

4,483

www.makna.org.my

GRAND TOTAL 5,509

18

FEATURE STORY

Q: What types of partners do you have right now?

A:

Before MAKNA Mobile Mammogram services were officially launched, we went around looking for sponsorship and managed to convince several corporations to come onboard and support our cause. There are several foundations and corporations such as Yayasan Tenaga Nasional, Yayasan Felda and MNRB Holdings Berhad that have committed themselves to sponsor these mammograms for women that are located in the rural areas who have poor access to such service.

We also collaborate with a host of other organisations and NGOs and currently, we also work closely with PERKESO. We certainly hope that more corporate responsible organisations will join us on our journey to bring mammograms to communities everywhere in the country.

Q: What would you say about the future of the service?

A:

The future looks very promising. We are thinking of expanding our services to Sabah and Sarawak at some point. To do this, feasibility studies are being carried out to see how best we can get this done. There are differences of operating the service in the Peninsular as compared with East Malaysia, and they are mainly to do with a totally different type of topography/road conditions in these states and also, the lack of road access. All this has to be taken into consideration.

19

NEOPLASIA { ISSUE 01/2014 }

At the moment, we are also hoping to upgrade some of the interrelated services involving the use of satellite in the transmission of data to specific stations where this will speed up the process of reporting of the results of mammograms.

Q: What kind of SCHEMEs do you have right now and for whom?

A:

Currently, we have three types of schemes that are available. The first one is specifically for women in the rural areas whose family household income is below RM3,500. In this instance, our sponsors will cover the cost of the mammogram.

The second scheme is for women with a total household income above RM3,500, where each screening will be charged RM150, at cost price.

The third scheme is delivered through our arrangements with PERKESO where MAKNA as a panel clinic, will provide the mammograms to women who are interested with the service by making use of their own allocated PERKESO vouchers for this particular purpose.

For more information about MAKNA Mobile Mammogram services, kindly visit www.makna.org.my or contact 03-21629178, ext 131 and 143 or email us at mammomobile@makna.org.my.

RESEARCH

Development of a Stool-based DNA Integrity Assay Test for

*AMDI Colorectal Research Team: Dr. Imran Abdul Khalid (PI), Prof. Dr. Narazah Mohd Yusoff, Dr. Muhamad Yusri Musa, Dr. Syed Atif Ali, En. Mohamad Basir Selvam Abdullah (Science Officer), Nurdianah Harif Fadzilah (Research Officer) and Muhamad Alif Che Nordin (Masters Candidate)

www.makna.org.my

20

COLORECTAL CANCER (CRC) IS A

DISEASE IN WHICH EPITHELIAL CELLS OF

COLON, RECTUM, OR APPENDIX

EXHIBIT UNCONTROLLABLE GROWTH. Colorectal cancer remains the third leading cause of malignant deaths in Malaysia and second in the world.

CRC is 90% and 75% curable if detected at stage I and II respectively.

Detection of pre-cancerous lesions (adenomas) and cancerous lesions (adenocarcinoma) in early stages may decrease CRC-associated morbidity and mortality.

Tests used for CRC screening include sigmoidoscopy, colonoscopy, double contrast barium enema, and virtual colonoscopy. These tests are invasive, technically demanding, and expensive and therefore unsuitable for mass screening of risk populations. Stool-based test such as fecal occult blood test (FOBT) and fecal immunochemical test (FIT) are non-specific and insensitive. Thus, there is a pressing need for a non-invasive, economical, and convenient yet sensitive and specific test for CRC screening.

Intestinal epithelium regenerates itself by shedding aged cells into the lumen. These exfoliated cells undergo 21

NEOPLASIA { ISSUE 01/2014 }

apoptosis, during which, their DNA is broken into small fragments. Tumours, on the other hand, shed cells with incompletely cleaved DNA, resulting in long, high molecular weight pieces of DNA (L-DNA). Elevated levels of L-DNA fragments could be a marker for detection of malignant cells in stool.

In our lab (Oncological and Radiological Cluster, AMDI USM) with the support from MAKNA grant, we are currently developing a stool-based DNA integrity assay for sensitive and specific detection of colorectal cancer. This research requires a standard harvest of DNA from fecal matter, then to be subjected to amplification using polymerase chain reaction (PCR). PCR is a powerful tool that can amplify DNA fragment from minute amount (from stool) to a million copies so that the exact copies of this DNA fragment can be easily visualised under ultra-violet ray.

The most promising aspect of our idea is the potential to be developed as a single tool that can detect any neoplastic lesion regardless the underlying genetic or epigenetic modification. We have evaluated a PCR-based DNA integrity assay test (PCR-DIA) on a cohort of 32 CRC and 32 healthy volunteers. PCR-DIA detected CRC with 56% sensitivity and 100% specificity (Yehya et al., 2012). Sensitivity and specificity of FOBT in this cohort was 43.75% and 87.5% respectively. These data show that PCR-DIA may be developed into a useful test for CRC screening.

RESEARCH

OBJECTIVE The objective of this study is to improve PCR-DIA test for sensitive detection of the neoplasm-derived colonocytes. We are designing a series of PCR primers specific to TP53 gene locus.

We believe that PCR-DIA test is capable of detecting colorectal cancer far superior than any available test today.

With the exponential advancement of new technologies, the cost of a single PCR reaction can be reduced to a more reasonable price in near future. We are positive that public compliance to screening programme will be improved using our tool and early detection can lead to a significant reduction in CRC incidence and mortality.

GOOD REASONS WHY YOU SHOULD Consider Screening for Colorectal Cancer

CRC is a silent and deadly disease - early detection means early intervention Survival of CRC is dependent on early detection. Patients have a 5-year survival rate of 90-95% following surgical intervention when diagnosed at Stage I, but the chances thinned to about 5-10% when diagnosed at Stage IV.

Prevention is always better than cure Despite being a deadly disease, CRC is deemed as one of the most preventable diseases. The two of the major causative factors for CRC: lifestyle and diet are manageable factors that can minimise the risk of getting CRC. Studies have shown that cigarette smoking, excess body weight, physical inactivity and low consumption of dietary fibre have posed a significant risk for CRC.

Long development of CRC has pried open a window of opportunity for frequent screening Typically, sporadic CRC cases develop via adenoma-carcinoma sequence, meaning your normal epithelium cells transform to benign neoplasm and followed by invasive carcinoma and eventually metastatic cancer through a series of acquired genetic and epigenetic modification.

