Early detection imperative
INTAN MAIZURA AHMAD KAMAL
Breast cancer patients stand the best chance for a cure with early detection, Dr Azlina Firzah Abdul Aziz tells INTAN MAIZURA AHMAD KAMAL
HER eyes tear as she talks about people dearest to her who have breast cancer. Although she deals with cancer patients everyday, Dr Azlina Firzah Abdul Aziz still finds it a little too much to bear to have a relative suffer the same fate.
“It’s not easy,” whispers the consultant breast surgeon at the Breast Care Centre in Pantai Hospital, KL, dabbing the corners of her eyes. “It’s truly a grounding effect when you see what they have to go through.”
What frustrates Azlina is that breast cancer has the best chances for a cure, yet there are still people who leave it too late. “They don’t understand the importance of early detection,” she says with a sigh. “The level of awareness is admittedly much better than say, 10 years ago, but we still have women coming in at stage 4, when the cancer has spread to other organs.”
Of the total number of female cancer patients in the country, about 30 per cent have breast cancer, reveals the 44-year-old mother of three.
The highest incidence is in Chinese women, particularly those in their 40s and 50s. This is actually a younger age group. For Caucasian women, for whom breast cancer is a post-menopausal disease.
“If I had my way, I’d have schoolgirls charting their menstruation and examining their breasts as soon as they hit puberty,” says Azlina, who was previously attached to Selayang Hospital. “I’ve had patients below 15 years old with benign (non-cancerous tumours). Although breast cancer rarely happens in those below 20, if they don’t know how to check their breasts, they won’t know about the changes that can happen.”
Early detection saves lives, stresses Azlina. “If they come to us when the lump is below 2cm, stage 1, the chance of survival is almost 100 per cent. When you’re already at stage 4, there’s no cure. The most you can do is prolong survival time.”
She adds: “We can give chemotherapy and drugs to kill the cancer cells but these are very expensive. Even in government hospitals, they’re limited. If you go for chemo, your survival period may run from one to four years. But this depends on where the cancer has spread to.
“If it involves the liver and it’s damaged, it’s tough. If it spreads to the brain, it’s worse.”
What advice does she have for those living with someone with cancer?
“Get help,” she says. “Don’t try to cope alone. There are many NGOs like Hospice Malaysia, which can assist. They don’t charge for their services and sometimes they’d even loan equipment. Even if somebody is in stage 4, you can make it comfortable for them.”
For breast cancer survivors, it’s important they make the time to join support groups, she adds. “There are many things they can learn to help improve their life. You can cope better if you know how. Don’t suffer in silence.”
Wednesday, December 16, 2009
Wednesday, November 11, 2009
Bagaikan hukuman mati
Bagaikan hukuman mati
Oleh Azida Shaharuddin
HUBUNGAN Siti Fatimah dengan Narimah bertambah rapat selepas bapanya meninggal dunia dan ibunya menghidap barah payu dara.
Dua beranak kongsi pengalaman berdepan barah payu dara
ANAK mana yang tidak sayangkan ibunya. Jika ibu sanggup melakukan apa saja waima berkorban harta dan nyawa demi kebahagiaan anaknya, begitu juga dengan kasih sayang seorang anak terhadap ibu tercinta. Sakit si ibu, sakit jugalah yang dirasai anak berkenaan.
Itulah yang dirasai Siti Fatimah Noor Abdul Aziz, sebaik mengetahui ibunya, Narimah Juffery, menghidap barah payu dara. Walaupun ibunya agak tenang ketika memaklumkan khabar buruk berkenaan, Siti Fatimah pula yang menangis sepuas-puasnya mengenangkan nasib ibunya.
Akui gadis berusia 28 tahun itu, beliau bagaikan turut mahu berkongsi sama pengalaman yang dilalui ibunya. Baginya, khabar buruk itu bagaikan satu hukuman mati yang cukup menakutkan.
Siti Fatimah yang bekerja sebagai Eksekutif Teknologi Maklumat (IT) merangkap pensyarah IT di Cosmopoint Sdn Bhd cawangan Johor Bahru berkata, beliau mula mengetahui keadaan ibunya itu selepas menduduki Sijil Pelajaran Malaysia (SPM), 10 tahun lalu.
Ketika itu, Siti Fatimah menemani ibunya, Narimah mengikuti kursus mengenai barah serviks dan payu dara, yang diadakan untuk ibu tunggal. Selepas menghadiri kursus berkenaan, ibunya menyedari ada ketulan pada payu dara sebelah kirinya.
"Ketika menemani ibu ke Hospital Pakar Johor, doktor memberitahu ibu perlu membuang seluruh payu dara kirinya... Saya terus menangis, tapi ibu tidak pula. Sebaliknya beliau tenang saja," katanya ketika ditemui di kediamannya di Bandar Baru Uda, Johor Bahru, baru-baru ini
Sejak itu, beliau kerap menemani ibunya berjumpa doktor mahupun mendapatkan rawatan di klinik dan hospital. Malah, selepas pembedahan ibunya, beliau akan menjadi pemandu bagi Narimah terutama ke tempat kerja di Sekolah Agama Taman Perling, Johor Bahru selain menjaga semua makan dan minum wanita itu antaranya memasak lauk sayur bening (tidak ditumis) dan antara lain ikan rebus bakar, supaya luka pembedahan ibunya cepat sembuh.
"Keadaan berbeza berbanding dulu apabila saya lebih rapat dengan bapa, namun selepas bapa meninggal dunia dan ibu pula sakit, hubungan kami menjadi semakin rapat, dan hati semakin sayang kepadanya.
"Kami seolah-olah menjadi kawan baik, langsung tidak boleh berenggang dan ke mana saja dekat mahupun jauh, pasti berdua. Teringat ketika ibu menyertai satu kursus seharian di Kota Tinggi, saya berasa resah ibu pulang lambat sedangkan ketika itu hari tidak begitu lewat," katanya.
Menyelitkan kisahnya sendiri, Narimah, 57, berkata beliau percaya mendapat penyakit itu kerana sifatnya yang sering kesedihan terutama selepas suaminya, Abdul Aziz Abdul Rahman meninggal dunia pada 31 Mei 1998 lalu selepas hidup bersama selama 25 tahun.
“Saya terus berubah karektor menjadi murung sepanjang masa. Perasaan sedih dan hiba dibawa setiap hari sehinggakan ketika memulakan enjin kenderaan hendak ke tempat kerja saja sudah menangis hingga tiba di sekolah. Malah sekiranya berjumpa sesiapa dan mereka sebut nama arwah pun saya gagal menahan perasaan dan terus menangis," katanya mengakui keadaan itu berlarutan sehingga enam bulan, sebelum mendapat tahu dirinya menghidap barah pada Julai 1999.
Ibu tunggal itu berkata, melihat dirinya pada cermin selepas kursus terbabit, beliau menyedari ada ketumbuhan sebesar kira-kira seinci pada payu dara sebelah kiri, lalu berjumpa doktor di klinik berdekatan rumah sebelum dirujuk ke Hospital Sultanah Aminah (HSA).
Selepas membuat pemeriksaan biopsi bagi mengambil tisu ketumbuhan pada 19 Jun 1999, doktor menghubunginya dan mengesahkan Narimah menghidap barah payu dara Tahap 1, dua minggu kemudian.
"Ketika mendapat berita itu, entah kenapa saya tidak sedih, sebaliknya saya mula mengamalkan perubatan Islam, iaitu mengisar lempoyang dan kurma yang diperah dengan kain sebelum jusnya diminum setiap hari.
"Saya dapati lama kelamaan ketumbuhan itu semakin kempis dan tidak terbonjol seperti sebelum ini. Berikutan itu saya meminta doktor melakukan pemeriksaan semula, namun disebabkan jadual penuh, saya terpaksa bertukar ke Hospital Pakar Johor pada Ogos tahun sama,” katanya.
Di hospital swasta itu, doktor tidak mencadangkannya melakukan biopsi kerana menyatakan ketulan kecil saja, sebaliknya terus melakukan pembedahan membuang ketumbuhan pada kos RM1,800.
"Namun tiga hari selepas itu, Dr Ismail mengesahkan saya menghidap barah dan mencadangkan supaya membuang keseluruhan payu dara sebelah kiri dan saya bersetuju. Dengan gaji ketika itu kurang RM1,000 dan menjadi ibu tunggal, saya bersyukur kos rawatan dan pembedahan ditanggung syarikat insurans sebanyak RM10,000," katanya.
Ibu kepada dua anak dan empat cucu itu berkata, sebulan selepas pembedahan beliau perlu menjalani rawatan kemoterapi sebanyak 12 kali, namun beliau hanya melalui rawatan itu sekali saja, dan berkat zikir selama tiga jam sepanjang rawatan itu beliau langsung tidak berasa loya mahupun muntah.
Begitu pun, seminggu selepas itu, Narimah mengakui badannya bertukar lemah seperti keadaan mabuk mengandung dan kurang selera makan.
"Ketika itu seorang kawan mencadangkan saya mengambil herba yang disediakan khas untuk penyakit barah selain mengamalkan perubatan Islam berzikir 'Serah Diri' dengan purata tiga jam sehari bertujuan memberi kekuatan dalaman.
"Sejak itu, saya langsung tidak lagi mengikuti rawatan kimoterapi sehingga 2003, apabila mendapatkan pemeriksaan kesihatan kerana kenaikan pangkat, doktor mengesahkan saya bebas barah," katanya.
Menyimpulkan kemungkinan Tuhan sayang padanya, hidup beliau kembali normal selepas bebas penyakit itu dan tidak lagi menjadikan sifat sedih satu amalan.
Oleh Azida Shaharuddin
HUBUNGAN Siti Fatimah dengan Narimah bertambah rapat selepas bapanya meninggal dunia dan ibunya menghidap barah payu dara.
Dua beranak kongsi pengalaman berdepan barah payu dara
ANAK mana yang tidak sayangkan ibunya. Jika ibu sanggup melakukan apa saja waima berkorban harta dan nyawa demi kebahagiaan anaknya, begitu juga dengan kasih sayang seorang anak terhadap ibu tercinta. Sakit si ibu, sakit jugalah yang dirasai anak berkenaan.
Itulah yang dirasai Siti Fatimah Noor Abdul Aziz, sebaik mengetahui ibunya, Narimah Juffery, menghidap barah payu dara. Walaupun ibunya agak tenang ketika memaklumkan khabar buruk berkenaan, Siti Fatimah pula yang menangis sepuas-puasnya mengenangkan nasib ibunya.
