NEOPLASIA 1/2017

ISSUE 01/2017

BREAST CANCER: PG 23

WHAT YOU NEED TO KNOW

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KLIMB KINABALU 2016 MAKNA VOLUNTEER

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APPRECIATION DAY 2016

Content Issue 01/2017 page

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01 From the President’s Desk

News & Happenings 05 PUTRA-MAKNA RUN 2016 –

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For Hope and Cancer Research

06 Pink October – Breast Cancer Awareness

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Cover Story 17 Volunteers and How They Support MAKNA

Throughout Malaysia 18 MAKNA Volunteer Appreciation Day 2016 19 A Work of Heart

Workshop 07 MAKNA Re-CYCLE, Give CYCLE 08 Kampar Majesty Ride 2016

Research

08 Honnets Unite to Raise Funds for MAKNA 09 Klimb Kinabalu 2016 11 Sabah 3rd Annual Fundraising Night

International

13 Connecting Cities with Care 15 MAKNA Steps Up to 2015-2030 United Nations

Sustainable Development Goals

23 Breast cancer: What you need to know Life Goes On

29 Semangatmu Menjadi Inspirasi ....

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EDITORIAL

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PENASIHAT / ADVISORS Dato’ Mohd Farid Ariffin Farahida Mohd Farid

Breast cancer:

What you need to know

EDITORIAL Geraldine Teoh Prema Ramasamy PENYUMBANG / CONTRIBUTORS Ammar Asyraf b.Rajmi Asif Muhammad Caitlin Bowles Nhan TB Dinh Dr Oon Chern Ein Priyadarshini Subramaniam Professor Dr Rozita Rosli Suhaila Nik Vemanna Appannah 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 REKACIPTA / DESIGN SG Global Support Services Sdn Bhd Level 18, Axiata Tower, No. 9 Jalan Stesen Sentral 5, KL Sentral, 50470 Kuala Lumpur.

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

IMPORTANT MESSAGE: The content here is general in nature and is provided for information purpose only. It is not a substitute for professional medical advice. Please consult your physician on any questions or concerns you may have regarding your health.

PRESIDENT’S DESK

Dear friends, For many people around the world, 2016 was a year of upheaval, challenge and change. This year had more than its fair share of political turmoil and saw some major shifts in global politics and economy. For many still, 2016 was the year they were diagnosed with cancer or the year they were declared cancer-free.

For those of use directly affected by these changes, it may seem the earth has moved under our very feet. Yet, change is constant – everyone ages; families see new additions or bid their final goodbyes to loved ones; work, health and relationships evolved, and so it goes. How we prepare for and adapt to change says a lot about our strength and ability to survive, as individuals and organisations.

In this issue, I want to pay special tribute to a group of people on whom MAKNA’s strength and survival greatly depend – MAKNA Volunteers. Every year, this group of dedicated individuals comprising cancer survivors, families, healthcare workers and members of the public give their blood, sweat and tears to putting up a good fight against cancer.

It still astounds me that the number of approved MAKNA volunteers – people who have undergone our rigorous volunteer training programme – adds up to close to 2,000 people.

These are men and women, young and old, between the ages of 19 and 73, 110 of whom have themselves survived cancer and are a pillar of strength for patients who meet them. In East Malaysia, our volunteer presence is 147, significantly lower in number but not in commitment.

We also have 57 international volunteers from around the world, 46 of whom are with MAKNA Vietnam.

These numbers testify that so many understand at a deeper level that cancer is a colossal foe, and that it must be met with an equal measure of collective strength, action and faith. I am grateful for every MAKNA volunteer, for their outstanding love and compassion and for making the heavy load lighter for so many cancer patients and their families.

As we begin the New Year, I wish to invite you, our donors, to volunteer with us if only for a short time. I guarantee that it will provide the best first-hand knowledge of how your contributions helped cancer patients and it will make for a rewarding and life-changing experience.

Thank you and may your 2017 be filled with love, laughter, good health and endless joy.

Farid 01

NEOPLASIA { ISSUE 01/2017 }

PRESIDENT’S DESK

Saudara saudari yang saya hormati, Tahun 2016 merupakan tahun yang penuh dengan pergolakan, cabaran dan perubahan bagi sebahagian besar penduduk dunia. Begitu juga dengan kancah politik serta keadaan ekonomi dunia yang telah melalui perubahan yang ketara. Bagi sesetengah daripada kita, tahun 2016 merupakan tahun mereka menerima berita bahawa mereka mendapat kanser atau mendapat khabar bahawa mereka telah bebas kanser.

Bagi mereka yang secara langsung terjejas akibat berita ini, dunia mereka seolah-olah menjadi gelap secara tiba-tiba. Namun begitulah adat dunia – umur kita semakin meningkat; keluarga kita semakin bertambah atau pergi meninggalkan kita buat selama-lamanya; pekerjaan, kesihatan dan perhubungan berubah dan begitulah seterusnya. Persediaan kita menghadapi perubahan ini menjadi cermin kepada kekuatan dan keupayaan kita untuk meneruskan kelangsungan hidup, sama ada sebagai seorang individu atau sebagai sebuah organisasi.

Dalam terbitan kali ini, izinkan saya menyampaikan penghargaan istimewa kepada mereka yang menjadi tulang belakang dan pendokong kepada kelangsungan MAKNA sebagai sebuah organisasi – para Sukarelawan MAKNA. Saban tahun, kumpulan individu yang terdiri daripada bekas pesakit kanser, ahli keluarga, pekerja penjagaan kesihatan dan orang awam berusaha bertungkus lumus untuk melawan penyakit kanser.

Saya masih tidak percaya bahawa bilangan sukarelawan MAKNA – mereka yang telah menjalani program latihan sukarelawan kami yang ketat – kini telah mencapai hampir 2,000 orang. Mereka terdiri daripada lelaki dan wanita, muda dan tua, berumur dari 19 hingga 73 tahun dan 110 daripada mereka telah berjaya pulih daripada kanser dan kini menjadi sumber kekuatan kepada para pesakit.

Di Sabah dan Sarawak, bilangan sukarelawan kami adalah seramai 147 orang. Bilangan ini mungkin kecil tetapi komitmen yang ditunjukkan mereka adalah sangat tinggi. Kami turut disertai oleh 57 orang sukarelawan antarabangsa dari seluruh dunia, termasuklah 46 orang sukarelawan yang berkhidmat dengan MAKNA Vietnam.

Bilangan sukarelawan ini membuktikan bahawa ramai yang memahami bahawa kanser merupakan musuh yang besar dan perlu dihadapi secara bersama. Saya amat terhutang budi dengan setiap sukarelawan MAKNA atas sikap kasih sayang dan keprihatinan yang ditunjukkan. Pendekatan ini sedikit sebanyak telah meringankan beban ramai pesakit kanser serta keluarga mereka.

Sempena Tahun Baru ini, saya dengan sukacitanya menjemput tuan-tuan dan puan-puan sebagai penderma kami untuk menjadi sukarelawan walaupun untuk tempoh yang pendek sahaja. Saya memberi jaminan bahawa pengalaman ini akan membuka mata tentang sejauh mana sumbangan anda berjaya membantu para pesakit selain memberikan pengalaman yang cukup bermakna buat semua.

Terima Kasih! Saya berharap semoga tahun 2017 anda ini dipenuhi dengan harapan, kasih sayang dan juga kesihatan yang baik.

Farid www.makna.org.my

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PRESIDENT’S DESK

亲爱的朋友们， 对于人们来说，2016年是个充满挑战和流动不定的一年。各种因素影 响了政治动荡，政治和经济。但是对其他人们来说，还是有许多不幸 的人被确诊罹患癌症，但是也有人战胜癌症威胁。 或许这些受影响的人，会瞬间觉得自己的世界受到很大的打击。一直 以来，变化莫测是永恒不变的定律 - 每个人都会变老；家庭也会添加 新成员或悲伤的向最爱的人献上最后的道别；工作、健康和人們建立 的关系也有所不定等等。因此，不管是身为个人或组织，我们该如何 应变，才可展现出我们求生的意志力和恒心。 在本期，我想特别感谢和赞扬MAKNA大大仰仗的力量和赖以生存的支 撑。每年，这群全心全意付出的人士涵括癌症幸存者、家庭、医务人 员和公众人士，奉献出他们的血汗和泪水来全力对抗癌症的威胁。 事到如今，我对于认证的MAKNA义工人数感到惊讶。这群通过我们严格 的义工培训课程的人数总和达到近2,000人，当中有男有女、有老有年 少的，年龄介于19岁至73岁。在义工当中，也有110人是癌症幸存者， 也是病患们的力量支柱。在东马，我们的义工人数只有147人，但是他 们所许下的承诺非常巨大。除此之外，我们也有57位来自全球各地的 国际义工，包括了46位全力奉献给MAKNA在越南的服务。 义工的数量验证了很多人士认同癌症是个危险的敌人，需要具备集体 力量、行动和信念的同等措施来应对癌症。我非常感激每位MAKNA义工 所付出的无以伦比的关爱和怜悯，以及减轻许多癌症病患和其家庭的 负担。 随着我们迈入新的一年，我诚恳的邀请您 - 我们希望的捐赠者能参与 我们的义工活动，不限短期或长期的也好。我保证它将提供您最佳的 新鲜经验和知识，关于您的贡献如何能帮助癌症病患们，以及这亦将 成为一个让您获益无穷及改变人生的体验。 我在此感谢各位的相助，也祝福大家在新的一年2017有个快乐安宁， 健健康康和事事顺利的一年。