This course of progression occurs over decades. So, an annual screening for CRC is more than enough to detect CRC lesion at its earliest stage possible. www.makna.org.my

22

HEALTH FOCUS

GOLDEN FLAX SEEDS

BROWN FLAX SEEDS

Reasons Your Body Loves

FLAX SEED By Diana Herrington

Flaxseeds have been cultivated for their health benefits for 5,000 years.

They’ve been around for ages, but only in the last few decades has nutritional science realized just how good they are for us. I love adding flaxseeds to my meals and baking! Let’s learn more about this PowerFood.

FLAX SEEDS ARE ONE OF THE FOODS HIGHEST IN SOLUBLE AND INSOLUBLE FIBER. 4 Tbsp flax meal = 8 grams of fiber • Great for detoxing of the body. They contain a gummy soluble fiber called mucilage which protects intestinal flora.

• Helps keep bowel movements regular eliminating toxins.

• Blocks excess acidity thus improves digestion.

• The fibre has cholesterol-lowering effects.

• The high fiber helps stabilize blood sugar.

23

NEOPLASIA { ISSUE 01/2014 }

FLAXSEED LIGNANS FIGHT CANCER, INFECTION AND MORE. • Flaxseeds Reduce Prostate Cancer: Research studies show lignans can slow the growth of prostate cancer cells.

• Flaxseeds help with Breast Cancer Survival: Three studies followed thousands of women diagnosed with breast cancer were published at PubMed Central® 1. 2. 3. They found “Lignans might play an important role in reducing all-cause and cancer-specific mortality of the patients operated on for breast cancer.”

Flaxseeds are so good I use them in all my cooking classes and detoxes!

• Lignans seem to have antibacterial, antifungal, and antiviral properties.

• Lignans may reduce pre-menopausal symptoms, promote fertility and prevent Type 2 diabetes.

FLAX SEED OMEGA-3 ESSENTIAL FATTY ACIDS REDUCE INFLAMMATION Many chronic diseases (heart disease, arthritis, asthma, diabetes) are developed from too much inflammation; this is enhanced by having too little Omega-3 intake. Flaxseed oil can be a real help.

Benefits of essential fatty acids: • increases “good” Cholesterol levels • for organ health • keep joints supple • a healthy brain; very important when a child’s brain grows the fastest, in utero and during infancy • a healthy heart and arteries • can nourish immune system • help keep bones strong for a smooth skin

FLAX SEEDS FLOWER

FLAX SEED MEAL IS LOW CARB, LOW GLYCEMIC INDEX, AND GLUTEN FREE • Although flaxseeds are not a grain, they have a similar vitamin and mineral profile and are often used in grain recipes.

• For those on a low carbohydrate diet, or a gluten-free diet, flaxseed meal is perfectly safe. It has a low glycemic index of 32 and with it’s high fiber is good for weight loss.

Wherever flaxseed becomes a regular food item among the people, there will be better health.

- Mahatma Gandhi

Diana Herrington turned a debilitating health crisis into a passion for helping others with healthy, sugar-free, gluten-free, eating and cooking. After testing and researching every possible healthy therapy on her delicate system she has developed simple, powerful principles which she shares in her recent book Eating Green and Lean, and as host to Care2 groups: Healthy Living Network and Healthy Cooking. She is the head chef at Real Food for Life, where she shares recipes and tips.

www.makna.org.my

24

HEALTH FOCUS

FLAXSEED TRIVIA • Hippocrates used flaxseed for relief of intestinal discomfort.

• The Egyptians used linen (made from flax seed) to wrap their mummies.

• Christ wore linen in his tomb. Homer tells of sails made of linen in his Odyssey.

• Laws were passed requiring people to consume flax seeds for its health benefits by King Charlemagne in the 8th century.

• Flax was one of the original medicines, used by Hippocrates himself.

• Some flax varieties are grown for oil, some for their fiber to make linen.

CAUTION ABOUT FLAXSEEDS

If you have a delicate digestive system, start with low doses of flax meal to begin with (one table spoon per day) and work up to two.

If you have a significant digestive disorder, the fiber/laxative effect of flax could be serious. The National Institutes of Health recommends that people with bowel problems or disease should not consume flaxseed.

Some researchers are concerned about the levels of cyanide compounds (cyanogenic glycosides) in flaxseed, but all studies so far have shown that they do not create the anticipated problems in the body.

FLAXSEED HISTORY Stone Age: Flax remnants were found in Stone Age dwellings in Switzerland.

Around 3000 BC: Flaxseed was cultivated in Babylon.

25

NEOPLASIA { ISSUE 01/2014 }

8th Century: King Charlemagne passed laws requiring his subjects to consume it because he believed in its health benefits.

HEALTH FOCUS

What do you say to someone who has breast cancer? Well, you shouldn’t immediately launch into a list of folks who died of cancer, or about the horrible side effects of surgery and chemotherapy, nor should you downplay the seriousness of it all. A few simple words of support or a hug will do.

Since my diagnosis, I’ve been the recipient of too many kind words and gestures to count, but I’ve also heard some very odd things.

Upon hearing my diagnosis of breast cancer:

Here’s my Top 10 “They said what!?” List.

1. “Just be grateful you don’t have (insert any other form of) cancer.”

That’s the same kind of logic that applied after I was diagnosed with multiple sclerosis (MS). Yes, I’m very grateful that I don’t have a worse cancer or a worse neurological disease. There’s always something worse. I’m also grateful that I’m not being stabbed in the eye with a hot poker or lit on fire. That doesn’t mean that the reality of breast cancer should be minimized.

2. “I’ve known lots of women who have had breast cancer. It’s not a big deal these days.”

According to The American Cancer Society, breast cancer is the most common cancer among American women, except for skin cancers, and is the second leading cause of cancer death in women, surpassed only by lung cancer. The most recent estimates (for 2010) were:

• About 207,090 new cases of invasive breast cancer will be diagnosed in women.

• About 54,010 new cases of carcinoma in situ (CIS) will be diagnosed (CIS is non-invasive and is the earliest form of breast cancer).

• About 39,840 women will die from breast cancer.

In addition to the obvious health problem, the financial considerations, especially if you are uninsured, underinsured, or purchase your health insurance in the individual market, create tremendous long-term stress. Employment issues and family considerations add to the mix. Yes, it’s a big deal. We can end breast cancer by 2020.

3. “Now you’ll have more credibility as a health writer.”

Seriously? What disease should I choose next?

www.makna.org.my

26

HEALTH FOCUS About mastectomy:

About surviving:

4. “At least it’s not an arm or a leg or

10. “It’s all mental. If you decide to beat it, you will.”

Another attempt to make me feel better and, again, I’m grateful things aren’t worse. Still, I’m very attached to all my body parts, including my breasts. I was using it, thank you.