Akui gadis berusia 28 tahun itu, beliau bagaikan turut mahu berkongsi sama pengalaman yang dilalui ibunya. Baginya, khabar buruk itu bagaikan satu hukuman mati yang cukup menakutkan.
Siti Fatimah yang bekerja sebagai Eksekutif Teknologi Maklumat (IT) merangkap pensyarah IT di Cosmopoint Sdn Bhd cawangan Johor Bahru berkata, beliau mula mengetahui keadaan ibunya itu selepas menduduki Sijil Pelajaran Malaysia (SPM), 10 tahun lalu.
Ketika itu, Siti Fatimah menemani ibunya, Narimah mengikuti kursus mengenai barah serviks dan payu dara, yang diadakan untuk ibu tunggal. Selepas menghadiri kursus berkenaan, ibunya menyedari ada ketulan pada payu dara sebelah kirinya.
"Ketika menemani ibu ke Hospital Pakar Johor, doktor memberitahu ibu perlu membuang seluruh payu dara kirinya... Saya terus menangis, tapi ibu tidak pula. Sebaliknya beliau tenang saja," katanya ketika ditemui di kediamannya di Bandar Baru Uda, Johor Bahru, baru-baru ini
Sejak itu, beliau kerap menemani ibunya berjumpa doktor mahupun mendapatkan rawatan di klinik dan hospital. Malah, selepas pembedahan ibunya, beliau akan menjadi pemandu bagi Narimah terutama ke tempat kerja di Sekolah Agama Taman Perling, Johor Bahru selain menjaga semua makan dan minum wanita itu antaranya memasak lauk sayur bening (tidak ditumis) dan antara lain ikan rebus bakar, supaya luka pembedahan ibunya cepat sembuh.
"Keadaan berbeza berbanding dulu apabila saya lebih rapat dengan bapa, namun selepas bapa meninggal dunia dan ibu pula sakit, hubungan kami menjadi semakin rapat, dan hati semakin sayang kepadanya.
"Kami seolah-olah menjadi kawan baik, langsung tidak boleh berenggang dan ke mana saja dekat mahupun jauh, pasti berdua. Teringat ketika ibu menyertai satu kursus seharian di Kota Tinggi, saya berasa resah ibu pulang lambat sedangkan ketika itu hari tidak begitu lewat," katanya.
Menyelitkan kisahnya sendiri, Narimah, 57, berkata beliau percaya mendapat penyakit itu kerana sifatnya yang sering kesedihan terutama selepas suaminya, Abdul Aziz Abdul Rahman meninggal dunia pada 31 Mei 1998 lalu selepas hidup bersama selama 25 tahun.
“Saya terus berubah karektor menjadi murung sepanjang masa. Perasaan sedih dan hiba dibawa setiap hari sehinggakan ketika memulakan enjin kenderaan hendak ke tempat kerja saja sudah menangis hingga tiba di sekolah. Malah sekiranya berjumpa sesiapa dan mereka sebut nama arwah pun saya gagal menahan perasaan dan terus menangis," katanya mengakui keadaan itu berlarutan sehingga enam bulan, sebelum mendapat tahu dirinya menghidap barah pada Julai 1999.
Ibu tunggal itu berkata, melihat dirinya pada cermin selepas kursus terbabit, beliau menyedari ada ketumbuhan sebesar kira-kira seinci pada payu dara sebelah kiri, lalu berjumpa doktor di klinik berdekatan rumah sebelum dirujuk ke Hospital Sultanah Aminah (HSA).
Selepas membuat pemeriksaan biopsi bagi mengambil tisu ketumbuhan pada 19 Jun 1999, doktor menghubunginya dan mengesahkan Narimah menghidap barah payu dara Tahap 1, dua minggu kemudian.
"Ketika mendapat berita itu, entah kenapa saya tidak sedih, sebaliknya saya mula mengamalkan perubatan Islam, iaitu mengisar lempoyang dan kurma yang diperah dengan kain sebelum jusnya diminum setiap hari.
"Saya dapati lama kelamaan ketumbuhan itu semakin kempis dan tidak terbonjol seperti sebelum ini. Berikutan itu saya meminta doktor melakukan pemeriksaan semula, namun disebabkan jadual penuh, saya terpaksa bertukar ke Hospital Pakar Johor pada Ogos tahun sama,” katanya.
Di hospital swasta itu, doktor tidak mencadangkannya melakukan biopsi kerana menyatakan ketulan kecil saja, sebaliknya terus melakukan pembedahan membuang ketumbuhan pada kos RM1,800.
"Namun tiga hari selepas itu, Dr Ismail mengesahkan saya menghidap barah dan mencadangkan supaya membuang keseluruhan payu dara sebelah kiri dan saya bersetuju. Dengan gaji ketika itu kurang RM1,000 dan menjadi ibu tunggal, saya bersyukur kos rawatan dan pembedahan ditanggung syarikat insurans sebanyak RM10,000," katanya.
Ibu kepada dua anak dan empat cucu itu berkata, sebulan selepas pembedahan beliau perlu menjalani rawatan kemoterapi sebanyak 12 kali, namun beliau hanya melalui rawatan itu sekali saja, dan berkat zikir selama tiga jam sepanjang rawatan itu beliau langsung tidak berasa loya mahupun muntah.
Begitu pun, seminggu selepas itu, Narimah mengakui badannya bertukar lemah seperti keadaan mabuk mengandung dan kurang selera makan.
"Ketika itu seorang kawan mencadangkan saya mengambil herba yang disediakan khas untuk penyakit barah selain mengamalkan perubatan Islam berzikir 'Serah Diri' dengan purata tiga jam sehari bertujuan memberi kekuatan dalaman.
"Sejak itu, saya langsung tidak lagi mengikuti rawatan kimoterapi sehingga 2003, apabila mendapatkan pemeriksaan kesihatan kerana kenaikan pangkat, doktor mengesahkan saya bebas barah," katanya.
Menyimpulkan kemungkinan Tuhan sayang padanya, hidup beliau kembali normal selepas bebas penyakit itu dan tidak lagi menjadikan sifat sedih satu amalan.
Pengesanan awal selamatkan nyawa
Pemakanan & Kesihatan: Pengesanan awal selamatkan nyawa
Oleh Fadzlena Jafar
Wanita digesa lakukan pemeriksaan barah payu dara sendiri selain segera bertemu doktor untuk rawatan
PENGALAMAN menakutkan pesakit barah ketika melakukan rawatan kemoterapi, selain stigma masyarakat terhadap wanita yang terpaksa membuang payu daranya dikenal pasti antara punca ramai wanita enggan mendapatkan rawatan perubatan moden.
Malah, ada pesakit yang mengambil keputusan berkenaan walaupun ketika didiagnos mereka hanya berada pada tahap satu yang mana peluang untuk sembuh hampir 100 peratus.
Bagaimanapun, Pakar Bedah Payu Dara Hospital Pantai Kuala Lumpur (HPKL), Dr Azlina Firzah Abdul Aziz, berkata ada pesakit yang membuat pilihan dengan mengamalkan perubatan alternatif seperti mengambil herba tanpa menyedari amalan itu menyebabkan keadaan mereka semakin kritikal.
“Kajian mendapati, kebanyakan pesakit di Malaysia lambat mendapatkan rawatan perubatan yang betul kerana meminta nasihat daripada individu tidak terlatih atau menawarkan pilihan dengan menjanjikan kaedah seperti herba dan suplemen, kononnya dapat mengelakkan pembedahan.
“Janji diberikan pasti menarik pesakit terutama yang takut akan pembedahan dan komplikasi akibat rawatan seperti kemoterapi. Inilah yang menyebabkan ramai yang akhirnya datang kepada kita dalam keadaan yang sudah teruk sehingga peluang sembuh agak tipis,” katanya pada majlis pelancaran kempen kesedaran Wear It Pink 2009 anjuran HPKL, baru-baru ini.
Kempen itu dilancarkan oleh Menteri Pembangunan, Keluarga dan Masyarakat, Datuk Seri Shahrizat Abdul Jalil. Turut hadir Pengerusi Pantai Holdings Berhad (Pantai Holdings), Tan Sri Mohamed Khatib Abdul Hamid; Pengarah Urusan Kumpulan Pantai Holdings, Faisal Ismail; Pengarah Eksekutif Divisyen Operasi Hospital, Pantai Holdings, Chan Boon Kheng; Ketua Pegawai Eksekutif HPKL, Tan Suet Guan; Presiden Avon Malaysia, Mansoor Wan Abdullah dan Presiden Persatuan Kebajikan Barah Payu Dara (BCWA), Ranjit Kaur.
Dianggarkan satu dalam 19 wanita di negara ini berisiko menghidap barah payu dara sekali dalam hidup mereka. Daftar Kanser Kebangsaan 2003-2005 menunjukkan pada tempoh itu sebanyak 11,952 kes baru barah payu dara dikesan, tetapi angka berkenaan dikatakan tidak memaparkan jumlah sebenar pesakit barah payu dara di negara ini memandangkan laporan kepada Daftar berkenaan tidak diwajibkan.
Ini bermakna jumlah yang betul mungkin jauh lebih tinggi terutama jika pesakit mendapatkan rawatan di hospital swasta mahupun perubatan alternatif.
Apa yang lebih membimbangkan, jika selama ini pesakit hanya membabitkan mereka yang sudah berusia khususnya di kalangan wanita menopaus, namun sejak kebelakangan ini semakin ramai gadis muda seawal usia belasan tahun turut dikesan menghidap penyakit yang dikatakan pembunuh nombor satu wanita itu.
Dr Azlina berkata, barah payu dara memberi kesan bukan saja kepada pesakit, bahkan setiap ahli keluarga dan rakan, selain menyebabkan kerugian kepada negara apabila ramai wanita terpaksa keluar daripada pasaran kerja bagi membolehkan mereka mendapatkan rawatan sewajarnya.
Beliau berkata, walaupun ketika ini ada pelbagai kempen kesedaran terhadap penyakit itu dilakukan, kempen seumpama itu perlu dipertingkatkan kerana pengesanan awal dapat memberikan rawatan lebih komprehensif.
“Kita melihat ada banyak kempen kesedaran dijalankan pelbagai pihak, baik kerajaan mahupun swasta. Percaya atau tidak, ia masih belum mencukupi kerana sehingga kini tiada kaedah tepat bagi mencegah barah payu dara dan tiada ujian darah bersesuaian bagi mengesan penyakit ini, tetapi dengan pengesanan awal khususnya di kalangan pesakit Tahap 1, peluang untuk bebas daripada penyakit itu bagi tempoh lima tahun berikutnya hampir 100 peratus.