法立

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NEOPLASIA { ISSUE 01/2017 }

PRESIDENT’S DESK

அன்புள்ள நண்பர்களே, உலகில் உள்ள பெரும்பாலான மனிதர்களுக்கு 2016ம் ஆண்டு ஒரு திடீர் திருப்பமாகவும், மாற்றமாகவும், சவால்மிக்க ஒரு ஆண்டாகவும் அமைந்தது. இந்த ஆண்டு உலகரீதியில் அரசிலிலும், ப�ொருளாதாரத்திலும், பெரும் மாற்றத்தையும், அரசியலில் சரிசமமான குழப்பத்தையும் காண முடிந்தது. பெரும்பாலானவர்களுக்கு 2016ம் ஆண்டு இன்னமும் புற்றுந�ோய் இருப்பதை உறுதிப்படுத்திய ஆண்டாகவும், முற்றிலும் புற்றுந�ோயிலிருந்து விடுபட்டவர்கள் உள்ள ஆண்டாகவும் அமைந்தது. இந்த மாற்றங்களால் நேரடியாக பாதிக்கப்பட்ட நம் ப�ோன்றவர்களுக்கு உலகமே தலைகீ ழாக மாறி விட்டது ப�ோன்ற ஒரு த�ோற்றம் ஏற்படும். இருந்தாலும், மாற்றங்கள் நிலையானது. முதுமை குடும்பங்களில் குழந்தைகளின் புதுவரவு, அன்பானவர்களின் இறிதிப் பயணம், வேலை, சுகாதாரம், ச�ோந்த பந்த வளர்ச்சி இப்படியாக. இந்த மாற்றங்களுக்கு ஏற்ப நம்மை நாம் தயார் படுத்திக் க�ொள்வதற்கும், ஏற்றுக்கொள்வதற்கும்,உயிர் வாழ்வதற்கும், தனிப்பட்டவர்களின் மற்றும் ப�ொது அமைப்புகளின் வலிமையும் திறமையும்தான் காரணம். இந்த இதழில், MAKNAவின் ஆற்றலுக்கும், நிலைத்தன்மைக்கும் உறுதுனையாக இருக்கும் MAKNAன் தனி குழுக்களுக்கு எனது சிறப்பான வாழ்த்துக்களை கூறிக் க�ொள்கிறேன். ஓவ்வொரு வருடமும், தியாக உள்ளம் க�ொண்ட தனியார்களும், புற்றுந�ோயிலிருந்து விடுபட்டவர்களும், குடும்பங்களும், சுகாதார கவனிப்பாளர்களும், ப�ொது மக்களும் சேர்ந்து இந்த கடுமையான புற்றுந�ோயை ஒழிப்பதற்கு கடுமையாக பாடுபடுகிறார்கள்.

MAKNAவால் அங்கீகரிக்கப்பட்ட தன்னார்வளர் பயிற்சிக்கு கிட்ட தட்ட 2000 பேர்கள் சென்றார்கள் என்பதை அறிய எனக்கு திகைப்பாக இருக்கிறது. இவர்களில் ஆண்களும் பெண்களும் 19 வயதிலிருது 73 வயதுவரை உள்ளவர்களும், புற்றுந�ோயிலிருது விடுபட்டவர்களில் 110 பேர்களும் அடங்குவர். இவர்கள்தான் ந�ோயாளிகளை சந்திக்கும் வலிமைமிக்க தூண்கள் கிழக்கு மலேசியாவில் நம்முடைய தன்னாற்வளர்களின் எண்ணிக்கை 147 . எண்ணிக்கையில் குறைவாக இருந்தாலும் ஈடுபாட்டில் குறைந்தவர்கள் அல்ல. சர்வதேச அளவில் 57 தன்னார்வளர்கள் உள்ளனர். இதில் MAKNA VIETNAM மில் 46 பேர்கள். புற்றுந�ோய் ஒரு மாபெரும் எதிரிஎன்பதை அதிகமானவர்கள் ஆழமாக நம்புவதை இந்த எண்ணிக்கை நிறூப்பிக்கிறது. அதனால் சரிசமமான அளவ�ோடும், ஒன்றுபட்ட ஊக்கத்துடனும், நம்பிக்கையுடனும் இதை எதிர் க�ொள்ள வேண்டியிருக்கிறது. MAKNA தன்னாவளர்கள், அன்போடும், இரக்கத்தோடும் புற்றுந�ோய் ந�ோயாளிகளையும் அவர்கள் குடும்பத்தாரையும் கவனித்துக் க�ொண்டுவதற்கு நான் நன்றி ச�ொல்ல கடமைப்பட்டுள்ளேன். புதுவருடத்தை எதிர்நோக்கும் இவ்வேளையில் நன்கொடயாளர்களையும், தன்னார்வளர்களையும் வரவேற்கிறேன். புற்றுந�ோய் ந�ோயாளிகளின் வாழ்க்கையில் ஒரு திருப்பம் எற்படவும், வெகுமதியாகவும் அமைய உங்களின் பங்கு பெரும் உதவியாக அமைந்தது, உங்களுக்கு ஒரு நல்ல அறிவுப்பூர்வ அனுபவமாக அமையும் என்பதற்கு உத்தரவாதம் அளிக்கிறேன். உங்களின் ஆதரவுக்கு மிக்க நன்றி. வரும் 2017-ம் ஆண்டு உங்களுக்கு நல்லத�ொரு மகிழ்ச்சியான, ஆர�ோக்கியமான, வருடம்மாக அமைய வாழ்த்துகிறேன்.

ப்ஹாரிட் www.makna.org.my

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NEWS & HAPPENINGS

PUTRA-MAKNA RUN 2016 “For Hope and Cancer Research”

By Professor Dr Rozita Rosli, Institute of Bioscience, Universiti Putra Malaysia “For Hope and Cancer Research” was the theme for the first-ever PUTRA-MAKNA RUN that was held at the Universiti Putra Malaysia (UPM) stadium on 12 March 2016.

This was in conjunction with World Cancer Day and the UPM Sports Carnival.

Laugh Together lah

The main objective of the event was to highlight cancer research at UPM and the close collaboration between UPM and MAKNA through the UPM-MAKNA Cancer Research Laboratory at the Institute of Bioscience.

PUTRA-MAKNA RUN 2016 received overwhelming support from close to a thousand participants from within and outside UPM, as well as sponsors such as Yakult, CIMB, MAEPS, GE Health and Borseiko Health Solutions.

The event was officiated by Dato’ Seri Idris Jusoh, Minister of Higher Education, and was graced by the presence of Tan Sri Tajol Rosli and Professor Datin Paduka Dr. Aini Ideris, UPM vice-chancellor as well as MAKNA Executive Member.

Professor Dr Rozita Rosli currently heads the UPM-MAKNA Cancer Research Laboratory at the Institute of Bioscience, Universiti Putra Malaysia. She is also attached to the Faculty of Medicine and Health Sciences, UPM. Her research area of interest is in Cancer Genetics.

Prof Rozita can be reached at rozita@upm.edu.my.

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NEOPLASIA { ISSUE 01/2017 }

Source: toonut.com

INK OCTOBER

NEWS & HAPPENINGS

Breast Cancer Awareness Workshop: Diagnosis and Basic Nursing Care

By Asif Muhammad and Dr Oon Chern Ein, Institute for Research in Molecular Medicine, Universiti Sains Malaysia

Breast Cancer Awareness Month kicked off with yet another successful collaborative effort between MAKNA and Universiti Sains Malaysia (USM) headed

by Azlina Abdullah and Dr Oon Chern Ein. A breast cancer awareness workshop was held at the Institute for Research in Molecular Medicine (INFORMM), USM, with close to 40 people participating, including cancer survivors, students and the public.

rare opportunity to gain insight into how breast cancer is diagnosed through a sharing session with Professor Dr. Gurjeet Kaur, a pathologist and the deputy director of INFORMM. During her talk, she shared her experience behind the scenes as a pathologist and imparted knowledge on different types of breast cancer as well as the importance of screening for early detection and possible treatment options.

Cancer is one of the world’s deadliest diseases, responsible for millions of fatalities worldwide. Among the various factors leading to the high mortality rate are poor knowledge and ignorance of early signs and symptoms of the disease. Breast cancer is one of the leading causes of deaths among women around the globe. In Malaysia, it is among the top five cancers which are diagnosed and responsible for cancer-related deaths. According to the findings of the Malaysian Oncology Society, one in nineteen women in this country is at risk of developing breast cancer in their lifetime (1).

Recent surveys conducted in Malaysia have indicated that the incidence of cancer has drastically increased due to wrong perceptions and a lack of accurate information about cancer.

The workshop ended with a short course on basic nursing conducted by Hazwan Zulyardain from Pusat Sejahtera USM, during which participants were briefed on the importance and techniques used to measure blood pressure, body temperature, etc,. as a form of routine health monitoring.

The long-term collaborative commitment between MAKNA and USM has successfully witnessed a series of cancer awareness lectures and workshops aimed at educating the public about cancer over the last two years. For the first time, workshop participants had the

Community awareness and educational programmes such as the Breast Cancer Awareness Workshop can play a major role in increasing awareness of this lifethreatening disease and reduce cancer incidence. We wish to thank MAKNA and the Division of Industry and Community Network, USM, for their financial support in making this partnership a success.

Reference: Cancer Malaysia, Oncology Malaysia, Oncologist & Cancer Malaysian Oncological Society (MOS). Retrieved December 19, 2016, from Malaysian Oncological Society, http://malaysiaoncology.org/ article.php?aid=114 www.makna.org.my

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NEWS & HAPPENINGS

MAKNA Re-CYCLE, Give CYCLE Besides the cycling charity event held in Kampar, MAKNA has had even more action with two-wheelers in 2016. Volunteers have recently been on the lookout for bicycles, collecting, restoring and repairing them to be gifted to cancer patients. Known as ‘Re-CYCLE, Give CYCLE’, the initiative was led by the MAKNA Volunteer department.