I completely understand the intention of people who say this. Positive attitude (I have it in spades)

something you really have to use.”

5. “You must feel awful about…

self-esteem/loss of femininity/sexuality/ self-image.”

Should I feel awful? I wanted to live. That was more important than saving one breast. I can’t speak about how other women feel, but my sense of femininity and sensuality come from my spirit, not my body parts. I’d rather have that breast, but I’m still me, and not a stitch less feminine.

helps tremendously. It’s not what happens to us that defines who we are, but how we respond to those events.

The ability to hold on to positive feelings - to put fear aside and to truly live in the moment - is what sustains me and others with serious health problems. The mental component is a vital key to living each day to the fullest, and not becoming all about cancer. But however positive we may be, it’s not all mental. There are other forces at work, too.

6. “Well, you’re kind of small-breasted.

It could be worse.”

!!!?

7. “Which one?”

Like it matters. It’s a normal curious question, but it always makes me laugh.

About chemotherapy:

8. “Don’t be a wimp …”

I’m not sure what would constitute my being labeled a chemotherapy wimp, but thank you in advance for the guilt trip. I’ll do my best not to disappoint.

9. “Oh, you’re going to be sooooo sick!”

Ah, there’s the other side of the coin. Sounds like I can’t win.

Author’s Note: This is article is part of a series chronicling my first-hand patient perspective of life with Triple-Negative Breast Cancer. Without being overly self-indulgent, I hope to convey the raw emotion that comes with such a diagnosis… and the process of living with and beyond it. Entries will appear in Care2 Causes and in Care2 Healthy & Green Living.

Follow on Twitter @AnnPietrangelo

27

NEOPLASIA { ISSUE 01/2014 }

I cannot accept that people who succumb to cancer or other sometimes treatable diseases did so because they had the wrong attitude or didn’t try hard enough. That’s a mighty heavy burden to put on their shoulders.

I take comments like that with a grain of salt, understanding that sometimes words just tumble out before the speaker can fully appreciate their impact. We’ve all done it at one time or another… I know I’ve put my foot in my mouth more than once.

I have also been the recipient of an outrageous number of kindnesses and comforting words, which I will share in an upcoming post. Trust me on this … the most effective and most appreciated gestures are the simple ones.

HEALTH FOCUS

Study presented at the 2011 Breast Cancer Symposium revealed that 2,475 men and

393,259 women

with breast cancer.

While the average age for men at diagnosis was 67, it was 61 for the women. Lymph nodes were involved in 32 percent of the men, versus

22 percent of the women.

Man With Breast Cancer Says,

“D n’t Be Embarrassed…

It’s Too Important”

by Ann Pietrangelo

Somewhere in the back of his mind, 77 year-old Donald knew that men could get breast cancer. He remembered the sad case of a local man in his early 50s who succumbed to the disease after it spread to vital organs.

On vacation earlier this year, he noticed a hardness in his left breast while showering. His wife, Virginia, thought the nipple appeared inverted and a darker color than unusual. Donald readily admits that without his wife’s observation and insistence that they cut their vacation short, he likely would have procrastinated and delayed seeing a doctor. www.makna.org.my

28

HEALTH FOCUS

“The treatment protocol is slightly different for men than for women.

Dr. Michael Musci, Medical Oncologist, Ironwood Cancer & Research Centers

How does it feel to be a man with breast cancer?

A few tests and several weeks later, the shocking diagnosis of breast cancer became reality. Cancer is cancer and it’s never a welcome diagnosis. But how does it feel to be a man with breast cancer? Donald says, “Initially, I wanted to tell people I had a ‘chest cancer’ or a ‘breast tumor.’ However, we decided to ‘tell it like it is’ largely out of respect to our deceased young man. I do sort of joke about having a ‘woman’s disease,’ but responses are very supportive.”

Donald hopes that his openness will help other men to realize that they can get breast cancer, too, and he encourages men to promptly check out any suspicions. He suggests that men seek references from others, most likely women, who have had breast cancer and can refer them to specialists and support.

“Don’t be ashamed or embarrassed, it’s too important to you and your loved ones to delay treatment,” he cautions.

As for Donald and Virginia, the word “cancer” still elicits a certain amount of fear, but they are very optimistic about his prognosis. He is still undergoing chemotherapy and has yet to begin radiation treatment. The St. Louis Cancer and Breast Institute doctors and staff, along with community religious groups provide support and encouragement for which he is very grateful. He hasn’t actually felt the need to join a support group, but says that may come later.

Rare, but Not Unimportant Breast cancer in women is about 100 times more common than in men, says surgical oncologist Dr. Diane Radford, who specializes in breast cancer and breast diseases. “There are just under 2,000 new cases of breast cancer in men in the U.S. per year, and just under 400 deaths. To put in perspective almost 40,000 women die of breast cancer each year.”

29

NEOPLASIA { ISSUE 01/2014 }

Signs and Symptoms of Breast Cancer in Men • a breast mass — these are usually firm and painless, most commonly occurring below the nipple • skin changes (tethering) • nipple discharge • scaling of the nipple

Risk Factors for Breast Cancer in Men • gynecomastia (enlargement of the male breast) • elevated estrogen levels • therapeutic radiation exposure • Klinefelter’s syndrome • inherited BRCA2 mutation — males who are carriers of a deleterious BRCA2 mutation have a 6-8 percent lifetime risk of breast cancer, whereas female carriers have a risk of 50-80 percent. Dr. Radford makes it a practice to test male breast cancer patients for BRCA1/2 mutations.

Because male breast cancer is not a common occurrence, many people don’t even realize men can get breast cancer.

When men do find a lump or something unusual on their chest, they generally don’t think of cancer and put off going to the doctor. That’s a big mistake because, as Dr. Radford explains,

“Stage for stage cure rates for male breast cancer are similar to females, however, males are more likely to be diagnosed with more advanced stage and with lymph node involvement.”

As with women, she says, any symptoms or signs need to be evaluated. The vast majority of breast cancers in men are of the ductal type.

HEALTH FOCUS

Treatment for Breast Cancer in Men “Mastectomy will be the most common surgical treatment, although breast conservation could be offered,” says Dr. Radford. “Adjuvant treatment (radiation, chemotherapy, endocrine therapy) will be decided based on stage, estrogen receptor status of the tumor, etc.”