“Malah, dengan rawatan awal diberikan, pesakit juga boleh mengelakkan mastektomi (pembedahan membuang seluruh payu dara yang mempunyai sel barah), selain mencegah rasa sakit akibat barah yang semakin serius atau membolehkan pesakit melakukan pembedahan membentuk semula payu dara jika mastektomi dijalankan,” katanya.
Sehubungan itu, beliau menggesa wanita supaya melakukan pemeriksaan payu dara sendiri, selain tampil berjumpa doktor mendapatkan pemeriksaan jika mendapati keganjilan pada payu dara mereka.
Kempen Wear It Pink 2009 anjuran HPKL itu mendapat kerjasama Avon (M) Sdn Bhd, jenama kecantikan terkenal yang aktif dalam pelbagai kempen kesedaran barah payu dara, malah mempunyai program khusus dinamakan Kiss Goodbye to Breast Cancer.
Pada majlis itu, HPKL turut menyerahkan cek berjumlah RM20,000 kepada Ranjit yang disampaikan Shahrizar. Selain itu, pengasas butik Pink Jambu, Tengku Marina Ibrahim turut mengumumkan 50 peratus daripada jualan barangan di butik berkenaan sepanjang Oktober dan November ini akan disalurkan bagi kempen Wear It Pink 2009.
Lelaki juga berisiko hidap barah payu dara
BARAH payu dara bukan saja membabitkan wanita, bahkan turut memberi kesan kepada lelaki. Selain perlu memberikan sokongan kepada isteri atau ibu yang menghidap penyakit berkenaan, lelaki juga perlu sedar bahawa barah payu dara bukan ‘milik’ wanita semata-mata kerana penyakit itu turut menyerang lelaki.
Jika statistik antarabangsa menyatakan lelaki merangkumi 1 peratus daripada jumlah keseluruhan pesakit barah payu dara, di Malaysia Daftar Kanser Kebangsaan 2003-2005 menunjukkan penghidap barah payu dara di kalangan lelaki agak tinggi dengan 257 atau 2.15 peratus kes dikesan.
Pengerusi Pantai Holdings Berhad (Pantai Holdings), Tan Sri Mohamed Khatib Abdul Hamid, berkata kebanyakan lelaki beranggapan barah payu dara adalah penyakit wanita tanpa menyedari mereka juga berisiko menghidap penyakit berkenaan.
“Kita mendapati di Malaysia khususnya, lelaki enggan menghadiri ceramah umum barah payu dara kerana menganggap tiada kaitan dengan mereka. Tetapi kita perlu menolak jauh tanggapan negatif ini kerana bukan saja barah payu dara memberi kesan kepada kita jika isteri, ibu atau anak perempuan menghidapnya, bahkan lelaki juga berisiko diserang barah payu dara.
“Justeru, kita perlu meningkatkan kesedaran di kalangan masyarakat akan risiko penyakit ini. Sesiapa saja boleh menghidapnya, malangnya di Malaysia latar belakang perubatan menunjukkan keadaan yang membimbangkan kerana kebanyakan pesakit hanya datang mendapatkan rawatan pada tahap kritikal,” katanya.
Bagi meningkatkan kesedaran terhadap kesan barah payu dara kepada masyarakat, HPKL menubuhkan Pusat Penjagaan Payu Dara (BCC) pada Mei 2007 dengan menawarkan rundingan membabitkan barah payu dara.
Selain kempen kesedaran tahunan, BCC turut menganjurkan forum awam, ceramah kesihatan di sektor korporat dan kem kesihatan di kawasan luar bandar sepanjang tahun.
Oleh Fadzlena Jafar
Wanita digesa lakukan pemeriksaan barah payu dara sendiri selain segera bertemu doktor untuk rawatan
PENGALAMAN menakutkan pesakit barah ketika melakukan rawatan kemoterapi, selain stigma masyarakat terhadap wanita yang terpaksa membuang payu daranya dikenal pasti antara punca ramai wanita enggan mendapatkan rawatan perubatan moden.
Malah, ada pesakit yang mengambil keputusan berkenaan walaupun ketika didiagnos mereka hanya berada pada tahap satu yang mana peluang untuk sembuh hampir 100 peratus.
Bagaimanapun, Pakar Bedah Payu Dara Hospital Pantai Kuala Lumpur (HPKL), Dr Azlina Firzah Abdul Aziz, berkata ada pesakit yang membuat pilihan dengan mengamalkan perubatan alternatif seperti mengambil herba tanpa menyedari amalan itu menyebabkan keadaan mereka semakin kritikal.
“Kajian mendapati, kebanyakan pesakit di Malaysia lambat mendapatkan rawatan perubatan yang betul kerana meminta nasihat daripada individu tidak terlatih atau menawarkan pilihan dengan menjanjikan kaedah seperti herba dan suplemen, kononnya dapat mengelakkan pembedahan.
“Janji diberikan pasti menarik pesakit terutama yang takut akan pembedahan dan komplikasi akibat rawatan seperti kemoterapi. Inilah yang menyebabkan ramai yang akhirnya datang kepada kita dalam keadaan yang sudah teruk sehingga peluang sembuh agak tipis,” katanya pada majlis pelancaran kempen kesedaran Wear It Pink 2009 anjuran HPKL, baru-baru ini.
Kempen itu dilancarkan oleh Menteri Pembangunan, Keluarga dan Masyarakat, Datuk Seri Shahrizat Abdul Jalil. Turut hadir Pengerusi Pantai Holdings Berhad (Pantai Holdings), Tan Sri Mohamed Khatib Abdul Hamid; Pengarah Urusan Kumpulan Pantai Holdings, Faisal Ismail; Pengarah Eksekutif Divisyen Operasi Hospital, Pantai Holdings, Chan Boon Kheng; Ketua Pegawai Eksekutif HPKL, Tan Suet Guan; Presiden Avon Malaysia, Mansoor Wan Abdullah dan Presiden Persatuan Kebajikan Barah Payu Dara (BCWA), Ranjit Kaur.
Dianggarkan satu dalam 19 wanita di negara ini berisiko menghidap barah payu dara sekali dalam hidup mereka. Daftar Kanser Kebangsaan 2003-2005 menunjukkan pada tempoh itu sebanyak 11,952 kes baru barah payu dara dikesan, tetapi angka berkenaan dikatakan tidak memaparkan jumlah sebenar pesakit barah payu dara di negara ini memandangkan laporan kepada Daftar berkenaan tidak diwajibkan.
Ini bermakna jumlah yang betul mungkin jauh lebih tinggi terutama jika pesakit mendapatkan rawatan di hospital swasta mahupun perubatan alternatif.
Apa yang lebih membimbangkan, jika selama ini pesakit hanya membabitkan mereka yang sudah berusia khususnya di kalangan wanita menopaus, namun sejak kebelakangan ini semakin ramai gadis muda seawal usia belasan tahun turut dikesan menghidap penyakit yang dikatakan pembunuh nombor satu wanita itu.
Dr Azlina berkata, barah payu dara memberi kesan bukan saja kepada pesakit, bahkan setiap ahli keluarga dan rakan, selain menyebabkan kerugian kepada negara apabila ramai wanita terpaksa keluar daripada pasaran kerja bagi membolehkan mereka mendapatkan rawatan sewajarnya.
Beliau berkata, walaupun ketika ini ada pelbagai kempen kesedaran terhadap penyakit itu dilakukan, kempen seumpama itu perlu dipertingkatkan kerana pengesanan awal dapat memberikan rawatan lebih komprehensif.
“Kita melihat ada banyak kempen kesedaran dijalankan pelbagai pihak, baik kerajaan mahupun swasta. Percaya atau tidak, ia masih belum mencukupi kerana sehingga kini tiada kaedah tepat bagi mencegah barah payu dara dan tiada ujian darah bersesuaian bagi mengesan penyakit ini, tetapi dengan pengesanan awal khususnya di kalangan pesakit Tahap 1, peluang untuk bebas daripada penyakit itu bagi tempoh lima tahun berikutnya hampir 100 peratus.
“Malah, dengan rawatan awal diberikan, pesakit juga boleh mengelakkan mastektomi (pembedahan membuang seluruh payu dara yang mempunyai sel barah), selain mencegah rasa sakit akibat barah yang semakin serius atau membolehkan pesakit melakukan pembedahan membentuk semula payu dara jika mastektomi dijalankan,” katanya.
Sehubungan itu, beliau menggesa wanita supaya melakukan pemeriksaan payu dara sendiri, selain tampil berjumpa doktor mendapatkan pemeriksaan jika mendapati keganjilan pada payu dara mereka.
Kempen Wear It Pink 2009 anjuran HPKL itu mendapat kerjasama Avon (M) Sdn Bhd, jenama kecantikan terkenal yang aktif dalam pelbagai kempen kesedaran barah payu dara, malah mempunyai program khusus dinamakan Kiss Goodbye to Breast Cancer.
Pada majlis itu, HPKL turut menyerahkan cek berjumlah RM20,000 kepada Ranjit yang disampaikan Shahrizar. Selain itu, pengasas butik Pink Jambu, Tengku Marina Ibrahim turut mengumumkan 50 peratus daripada jualan barangan di butik berkenaan sepanjang Oktober dan November ini akan disalurkan bagi kempen Wear It Pink 2009.
Lelaki juga berisiko hidap barah payu dara
BARAH payu dara bukan saja membabitkan wanita, bahkan turut memberi kesan kepada lelaki. Selain perlu memberikan sokongan kepada isteri atau ibu yang menghidap penyakit berkenaan, lelaki juga perlu sedar bahawa barah payu dara bukan ‘milik’ wanita semata-mata kerana penyakit itu turut menyerang lelaki.
Jika statistik antarabangsa menyatakan lelaki merangkumi 1 peratus daripada jumlah keseluruhan pesakit barah payu dara, di Malaysia Daftar Kanser Kebangsaan 2003-2005 menunjukkan penghidap barah payu dara di kalangan lelaki agak tinggi dengan 257 atau 2.15 peratus kes dikesan.
Pengerusi Pantai Holdings Berhad (Pantai Holdings), Tan Sri Mohamed Khatib Abdul Hamid, berkata kebanyakan lelaki beranggapan barah payu dara adalah penyakit wanita tanpa menyedari mereka juga berisiko menghidap penyakit berkenaan.