Instead of collecting donations or buying new bicycles, the ‘Re-CYCLE, Give CYCLE’ project sought to involve volunteers by having them participate in the restoration and repair of the collected bicycles.

Village Bicycle Workshop (VBW), who partnered MAKNA in this initiative, conducted the workshop for 37 MAKNA volunteers. They were grouped into 10 teams with each team given a bicycle to repair and restore. Upon completion, the restored bicycles will be given to 10 of MAKNA’s most deserving cancer patients.

MAKNA hoped that taking a hands-on approach would foster greater ownership of the cause among its volunteers, while adding greater meaning and value to the time, effort and energy they put in to provide cancer patients from the lower income group with affordable transportation.

In addition, MAKNA also hoped to advocate waste reduction by recycling unused items, in this case, old bicycles, and to promote a healthier lifestyle by encouraging cycling.

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The workshop came to an end with MAKNA Deputy General Manager, Vemanna Appannah, presenting a memento – a key chain made from bicycle chain - to each mechanic and volunteer to thank them for their contribution to the ‘Re-CYCLE, Give CYCLE’ initiative.

The restoration and repair works were carried out at The Canopy, Jalan Riong, Bangsar– a location sponsored by Art Printing Works Sdn Bhd.

KAMPAR MAJESTY

NEWS & HAPPENINGS

RIDE 2016

By Ammar Asyraf b. Rajmi, MAKNA Executive

A total of 610 participants took part in a nationwide charity cycling event in aid of MAKNA. The 4th Kampar Majesty Ride 2016 was flagged off by Ahli Dewan Undangan Negeri of Manong, Mohamad Kamil Shafie, on behalf of the Perak Menteri Besar.

Various activities were held at the charity event, including a health exhibition and counselling sessions. The event raised a total of RM6,050 and all proceeds were channelled to MAKNA.

HONNETS UNITE TO RAISE FUNDS FOR MAKNA The atmosphere was lit at Honsbridge International – lit, noisy and tons of fun! That’s because the school recently held a charity fundraiser that saw overwhelming participation from its student body and teachers – or Honnets, for short. They were involved in various activities, including games and food, with the highlight being a creative flag competition and a soda stall serving a zesty, refreshing Infusion of lemonade and grape! The action picked up when the Honnets moved the fundraiser to the front door of the school.

Loud music, cakes, cookies and tanks of Infusion were involved. All proceeds collected were donated to MAKNA.

the fundraiser and awareness initiative coincided with the Merdeka celebration – an appropriate time indeed, as the events created unity among Honnets regardless of age and race.

The school also took the opportunity to raise awareness on Honsbridge educational benefits, which took place at the other side of Dataran Sunway, at Sunway Giza. Both www.makna.org.my

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NEWS & HAPPENINGS

By Vemanna Appannah, MAKNA Deputy General Manager Volunteers from near and far, regardless of age, from all walks of life, never fail to give their best in everything they do. The calling drives volunteers to get involved, be it dining at a charity event or climbing a mountain – whatever it takes to give back to the community.

These two activities in 2016 collectively raised RM97,600 in Sabah, the land below the wind. We hope that similar initiatives continuously receive support and inspire public action to volunteer and lend a hand to those in need.

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KLIMB K For the fourth time, MAKNA Kinabalu climb brought a new set of volunteer climbers together to summit Malaysia’s tallest mountain from 17 to 20 August 2016. The annual event, ‘Klimb Kinabalu’ replaces the alphabet ‘C’ in Climb with ‘K’.

‘K’ represents Kinabalu and Kanser in the local language.

Led by Vemanna Appannah, Deputy General Manager of MAKNA and an avid climber himself who has helmed all previous climbs, Klimb Kinabalu 2016 registered 13 climbers in total, each of them from various backgrounds and with diverse reasons for committing to the climb. Many responded to the challenge out of personal experience of either having lost family members or friends to cancer, or having seen how their loved ones battled the illness. Beyond

NEWS & HAPPENINGS

KINABALU 2016 committing to raising a minimum of RM2,000 per person, each climber also had to commit to two months of strength and stamina training, which included practice climbs and hikes at locations such as Bukit Gasing, Bukit Tabur, Gunung Datuk and Gunung Nuang.

At the Timpohon gate, the climbers were sent off by cancer survivor Amylia Mustapha, who had wanted to be part of the team but was unable to due to her health. Instead, her dream to climb Mount Kinabalu was shouldered by the 13 climbers that included four AirAsia Allstars staff.

The team was blessed with clear skies and fair weather on the first day as they headed to Laban Rata. The second day, however, the weather took a turn for the worse. From dawn, as the team began the summit trail, there was thick fog and chilly winds all the way.

Yet, the team persisted, knowing full well that the challenges they faced were nothing compared to the tough times and obstacles cancer patients go through.

It was raining the night when the team was resting at Laban Rata Rest House before continuing the summit climb at 2.30 a.m. As a result of the rain, the trail was slippery and there was a constant cold, strong wind.

Reaching Sayat-Sayat checkpoint, the team faced limited visibility due to thick fog surrounding the area.

The team was guided with some help from light from their headlamps breaking through the fog. This did not dampen the climbers’ spirits. Slowly, steadily with one goal in mind, all 13 were proud to overcome their challenges and made it to the summit. The team raised RM66,000.

Last year’s Klimb Kinabalu also saw AirAsia Berhad taking part as a benefactor for the good cause. In addition to sponsoring the flights of the climbers and working group to Kota Kinabalu, four AirAsia Allstars joined the expedition to raise public awareness of the terminal illness. The climbers and working team were all protected by Tune Protect, travel insurance by AirAsia.

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NEWS & HAPPENINGS

SABAH 3RD ANNUAL FUNDRAISING NIGHT

Put together time and heart and what do you get?

Volunteer Pn. Matahari Ismail, an active volunteer with MAKNA in Kota Kinabalu, Sabah.

Matahari has been reaching out to raise funds and awareness about cancer in Kota Kinabalu for a few good years now with MAKNA. She recently organised the 3rd fundraising dinner on 13 August 2016 at The Pacific Sutera Hotel, Kota Kinabalu, Sabah. Matahari, backed by the support of her husband, Helmie, has taken the onus of sharing with the local community MAKNA services and outreach to poor cancer patients and their families.

As in the previous years, diners at the charity event were treated to a fine feast and entertainment while doing their bit to support the cancer cause. Attractive lucky draw prizes were up for grabs with the grand lucky draw prize being a return ticket sponsored by Royal Brunei Airways to Ho Chi Minh City.

A tear-jerking video montage of Randy, a child who lost the battle to leukaemia, was shared at the event. The room was left with no dry eyes. Later, the evening livened up with the entertainment of local dancers and performers. A ballet dance, a capella by True Echo, and performances by husbandand-wife pair Jessel & Carol, Jonathan Tse and the charming Daud Abdillah made for a magical evening. Heartfelt thanks go to volunteer committee members Tanty, Laynnee and Shirley for their commitment, energy and time spared over the preceding months in planning the event with Matahari.

The evening left a profound impression on all volunteers, donors, supporters and sponsors who made the evening memorable. The final amount raised totalled RM31,000 in aid of cancer treatment and recovery of cancer patients. The previous two fundraising events raised RM17,120 (in 2013) and RM21,600 (in 2014) respectively.

THANK YOU TO THE FOL LUCKY DRAW SPONSORS 1. ANINA VON WINTERFELD 2. BORNEO TRAIL 3. BGB COUNTRY TOURS & TRAVEL SDN BHD 4. CHILLI VANILLA 5. CAROL WONG 6. DELITALY SDN BHD 7. GRAND BORNEO HOTEL 8. HOTEL NO 5 9. HYATT REGENCY KINABALU 10. MISS NORIEN ESPEY 11. MDM JUDY LEE 12. MDM PATRICIA MOSINOH 13. MR LEKAN ODEDEYI 14. ROYAL BRUNEI AIRLINES 15. SOLUXE HOTEL KOTA KINABALU 16. WARRIOR FITNESS KOTA KINABALU 17. ZIP BORNEO EMCEE ( MASTER OF CEREMONIES ) MOHAMMAD ISKANDAR SHAH ALI FUNDRAISING DINNER TICKET PRINTING SPONSOR THE ORANGE CHANNEL VIDEO MONTAJ ( RANDY ) YUZAIRI MD YUSOF LIGHTING & SOUND SYSTEM 1. SOUND TECH PRODUCTION SDN BHD

In 2015, MAKNA supported 592 patients in Sabah, and more activities and services are in the pipeline for East Malaysia.