Dr. Michael Musci, medical oncologist from Ironwood Cancer & Research Centers, adds: “The treatment protocol is slightly different for men than for women. The surgical treatment for men is modified radical mastectomy. Women often choose lumpectomy because they want to conserve their breasts. Men aren’t usually too concerned about saving breast tissue. Male breast cancer is most commonly treated with radiation, chemotherapy and/or tamoxifen, which is similar to treatment in females with breast cancer.”

Men can get all the same types of breast cancers that women do — progesterone receptor positive and negative, estrogen positive and negative, and HER2 positive and negative — and triple-negative breast cancer, which does not respond to hormone treatments like tamoxifen, says Dr. Musci.

Research into Breast Cancer in Men The world’s largest study into the genes that cause breast cancer in men shows similarities with female breast cancer, but identifies differences that could potentially lead to treatments specific to males. Results of the study conducted

by Breakthrough Breast Cancer and The Institute of Cancer Research (ICR) are published in the journal PLoS Genetics.

The research team studied 433 men with breast cancer and found that among the 12 most common genes that contribute to breast cancer in females, five add risk in men, although at a lesser rate. “It is exciting that this study is already producing results because we know so little about male breast cancer,” said Professor Anthony Swerdlow from the ICR. “We hope that this work will provide us with a much better understanding of the disease and allow us to find ways to prevent it.”

Another study presented at the 2011 Breast Cancer Symposium revealed that, on average, men are older than their female counterparts when diagnosed with breast cancer and frequently have more lymph node involvement. Study authors suggest this may be due to a “lack of awareness” among physicians and patients.

This study included information on 2,475 men and 393,259 women with breast cancer. While the average age for men at diagnosis was 67, it was 61 for the women.

Lymph nodes were involved in 32 percent of the men, versus 22 percent of the women. The study did not include information on risk factors like BRCA or family history.

“While the study itself has some limitations, the authors confirm what has been shown historically. Breast cancer in men occurs later in life, is frequently associated with a delay in diagnosis, and is commonly associated with lymph node involvement,” said Gail S. Lebovic, MD, a member of the 2011 Breast Cancer Symposium News Planning Team and past president of the American Society of Breast Disease.

“Although breast cancer is rare in men, these findings demonstrate that it is critically important to continue to raise awareness about the occurrence of breast cancer in men.”

This article was prompted by an email I received from someone who was had spent years trying to get more information regarding male breast cancer. That really got to me. Indeed, information specific to male breast cancer is hard to come by. However, there are a few takeaways: 1. Everyone should do what they can to educate themselves about the known causes of cancer, and make healthy lifestyle choices.

2. No matter how good those lifestyle choices may be, don’t ever fool yourself into thinking that cancer can’t happen to you.

3. If you’re a man, don’t assume that you cannot get breast cancer.

4. Whether you’re a man or a woman, be familiar with your own body. A lump in the chest area should be checked out so you know what you’re dealing with. If it is cancer, the earlier you begin treatment, the better your chances of a positive outcome. The good news is that most breast/chest lumps turn out to be benign.

www.makna.org.my

30

HEALTH FOCUS

OVERLOOKED SUPERFOOD

lowers

CHOLESTEROL

By Michelle Schoffro Cook

“Eat your peas!” is a common refrain in many households at meal time. That particular command may be rivaled by

“Eat your beans!”

Michelle Schoffro Cook Michelle Schoffro Cook, MSc, RNCP, ROHP, DNM, PhD is an international best-selling and 15-time book author and doctor of traditional natural medicine, whose works include: 60 Seconds to Slim, Weekend Wonder Detox, Healing Recipes, The Vitality Diet, Allergy-Proof, Arthritis-Proof, Total Body Detox, The Life Force Diet, The Ultimate pH Solution, The 4-Week Ultimate Body Detox Plan, and The Phytozyme Cure.

31

NEOPLASIA { ISSUE 01/2014 }

thanks to new research compiled by a group of American and Canadian scientists and doctors.

HEALTH FOCUS The research group analyzed 26 randomized clinical trials involving over 1000 volunteers of various ages, with an average age of 51. They concluded that eating 4.5 ounces of cooked legumes daily – the equivalent of three-quarters of a cup – lowered LDL cholesterol by five percent. This translates into an equivalent percentage reduction in heart attacks or other cardiovascular events, according to the researchers. LDL (low density lipoprotein) cholesterol is the “bad” cholesterol that collects in the walls of blood vessels and causes blockages. Diet is a major cause of LDL cholesterol build-up in the body.

A five percent reduction in heart attacks and cardiovascular events may not seem like a big deal but it is when you realize that heart disease is the number one killer of North Americans every year. The statistics are likely comparable in many other countries worldwide. Eating more beans on a daily basis may save millions of lives.

Dr. John L. Sievenpiper, a researcher at St. Michael’s Hospital in Toronto and one of the authors of the research noted that the average American diet includes less than one ounce of legumes per day, demonstrating that food avoidance habits developed in childhood often carry into adulthood. Most kids who avoided green beans and peas

probably disliked the way they were prepared rather than the legume itself. Both of these foods can be delicious when they are not baked or steamed to flavorless mush.

Fortunately, there is an exciting world of legumes to explore and enjoy. Legumes are a group of plants that contain “fruit” inside of pods. Most are rich in protein, fiber and assorted minerals required for great health. The main groups of legumes are beans, peas, lentils and peanuts. Peanuts can be linked to serious allergies so focusing on the first three groups may be a safer way to experience the hundreds of legume options.

Legumes are a great meat replacement in meals like chilli, curries, stir-fries and soups. They are excellent additions to salads (either hot or cold) or on their own. Personally, the taste of a fresh-picked green bean or peas from the garden is one of my favorite memories as a child on my grandparents’ farm. It was only as an adult that I discovered the versatility and great taste of lentils, chickpeas and other exotic legumes.

The fiber in legumes gives them their cholesterol-fighting superpowers. Specifically, the soluble fiber that is prevalent in many legumes is effective at lowering LDL cholesterol.

Here are some of the best beans and their fiber content, based on one cup of cooked legumes!

19 grams

17 grams

19 grams

17 grams

15 grams

Navy beans

Adzuki beans

Small White beans

Black turtle beans

Mung beans

16 grams

16 grams

15 grams

12 grams

18 grams

Lentils

Kidney beans

Pinto beans

Chickpeas

Yellow beans

www.makna.org.my

32

LIFE GOES ON

Talian Bantuan Kanser MAKNA telah ditubuhkan pada tahun 2008. Sejak ia bermula, talian ini semakin mendapat sambutan apabila kewujudannya dan perkhidmatan yang ditawarkannya menjadi pengetahuan orang ramai.

Talian ini beroperasi dari Isnin ke Jumaat, jam 9.00 pagi hingga 5.00 petang.