“Kita mendapati di Malaysia khususnya, lelaki enggan menghadiri ceramah umum barah payu dara kerana menganggap tiada kaitan dengan mereka. Tetapi kita perlu menolak jauh tanggapan negatif ini kerana bukan saja barah payu dara memberi kesan kepada kita jika isteri, ibu atau anak perempuan menghidapnya, bahkan lelaki juga berisiko diserang barah payu dara.
“Justeru, kita perlu meningkatkan kesedaran di kalangan masyarakat akan risiko penyakit ini. Sesiapa saja boleh menghidapnya, malangnya di Malaysia latar belakang perubatan menunjukkan keadaan yang membimbangkan kerana kebanyakan pesakit hanya datang mendapatkan rawatan pada tahap kritikal,” katanya.
Bagi meningkatkan kesedaran terhadap kesan barah payu dara kepada masyarakat, HPKL menubuhkan Pusat Penjagaan Payu Dara (BCC) pada Mei 2007 dengan menawarkan rundingan membabitkan barah payu dara.
Selain kempen kesedaran tahunan, BCC turut menganjurkan forum awam, ceramah kesihatan di sektor korporat dan kem kesihatan di kawasan luar bandar sepanjang tahun.
Friday, November 6, 2009
Pengesanan awal selamatkan nyawa
Berita Harian
Khamis, 05/11/2009
Pengesanan awal selamatkan nyawa
Oleh Fadzlena Jafar
Wanita digesa lakukan pemeriksaan barah payu dara sendiri selain segera bertemu doktor untuk rawatan
PENGALAMAN menakutkan pesakit barah ketika melakukan rawatan kemoterapi, selain stigma masyarakat terhadap wanita yang terpaksa membuang payu daranya dikenal pasti antara punca ramai wanita enggan mendapatkan rawatan perubatan moden.
Malah, ada pesakit yang mengambil keputusan berkenaan walaupun ketika didiagnos mereka hanya berada pada tahap satu yang mana peluang untuk sembuh hampir 100 peratus.
Bagaimanapun, Pakar Bedah Payu Dara Hospital Pantai Kuala Lumpur (HPKL), Dr. Azlina Firzah Abdul Aziz, berkata ada pesakit yang membuat pilihan dengan mengamalkan perubatan alternatif seperti mengambil herba tanpa menyedari amalan itu menyebabkan keadaan mereka semakin kritikal.
"Kajian mendapati, kebanyakan pesakit di Malaysia lambat mendapatkan rawatan perubatan yang betul kerana meminta nasihat daripada individu tidak terlatih atau menawarkan pilihan dengan menjanjikan kaedah seperti herba dan suplemen, kononnya dapat mengelakkan pembedahan.
"Janji diberikan pasti menarik pesakit terutama yang takut akan pembedahan dan komplikasi akibat rawatan seperti kemoterapi. Inilah yang menyebabkan ramai yang akhirnya datang kepada kita dalam keadaan yang sudah teruk sehingga peluang sembuh agak tipis," katanya pada majlis pelancaran kempen kesedaran 'Wear It Pink 2009' anjuran HPKL, baru-baru ini.
Kempen itu dilancarkan oleh Menteri Pembangunan, Keluarga dan Masyarakat, Datuk Seri Shahrizat Abdul Jalil. Turut hadir Pengerusi Pantai Holdings Berhad (Pantai Holdings), Tan Sri Mohamed Khatib Abdul Hamid; Pengarah Urusan Kumpulan Pantai Holdings, Faisal Ismail; Pengarah Eksekutif Divisyen Operasi Hospital, Pantai Holdings, Chan Boon Kheng; Ketua Pegawai Eksekutif HPKL, Tan Suet Guan; Presiden Avon Malaysia, Mansoor Wan Abdullah dan Presiden Persatuan Kebajikan Barah Payu Dara (BCWA), Ranjit Kaur.
Dianggarkan satu dalam 19 wanita di negara ini berisiko menghidap barah payu dara sekali dalam hidup mereka. Daftar Kanser Kebangsaan 2003-2005 menunjukkan pada tempoh itu sebanyak 11,952 kes baru barah payu dara dikesan, tetapi angka berkenaan dikatakan tidak memaparkan jumlah sebenar pesakit barah payu dara di negara ini memandangkan laporan kepada daftar berkenaan tidak diwajibkan.
Ini bermakna jumlah yang betul mungkin jauh lebih tinggi terutama jika pesakit mendapatkan rawatan di hospital swasta mahupun perubatan alternatif.
Apa yang lebih membimbangkan, jika selama ini pesakit hanya membabitkan mereka yang sudah berusia khususnya di kalangan wanita menopaus, namun sejak kebelakangan ini semakin ramai gadis muda seawal usia belasan tahun turut dikesan menghidap penyakit yang dikatakan pembunuh nombor satu wanita itu.
Dr. Azlina berkata, barah payu dara memberi kesan bukan saja kepada pesakit, bahkan setiap ahli keluarga dan rakan, selain menyebabkan kerugian kepada negara apabila ramai wanita terpaksa keluar daripada pasaran kerja bagi membolehkan mereka mendapatkan rawatan sewajarnya.
Beliau berkata, walaupun ketika ini ada pelbagai kempen kesedaran terhadap penyakit itu dilakukan, kempen seumpama itu perlu dipertingkat kerana pengesanan awal dapat memberikan rawatan lebih komprehensif.
"Kita melihat ada banyak kempen kesedaran dijalankan pelbagai pihak, baik kerajaan mahupun swasta. Percaya atau tidak, ia masih belum mencukupi kerana sehingga kini tiada kaedah tepat bagi mencegah barah payu dara dan tiada ujian darah bersesuaian bagi mengesan penyakit ini, tetapi dengan pengesanan awal khususnya di kalangan pesakit Tahap 1, peluang untuk bebas daripada penyakit itu bagi tempoh lima tahun berikutnya hampir 100 peratus.
"Malah, dengan rawatan awal diberikan, pesakit juga boleh mengelakkan mastektomi (pembedahan membuang seluruh payu dara yang mempunyai sel barah), selain mencegah rasa sakit akibat barah yang semakin serius atau membolehkan pesakit melakukan pembedahan membentuk semula payu dara jika mastektomi dijalankan," katanya.
Sehubungan itu, beliau menggesa wanita supaya melakukan pemeriksaan payu dara sendiri, selain tampil berjumpa doktor mendapatkan pemeriksaan jika mendapati keganjilan pada payu dara mereka.
Kempen 'Wear It Pink 2009' anjuran HPKL itu mendapat kerjasama Avon (M) Sdn. Bhd., jenama kecantikan terkenal yang aktif dalam pelbagai kempen kesedaran barah payu dara, malah mempunyai program khusus dinamakan 'Kiss Goodbye to Breast Cancer'.
Pada majlis itu, HPKL turut menyerahkan cek berjumlah RM20,000 kepada Ranjit yang disampaikan Shahrizat. Selain itu, pengasas butik Pink Jambu, Tengku Marina Ibrahim turut mengumumkan 50 peratus daripada jualan barangan di butik berkenaan sepanjang Oktober dan November ini akan disalurkan bagi kempen 'Wear It Pink 2009'.
Khamis, 05/11/2009
Pengesanan awal selamatkan nyawa
Oleh Fadzlena Jafar
Wanita digesa lakukan pemeriksaan barah payu dara sendiri selain segera bertemu doktor untuk rawatan
PENGALAMAN menakutkan pesakit barah ketika melakukan rawatan kemoterapi, selain stigma masyarakat terhadap wanita yang terpaksa membuang payu daranya dikenal pasti antara punca ramai wanita enggan mendapatkan rawatan perubatan moden.
Malah, ada pesakit yang mengambil keputusan berkenaan walaupun ketika didiagnos mereka hanya berada pada tahap satu yang mana peluang untuk sembuh hampir 100 peratus.
Bagaimanapun, Pakar Bedah Payu Dara Hospital Pantai Kuala Lumpur (HPKL), Dr. Azlina Firzah Abdul Aziz, berkata ada pesakit yang membuat pilihan dengan mengamalkan perubatan alternatif seperti mengambil herba tanpa menyedari amalan itu menyebabkan keadaan mereka semakin kritikal.
"Kajian mendapati, kebanyakan pesakit di Malaysia lambat mendapatkan rawatan perubatan yang betul kerana meminta nasihat daripada individu tidak terlatih atau menawarkan pilihan dengan menjanjikan kaedah seperti herba dan suplemen, kononnya dapat mengelakkan pembedahan.
"Janji diberikan pasti menarik pesakit terutama yang takut akan pembedahan dan komplikasi akibat rawatan seperti kemoterapi. Inilah yang menyebabkan ramai yang akhirnya datang kepada kita dalam keadaan yang sudah teruk sehingga peluang sembuh agak tipis," katanya pada majlis pelancaran kempen kesedaran 'Wear It Pink 2009' anjuran HPKL, baru-baru ini.
Kempen itu dilancarkan oleh Menteri Pembangunan, Keluarga dan Masyarakat, Datuk Seri Shahrizat Abdul Jalil. Turut hadir Pengerusi Pantai Holdings Berhad (Pantai Holdings), Tan Sri Mohamed Khatib Abdul Hamid; Pengarah Urusan Kumpulan Pantai Holdings, Faisal Ismail; Pengarah Eksekutif Divisyen Operasi Hospital, Pantai Holdings, Chan Boon Kheng; Ketua Pegawai Eksekutif HPKL, Tan Suet Guan; Presiden Avon Malaysia, Mansoor Wan Abdullah dan Presiden Persatuan Kebajikan Barah Payu Dara (BCWA), Ranjit Kaur.
Dianggarkan satu dalam 19 wanita di negara ini berisiko menghidap barah payu dara sekali dalam hidup mereka. Daftar Kanser Kebangsaan 2003-2005 menunjukkan pada tempoh itu sebanyak 11,952 kes baru barah payu dara dikesan, tetapi angka berkenaan dikatakan tidak memaparkan jumlah sebenar pesakit barah payu dara di negara ini memandangkan laporan kepada daftar berkenaan tidak diwajibkan.
Ini bermakna jumlah yang betul mungkin jauh lebih tinggi terutama jika pesakit mendapatkan rawatan di hospital swasta mahupun perubatan alternatif.
Apa yang lebih membimbangkan, jika selama ini pesakit hanya membabitkan mereka yang sudah berusia khususnya di kalangan wanita menopaus, namun sejak kebelakangan ini semakin ramai gadis muda seawal usia belasan tahun turut dikesan menghidap penyakit yang dikatakan pembunuh nombor satu wanita itu.