We wish to thank the following sponsors and supporters (please see Fundraising Dinner Sponsor List): 11

NEOPLASIA { ISSUE 01/2017 }

NEWS & HAPPENINGS

LLOWING SPONSORS/SUPPORTERS DONORS & SUPPORTERS 1. CELCOM TIMUR

ORGANISING COMMITTEE 1. LAYNEE MARIANO

2. CREST MEGAWAY SDN BHD

2. NORIEN ESPEY

3. DATIN BIBI FARIZAN AMJAD

3. SHIRLEY ROSEMARY PRIMUS

4. DATIN ZALEHA ABDULLAH 5. DEWAN PERNIAGAAN BUMITERA SABAH HOLDING SDN BHD 6. HAP SENG SDN BHD

4. TANTY ZELIANA ZAKI

7. MDM AZLINA RAHIM 8. MDM BIBI GULSHON 9. MDM KHATIZAH HARRIS

Laugh Together lah

PHOTOGRAPHER & VIDEOGRAPHER 1. ART 2 QOI PRODUCTION 2. M.SAIRUL MALAI HASSAN 3. SIURANG DOT COM

10. MDM TINA TEO

- WAN FHAIRUZ

11. MDM THEODORA @ DORA WATSON

- WAN AZMI

12. MDM RENA KASHELDA DIEGO

- WAN SHAFIZAN

13. SHERIMAN JUAN PETER 14. MDM SHIRLEY ROSEMARY PRIMUS

CELEBRITIES & ENTERTAINERS

15. MR AHMAD FIRDAUSS ANIFAH AMMAN

1. CLERRETTA RAYMOND

16. MR DAVID GERAINT STALLARD POWELL

2. DAUD ABDILLAH

17. MR MALCOLM ABIDIN MADINGKIR

3. JESSEL C.P YANSALANG

18. NORAINI ISMAIL

4. JONATHAN TSE

19. PEMBINAAN AZAM JAYA SDN BHD

5. KUMPULAN PENARI KINABALU

20. PEMBINAAN KEKAL MEWAH SDN BHD

6. NORA RIDZWAN

21. PRIMA CL SDN BHD

7. TRUE ECHO

22. ROZITA MASTOR

- ABRAHIM MOJINGOL

23. SABAH BIG BIKES ASSOCIATION

- ANDERSON NEIL HUMPHREY

24. SABAH LAND DEVELOPMENT BOARD

- DARRELL DE LOREAN SANDAH

25. SABAH PORT AUTHORITY

- KELIMEN SAWATAN

26. SERI HEBAT STORE

- STEVELL LUMBASI

27. SOUND TECH PRODUCTION SDN BHD

- WALTER D C SAKANDAR

28. SUPER WASH LAUNDRY SDN BHD 29. TARIE TRAVEL & TOURS SDN BHD 30. THAMALAGHA P.KRISHNASAMY 31. YURIE WONG

Source: toonut.com

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INTERNATIONAL

CONNECTING CITIES WITH CARE: MAKNA IN VIETNAM SPREADING LAUGHTER TO DA NANG CITY

By Nhan TB Dinh, MAKNA International Division In August 2016, cancer patients at K Hospital Hanoi, Vietnam enjoyed a full range of support services ranging from Laughter Yoga to support groups.

This first-time experience was brought about by the “Hanging Onto Hope” campaign and MAKNA Vietnam. The initiative featured an art exhibition, sharing inspirational quotes, designing greeting cards, and a mobile library with a good selection of books such as the Chicken Soup for the Soul series, among many others.

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This meaningful and hands-on service started in June after the MAKNA Vietnam Laughter Yoga field trip to Da Nang Oncology Hospital. Seeing the need for more support services in often overcrowded metropolitan areas, MAKNA mobilised young volunteers with exceptional artistic talent to convey a message of hope and care for cancer patients with their paintings.

INTERNATIONAL

KẾT NỐI CÁC THÀNH PHỐ THÔNG QUA CHĂM SÓC Y TẾ:

MAKNA VIỆT NAM MANG TIẾNG CƯỜI ĐẾN THÀNH PHỐ ĐÀ NẴNG Tháng 8 năm 2016, các bệnh nhân ung thư tại bệnh viện K Hà Nội, Việt Nam đã được trải nghiệm các dịch vụ hỗ trợ từ liệu pháp Yoga Cười đến chia sẻ cảm xúc. MAKNA Việt Nam đồng hành cùng Dự án tình nguyện “Một bức tranh - Nhiều hy vọng tại Hà Nội” để mang đến trải nghiệm đầu tiên thật thú vị cho các bệnh nhân. Chương trình bao gồm triển lãm tranh, những câu trích dẫn truyền cảm hứng, làm thiệp chúc mừng, thư viện di động với những cuốn sách hay và bổ ích như Bộ sách “Chicken Soup for the Souls - Quà tặng cuộc sống”.

Dịch vụ ý nghĩa và rất thiết thực này đước khởi xướng từ tháng 6 sau khi MAKNA Việt Nam tổ chức lớp tập huấn Yoga Cười tại Bệnh viện Ung bướu Đà Nẵng. Nhận thấy nhu cầu cần thêm nhiều dịch vụ hỗ trợ tại các đô thị đông đúc, MAKNA đã nỗ lực huy động sự tham gia của các tình nguyện viên trẻ có tài năng nghệ thuật xuất chúng. Kết quả thu nhận được là những hy vọng mà tình nguyện viên cùng nhóm lên trong những bệnh nhân ung thư – những ‘hy vọng’ đầy sắc màu như những ‘bức tranh’ mà họ vẽ.

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INTERNATIONAL

MAKNA STEPS UP TO

2015-2030 UNITED NATIONS SUSTAINABLE DEVELOPMENT GOALS

By Nhan TB Dinh, MAKNA International Division During the last week of July, MAKNA participated in the UN HABITAT’s Preparatory Committee Conference in Indonesia, working towards the New Urban Agenda, which will serve as the blueprint for all urban planners in the next 20 years.

The New Urban Agenda is a solid milestone under Sustainable Development Goal 11 or SDG 11 (Sustainable Cities and Communities). Its key messages reach farther than simply sustainable planning, striving for equitable access to all services involved in the growth of countries. This is a trend that MAKNA sees as pertinent in Malaysia and South East Asia in general, where there exists geographical sparsity and large gaps between urban and rural access to public healthcare.

Seeing urban-rural linkage as the missing piece in the puzzle to many expanding metropolitans, MAKNA seized the opportunity to introduce its Mobile Screening Unit initiative as a pragmatic solution to bridging the gap in cancer prevention. Following that,

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MAKNA was able to have Neoplasia, our newsletter, and our Mobile Unit infographic included in the UN’s Urban Library. MAKNA’s efforts harmonised with the other 71 exhibitors that were made up of UN agencies, governments, academia, NGOs and civil society, in the search for sustainable development catered for the Asian context.

MAKNA is taking bold steps in establishing networks within the UN system, including the UN ESCAP (Bangkok), UNV-UNDP (Bangkok & Kuala Lumpur), UN Major Group for Children and Youth (Hong Kong), UN University – Institute for the Advanced Study of Sustainability (Tokyo), and the International Institute for Global Health (Kuala Lumpur).

There is no indefectible solution that fits all, but MAKNA sees opportunities like this as a crosssector solution hub, where ‘no one is left behind.’

INTERNATIONAL

MAKNA TIẾN GẦN HƠN ĐẾN CÁC MỤC TIÊU PHÁT TRIỂN BỀN VỮNG CỦA LIÊN HỢP QUỐC (LHQ) GIAI ĐOẠN

2015-2030

Cuối tháng 7, MAKNA tham dự Hội nghị Ban trù bị UN HABITAT tại In-đô-nê-xi-a, nhằm xây dựng Chương trình nghị sự mới về đô thị.

Chương trình này sẽ đóng vai trò hướng dẫn cho các nhà quy hoạch đô thị trong vòng 20 năm tới.

Chương trình nghị sự mới về đô thị là một sự kiện quan trọng trong SDG11 (Các thành phố và cộng đồng bền vững). Những thông điệp chính của chương trình nghị sự không chỉ là quy hoạch bền vững đơn thuần mà còn là quyền bình đẳng trong tiếp cận mọi dich vụ liên quan đến tăng trưởng của các quốc gia. Đây là xu hướng tại Ma-lai-xi-a nói chung và tại những nơi MAKNA nhận thấy sự tương đồng do đặc điểm địa lý dàn trải của khu vực Đông Nam Á cũng như khoảng cách lớn giữa khu vực thành thị và nông thôn trong tiếp cận với hệ thống chăm sóc sức khỏe công.

Nhận thấy mối liên hệ giữa khu vực thành thị và nông thôn là câu đố chưa có lời giải với nhiều đô thị đang mở rộng, MAKNA nhân cơ hội này giới thiệu sáng kiến Đơn vị sàng lọc lưu động như một giải pháp hữu hiệu nhằm thu hẹp khoảng cách trong phòng ngừa ung thư, thông qua việc đưa tập

nội san Neoplasia cũng như bản thiết kế đồ họa thông tin về Đơn vị sàng lọc lưu động vào thư viện đô thị của LHQ. Những nỗ lực của MAKNA hài hòa với 71 đơn vị triển lãm đến từ các cơ quan của LHQ, chính phủ, học viện, các tổ chức phi chính phủ và tổ chức xã hội dân sự vì mục tiêu chung: tìm kiếm sự phát triển bền vững cho khu vực châu Á.

MAKNA đang có những bước tiến vững chắc trong việc xây dựng mạng lưới trong hệ thống LHQ bao gồm UN ESCAP (Băng-cốc), UNVUNDP (Băng-cốc & Kua-la Lum-pua), Nhóm chủ đạo của LHQ về trẻ em và thanh thiếu niên (Hồng Kông), Đại học LHQ – Viện nghiên cứu cao cấp về bền vững (Tô-ky-ô) và Viện nghiên cứu quốc tế về sức khỏe toàn cầu (Kua-la Lum-pua).

Không có hình mẫu hoàn hảo cho tất cả, nhưng MAKNA coi những cơ hội như hội nghị này là nơi để trao đổi, học hỏi, để ‘không ai bị tụt lại phía sau’.

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COVER STORY

VOLUNTEERS AND HOW THEY SUPPORT MAKNA THROUGHOUT MALAYSIA

By Priyadarshini Subramaniam, MAKNA Volunteer Coordinator

VOLUNTEER LEADERS GATHER FOR KNOWLEDGE SHARING TO SERVE THE COMMUNITY BETTER MAKNA Volunteers are passionate and committed to carrying forth the vision and mission of MAKNA. They proudly represent MAKNA as ambassadors and uphold the motto that “the human spirit can achieve whatever it sets out to do when the will is able.” These strong values and beliefs help our volunteers to spread the “Work of Heart”.

conducted on 31 July 2016 at the MAKNA Head Office in Kuala Lumpur, while in East Malaysia, the Volunteer Leaders Refresher Meeting 2016 was held on 20 August 2016 in Kota Kinabalu, Sabah for East Malaysian volunteers. Both meetings focused on updating volunteers on developments at MAKNA and the services provided for its main beneficiaries (cancer patients).