1800-88-62562 TALIAN BANTUAN

BEBAS TOL KANSER MAKNA

Sejak penubuhannya, sebanyak 3,144 panggilan melalui telefon telah terima di samping 420 pertanyaan melalui emel atau Facebook MAKNA. 33

NEOPLASIA { ISSUE 01/2014 }

LIFE GOES ON

Talian ini dikendalikan oleh seorang jururawat onkologi yang bertauliah dan dibantu oleh seorang bekas jururawat yang berpengalaman mengendali kumpulan sokongan.

Untuk mereka yang memerlukan bantuan serta maklumat mengenai kanser, anda boleh menghantar terus emel kepada cancerhelpline.makna.org.my atau melakukan perbincangan melalui telefon talian bebas tol MAKNA 1800-88-62562.

Untuk memberi gambaran tentang perjalanan proses khidmat nasihat yang disediakan oleh talian bantuan MAKNA ini, berikut disenaraikan urutan daripada permulaan sehingga pengakhiran proses yang terlibat dalam memberi khidmat nasihat kepada pemanggil talian tersebut.

1. Terima panggilan daripada pesakit / penjaga pesakit, saudara terdekat atau rakan pesakit.

2. Kes dan permasalahan dibincang melalui telefon (talian bebas tol MAKNA), emel atau facebook MAKNA. 3. Kes yang dirujuk untuk lawatan terlebih dahulu mendapat persetujuan daripada pesakit sendiri atau penjaga yang terdekat.

4. Jika kes di luar kawasan Lembah Kelang, ia akan dibantu oleh sukarelawan yang terdiri daripada bekas pesakit kanser MAKNA. Kes yang dirujuk dan butiran pesakit diklasifikasikan sebagai “private and confidential.�

Seterusnya, untuk perkongsian pengetahuan dan maklumat, berikut ditampilkan beberapa contoh kes yang pernah ditangani di bawah:

KES 1

Cik Annie (bukan nama sebenar), 27 tahun, Ampang, berketurunan Cina Diagnosis: Kanser Payudara

Kes ini dirujuk dari Facebook MAKNA oleh sahabat baik pesakit.

Setelah mendapat maklumbalas daripada sahabat baik Annie dan mendapat butiran lengkap pesakit, saya menghubungi pesakit untuk perbincangan lanjut. Melalui perbincangan telefon dengan pesakit, didapati beliau sudah amat tertekan dan tidak berhenti menangis sepanjang perbualan kami. Setelah mendapat persetujuan pesakit, saya dan seorang bekas pesakit kanser menetapkan tarikh dan masa untuk pergi melawat Annie.

2 hari selepas itu, kami pun menziarahi Annie. Beliau tinggal di pinggir Ampang, iaitu di sebuah rumah pangsa lima tingkat. Keadaan sekeliling rumahnya adalah bersih dan terdapat pokok-pokok pasu. Tingkap depan rumah kelihatan tertutup rapat dan pintunya berkunci.

Setelah pintu diketuk berkali-kali, seorang wanita muda hanya membuka tingkap dan setelah kami memperkenalkan diri, pintu kemudian dibuka dan terus kami memasuki ruang dewan yang sangat kelam dan tidak bercahaya. Kain langsir juga tertutup rapat.

Apabila saya mula berbual dengan pesakit, saya dapati beliau terlalu tertekan, kurus dan tidak bermaya. Beliau tinggal bersama nenek yang sudah tua. Menurut Annie, beliau memang dibesarkan oleh datuk dan neneknya.

Datuknya sudah meninggal dunia 4 tahun yang lalu. Saya juga berpendapat melalui pertanyaan saya, tiada risiko atau penyebab yang jelas yang membawa kepada kanser payudara yang dialami oleh pesakit. Pesakit enggan bercerita secara mendalam berkenaan ibu bapanya.

Annie mengaku masih tidak dapat menerima hakikat beliau telah didiagnosis dengan kanser walaupun setahun sudah berlalu. Rancangannya untuk menjalani pembedahan ditunda kerana beliau ingin mencuba merawat dirinya dengan ubatan tradisional setelah terpengaruh dengan maklumat yang diperolehinya melalui internet serta cadangan daripada kawan-kawan. Malangnya keadaannya bertambah teruk dan pada suatu hari, nanah mula meleleh dari puting payudara kanan 3 bulan yang lepas dan pada masa yang sama, tekstur dan warna kulit payudaranya mula berubah.

Saya tidak dapat memastikan ‘staging’ penyakitnya ketika itu kerana pesakit keberatan untuk berkongsi maklumat dengan sepenuhnya. Beliau sudah agak ketidakkeruan memandangkan rancangannya untuk berkahwin pada bulan hadapan telah mula diaturkan dan pada yang sama beliau bergelut dengan penyakit kanser. Setakat ini, Annie tidak pernah bercerita atau berkongsi dengan bakal suami tentang keadaannya kerana gerun memikirkan akibatnya.

Sejenak kemudian, kaunseling dan perbincangan pun dibuat seterperinci mungkin. Setelah yakin dan mendapat kata sepakat daripada pesakit, saya meninggalkan beliau dengan neneknya.

Seminggu selepas lawatan, saya menerima ucapan tahniah daripada rakan beliau mengenai usaha pesakit mendapatkan rawatan lanjut di hospital yang berdekatan. Bakal suami telah dimaklumkan berita kesakitannya sejurus selepas kami balik. Annie bertuah kerana diberi sokongan penuh oleh bakal suami dan keluarga serta rakan sekerja. Setelah 2 tahun berlalu, pesakit telah selamat menjalani rawatan dan bahagia bersama suami dan keluarga, malah masih bekerja di tempat yang sama. www.makna.org.my

34

KES 2

En Yusman (bukan nama sebenar) 22 tahun, Pelabuhan Kelang, berketurunan Melayu Diagnosis: Limfoma – peringkat 4

Kes dirujuk daripada talian bebas tol MAKNA Saya mendapat panggilan telefon daripada kakak pesakit.

Beliau sangat risau dengan keadaan adiknya, Yusman dan ibu bapa mereka tidak dapat membantu atau memujuk adiknya supaya ke hospital untuk mendapatkan rawatan.

Setelah mendapat persetujuan daripada pemanggil, saya ditemani seorang pegawai MAKNA untuk melawat Yusman.

Rumah pesakit adalah rumah pangsa 10 tingkat di Kelang.

Pesakit tinggal di tingkat 4. Kawasan sekeliling perumahan agak terbiar.