Dr. Azlina berkata, barah payu dara memberi kesan bukan saja kepada pesakit, bahkan setiap ahli keluarga dan rakan, selain menyebabkan kerugian kepada negara apabila ramai wanita terpaksa keluar daripada pasaran kerja bagi membolehkan mereka mendapatkan rawatan sewajarnya.
Beliau berkata, walaupun ketika ini ada pelbagai kempen kesedaran terhadap penyakit itu dilakukan, kempen seumpama itu perlu dipertingkat kerana pengesanan awal dapat memberikan rawatan lebih komprehensif.
"Kita melihat ada banyak kempen kesedaran dijalankan pelbagai pihak, baik kerajaan mahupun swasta. Percaya atau tidak, ia masih belum mencukupi kerana sehingga kini tiada kaedah tepat bagi mencegah barah payu dara dan tiada ujian darah bersesuaian bagi mengesan penyakit ini, tetapi dengan pengesanan awal khususnya di kalangan pesakit Tahap 1, peluang untuk bebas daripada penyakit itu bagi tempoh lima tahun berikutnya hampir 100 peratus.
"Malah, dengan rawatan awal diberikan, pesakit juga boleh mengelakkan mastektomi (pembedahan membuang seluruh payu dara yang mempunyai sel barah), selain mencegah rasa sakit akibat barah yang semakin serius atau membolehkan pesakit melakukan pembedahan membentuk semula payu dara jika mastektomi dijalankan," katanya.
Sehubungan itu, beliau menggesa wanita supaya melakukan pemeriksaan payu dara sendiri, selain tampil berjumpa doktor mendapatkan pemeriksaan jika mendapati keganjilan pada payu dara mereka.
Kempen 'Wear It Pink 2009' anjuran HPKL itu mendapat kerjasama Avon (M) Sdn. Bhd., jenama kecantikan terkenal yang aktif dalam pelbagai kempen kesedaran barah payu dara, malah mempunyai program khusus dinamakan 'Kiss Goodbye to Breast Cancer'.
Pada majlis itu, HPKL turut menyerahkan cek berjumlah RM20,000 kepada Ranjit yang disampaikan Shahrizat. Selain itu, pengasas butik Pink Jambu, Tengku Marina Ibrahim turut mengumumkan 50 peratus daripada jualan barangan di butik berkenaan sepanjang Oktober dan November ini akan disalurkan bagi kempen 'Wear It Pink 2009'.
Kempen kesedaran barah payu dara
Berita Harian
Khamis, 05/11/2009
Kempen kesedaran barah payu dara
KUALA LUMPUR: Satu acara bagi meningkatkan kesedaran orang ramai mengenai penyakit barah payu dara, 'OutRageously PINK Nite 2009', akan berlangsung di pusat belah-belah Bangsar Village pada Sabtu ini, selama empat jam mulai 6 petang.
Majlis itu meraikan mereka yang berjaya mengharungi cabaran ketika diserang penyakit itu bertemakan warna merah jambu dan semua kutipan yang diperoleh termasuk melalui kempen 'Stand Up For Pink', Oktober lalu, akan diserahkan kepada Dana Kanser Payudara, Pusat Perubatan Universiti Malaya.
Menurut kenyataan orang ramai yang hadir ke majlis anjuran Bangsar Village dengan kerjasama 'Venusbuzz', 'Lariche Community', 'College of Radiology Academy of Medicine of Malaysia' dan 'Malaysian Breast Cancer Council' itu dengan berpakaian merah jambu, turut berpeluang memenangi pelbagai hadiah istimewa yang disediakan.
Selain persembahan fesyen oleh pesakit yang sembuh dari penyakit berbahaya itu, pelbagai persembahan lain antaranya oleh penulis lagu, Juwita Suwito dan Elvira Arul.
Aktiviti menarik juga turut menanti kanak-kanak apabila mereka akan dihiburkan dengan aktiviti lukisan wajah, gerai ukuran belon yang ditaja Laura Mercier serta 'Lariche Community'.
Khamis, 05/11/2009
Kempen kesedaran barah payu dara
KUALA LUMPUR: Satu acara bagi meningkatkan kesedaran orang ramai mengenai penyakit barah payu dara, 'OutRageously PINK Nite 2009', akan berlangsung di pusat belah-belah Bangsar Village pada Sabtu ini, selama empat jam mulai 6 petang.
Majlis itu meraikan mereka yang berjaya mengharungi cabaran ketika diserang penyakit itu bertemakan warna merah jambu dan semua kutipan yang diperoleh termasuk melalui kempen 'Stand Up For Pink', Oktober lalu, akan diserahkan kepada Dana Kanser Payudara, Pusat Perubatan Universiti Malaya.
Menurut kenyataan orang ramai yang hadir ke majlis anjuran Bangsar Village dengan kerjasama 'Venusbuzz', 'Lariche Community', 'College of Radiology Academy of Medicine of Malaysia' dan 'Malaysian Breast Cancer Council' itu dengan berpakaian merah jambu, turut berpeluang memenangi pelbagai hadiah istimewa yang disediakan.
Selain persembahan fesyen oleh pesakit yang sembuh dari penyakit berbahaya itu, pelbagai persembahan lain antaranya oleh penulis lagu, Juwita Suwito dan Elvira Arul.
Aktiviti menarik juga turut menanti kanak-kanak apabila mereka akan dihiburkan dengan aktiviti lukisan wajah, gerai ukuran belon yang ditaja Laura Mercier serta 'Lariche Community'.
Sunday, April 5, 2009
Breast cancer survivors challenge the waves
Breast cancer survivors challenge the waves
Isaac Hiew
|The Pink Challengers show their positive side ... "that
there is life after breast cancer".
The Pink Challengers – a group of 15 gutsy breast cancer survivors recently rowed a dragon boat across the 3.8km Penang channel to drum up the message: "There can be life after breast cancer."
The event organised by the Breast Cancer Welfare Association (BCWA) with the theme "Paddle for Courage, Strength and Change" saw the Pink Challengers rowing from Bagan Ajam, Butterworth to Tanjong City Marina.
On hand to support them was Royal Australian Air Force personnel who rowed another dragon boat alongside the Pink Challengers. Present to welcome them after the event was Penang State executive councillor Danny Law Heng Kiang.
Their arrival at Tanjung City Marina was greeted by honks from the biking fraternity, including members of the Harley Owners Group Malaysia Chapter.
To mark the end of the Penang Channel Challenge, the Pink Challengers observed a moment of silence, before casting flowers into the water in memory of women the world over, who had lost the battle with breast cancer and for those who are still battling the disease.
The Pink Challengers, formed in March 2007, is the country’s first dragon boat team made up entirely of breast cancer survivors, for whom rowing across rough waters is a symbolic activity – resonating with their personal battles against the disease.
Through the Penang Channel Challenge, they hoped to inspire others that having cancer does not render them hopeless, even through the roughest of journeys in life.
Over the years of training together, these women have formed a mutual companionship and camaraderie and consider themselves "sworn-sisters" who have gone through thick and thin.
As one of the team members said: "We are in the same boat."
"This event is significant to us as we take on the waves, and push through the resistance, symbolising the battle that everyone in this team has experienced breast cancer," said BCWA president Ranjit Kaur, who was also the drummer for the team.
She said the physical action of paddling, which builds up body strength and flexibility of the arms, is also a way of preventing lymphoedema or arm swelling – a side effect of breast cancer treatment.
Earlier, BCWA received a RM10,000 donation from ceramics tile manufacturer MML Marketing Sdn Bhd, a brand under Malaysian Mosaics Bhd.
Updated: 10:00AM Mon, 06 Apr 2009
Printable Version | Email to a Friend
Isaac Hiew
|The Pink Challengers show their positive side ... "that
there is life after breast cancer".
The Pink Challengers – a group of 15 gutsy breast cancer survivors recently rowed a dragon boat across the 3.8km Penang channel to drum up the message: "There can be life after breast cancer."
The event organised by the Breast Cancer Welfare Association (BCWA) with the theme "Paddle for Courage, Strength and Change" saw the Pink Challengers rowing from Bagan Ajam, Butterworth to Tanjong City Marina.
On hand to support them was Royal Australian Air Force personnel who rowed another dragon boat alongside the Pink Challengers. Present to welcome them after the event was Penang State executive councillor Danny Law Heng Kiang.
Their arrival at Tanjung City Marina was greeted by honks from the biking fraternity, including members of the Harley Owners Group Malaysia Chapter.
To mark the end of the Penang Channel Challenge, the Pink Challengers observed a moment of silence, before casting flowers into the water in memory of women the world over, who had lost the battle with breast cancer and for those who are still battling the disease.
The Pink Challengers, formed in March 2007, is the country’s first dragon boat team made up entirely of breast cancer survivors, for whom rowing across rough waters is a symbolic activity – resonating with their personal battles against the disease.
Through the Penang Channel Challenge, they hoped to inspire others that having cancer does not render them hopeless, even through the roughest of journeys in life.
Over the years of training together, these women have formed a mutual companionship and camaraderie and consider themselves "sworn-sisters" who have gone through thick and thin.
As one of the team members said: "We are in the same boat."
"This event is significant to us as we take on the waves, and push through the resistance, symbolising the battle that everyone in this team has experienced breast cancer," said BCWA president Ranjit Kaur, who was also the drummer for the team.
She said the physical action of paddling, which builds up body strength and flexibility of the arms, is also a way of preventing lymphoedema or arm swelling – a side effect of breast cancer treatment.
Earlier, BCWA received a RM10,000 donation from ceramics tile manufacturer MML Marketing Sdn Bhd, a brand under Malaysian Mosaics Bhd.
Updated: 10:00AM Mon, 06 Apr 2009
Printable Version | Email to a Friend
Friday, March 13, 2009
Rising pressure of healthcare cost
Saturday March 14, 2009
Rising pressure of healthcare cost
By CECILIA KOK
Increases in medical bills are outpacing the general inflation rate each year. That raises the question whether healthcare is reserved only for those who can afford it
“I got the bill for my surgery. Now I know what those doctors were wearing masks for”
– American bureaucrat, James H. Boren (1925)
WHAT is the value of a human’s health? Sixteenth-century English scholar and vicar at Oxford University Robert Burton put it at such: “Restore a man to his health, and his purse lies open to thee.”
That denotes that health is priceless, and almost everyone would pay anything to get well. With the doctors’ power to demand, medical services do not come cheap.