To propel volunteers towards reaching both their potential and greater heights in service delivery, the MAKNA Volunteer Management Unit (VMU) regularly communicates with volunteer leaders across Malaysia, giving updates and holding periodic meetings to keep all volunteer leaders abreast with the changes and developments with regard to MAKNA policies, procedures and practices. These meetings enable volunteer leaders to share knowledge towards serving the community in the best way possible, to mobilise resources best and to enhance leadership.

With the extensive expansion of MAKNA services to East Malaysia in 2016 that will continue through 2017, the VMU hopes to empower existing volunteers and new ones alike to serve in East Malaysia. Both Sabah and Sarawak are supported greatly by MAKNA and we hope that the services and support given will continue to grow and improve particularly with the backing of our volunteer force.

With that purpose in mind, the 2nd Quarterly Volunteer Leaders Meeting 2016 for Peninsular Malaysia was

Register at our website: www.makna.org.my to be a part of our “Work of Heart” or write in to priyadarshini@makna.org.my for more information about volunteering with MAKNA.

Home Visit by Volunteers Over the past 15 months the Volunteer Management Unit (VMU) has been actively training individual volunteers and educational institutions that have adopted the MAKNA Volunteer Club Modules. Trainings such as the MAKNA Introductory Programme (MIP) and Basic Nursing Care (BNC) Modules I and II make up the three compulsory volunteer trainings. In addition, volunteers also undergo the Home Visit Training to get involved in home outreach. 2016, in particular, has seen many new volunteers being initiated into home visit activities.

The Home Visit Training is offered to new volunteers to enable them to experience the reality of a cancer patient’s everyday life and to witness the impact of cancer. The training also equips them with relevant knowledge to conduct home visits on their own should they take on this specialization from the MAKNA range of services. Our volunteers support all aspects of MAKNA services wherever possible and have been integral in assisting the Home Visit Department reach their annual target of visiting an average of 5000 cases per year. The VMU and volunteers have pledged to give the Home Visit Department as much support as possible and have made good contributions to patients in no small ways.

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NEOPLASIA { ISSUE 01/2017 }

We at VMU believe in the adage “Sedikit-sedikit, lamalama jadi bukit.” Should you be interested in contributing to the height and strength of the “bukit” , do register at our website, www.makna.org.my and/or if you are interested in adopting the MAKNA Volunteer Club Module in your school, college or university, please write in to priyadarshini@makna.org.my for more information. * The featured photos show young volunteers from Taylor’s College Subang Jaya conducting home visits to cancer patients in the Klang Valley.

Other images show new and promising volunteers who are themselves cancer survivors and Kadulliah Ghazali from Kuala Lumpur.

MAKNA Volunteer Appreciation Day

COVER STORY

2016

MAKNA recently celebrated its volunteer force as a gesture of gratitude for their hard work and selfless dedication to volunteering. Over 100 MAKNA volunteers from all over Peninsular Malaysia attended the Volunteer Appreciation Day, held in conjunction with International Volunteers Day, at Taman Botani Perdana, Kuala Lumpur.

Themed Volunteers Give Back, the lead-up to the appreciation day was the Re-CYCLE, Give CYCLE initiative that started in September, where MAKNA volunteers collected and restored 10 used bicycles with the help of mechanics and friends of project partner, Village Bicycle Workshop. The restored bicycles were presented to cancer patients during the appreciation day. Besides serving as a platform to hand over the bicycles, the appreciation day aimed to recognise the invaluable service that volunteers give to MAKNA and cancer patients.

At the event, 19 volunteers were presented with awards

by MAKNA Founder and President, Dato’ Mohd Farid Ariffin, in recognition of their outstanding performance.

The highest recognition, the Excellence Award, was presented to Latipah Bt Saat and Max Chong Kam Kok who had distinguished themselves with their exceptional, long-term commitment to serving the community.

Dato’ Farid also presented seven volunteers with the Potential Volunteer Leader Award. This award recognised their readiness to lead and take on leadership challenges in the years to come. Recipients of the award had consistently demonstrated acts of selfless contribution

towards community work and had fulfilled a minimum of 40 hours of volunteer service. As Potential Volunteer Leaders, they are responsible for building new teams and a network of volunteers under the leader’s supervision.

In addition, two volunteers were presented with the Promising Youth Award. This Special Recognition Award was introduced specifically to recognise volunteers who are cancer patients or survivors, caregivers or physically challenged, to commend their admirable spirit of giving despite the personal challenges and hardships they face.

“I thank all MAKNA volunteers for the guidance, care and love they have tirelessly shown to those who are less fortunate.

Their selflessness and indefatigable spirit to help are truly commendable. They have made it possible for MAKNA to extend our support to a larger group of cancer patients and their families not just here in Malaysia, but in Vietnam too, and we hope in more countries in the future,” said Dato’ Farid.

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COVER STORY

Fundraising Campaigns

Klimb Kinabalu 2016 Fight Against Cancer 17-20 August 2016

13 climbers, determined and

focused on reaching the peak

4,095 metres conquered

RM30,000 raised by volunteers Sabah under the lead of Pn. Matahari Ismail, Blue Vest Volunteer Leader

Recreational activities with cancer patients

Taylor’s College Subang Jaya.

WACKY – A Day of Fun, 21 May 2016 19

NEOPLASIA { ISSUE 01/2017 }

COVER STORY

Volunteer Activities Lanyard making project for confronting cancer curing & caring conference (6-7 August) Hospital Sultanah Bahiyah, Alor Setar, Kedah.

eers

it by

Vis ome

H

olunt ew V

N

5-6 August 2016, KL. Dataran Petaling Jaya

23-24 July 2016, Penang.

Taman Perbandaran Pulau Pinang

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COVER STORY

Fundraising Campaigns Recipients (Paediatric)

Cempaka Damansara, Interact Club Internationa Understanding Day – Defy All Odds 23 July 2013

The Dancing Feet 28 May 2016

Unisza – Dietetic Charity Week 2016 14-16 April 2016 Unisza, Campus Gong Badak

Buka Puasa / Hi Tea / Raya Makan

By Mama Lina

MAKNA Recreational Activities 21

NEOPLASIA { ISSUE 01/2017 }

Jump Ad Pool 21 May 2016 The Everly Hotel, Putrajaya

COVER STORY

Peninsular Malaysia 2nd Quarterly Volunteer Leaders 2016 Meeting 31 July 2016 MAKNA Conference Room

East Malaysia Volunteer Leaders Refresher Meeting 20 August 2016

Volunteer Leaders 2016 Meeting – Peninsular & East Malaysia www.makna.org.my

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RESEARCH

Breast cancer:

What you need to know

By Caitlin Bowles and Dr Oon Chern Ein*, Institute for Research in Molecular Medicine, Universiti Sains Malaysia

What is breast cancer?

Breast cancer is the second most common type of cancer in the world today, with around 1.7 million new cases diagnosed every year (World Cancer Research Fund International, IARC and WHO, 2012). With the highest mortality rate of any cancer affecting women in Malaysia, breast cancer is the most common, with one in 19 women being at risk of developing this disease in their lifetime (Malaysian Oncological Society, undated).

Cancer is caused by uncontrolled cell division which forms a mass of cells called a tumour. Cancer cells have a variety of ways to evade cell death. This means that the cancer cells are unaffected by the body’s normal mechanisms to kill old or unwanted cells, so the cells will not die and the tumour will continue to grow. It is associated with several biological risk factors, such being a carrier of the mutated BRCA I and BRCA II genes.

Being a carrier increases the risk of developing breast cancer from 12% to 50% (National Cancer Institute, 2003). Other contributing risk factors include obesity, diet, lifestyle choices, late menopause and exposure to radiation or chemicals.

The first symptom is usually a lump in the breast, which is painless and grows slowly, possibly altering the shape of the breast. There may be discharge from the nipple, and it may become blood stained or inverted. As the tumour grows it may come through the skin and become infected, and as the cancer spreads to other areas of the body, it can cause bone pain, chronic cough, sore liver and severe headaches.

Breast cancer staging There are five stages of breast cancer: stage 0 refers to non-invasive ductal carcinoma in situ (DCIS) which describes the pre-malignant condition of the milk ducts in the breast, lobular carcinoma in situ (LCIS) which refers to the abnormal cell growth in the breast lobules, and Paget’s disease of the breast that affects the skin around the nipple and areola without association with invasiveness. Stages I through IV are used to describe invasive breast cancer. In Stage I, the cancer cells have 23

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migrated to the surrounding breast tissue, forming a small tumour that may be felt on inspection. In Stage II the tumour has grown and spread from its original location into the surrounding breast tissue and/or extended to the underarm (axillary) lymph nodes but has not metastasized to distant regions of the body. A Stage III tumour is quite large, and is present in the axillary lymph nodes, and when more progressed, is visible on the skin of the breast and the chest wall, but has not spread to distant organs. In Stage IV the tumour has metastasized to one or more areas/ organs of the body, usually via the blood vessels and the lymph nodes.

A doctor will assess the stage using the TNM staging system which takes into account the tumour size (T), advancement of cancer spread to the lymph nodes (N), and whether the tumour has metastasized to other regions in the body (M). A value from 0 to 4 is given based on how big the tumour (T) is and if it has spread to the wall of the chest. For lymph node involvement (N), a number from 0 to 3 indicates if the cancer has spread to the lymph nodes, and if so, how many are involved. For metastasis (M) either a 0 or 1 is given to show whether the cancer has spread to distant organs. A higher value for TNM indicates a further progressed cancer.