Saya memberi salam kepada tuan rumah, dan berkenalan dengan ibu bapa pesakit. Saya anggarkan umur mereka dalam linkungan lewat 50-an. Selepas berbincang dan mengambil butiran pesakit, saya dibawa masuk ke bilik pesakit. Keadaan bilik pesakit gelap dan tingkap bertutup rapat. Pesakit kelihatan tidur berselimut penuh. Menurut ibu Yusman, pesakit telah berkeadaan demikian sejak 3 bulan yang lalu. Makan di bilik dan mandi jika disuruh. Pesakit dikatakan tidak berupaya menguruskan diri sendiri seperti masa sebelumnya.

Ketika lampu dipasang, saya dapati pesakit sangat kurus, cengkung dan tidak bermaya. Akan tetapi saya dapat mengagak pesakit adalah seorang yang aktif sebelum ini, periang dan mempunyai raut wajah yang tampan dengan ketinggian yang sederhana. Ibunya memberitahu Yusman sudah terlantar sejak 3 bulan yang lepas selepas balik dari bermain bola.

Selepas diselidik pesakit telahpun menjalani rawatan kemoterapi sebanyak 3 kali di hospital di Petaling Jaya namun tidak meneruskan rawatan disebabkan oleh tidak tertahan dengan kesan daripada rawatan. Pesakit merupakan penerima bantuan kewangan MAKNA. Bapa pesakit memberitahu selepas menjalani 3 sesi kemoterapi, pesakit boleh menjalani aktiviti harian seperti biasa dan akibatnya enggan kembali ke hospital untuk rawatan seterusnya. Namun pada pengamatan saya melalui perbincangan dengan ibu bapa pesakit, mereka kurang mendapat bimbingan mengenai kanser dan kepentingan rawatan kepada pesakit.

Saya kemudiannya menasihatkan pesakit dan keluarganya supaya memberi sokongan antara satu sama lain. Lebih-lebih 35

NEOPLASIA { ISSUE 01/2014 }

lagi surat rujukan doktor mengatakan prognosis pesakit adalah kurang baik.

Namun demikian saya meyakinkan keluarga dan pesakit supaya mendapatkan rawatan simptomatik di hospital disebabkan keadaan pesakit yang sudah “dehydrated� disebabkan kurang pengambilan cecair dan makanan.

Selang seminggu selepas pertemuan tersebut, kakak pesakit mengatakan adiknya berasa kesal kerana tidak mendapatkan rawatan lanjut ketika keadaan penyakit masih terkawal.

Walaupun begitu, apa yang menggembirakan saya adalah pesakit cuba bangkit semula untuk turut menjalani aktiviti harian seperti biasa walaupun dalam seribu kepayahan.

Setelah 2 bulan tidak mendengar khabar daripada keluarga Yusman, saya diberitahu pesakit telah meninggal dunia.

Walaupun mereka berasa sedih atas kehilangan mereka, mereka juga bersyukur kerana telah cuba memberi pesakit apa yang terbaik bagi mengurangkan kesakitan, menceriakan hari-hari terakhir beliau dan menerima sahaja segala ketentuan Ilahi.

Cabaran yang saya lalui adalah tidak sebegitu mudah terutama dalam menangani permasalahan pesakit kanser yang melibatkan emosi dan psikologi pesakit. Saya juga mendapati menunggu pesakit untuk benar-benar berkongsi perasaan mereka adalah amat sukar terutama bagi mereka yang lebih muda dan masih berkerjaya.

LIFE GOES ON

BANTUAN MAKNA MENJADI PENDORONG UNTUK BERJAYA Oleh Oleh Muhamad Muhamad Razif Razif Ramly Ramly

Saya menerima bantuan berbentuk biasiswa dari MAKNA di bawah program “Young Cancer Survivor Scholarship�.

Setelah membuat permohonan untuk bantuan kewangan untuk meneruskan pengajian di universiti, MAKNA telah menganugerahkan biasiswa kepada saya berdasarkan kriteria yang ditetapkan.

Program ini diasaskan oleh MAKNA untuk menyokong dan membantu bekas pesakit kanser yang layak menyambung pelajaran di peringkat universiti tetapi menghadapi cabarancabaran dari segi kewangan atau kesulitan dalam biasiswa.

Bantuan yang disalur telah menangung kos pengajian saya di universiti dari segi yuran pengajian dan juga kos sara hidup saya di universiti dari tahap diploma hingga ijazah, iaitu pada tahun 2009 hingga 2014.

Dengan bantuan yang diberikan oleh MAKNA, ia sedikit sebanyak dapat membantu saya untuk terus belajar dan mengurangkan bebanan yang ditanggung oleh keluarga saya untuk menampung kos pengajian saya. Bantuan yang saya terima telah menjadi perangsang kepada saya untuk mendapat keputusan terbaik dalam peperiksaan untuk setiap semester dan menjadi sumber inspirasi untuk mengejar cita-cita saya.

Bantuan yang diberikan sebenarnya banyak membantu saya menampung membiayai perbelanjaan untuk melengkapkan pengajian saya untuk setiap semester. Sepanjang pengajian saya di universiti, ia menyedarkan saya bahawa setiap kejadian yang berlaku ada hikmah di sebaliknya yang hanya disampaikan melalui perlambangan dan tidak secara terangterangan. Segala jasa baik yang diberikan oleh MAKNA amatlah saya hargai dan berharap MAKNA dapat terus maju, berjaya dan membantu golongan yang memerlukan. * Razif kini bekerja di MAKNA sebagai kakitangan tetap.

www.makna.org.my

36

FEEDBACK / COMMENTS

TO MAKNA FROM A PATIENT’S HUSBAND Dear Puan Farahida, It was a pleasure to meet and talk yesterday.

As I said, when people here give me an honorarium (“wang ehsan”), I feel bad for so long as it stays in my own pocket and I cannot feel happy spending the money on myself. It is only right, I feel, that money of that kind and those origins should be returned to bring some “faedah” to the Malaysian society.

These days after our experiences of recent years, I can think of no better public cause or organisation to support, and none that is closer to my own heart than MAKNA. Prof. Norani Othman, my wife, had intestinal surgery (with Prof. Ismail Sagap) in late 2010 and then after several months of chemotherapy at HUKM under the overall supervision of Prof.

Datuk Fuad, and after three “clear” years, suddenly this other cancer (not a secondary/metastasis) showed on October (spotted by a very attentive, “eagle-eyed” radiography specialist at HUKM who, on second viewing, saw there was something that might warrant recalling Prof. Norani back for further “investigation.”