And with the continuous rise of investments in research and development as well as the adoption of the latest technologies to deal with the rapid emergence of new and complicated illnesses (and the re-emergence of some deadly ones), healthcare costs are soaring by the day.
So, who can afford to fall sick these days?
Across the world, the increases in doctors’ bills are outpacing the general inflation rate each year. It is estimated that the global medical inflation averages about 10% each year.
In Malaysia, medical inflation is estimated to be around 15% each year. That is to say, a simple appendicitis surgery that cost RM1,800 three years ago will set you back by about RM3,000 today.
The next question then: Is healthcare reserved only for those who can afford it?
Far from it. As former Health Ministry director-general Tan Sri Dr Abdul Khalid Sahan puts it, healthcare has been universally accepted as a basic right of all citizens.
“Everyone has a right to receive it irrespective of his or her ability to pay,” Khalid explains, adding that the Government is accountable for ensuring that healthcare is made accessible to all citizens.
The existence of public healthcare services in Malaysia is in line with that notion. Although the system is not perfect, its services are provided almost free of charge because they are heavily subsidised by the Government.
And complementing the public healthcare system in Malaysia is the private sector, whose existence is supposed to help improve the delivery standards of the public healthcare sector – in that the “richer” patients would go to the private hospitals, and therefore, help lighten the workload of the public sector, so that the “poorer” patients can have better and faster services at government hospitals.
Private healthcare services are expensive (or as some would complain, ridiculously expensive) mainly because they are profit-driven centres.
Shocking bills
Over the years, there have been growing concerns that private hospitals tend to overcharge their patients. According to Dr Chan Chee Khoon, professor and convenor for health and social policy research cluster at Universiti Sains Malaysia, there are built-in incentives for over-investigation, over-treatment and over-medication in a profit-driven, fee-for-service system.
Therefore, some patients have been slapped with exorbitant charges by private hospitals due to “unnecessary” treatment courses.
For example, there is the case of Madam LC, in her 60s, who had been diagnosed with breast cancer with metastasis to liver stage IV, and was admitted to a private hospital in Kuala Lumpur in January. Upon discharge the following day, she was slapped with a bill of more than RM7,000. Of this amount, nearly half was for a specific medication called Injection Aclasta, which, according to the patient, retailed at only RM1,400. In addition, LC was also billed for a bilateral mammogram, when she actually did a single one, as she had a left mastectomy more than 10 years ago.
Upon protest, LC was offered a 7% discount, which included a revision of the mammogram charges. She turned down the offer because she felt she was still being overcharged for the medication.
In the middle of last month, she received a telephone call and an SMS from the hospital’s public relations officer, offering a 20% refund. She requested the offer be made in writing but to this day, she has yet to hear from the hospital.
Unfortunately, LC’s experience is not an isolated case. As an industry analyst puts it, whenever the patient is unaware and “can afford it”, such practices tend to occur because private hospitals are driven by profits.
However, a private hospital doctor told StarBizWeek that most of them do not mean to over-diagnose or over-treat patients. He explains that doctors in the private hospitals tend to subject their patients to “better monitoring” as part of what they call defensive medicine, due to the rising risk of litigation.
He adds, “So, gone are the days when the doctor would send the patient home for self-monitoring before admitting him or her for further treatment.”
Nevertheless, thanks to the introduction of medical insurance, certain medical expenses incurred by policyholders can be taken care of. Hence, it is viewed as increasingly important for individuals to have such insurance policies, with sufficient coverage.
This is because we have often heard of how terminally ill patients had to endure the high costs of treatment. Some even had to borrow money. Some had exhausted their insurance coverage and some had given up hope for medication.
Then again, while medical insurance policies have helped to alleviate the financial burden of patients, they have also contributed to the rapid increase of medical costs at private hospitals. This is because insurance policies are another opportunity through which private hospitals can make quick bucks.
Affordability issue
It is estimated that only about 40% of the country’s population, or 10.8 million Malaysians, are medically insured. This leaves about 16.2 million people without health insurance policies. Then again, this may not be a big concern in Malaysia as patients can always turn to the Government.
Over the years, the steep costs at private healthcare centres have caused some patients to go back to public healthcare. And with the global recession, even more are expected to seek public, rather than private, healthcare services.
Dr Pawel Suwinski, Frost & Sullivan Malaysia Sdn Bhd’s senior consultant of healthcare practice for Asia-Pacific, says this may be the trend, given the present economic condition, which has an impact on consumers’ incomes, making private healthcare services increasingly unaffordable to many.
Suwinski points out that people will obviously make their choices based on affordability. And between the options of a cheaper but more troublesome public healthcare and a more convenient but expensive private healthcare, patients are now more likely going to opt for the former.
Association of Private Hospitals of Malaysia (APHM) president Datuk Dr Jacob Thomas concedes that it is possible that patients will turn to the public healthcare system in these troubled times, but he argues that there is only so much that the public hospitals can cope with. As it stands now, these hospitals are already overloaded with patients.
The healthcare gap
Undeniably, there is a huge disparity between public and private healthcare services in Malaysia. First, the public healthcare sector continues to lose its trained medical professionals to the more lucrative and usually urban-based private sector.
Also, it has to cater to the growing number of patients as the bulk of the Malaysian population cannot afford private healthcare.
The massive brain drain and the higher volume of patients have resulted in an overwhelming workload for the public healthcare sytem. At present, the public sector accounts for about 39,000, or 77%, of the total hospital beds in the country, while the private sector accounts for the remainder of about 12,000 beds.
But there are almost 9,000 doctors in the private sector, compared with about 13,500 doctors employed by the Government.
So, the ratio of doctors to hospital beds is still lower for the private sector, which has one doctor to attend to every 1.3 beds, versus the public sector’s one doctor for every three beds.
As a result, patients at government hospitals wait longer to get medical attention and they get less personalised attention from the doctors. Therefore, there tends to be a lack of communication between doctors and patients.
Equally competent
However, industry observers say this does not mean that doctors at public hospitals are any less competent than their counterparts in the private sector.
Frost & Sullivan’s Suwinski says the public healthcare sector, in fact, has more experienced specialists, who are also involved in the teaching process for the medical profession.
APHM’s Thomas concurs, saying that most doctors in the private sector are after all, products of the public sector. Hence, there is not much difference in the competency levels between doctors of both sectors.
He adds that the private healthcare sector has been “fortunate”, as it does not have a large volume of patients, and is therefore able to provide more personalised attention.
According to Suwinski, the perception that public healthcare services are inferior is mainly due to the longer waiting hours at government hospitals and their less attractive facades. “But these have no connection with the quality of care delivered,” he points out.
He thinks the public healthcare sector can overcome the poor perception by upgrading older facilities, acquiring new technologies and equipment, and improving its manpower.
Meanwhile, Thomas points out that the public-private partnership was recently established to help the Government cope with its growing list of patients.
The partnership involves the Government sending some of its patients to the private sector for certain consultation and treatment. The process will not burden the patients as the costs incurred are still borne by the Government.
“It is a win-win situation, whereby the private sector can help ease the load of public hospitals,” Thomas explains.
Beyond borders
A recent study by the National University of Singapore shows that the process of transforming Malaysian healthcare into a global commodity is well under way. This is underpinned by the Government’s effort in institutionalising various incentives such as tax support, accreditation, sales promotion and marketing activities to promote the country as a healthcare hub.
According to Thomas, the private healthcare sector has been tasked to be the driver of medical tourism in Malaysia.
Among the factors working to Malaysia’s advantage, Thomas says, are its cost-competitiveness compared to the regional and international markets, the good infrastructure, and the fact that English is widely spoken here.
In addition, the overall performance of Malaysia’s healthcare system is considered remarkably good by the standards of the World Health Organisation (WHO).
Indicators supporting this are the country’s health-adjusted life expectancy, which is around 63 years (comparable to that of industrialised countries), and the maternal mortality rates, which have fallen by more than ten-fold over the last four decades (from 320 deaths per 100,000 livebirths in 1957 to less than 30 deaths per 100,000 livebirths currently).
According to Suwinski, WHO considers the Malaysian healthcare system to be one of the best and a role model for developing nations.
Frost & Sullivan had earlier estimated that Malaysia’s healthcare industry would grow 8% this year, supported by a 2009 budget allocation of RM13.7bil. Last year, the Government spent about RM13bil on the healthcare industry.
Room for improvement
Malaysia devotes only a small portion of its gross domestic product (GDP) annually to healthcare. Over the years, the Government has consistently spent less than 3% of its GDP on the healthcare sector. The WHO-recommended level is 5%.
But it is almost in line with the trend of neighbouring countries Singapore and Thailand that have been dedicating around 4% of their GDP on health spending. On the other hand, the expenditures on health by the governments of rapidly developing China and India have both exceeded 5% of their GDP since 2002.
In general, developed countries allocate larger portions of their budgets to healthcare. The US, for example, dedicates around 15% of its GDP annually to health spending, while Japan dedicates around 8% and Britain, 7%.
According to an analyst, by consistently spending less than the WHO-recommended amount, a country could turn its healthcare system into a laggard.
Industry observers say the importance of healthcare cannot be underestimated. As Khalid puts it, healthcare goes beyond the individual recipients to the family and society, and investment in health is an indirect investment in the economy of the country.
Rising pressure of healthcare cost
By CECILIA KOK
Increases in medical bills are outpacing the general inflation rate each year. That raises the question whether healthcare is reserved only for those who can afford it
“I got the bill for my surgery. Now I know what those doctors were wearing masks for”
– American bureaucrat, James H. Boren (1925)
WHAT is the value of a human’s health? Sixteenth-century English scholar and vicar at Oxford University Robert Burton put it at such: “Restore a man to his health, and his purse lies open to thee.”
That denotes that health is priceless, and almost everyone would pay anything to get well. With the doctors’ power to demand, medical services do not come cheap.
And with the continuous rise of investments in research and development as well as the adoption of the latest technologies to deal with the rapid emergence of new and complicated illnesses (and the re-emergence of some deadly ones), healthcare costs are soaring by the day.
So, who can afford to fall sick these days?
Across the world, the increases in doctors’ bills are outpacing the general inflation rate each year. It is estimated that the global medical inflation averages about 10% each year.
In Malaysia, medical inflation is estimated to be around 15% each year. That is to say, a simple appendicitis surgery that cost RM1,800 three years ago will set you back by about RM3,000 today.
The next question then: Is healthcare reserved only for those who can afford it?