Once the stage has been obtained, it is used to determine a treatment plan for the patient, as more progressed tumours will be treated differently from smaller tumours.

Treatment options Most people diagnosed with breast cancer (Stage I and above) will undergo some form of surgery to remove the tumour, though at Stage IV this is more to alleviate the symptoms than treat the disease. As it is difficult to discern whether every cancerous cell has been removed, radiation therapy is often used after surgery to ensure the cancer does not return, but this is only in stages I and II. If the cancer is more progressed, it will not have a sufficient effect. A dosage of radiation is given to the affected area, which damages the DNA of the cells in the path of the beam, meaning they are unable to divide and will die.

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Chemotherapy is very commonly used in breast cancer.

For those with early stage invasive tumours, it is used before surgery to reduce the size of the tumour, and after surgery to kill any cancerous cells that may be left behind to ensure the cancer does not return.

Chemotherapy works by killing cells that are undergoing multiplication, which occurs frequently in a tumour. In advanced-stage tumours, chemotherapy is used to do as much damage as possible to the cancer cells, to help reduce the size of the tumour.

negative tumours. For these types of cancers, drugs are given to block the signalling pathway of HER2, therefore stopping cell growth. The drug most commonly used is Trastuzumab, which is sold under the brand name Herceptin. The treatment options regularly used for breast cancer patients are summarised in figure 1.

Conclusion Today there is increasing research into targeted therapies, which act to suppress a specific pathway within the tumour that allows the cells to evade apoptosis and continue replication. As the field advances, the prognosis for a patient diagnosed with breast cancer is improving, but the disease still accounts for the highest number of cancer-related deaths for women. At the moment, the prognosis is somewhat reliant on discovery at an early stage, but it is hoped that new targeted therapies will be able to send progressed cancers into remission and prolong patient survival.

Other types of treatment rely on specific hormone receptors expressed by the tumour to stop the action of the related hormones, which keep the cells alive and promote cancer cell replication. The important receptors in breast cancer are oestrogen receptors (ER), progesterone receptors (PR). For ER and PR-positive tumours, hormone therapy may be used, but for ER and PR-negative tumours, they will have no effect. These drugs will either stop the body from making the hormones or block the action of the hormone, thus interfering with the signalling pathways activated by the hormone receptors in the cancer cells.

The cells need these hormones in order to grow, so when the signal is no longer received, they will Figure 1. The figure depicts a range of cancer treatments. These diagrams are stop growing. extremely simplified, and are not to scale, but provide a basic overview of the different types of systemic and local treatments.

It is estimated that around 70 percent of breast cancers are ER-positive with most ER-positive breast cancers also being PR-positive (Dunnwald et al., 2007). For ER-positive tumours, a drug called Tamoxifen can be used. It has a wide range of effects from inhibiting the spread of breast cancer to other regions of the body, to shrinking tumours and increasing life expectancy. Aromatase inhibitors (which stop oestrogen from being made, thus slowing the growth of tumours) are used to treat post-menopausal women. These are just some of the drugs used; there are a wide range available, and are chosen based on the patient’s needs and responsiveness.

Another important classification of breast cancer is whether or not human epidermal growth factor receptor 2 (HER2), a gene that produces cell receptors, is amplified in the tumour. Breast cancers with elevated HER2 are described as HER2-positive, and these types of breast cancer are more aggressive than HER2-

References: Globocan, WHO and International Agency for Research on Cancer, (2012), All cancers excluding non-melanoma skin cancer, Available at http://globocan.iarc. fr/Pages/fact_sheets_ cancer.aspx Malaysian Oncology Society, (undated), Breast Cancer, Available at http://www. malaysiaoncology.org/ article.php?aid=114

National Cancer Institute, (2003), BRCA1 and BRCA2: Cancer Risk and Genetic Testing, Available at http://www.cancer.gov/ about-cancer/causes-prevention/genetics/brca-fact-sheet World Cancer Research Fund International, (2012), Worldwide Data, Available at http://www.wcrf.org/int/cancer-facts-figures/ worldwide-data Dunnwald LK, Rossing MA, Li CI. Hormone receptor status, tumor characteristics, and prognosis: a prospective cohort of breast cancer patients. Breast Cancer Research 2007; 9(1):R6. *Corresponding author: Dr Oon’s research area of interest includes investigating the use of novel therapeutic agents to target tumour angiogenesis (formation of new blood vessels in cancer) and overcoming tumour resistance, with emphasis on targeting cancer pathways to modulate the downstream signalling pathways in the cancer cells and tumour microenvironment.

Caitlin Bowles is a BSc (Biomedicine) student at Keele University, United Kingdom who is pursuing her final year project at the Institute for Research in Molecular Medicine, USM. www.makna.org.my

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Kanser Payudara: Apa yang anda perlu tahu Oleh Caitlin Bowles dan Dr Oon Chern Ein* Universiti Sains Malaysia

Apakah kanser payudara?

Kanser payudara merupakan kanser yang kedua paling kerap ditemui di dunia dengan anggaran 1.7 juta kes baru disahkan pada setiap tahun (World Cancer Research Fund International, 2012). Dengan kadar kematian tertinggi berbanding kanser lain, kanser payudara adalah kanser paling biasa dihidapi oleh wanita di Malaysia,iaitu 1 daripada 19 orang wanita berisiko menghidapi penyakit ini dalam hayat mereka (Malaysian Oncological Society, undated).

Kanser berpunca daripada pembahagian sel yang tidak terkawal yang membentuk sekumpulan sel yang dipanggil tumor. Sel-sel kanser mempunyai pelbagai cara untuk mengelakkan daripada mati. Ini bermakna sel-sel kanser tidak dipengaruhi oleh mekanisme normal badan untuk membunuh sel-sel lama atau yang tidak diingini. Sel-sel kanser ini tidak akan mati dan tumor tadi akan terus membesar. Penyakit kanser dikaitkan dengan beberapa faktor risiko biologi seseorang, seperti individu yang membawa gen bermutasi BRCA I dan BRCA II. Sebagai pembawa, risiko untuk seseorang itu mendapat kanser payudara meningkat daripada 12% kepada 50% (National Cancer Institute, 2003). Faktor-faktor penyumbang lain termasuklah obesiti, diet, pilihan gaya hidup, menopaus lewat dan pendedahan kepada pancaran radioaktif atau bahan kimia.

Gejala pertama yang dialami biasanya adalah ketulan pada payudara, tidak menyakitkan dan tumbuh perlahan-lahan, yang mungkin mengubah bentuk payudara. Terdapat juga lelehan keluar daripada puting payudara, atau puting payudara ada berbekas darah dan tenggelam. Apabila tumor semakin membesar, ia akan merebak melalui kulit dan menyebabkan jangkitan. Jika kanser merebak ke bahagian badan yang lain, ia boleh menyebabkan sakit tulang, batuk yang kronik, masalah hati dan sakit kepala yang teruk.

Peringkat kanser payudara Terdapat lima peringkat dalam kanser payudara: Peringkat 0 merujuk kepada ductal carcinoma in situ (DCIS) iaitu bukan invasif yang menerangkan keadaan pra-malignan saluran susu di dalam payudara. Lobular carcinoma in situ (LCIS) merujuk kepada pertumbuhan sel yang tidak normal di dalam lobul payudara. Sementara penyakit Paget payudara pula memberi kesan pada kulit di sekitar puting dan areola dan tidak berkaitan dengan invasif. Peringkat I hingga IV digunakan untuk menggambarkan kanser payudara invasif.

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Pada Peringkat I, sel-sel kanser telah berpindah ke tisu di sekeliling payudara, membentuk tumor kecil yang boleh dirasai semasa pemeriksaan. Pada Peringkat II tumor telah membesar dan merebak dari lokasi asal ke tisu di sekitar payudara dan/atau merebak ke nodus limfa ketiak (aksilari) tetapi belum menular ke bahagian-bahagian yang jauh.

Pada Peringkat III, tumor agak besar, dan berada di dalam nodus limfa aksilari. Jika yang lebih teruk sedikit, akan ada di kulit payudara dan di dinding dada, tetapi belum lagi merebak ke organ-organ yang jauh. Pada Peringkat IV tumor telah memetastasis atau merebak kepada satu atau lebih kawasan/organ badan, biasanya melalui saluran darah dan nodus limfa.

Doktor akan menilai peringkat kanser dengan menggunakan sistem pemeringkatan TNM dengan mengambil kira saiz tumor (T), sejauh mana kanser merebak ke nodus limfa (N), sama ada tumor telah metastasis atau merebak ke bahagian-bahagian lain di dalam badan (M). Nilai 0-4 diberikan berdasarkan kepada berapa besarnya tumor (T) dan sama ada ia telah merebak ke dinding dada. Bagi kes yang melibatkan nodus limfa (N), nilai 0 hingga 3 menunjukkan sama ada kanser telah merebak ke nodus limfa jika benar, berapa banyakkah nodus limfa yang terlibat.

Untuk metastasis (M), nombor 0 atau 1 diberikan untuk menunjukkan sama ada kanser telah merebak ke organorgan yang lebih jauh. Nilai TNM yang lebih tinggi diberikan kepada kanser yang lebih teruk.

Apabila peringkat kanser diperolehi, ia digunakan untuk menentukan pelan rawatan untuk pesakit, kerana tumor yang lebih teruk akan dirawat dengan cara yang berbeza berbanding tumor yang lebih kecil.