I was most impressed by and grateful for the wonderful expert treatment that she received, and as I said, you don’t have to spend very much time sitting around in a large Malaysian government/public hospital to be reminded that there is a lot of suffering in the world and that many people simply lack the means to avail themselves of the treatments that might alleviate that suffering.

37

NEOPLASIA { ISSUE 01/2014 }

Yet, in this terrible and often clearly heart-rending situation, MAKNA makes the amazing commitment that every needful patient will be treated, most impressive!

How it can be done I do not know, but every bit of support, I imagine must help reduce the huge load. So it seemed pretty obvious to me that I should quickly pass on the benefit of the “wang ehsan” that University Malaya recently gave me to MAKNA. To support the treatment of patients “of limited means” at the chemotherapy and radiotherapy units at HUKM that come under MAKNA’s overview at the Pusat Kanser PPHUKM/MAKNA programme there.

It was a pleasure for me to pass on the honorarium. It was a pleasure to meet you and it was also very good for me (my doctor would approve!) to take a long walk through the city along Jalan Ampang to your office and back.

So, there were benefits “all around” for everybody.

With very best wishes from myself and Prof. Norani Othman.

Sincerely, Clive S. Kessler Emeritus Professor, Sociology & Anthropology School of Social Sciences The University of New South Wales Sydney, NSW, Australia 2025

INTERESTING STUFF

INTERESTING

STUFF :)

Coca-Cola was originally green.

In the 1400’s a law was set forth in England that a man was allowed to beat his wife with a stick no thicker than his thumb. Hence we have “the rule of thumb.”

Many years ago in Scotland, a new game was invented. It was ruled “Gentlemen Only...Ladies Forbidden”...and thus the word GOLF entered into the English language.

The first couple to be shown in bed together on prime time TV was Fred and Wilma Flintstone.

Every day more money is printed for Monopoly than the U.S. Treasury.

Men can read smaller print better than women can; women can hear better.

It is impossible to lick your elbow.

The State with the highest percentage of people who walk to work: Alaska.

The percentage of Africa that is wilderness: 28% (now get this...) ...the percentage of North America that is wilderness: 38%.

The average number of people airborne over the U.S. in any given hour: 61,000.

Intelligent people have more zinc and copper in their hair.

The first novel ever written on a typewriter: Tom Sawyer.

The San Francisco Cable cars are the only mobile National Monuments.

Each king in a deck of playing cards represents a great king from history: Spades - King David, Hearts - Charlemagne, Clubs -Alexander, the Great, Diamonds - Julius Caesar

If a statue in the park of a person on a horse has both front legs in the air, the person died in battle. If the horse has one front leg in the air the person died as a result of wounds received in battle. If the horse has all four legs on the ground, the person died of natural causes.

Q. Half of all Americans live within 50 miles of what?

A. Their birthplace Q. Most boat owners name their boats. What is the most popular boat name requested?

A. Obsession Q. If you were to spell out numbers, how far would you have to go until you would find the letter “A”?

A. One thousand Q. What do bulletproof vests, fire escapes, windshield wipers, and laser printers all have in common?

A. All were invented by women.

Q. What is the only food that doesn’t spoil?

A. Honey Q. Which day are there more collect calls than any other day of the year?

A. Father’s Day In Shakespeare’s time, mattresses were secured on bed frames by ropes. When you pulled on the ropes the mattress tightened, making the bed firmer to sleep on. Hence the phrase......... “goodnight, sleep tight.”

It was the accepted practice in Babylon 4,000 years ago that for a month after the wedding, the bride’s father would supply his son-in-law with all the mead he could drink.

Mead is a honey beer and because their calendar was lunar based, this period was called the honey month, which we know today as the honeymoon.

111,111,111 x 111,111,111 = 12,345,678,987,654,321

www.makna.org.my

38

INTERESTING STUFF

39

1930

1934

1938

1950

1954

1958

1962

1966

1970

1974

1978

1982

1986

1990

1994

1998

2002

2006

2010

2014

NEOPLASIA { ISSUE 01/2014 }

INTERESTING STUFF

WORLD CUP 2014 – BRAZIL Yes, the World Cup is once again upon us. This time in Brazil and from June 12 to July 13, 2014, citizens of the world and football fans will be in deep frenzy watching and supporting their favourite teams, hoping for glory and achievements of the highest order in the footballing world.

Okay fans, sit up and digest some of these facts in anticipation of the biggest sporting event in the universe! Just a recap of the some of the statistics we have had since the beginning of the most famous game that never fails to excite and entertain individuals and communities all over the world.

MOST CHAMPIONSHIPS

MOST WORLD CUP APPEARANCES www.makna.org.my

40

INTERESTING STUFF

INDIVIDUAL

Most championships = 3

Pelé

Most appearances in a World Cup final = 3

(Brazil, 1958, 1962 - only played in first two matches; medal awarded retroactively by FIFA in 2007 and 1970) Most tournaments played = 5 Antonio Carbajal (Mexico, 1950–1966) Most matches played, finals = 25 Lothar Matthäus (Germany, 1982–1998) Most minutes played, finals = 2,217 minutes Paolo Maldini ( Italy, 1990–2002) Most matches played, qualifying = 68 Iván Hurtado ( Ecuador, 1994–2010) Most matches won = 16 Cafu (Brazil, 1994–2006) Most finals played with different teams = 2 Luis Monti Argentina (1930), Italy (1934) Most appearances as substitute = 11 Denílson (Brazil, 1998–2002)

Youngest player = 7 years and 41 days Norman Whiteside (Northern Ireland, vs Yugoslavia, 1982) Youngest player, final = 17 years and 249 days Pele ( Brazil, vs Sweden, 1958) 41

NEOPLASIA { ISSUE 01/2014 }

Cafu

(Brazil, 1994, 1998, 2002)

Most appearances as captain = 16 Diego Maradona (Argentina, 1986–1994)

Youngest player, qualifying match = 13 years and 310 days Souleymane Mamam (Togo, vs Zambia, 6 May 2001, 2002 CAF Group 1) Youngest captain = 21 years and 109 days Tony Meola (United States, vs Czechoslovakia, 10 June 1990) Oldest player = 42 years and 39 days Roger Milla (Cameroon, vs Russia, 1994) Oldest player, final = 40 years and 133 days Dino Zoff (Italy, vs Germany, 1982).

Oldest player, qualifying match = 46 years and 180 days MacDonald Taylor, Sr. (U.S. Virgin Islands, vs St. Kitts and Nevis, 18 February 2004, 2006 CONCACAF Prelim Group 4) Oldest captain = 40 years and 292 days Peter Shilton (England, vs Italy, 7 July 1990).