Far from it. As former Health Ministry director-general Tan Sri Dr Abdul Khalid Sahan puts it, healthcare has been universally accepted as a basic right of all citizens.
“Everyone has a right to receive it irrespective of his or her ability to pay,” Khalid explains, adding that the Government is accountable for ensuring that healthcare is made accessible to all citizens.
The existence of public healthcare services in Malaysia is in line with that notion. Although the system is not perfect, its services are provided almost free of charge because they are heavily subsidised by the Government.
And complementing the public healthcare system in Malaysia is the private sector, whose existence is supposed to help improve the delivery standards of the public healthcare sector – in that the “richer” patients would go to the private hospitals, and therefore, help lighten the workload of the public sector, so that the “poorer” patients can have better and faster services at government hospitals.
Private healthcare services are expensive (or as some would complain, ridiculously expensive) mainly because they are profit-driven centres.
Shocking bills
Over the years, there have been growing concerns that private hospitals tend to overcharge their patients. According to Dr Chan Chee Khoon, professor and convenor for health and social policy research cluster at Universiti Sains Malaysia, there are built-in incentives for over-investigation, over-treatment and over-medication in a profit-driven, fee-for-service system.
Therefore, some patients have been slapped with exorbitant charges by private hospitals due to “unnecessary” treatment courses.
For example, there is the case of Madam LC, in her 60s, who had been diagnosed with breast cancer with metastasis to liver stage IV, and was admitted to a private hospital in Kuala Lumpur in January. Upon discharge the following day, she was slapped with a bill of more than RM7,000. Of this amount, nearly half was for a specific medication called Injection Aclasta, which, according to the patient, retailed at only RM1,400. In addition, LC was also billed for a bilateral mammogram, when she actually did a single one, as she had a left mastectomy more than 10 years ago.
Upon protest, LC was offered a 7% discount, which included a revision of the mammogram charges. She turned down the offer because she felt she was still being overcharged for the medication.
In the middle of last month, she received a telephone call and an SMS from the hospital’s public relations officer, offering a 20% refund. She requested the offer be made in writing but to this day, she has yet to hear from the hospital.
Unfortunately, LC’s experience is not an isolated case. As an industry analyst puts it, whenever the patient is unaware and “can afford it”, such practices tend to occur because private hospitals are driven by profits.
However, a private hospital doctor told StarBizWeek that most of them do not mean to over-diagnose or over-treat patients. He explains that doctors in the private hospitals tend to subject their patients to “better monitoring” as part of what they call defensive medicine, due to the rising risk of litigation.
He adds, “So, gone are the days when the doctor would send the patient home for self-monitoring before admitting him or her for further treatment.”
Nevertheless, thanks to the introduction of medical insurance, certain medical expenses incurred by policyholders can be taken care of. Hence, it is viewed as increasingly important for individuals to have such insurance policies, with sufficient coverage.
This is because we have often heard of how terminally ill patients had to endure the high costs of treatment. Some even had to borrow money. Some had exhausted their insurance coverage and some had given up hope for medication.
Then again, while medical insurance policies have helped to alleviate the financial burden of patients, they have also contributed to the rapid increase of medical costs at private hospitals. This is because insurance policies are another opportunity through which private hospitals can make quick bucks.
Affordability issue
It is estimated that only about 40% of the country’s population, or 10.8 million Malaysians, are medically insured. This leaves about 16.2 million people without health insurance policies. Then again, this may not be a big concern in Malaysia as patients can always turn to the Government.
Over the years, the steep costs at private healthcare centres have caused some patients to go back to public healthcare. And with the global recession, even more are expected to seek public, rather than private, healthcare services.
Dr Pawel Suwinski, Frost & Sullivan Malaysia Sdn Bhd’s senior consultant of healthcare practice for Asia-Pacific, says this may be the trend, given the present economic condition, which has an impact on consumers’ incomes, making private healthcare services increasingly unaffordable to many.
Suwinski points out that people will obviously make their choices based on affordability. And between the options of a cheaper but more troublesome public healthcare and a more convenient but expensive private healthcare, patients are now more likely going to opt for the former.
Association of Private Hospitals of Malaysia (APHM) president Datuk Dr Jacob Thomas concedes that it is possible that patients will turn to the public healthcare system in these troubled times, but he argues that there is only so much that the public hospitals can cope with. As it stands now, these hospitals are already overloaded with patients.
The healthcare gap
Undeniably, there is a huge disparity between public and private healthcare services in Malaysia. First, the public healthcare sector continues to lose its trained medical professionals to the more lucrative and usually urban-based private sector.
Also, it has to cater to the growing number of patients as the bulk of the Malaysian population cannot afford private healthcare.
The massive brain drain and the higher volume of patients have resulted in an overwhelming workload for the public healthcare sytem. At present, the public sector accounts for about 39,000, or 77%, of the total hospital beds in the country, while the private sector accounts for the remainder of about 12,000 beds.
But there are almost 9,000 doctors in the private sector, compared with about 13,500 doctors employed by the Government.
So, the ratio of doctors to hospital beds is still lower for the private sector, which has one doctor to attend to every 1.3 beds, versus the public sector’s one doctor for every three beds.
As a result, patients at government hospitals wait longer to get medical attention and they get less personalised attention from the doctors. Therefore, there tends to be a lack of communication between doctors and patients.
Equally competent
However, industry observers say this does not mean that doctors at public hospitals are any less competent than their counterparts in the private sector.
Frost & Sullivan’s Suwinski says the public healthcare sector, in fact, has more experienced specialists, who are also involved in the teaching process for the medical profession.
APHM’s Thomas concurs, saying that most doctors in the private sector are after all, products of the public sector. Hence, there is not much difference in the competency levels between doctors of both sectors.
He adds that the private healthcare sector has been “fortunate”, as it does not have a large volume of patients, and is therefore able to provide more personalised attention.
According to Suwinski, the perception that public healthcare services are inferior is mainly due to the longer waiting hours at government hospitals and their less attractive facades. “But these have no connection with the quality of care delivered,” he points out.
He thinks the public healthcare sector can overcome the poor perception by upgrading older facilities, acquiring new technologies and equipment, and improving its manpower.
Meanwhile, Thomas points out that the public-private partnership was recently established to help the Government cope with its growing list of patients.
The partnership involves the Government sending some of its patients to the private sector for certain consultation and treatment. The process will not burden the patients as the costs incurred are still borne by the Government.
“It is a win-win situation, whereby the private sector can help ease the load of public hospitals,” Thomas explains.
Beyond borders
A recent study by the National University of Singapore shows that the process of transforming Malaysian healthcare into a global commodity is well under way. This is underpinned by the Government’s effort in institutionalising various incentives such as tax support, accreditation, sales promotion and marketing activities to promote the country as a healthcare hub.
According to Thomas, the private healthcare sector has been tasked to be the driver of medical tourism in Malaysia.
Among the factors working to Malaysia’s advantage, Thomas says, are its cost-competitiveness compared to the regional and international markets, the good infrastructure, and the fact that English is widely spoken here.
In addition, the overall performance of Malaysia’s healthcare system is considered remarkably good by the standards of the World Health Organisation (WHO).
Indicators supporting this are the country’s health-adjusted life expectancy, which is around 63 years (comparable to that of industrialised countries), and the maternal mortality rates, which have fallen by more than ten-fold over the last four decades (from 320 deaths per 100,000 livebirths in 1957 to less than 30 deaths per 100,000 livebirths currently).
According to Suwinski, WHO considers the Malaysian healthcare system to be one of the best and a role model for developing nations.
Frost & Sullivan had earlier estimated that Malaysia’s healthcare industry would grow 8% this year, supported by a 2009 budget allocation of RM13.7bil. Last year, the Government spent about RM13bil on the healthcare industry.
Room for improvement
Malaysia devotes only a small portion of its gross domestic product (GDP) annually to healthcare. Over the years, the Government has consistently spent less than 3% of its GDP on the healthcare sector. The WHO-recommended level is 5%.
But it is almost in line with the trend of neighbouring countries Singapore and Thailand that have been dedicating around 4% of their GDP on health spending. On the other hand, the expenditures on health by the governments of rapidly developing China and India have both exceeded 5% of their GDP since 2002.
In general, developed countries allocate larger portions of their budgets to healthcare. The US, for example, dedicates around 15% of its GDP annually to health spending, while Japan dedicates around 8% and Britain, 7%.
According to an analyst, by consistently spending less than the WHO-recommended amount, a country could turn its healthcare system into a laggard.
Industry observers say the importance of healthcare cannot be underestimated. As Khalid puts it, healthcare goes beyond the individual recipients to the family and society, and investment in health is an indirect investment in the economy of the country.
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GlobalHealth Asia plans provide comprehensive medical insurance coverage for you and your family wherever you live, work or play. You have the freedom to choose any physician, hospital or clinic in any country around the world. GlobalHealth Asia can also provide medical coverage to those with pre-existing medical conditions. In addition, we include worldwide International SOS emergency and evacuation assistance in the event of an immediate medical need. GlobalHealth Asia is your innovative personal medical insurer.
Assessing IT in healthcare
Published: Tuesday March 10, 2009 MYT 10:42:00 AM
Updated: Tuesday March 10, 2009 MYT 11:23:50 AM
Assessing IT in healthcare
By STEVEN PATRICK
KUALA LUMPUR: An initiative to evaluate the cost and benefits of IT in healthcare was announced at the Healthcare Information and Management Systems Society (HIMSS) Asia Pacific show, which was held here recently.
Called the Alliance for Clinical Excellence (Ace), the first movers of this global, non-profit initiative include the Hong Kong Society of Medical Informatics, Singapore’s Ministry Of Health Holdings Pte Ltd and the National University of Singapore’s School of Computing.
The first IT healthcare solutions providers involved in Ace are Orion Health (from the United States), iSoft and Chik Services Pte Ltd (both from Australia) and US enterprise solutions giant Oracle Corp. The Ace secretariat is based in Singapore.
Ace seeks to create objective assessments of the benefits and costs of IT and related processes that can be applied across contexts, culture or medical regimes.
Chris Hobson, chief medical officer of Orion Health said that although governments around the world spend billions of dollars on IT in healthcare, no one can quantify its benefits, whether in terms of return on investment or quality of care for patients.
“This is a pressing concern for governments who don’t have the tools to evaluate whatever money they spend on IT infrastructure in healthcare. The benefits must be transparent to the customer,” he said.