Pilihan rawatan Kebanyakan orang yang disahkan menghidap kanser payudara (Peringkat I dan ke atas) akan menjalani pembedahan untuk membuang tumor, walaupun di Peringkat IV adalah lebih kepada mengurangkan gejala berbanding merawat penyakit ini. Memandangkan sukar untuk memastikan sama ada setiap sel kanser telah dikeluarkan, terapi radiasi sering digunakan selepas pembedahan untuk memastikan kanser tersebut tidak akan kembali. Tetapi ini adalah untuk peringkat I dan II sahaja kerana kesannya terlalu sedikit bagi kanser yang lebih teruk. Dos radiasi diberikan pada bahagian yang terbabit, untuk merosakkan sel-sel DNA pada laluan alur.

Ia bermakna sel-sel tidak akan dapat membahagi dan akan mati.

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Rawatan kemoterapi adalah paling biasa digunakan dalam kanser payudara. Bagi mereka yang mempunyai tumor invasif peringkat awal, rawatan ini digunakan sebelum pembedahan untuk mengurangkan saiz tumor, manakala selepas pembedahan pula bertujuan untuk membunuh sel-sel kanser yang tinggal bagi memastikan kanser tersebut tidak akan kembali. Kemoterapi berfungsi dengan membunuh sel-sel yang membahagi, yang kerap berlaku dalam tumor. Dalam tumor peringkat akhir, kemoterapi digunakan untuk merosakkan sel-sel kanser sebanyak mungkin untuk mengurangkan saiz tumor.

Rawatan jenis lain adalah bergantung kepada reseptor hormon tertentu mengikut tumor tersebut. Tujuan rawatan tersebut adalah untuk menghentikan tindakan hormon serta menjaga sel-sel supaya hidup dan menggalakkan replikasi atau penambahan sel kanser. Reseptor utama dalam kanser payudara adalah reseptor estrogen (ER) dan reseptor progesteron (PR). Untuk tumor positif ER dan PR, terapi hormon boleh digunakan. Tetapi kaedah ini tidak berkesan bagi tumor negatif ER dan PR. Ubat-ubatan ini sama ada akan menghentikan tubuh daripada menghasilkan hormon atau menghalang tindakan hormon, sekali gus mengganggu laluan isyarat yang diaktifkan oleh reseptor hormon dalam sel-sel kanser. Sel-sel ini memerlukan hormon tersbut untuk berkembang, maka apabila isyarat tidak lagi diterima, ia akan berhenti membesar.

Kesimpulan Hari ini terdapat peningkatan dalam penyelidikanberkenaan terapi sasaran yang bertindak untuk merencatkan laluan tertentu di dalam tumor yang membolehkan sel-sel mengelak apoptosis atau kematian sel dan atau sebaliknya terus bertambah. Seiring dengan kemajuan, prognosis bagi pesakit yang disahkan menghidap kanser payudara semakin baik, tetapi kanser ini masih lagi merupakan kanser yang menyebabkan banyak kematian di kalangan wanita. Buat masa ini prognosis bergantung kepada pengesanan pada peringkat awal. Adalah diharapkan agar terapi sasaran baharu akan dapat meredakan kanser yang sedang berkembang kepada remisi atau semakin mengecil untuk memanjangkan hayat pesakit.

Rujukan: Globocan, WHO and International Agency for Research on Cancer, (2012), All cancers excluding non-melanoma skin cancer, Available at http://globocan.iarc.fr/Pages/fact_sheets_ cancer.aspx Malaysian Oncology Society, (undated), Breast Cancer, Available at http://www.malaysiaoncology.org/article.php?aid=114 National Cancer Institute, (2003), BRCA1 and BRCA2: Cancer Risk and Genetic Testing, Available at http://www.cancer.gov/ about-cancer/causes-prevention/ genetics/brca-fact-sheet

Dianggarkan bahawa kira-kira 70 peratus daripada kanser payudara adalah ERpositif, dan kebanyakan World Cancer Research Fund kanser payudara International, (2012), Worldwide ER-positif juga adalah Data, Available at http://www.

PR-positif (Dunnwald et wcrf.org/int/cancer-facts-figures/ al., 2007). Untuk tumor worldwide-data positif ER, ubat yang dipanggil Tamoxifen Dunnwald LK, Rossing MA, Li CI. boleh digunakan.

Hormone receptor status, tumor Ubat ini mempunyai pelbagai kesan termasuk characteristics, and prognosis: menghalang penularan a prospective cohort of breast kanser payudara ke cancer patients. Breast Cancer bahagian lain badan, Rajah 1. Rajah menunjukkan pelbagai jenis rawatan kanser. Gambar rajah Research 2007; 9(1):R6. mengecutkan tumor ini diringkaskan, dan tidak mengikut skala, tetapi memberikan gambaran serta meningkatkan asas pelbagai jenis rawatan sistemik dan setempat. jangka hayat pesakit.

Perencat aromatase yang menghentikan penghasilan estrogen dan seterusnya melambatkan pertumbuhan tumor. Ia digunakan untuk Bidang kajian Dr Oon termasuklah mengkaji penggunaan agen merawat wanita selepas menopaus. Ini hanyalah terapeutik tertentu yang menyasarkan tumour angiogenesis sebahagian daripada ubat-ubatan yang kerap digunakan. (pembentukan saluran darah baharu dalam kanser) dan Terdapat pelbagai jenis ubatan dan ia dipilih berdasarkan mengatasi ketahanan tumor, dengan memberi penekanan kepada keperluan pesakit dan responsif. terhadap laluan kanser bagi mengawal laluan isyarat hiliran Klasifikasi lain yang penting untuk kanser payudara adalah sama ada reseptor faktor pertumbuhan epidermis manusia 2 (HER2), iaitu gen yang menghasilkan reseptor sel, yang semakin bertambah dalam tumor. Barah payudara dengan HER2 yang tinggi digambarkan sebagai HER2 positif.

Kanser payudara jenis ini adalah lebih agresif berbanding tumor negatif HER2. Bagi kanser ini, ubat diberikan untuk menyekat laluan isyarat HER2, untuk menghentikan pertumbuhan sel. Ubat yang paling biasa digunakan adalah istrastuzumab, yang dijual di bawah jenama Herceptin.

Pilihan rawatan ini digunakan untuk pesakit kanser payudara dan dirujuk dalam Rajah 1.

pada sel-sel kanser dan persekitaran mikro tumor.

Caitlin Bowles adalah pelajar Sarjana Muda (Bioperubatan) di Keele University, United Kingdom yang sedang melanjutkan projek akhir tahunnya di Institut Penyelidikan Perubatan Molekul, USM.

www.makna.org.my

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乳癌: 您须知的事项 由Caitlin Bowles 和 Oon Chern Ein博士*呈献 马来西亚理科大学

什么是乳癌？ 乳癌是现今世界第二最常见的癌症种类，每年 约有1700万件个案被确诊(世界癌症研究基金 会，2012年)。在影响马来西亚女性死亡率最 高的众多癌症种类中，乳癌是马来西亚女性最 普遍罹患的癌症，19位女性中就有1位会在其 人生中面对罹患乳癌的风险(马来西亚肿瘤协 会，未注日期)。 癌症是由失控细胞分裂形成一种叫肿瘤的细胞 群所导致。癌细胞有各种逃避细胞死亡的方 式。这代表癌细胞不会被身体杀死旧或该汰换 细胞的正常机制所影响，因此细胞将不会死 亡，而肿瘤将会持续增长。这与数个生物风险 因素息息相关，例如身带突变BRCA I 和BRCA II基因者。体内潜伏这类突变基因者罹患乳 癌的风险会从12%提升到50% (国家癌症研究 所，2003年)。其他导致癌症的风险因素还包 括肥胖、饮食、生活方式选择、迟停经及曝露 于辐射或化学物下。 首个症状通常是乳房出现不痛且会慢慢增长的 肿块，并可能会让乳房变形。乳头也可能会有 分泌物，并可能带血或乳头凹陷。随着肿瘤变 大，它有可能会穿透皮肤并受到感染。而随着 癌细胞扩散到其他身体部位，这也将导致骨 痛、慢性咳嗽、肝痛和严重头痛。

乳癌分期 乳癌可分为五期：0期指的是非侵略性原位 乳管癌 (DCIS)，说明乳房输乳管病变前的状 况； 乳小叶原位癌(LCIS)指的是乳小叶内不正 27

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常的细胞增生；而乳頭佩吉特氏病（Paget’s disease of the breast）则会在没有发生侵略性 状况下影响乳头和乳晕周围的皮肤。第一期到 第四期通常用来形容侵略性乳癌。在第一期， 癌细胞会转移到周围的乳房组织，形成一个可 能通过触摸检查感觉到的小肿瘤。在第二期， 肿瘤会增长并从原位扩散到周围的乳房组织和/ 或延伸到腋下(腋窝)淋巴结，但尚未转移到远 处的身体部位。第三期的肿瘤颇大，并会出现 在腋窝下的淋巴结，更严重的话会出现在乳房 和胸壁的皮肤上，但尚未扩散到远处的身体器 官。 在第四期，肿瘤会通过血管和淋巴结转移 到一处或更多处身体部位/器官。 医生将采用恶性肿瘤病期分类系统（TNM staging system）来评估病期，即把肿瘤大小 (T)、癌症扩散到淋巴结的恶化程度(N)，以及 肿瘤是否已经转移到身体其他区域(M)纳入考 量。根据肿瘤大小(T)及肿瘤已经扩散到胸壁的 情况，给予0到4的评值。至于涉及淋巴结(N)的 话，以0到3的评值来标明癌症是否已经扩散到 淋巴结，以及如果已扩散，情况有多严重。至 于癌细胞转移(M)，只需给予0或1的评值来显 示癌症是否已经扩散到远处身体器官。更严重 的癌症状况会以更高的TNM值来指明。 一旦确定病期，就会用来决定病人的疗程；更 严重的肿瘤会以有别于更小型肿瘤的治疗方案 来进行疗程。