Oldest player to debut in a World Cup finals tournament = 39 years and 321 days David James (England, vs Algeria, 18 June 2010).

INTERESTING STUFF

GOALSCORING - INDIVIDUAL

Most goals scored, overall finals = 15

Ronaldo

Most goals scored in a tournament = 13 Just Fontaine

(Brazil, 1998–2006)

(France), 1958

Most consecutive hat-tricks = 2 Sándor Kocsis (Hungary, 1954) and

Gerd Müller

(West Germany, 1970)

Most goals scored, overall qualifying = 35 Ali Daei (Iran, 1994–2006)

Most matches with at least one goal = 11 Ronaldo (Brazil, 1998–2006).

Most goals scored in a match = 5 Oleg Salenko (Russia, vs Cameroon, 1994)

Most consecutive matches with at least one goal = 6 Just Fontaine (France, 1958) and Jairzinho (Brazil, 1970).

Most goals scored in a lost match = 4 Ernest Wilimowski (Poland, vs Brazil, 1938)

Most matches with at least two goals = 4 Sándor Kocsis (Hungary, 1954), Just Fontaine (France, 1958), Ronaldo (Brazil, 1998–2006) and Miroslav Klose (Germany, 2002–2010).

Most goals scored in a qualifying match = 13 Archie Thompson (Australia, vs American Samoa, 2002 OFC Group 1).

Most goals scored in a final match = 3 Geoff Hurst (England, vs West Germany, 1966).

Most goals scored in all final matches = 3 Vavá (Brazil, 2 vs Sweden in 1958 & 1 vs Czechoslovakia in 1962), Pelé (Brazil, 2 vs Sweden in 1958 & 1 vs Italy in 1970), Geoff Hurst (England, 3 vs West Germany in 1966), and Zinedine Zidane (France, 2 vs Brazil in 1998 & 1 vs Italy in 2006).

Most consecutive matches with at least two goals = 4 Sándor Kocsis (Hungary, 1954).

Most hat-tricks = 2 Sándor Kocsis (Hungary, 1954), Just Fontaine (France, 1958), Gerd Müller (West Germany, 1970), and Gabriel Batistuta (Argentina, 1994 and 1998).

www.makna.org.my

42

It is that time of the year again where MAKNA takes pride climbing

MOUNT KINABALU FOR CANCER.

25 climbers will ascend Mount Kinabalu this September and the climb is open for registration now.

2014

INTERESTED?

Call us now and earn yourself the ascent of a lifetime!

People battling CANCER wants only ONE thing – to WIN the Battle at all costs. At MAKNA, we are committed to providing accessibility to financially-challenged cancer patients to necessary treatment and services.

Together with ordinary Malaysians from all walks of life, MAKNA hopes to inspire an extraordinary change and give people affected by cancer renewed hope in life.

Climb Period

1 - 4 SEPT

tK

b alu

i

na

sia la y

M oun

4,095 Metres , S a b a h,

M

a

For Queries & Registration Confirmation, please contact Ms. Hanita Hanim at 03-2162 9178 or e-mail to hanim@makna.org.my 43

NEOPLASIA { ISSUE 01/2014 }

Klimb for Kancer is a fundraising campaign that aims to raise the level of awareness of cancer and generate sufficient funds to help financiallychallenged cancer patients and their families. The letter “K” used in Klimb for Kancer (Climb for Cancer) is derived from the word Kinabalu. This initiative is hoped to encourage patients to adopt pro-active steps in the area of prevention, detection, and treatment of cancer.

Funds raised from this initiative will provide uninterrupted supply of financial assistance, surgical equipment, liquid food, prostheses, and prescribed drugs to poor cancer patients and also provide young cancer survivors with educational scholarships.

Each Climber cum Fundraiser shall raise minimum of RM2,000 which will be channelled to cancer patients assisted by MAKNA (this excludes Registration FEE).

MOUNT KINABALU: KLIMB for KANCER 20143

REPLY FORM

This fundraising campaign needs all the support it can get, as such your contributions will give it the necessary boost to so that further assistance can be provided to cancer patients under our bursary list.

I/WE DONATE (please tick (

) where appropriate)

RM500

This donation will support 1 poor patient’s travelling expenses to the hospital for treatment (for one year).

RM1,000

This donation will provide a patient with a chemo port that aids the administration of chemotherapy drugs.

RM2,000

This donation will maintain 1 patient’s one-year supply of Ensure Milk Powder food supplement to help recovery from cancer treatment.

Or an invaluable contribution of RM _____________ (any amount) to give someone a meaning to life.

Sponsor Details:Name (as per NRIC) : NRIC

:

Company Name

:

Address :

Postcode :

City / Country :

E-mail

:

Tel (Mobile)

:

Tel (Off) :

CHEQUE (made payable to MAKNA) MASTER CARD

Tel (Hs) :

Cheque No:

VISA

Cardholders’s Name : Credit Card No : Expiry Date Date : BANK-IN

:

/ Signature :

: MAYBANK Account No. 5140 7533 9083

(please attach bank-in slip together with this Reply Form to the address below)

About the Charity: MAKNA (Majlis Kanser Nasional) MAKNA (Majlis Kanser Nasional or the National Cancer Council) is a not-for-profit social enterprise mainly tasked to pool and utilise every effort, expertise and financial aid from every faction of society, and to fight cancer and reduce the related pain, suffering and morbidity that cancer patients and their families often experience.

Donations are Tax Exempted SEND this REPLY FORM to: MAKNA (Majlis Kanser Nasional) BG 03A & 05, Ground Floor, Megan Ambassy, 225 Jalan Ampang, 50450 Kuala Lumpur, Malaysia. www.makna.org.my Tel: +603-2162 9178 Fax: +603-2162 9203 E-mail: vem@makna.org.my www.facebook.com/maknacancer www.twitter.com/makna_malaysia

National Cancer Council (MAKNA) BG 03A & 05, Ground Floor, Megan Ambassy, 225 Jalan Ampang, 50450 Kuala Lumpur.

Tel: +603-2162 9178 Fax: +603-2162 9203 Email: makna@makna.org.my www.makna.org.my www.facebook.com/maknacancer www.twitter.com/makna_malaysia

Bring a new meaning to life www.makna.org.my/donate

Join us and make a difference www.makna.org.my/get-involved

Shop for a good cause www.makna.org.my/shop

Your contribution can change lives. Support our cause, together we can move mountains.

There is so much we can do to fight cancer. Every step you take brings us all closer to a cancer free future.

Every ringgit raised from this section will literally transform lives. This is where donations “will never go out of fashion.