疗程选择 大部分被确证罹患乳癌的人士(第一期及以上)将 会进行各种形式的去除肿瘤手术，纵然这种方

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式在第四期病期里更趋向缓和症状大于治疗。 由于很难辨明癌细胞是否全部清除，因此术后 通常会进行放射治疗，以确保癌症不会复发。 但是，这仅适用于第一期和第二期阶段。对于 更严重的癌症，这种疗程不会带来太大的效 能。在受影响的部位放射一定剂量的辐射，会 在放射过程中损坏细胞的DNA，这表示它们将 无法分裂并将死亡。 化疗常用来治疗乳癌，尤其是那些罹患初期侵 略性肿瘤的病患。这类疗程会在术前用来缩小 肿瘤尺寸，并在术后用来消灭可能遗漏的癌细 胞，确保癌症不会复发。化疗的作用是杀死那 些正在进行增殖的细胞，这个情况常见于肿 瘤。在肿瘤更恶化的病期，将会用此疗程来尽 可能破坏癌细胞，以协助缩小肿瘤尺寸。 其他疗程种类针对特定利用荷尔蒙受体来表现 的肿瘤，依靠停止相关荷尔蒙，即那些维持细 胞生存并促进癌细胞复制的荷尔蒙之行动。乳 癌最重要的受体是雌激素受体 (ER)、孕激素受 体(PR)。针对阳性雌激素受体和孕激素受体肿 瘤，可采纳荷尔蒙治疗，但对阴性雌激素受体 和孕激素受体肿瘤则会无效。这些药物可能会 阻止身体生产荷尔蒙或是阻挡荷尔蒙的行动， 从而干扰癌细胞内荷尔蒙受体激活的信号途 径。这些细胞需要荷尔蒙来增长，因此当它们 无法接收到信号，它们将会停止增长。 估计约有70%的乳癌是阳性雌激素受体，而大 部分阳性雌激素受体的乳癌也是阳性孕激素受 体 (Dunnwald et al., 2007)。对于阳性雌激素 受体肿瘤，一种叫Tamoxifen的药物可以使用； 它拥有广泛的效能，包括从抑制乳癌扩散到身 体其他区域，到缩小肿瘤及延长预期寿命。芳 香酶抑制剂可阻止雌激素生产进而减缓肿瘤增 长，通常用来治疗停经后的女性。这些只是所 采用药物的一部分，市面上还有广泛种类供选 择，而这些药物是根据病人需求和病况反应而 选择。 乳癌另一个重要的分类是辨别是否具备人类表 皮生长因子受体2 (HER2)。它是一种生产会放 大肿瘤的细胞受体之基因。HER2增加的乳癌被 称为阳性HER2，而这种乳癌会比阴性 HER2肿 瘤更具侵略性。对于这类癌症，普遍使用的药 物是以Herceptin品牌销售的曲妥单抗。通常用 于治疗乳癌病患的疗程选项总结如图1所展示。

总结

图 1. 此图描述一系列的癌症疗程。这些图表极为简化且没 有衡量比例，只提供各种不同种类的系统性和局部疗程的 基本概况。

步，被诊断罹患乳癌的病患之病情预测也随之 提升。尽管如此，女性死于癌症的数字还是高 居不下。在现阶段，病情预测或多或少还是取 决于及早在病发初期发现，但希望新的靶向治 疗将能缓解恶化的癌症病情，并延长病患的寿 命。 参考资料： Globocan、WHO和国际机构针对癌症进行研究，(2012 年)，所有癌症除了非黑瘤皮肤癌之外，可取自 http:// globocan.iarc.fr/Pages/fact_sheets_cancer.aspx 马来西亚肿瘤协会，(未注日期)，乳癌，可取自 http:// www.malaysiaoncology.org/article.php?aid=114 国家癌症研究所，(2003年)，BRCA1和BRCA2：癌症风 险和基因测试， 可取自http://www.cancer.gov/aboutcancer/causes-prevention/genetics/brca-fact-sheet 世界癌症研究基金会，(2012年)，全球数据，可取 自 http://www.wcrf.org/int/cancer-facts-figures/ worldwide-data Dunnwald LK, Rossing MA, Li CI。激素受体状态、肿瘤 特征和病情预测：乳癌病患的一个前瞻性共享同样特征的 群组。乳癌研究 2007; 9(1):R6.

Oon博士的研究范畴包括使用新的治疗剂来靶向治疗肿瘤 血管生成(癌细胞内形成新血管) 及克服肿瘤耐药性，重 点靶向治疗癌症途径来调整癌细胞和肿瘤微环境内的下 游信号途径。 Caitlin Bowles是英国基尔大学的生物医药理学士（BSc） 课程的学生，目前在马来西亚理科大学的分子医学研究机 构进行最后一年的毕业项目。

今天，靶向治疗方面的研究越来越多。靶向治 疗是通过抑制肿瘤内那些让躲过细胞死亡并持 续复制过程的特定途径。随着这个领域的进 www.makna.org.my

28

LIFE GOES ON

Semangatmu Menjadi Inspirasi ....

By Suhaila Nik, MAKNA Home Visit Executive

Sabri Bin Yahya Usianya kini mencecah 61 tahun dan beliau telah disahkan menghidap Diffuse Large B-Cell Lymphoma (DLBCL) sejak April 2014. Rawatan kimoterapi sebanyak 6 cycles sudah selesai dilaluinya.

Namun kini masih menjalani rawatan secara berkala di Hospital Ampang sebanyak 2-3 kali sebulan bagi memantau tahap kesihatan beliau.

Bukan sahaja diuji dengan penyakit kanser malah dirimu juga kehilangan daya penglihatan sejak beliau berusia 26 tahun. Nasib yang sama juga turut dilalui oleh sang isteri yang juga kehilangan daya penglihatan sejak berusia 20 tahun. Hasil perkahwinan, mereka dikurniakan 4 orang anak yang kini sudah berusia antara 29 tahun sehingga 19 tahun. Kesemua anaknya juga turut mengalami masalah yang sama iaitu rabun setelah mereka meganjak ke usia remaja.

Walaupun mempunyai kekurangan namun kesemua mereka mempunyai pekerjaan bagi menampung perbelanjaan seisi keluarga. Salah seorang anak perempuannya kini masih lagi sedang menuntut dalam bidang urutan. Pesakit dan isteri juga mempunyai pencen masing-masing untuk perbelanjaan bulanan

29

NEOPLASIA { ISSUE 01/2017 }

mereka dan sentiasa bersyukur dengan rezeki yang diberikan. Tambah beliau lagi, ujian yang diterimanya ini hanyalah kecil sahaja berbanding dengan insan-insan lain di luar sana.

Teksi merupakan pengangkutan utama yang diperlukan oleh beliau tatkala mempunyai rawatan di Hospital Ampang. Beliau terlebih dahulu akan menghubungi teksi untuk memaklumkan tarikh rawatannya. Pemandu teksi yang sudah mengenali pesakit ini biasanya turut membantu membawa beliau ke klinik yang sepatutnya kerana faham dengan keadaan pesakit. Kunjungan kami pada 17 Ogos yang lalu ke rumahnya di Taman Melati Setapak mendapati bahawa beliau kini menggunakan lampin pakai buang kerana keadaan kesihatannya yang sedikit uzur untuk berulang alik ke tandas.

Bagi meringankan beban pesakit dan ahli keluarganya, MAKNA telah menyalurkan bantuan kewangan kepada pesakit sebanyak RM500 untuk tambang ulang alik ke hospital. Dikesempatan itu beliau melahirkan ribuan terima kasih kerana telah membantu beliau.

LIFE GOES ON

Spirit that Inspires ....

By Suhaila Nik, MAKNA Home Visit Executive

The MAKNA Home Visit team recently visited Sabri bin Jahaya, a visually-impaired cancer patient, whose humility and unrelenting spirit were a true inspiration.

“All the trials and challenges thrown at me and my family are just small tests for us to face and overcome. There are so many people out there who are worse off than us,” says Sabri.

Sabri Bin Jahaya, 61, was diagnosed with Diffuse Large B-Cell Lymphoma (DLBCL) in April 2014. Since then, he has completed six cycles of chemotherapy and continues to seek cancer treatment at Ampang Hospital up to three times a month.

Sabri travels to Ampang Hospital by taxi, the only mode of transportation available to him to access his treatment. He usually informs his taxi driver, who knows the family’s condition well and always helps to take him to the hospital and clinics whenever needed.

His battle with cancer is formidable, what more with blindness. Sabri lost his vision at the age of 26 and his wife experienced the same when she was 20. The couple is blessed with four children aged between 19 and 29, all of whom have suffered visual impairment since their teens.

MAKNA Home Visit team, who visited Sabri on 17 August in his home in Taman Melati, learned that he is now using diapers due to his weakened condition, which does not allow him to make trips to the toilet frequently.

Yet, the family never let their circumstances keep them from living their lives and ensuring that there was food on the table for all at home.

All four children are working to bear the family’s expenses. One of the daughters in the family is still pursuing her studies in massage therapy.

Both Sabri and his wife receive a pension which enables them to afford their monthly living costs and hospital bills. Both are very grateful for any form of support given them, especially financial.

To ease Sabri’s and his family’s burden, MAKNA has been helping him bear the cost of his trips to the hospital with a travel allowance of RM500, for which Sabri wishes to express his gratitude to all MAKNA donors supporting him and his family.

There is no measure for one’s suffering when one is enduring the hardest times in their lives. But the care given Sabri is a gentle light shone on him and many patients receiving assistance through MAKNA, thanks to the contributions of our donors.

www.makna.org.my

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MAKNA WOULD LIKE TO SAY TO ALL OUR SPONSORS & PARTNERS

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

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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.