Mehdi Khaled, vice-president of Oracle Asia Pacific and Japan healthcare and life services, explained that the Ace initiative is more than just a think-tank.
“We don’t want to just think and discuss, we want to actually do. The more we brainstorm, the more progress we will make. We want to come up with clear metrics for determining the proper criteria for deploying IT in healthcare. He added that Ace will be putting up periodical research material and publications online in the near future.
He said that they would be speaking to the Malaysian government to get involved in the Ace initiative.
The uses of IT in healthcare include electronic health records and clinical applications, which are aimed at helping healthcare providers make clinical decisions.
Updated: Tuesday March 10, 2009 MYT 11:23:50 AM
Assessing IT in healthcare
By STEVEN PATRICK
KUALA LUMPUR: An initiative to evaluate the cost and benefits of IT in healthcare was announced at the Healthcare Information and Management Systems Society (HIMSS) Asia Pacific show, which was held here recently.
Called the Alliance for Clinical Excellence (Ace), the first movers of this global, non-profit initiative include the Hong Kong Society of Medical Informatics, Singapore’s Ministry Of Health Holdings Pte Ltd and the National University of Singapore’s School of Computing.
The first IT healthcare solutions providers involved in Ace are Orion Health (from the United States), iSoft and Chik Services Pte Ltd (both from Australia) and US enterprise solutions giant Oracle Corp. The Ace secretariat is based in Singapore.
Ace seeks to create objective assessments of the benefits and costs of IT and related processes that can be applied across contexts, culture or medical regimes.
Chris Hobson, chief medical officer of Orion Health said that although governments around the world spend billions of dollars on IT in healthcare, no one can quantify its benefits, whether in terms of return on investment or quality of care for patients.
“This is a pressing concern for governments who don’t have the tools to evaluate whatever money they spend on IT infrastructure in healthcare. The benefits must be transparent to the customer,” he said.
Mehdi Khaled, vice-president of Oracle Asia Pacific and Japan healthcare and life services, explained that the Ace initiative is more than just a think-tank.
“We don’t want to just think and discuss, we want to actually do. The more we brainstorm, the more progress we will make. We want to come up with clear metrics for determining the proper criteria for deploying IT in healthcare. He added that Ace will be putting up periodical research material and publications online in the near future.
He said that they would be speaking to the Malaysian government to get involved in the Ace initiative.
The uses of IT in healthcare include electronic health records and clinical applications, which are aimed at helping healthcare providers make clinical decisions.
Wednesday, March 11, 2009
Blood, ultrasound tests catch ovarian cancer
WEB EDITION :: International News
Blood, ultrasound tests catch ovarian cancer
WASHINGTON (March 11, 2009) : Blood tests and ultrasound scans can catch deadly ovarian cancer at the most early and treatable stages, British doctors reported on Tuesday, saying it may finally be possible to screen women for the disease.
Their study of 200,000 women who used both tests together caught 90 percent of ovarian cancer cases, while using ultrasound alone each year caught 75 percent. Nearly half the cases were in the early stage I or stage II phases, when the cancer has not spread far and can sometimes be cured.
As there is no current good test for ovarian cancer, having a reliable screening test could save many lives, Ian Jacobs and Usha Menon of University College London reported in the journal Lancet Oncology.
"The initial findings of this long-term study are encouraging, particularly because almost half of the ovarian cancers detected were at an early stage (stage 1), when survival rates can be as high as 90 percent," Peter Reynolds of Britain's Ovarian Cancer Action said in a statement.
Ovarian cancer is one of the most deadly cancers, in part because the symptoms are so vague that women often are not diagnosed until it is too late.
It was diagnosed in more than 21,000 women in the United States in 2008 and killed more than 15,000; in Britain it affects about 7,000 women a year and kills more than 4,000.
Jacobs and Menon said both the CA125 blood test and the transvaginal ultrasound test have been fine-tuned in recent years and now offer more useful information to doctors.
They analysed interim results of a trial that started in 2001, enrolling more than 200,000 women past menopause who got one of three screening approaches: both ultrasound and the CA 125 blood test annually, ultrasound alone or no screening.
CA125 looks for a compound produced by ovarian tumors, but other conditions such as endometriosis, benign ovarian cysts, pregnancy, and pelvic inflammatory disease all produce higher levels of CA125.
Using both screens together found 34 out of 38 cases of ovarian cancer that eventually developed, while ultrasounds alone found 24 out of 32, Jacobs and Menon reported.
It is not clear whether these tests have reduced the death rate from ovarian cancer among the women in the study, the researchers said -- more time is needed to show that.
"While preliminary, these encouraging data demonstrate that we may be able to use current affordable technologies to detect ovarian cancer at a curable stage," Dr. Beth Karlan of the American Society of Clinical Oncology said in a statement.
"Further follow-up should help us determine if these approaches can be cost-effective and truly reduce deaths from ovarian cancer." - Reuters
Updated: 11:51AM Wed, 11 Mar 2009
Printable Version | Email to a Friend
Blood, ultrasound tests catch ovarian cancer
WASHINGTON (March 11, 2009) : Blood tests and ultrasound scans can catch deadly ovarian cancer at the most early and treatable stages, British doctors reported on Tuesday, saying it may finally be possible to screen women for the disease.
Their study of 200,000 women who used both tests together caught 90 percent of ovarian cancer cases, while using ultrasound alone each year caught 75 percent. Nearly half the cases were in the early stage I or stage II phases, when the cancer has not spread far and can sometimes be cured.
As there is no current good test for ovarian cancer, having a reliable screening test could save many lives, Ian Jacobs and Usha Menon of University College London reported in the journal Lancet Oncology.
"The initial findings of this long-term study are encouraging, particularly because almost half of the ovarian cancers detected were at an early stage (stage 1), when survival rates can be as high as 90 percent," Peter Reynolds of Britain's Ovarian Cancer Action said in a statement.
Ovarian cancer is one of the most deadly cancers, in part because the symptoms are so vague that women often are not diagnosed until it is too late.
It was diagnosed in more than 21,000 women in the United States in 2008 and killed more than 15,000; in Britain it affects about 7,000 women a year and kills more than 4,000.
Jacobs and Menon said both the CA125 blood test and the transvaginal ultrasound test have been fine-tuned in recent years and now offer more useful information to doctors.
They analysed interim results of a trial that started in 2001, enrolling more than 200,000 women past menopause who got one of three screening approaches: both ultrasound and the CA 125 blood test annually, ultrasound alone or no screening.
CA125 looks for a compound produced by ovarian tumors, but other conditions such as endometriosis, benign ovarian cysts, pregnancy, and pelvic inflammatory disease all produce higher levels of CA125.
Using both screens together found 34 out of 38 cases of ovarian cancer that eventually developed, while ultrasounds alone found 24 out of 32, Jacobs and Menon reported.
It is not clear whether these tests have reduced the death rate from ovarian cancer among the women in the study, the researchers said -- more time is needed to show that.
"While preliminary, these encouraging data demonstrate that we may be able to use current affordable technologies to detect ovarian cancer at a curable stage," Dr. Beth Karlan of the American Society of Clinical Oncology said in a statement.
"Further follow-up should help us determine if these approaches can be cost-effective and truly reduce deaths from ovarian cancer." - Reuters
Updated: 11:51AM Wed, 11 Mar 2009
Printable Version | Email to a Friend
Monday, March 2, 2009
Expansion move for Hospis
Saturday February 28, 2009
Expansion move for Hospis
By JAYAGANDI JAYARAJ
TO cater to their expanding needs, Hospis Malaysia in Taman Sri Bahtera, Cheras, is extending its building.
The new wing, which is expected to be completed by the end of the year, is a double-storey structure with a basement.
The project will cost RM5mil.
Hospis Malaysia general manager Rosehayati Ahmad said the extension was to cater to a day-care centre, treatment room, resting room and counselling room, while the basement was to store medical equipment.
She said the current building was occupied 10 years ago and since then the number of patients and their needs had grown.
Zaharil (right) presenting a mock cheque for RM5,000 to (from right) Leong Boon Peng, Teh Chee Keong, Dr Goh, Hospis Malaysia CEO & medical director Dr Ednin Hamzah and its council member, Linda Phang.
“We have about 400 patients with life-threatening diseases registered with us.
“Although we do not have patients living in the building with us, we need room for facilities like the day-care centre,” she said during a cheque presentation ceremony by MCA Cheras to Hospis Malaysia for the building fund on Thursday.
The organisation provides palliative medicine and care through a homecare programme where doctors and nurses administer their services at a patient’s home.
Rosehayati said the day-care centre was for patients who wanted to spend some time here and take part in activities with other patients.
“These activities can be simple like flower arrangement or handicraft.”
The day-care centre is open on Tuesdays and Thursdays. There are about 15 patients a day.
Meanwhile, the organisation also loans medical equipment, beds and wheelchairs to patients.
“We have these equipment ready and those who are in need of them could borrow it from us.
“Once the basement is completed, the available equipment such as oxygen tanks, beds and suction pumps will be stored in there. Right now, space is a restriction,” she added.
Funded by public donations and contributions, the organisation’s operations expenditure for a year is RM1.6mil.
Present during the cheque presentation was Cheras MCA secretary Dr Jeffrey Goh and Implementation Coordination Unit director Datuk Mohd Zaharil Kasim.
Those who wish to contribute to the organisation’s building fund can contact 03-9133 3936.
Expansion move for Hospis
By JAYAGANDI JAYARAJ
TO cater to their expanding needs, Hospis Malaysia in Taman Sri Bahtera, Cheras, is extending its building.
The new wing, which is expected to be completed by the end of the year, is a double-storey structure with a basement.
The project will cost RM5mil.
Hospis Malaysia general manager Rosehayati Ahmad said the extension was to cater to a day-care centre, treatment room, resting room and counselling room, while the basement was to store medical equipment.
She said the current building was occupied 10 years ago and since then the number of patients and their needs had grown.
Zaharil (right) presenting a mock cheque for RM5,000 to (from right) Leong Boon Peng, Teh Chee Keong, Dr Goh, Hospis Malaysia CEO & medical director Dr Ednin Hamzah and its council member, Linda Phang.
“We have about 400 patients with life-threatening diseases registered with us.
“Although we do not have patients living in the building with us, we need room for facilities like the day-care centre,” she said during a cheque presentation ceremony by MCA Cheras to Hospis Malaysia for the building fund on Thursday.
The organisation provides palliative medicine and care through a homecare programme where doctors and nurses administer their services at a patient’s home.
Rosehayati said the day-care centre was for patients who wanted to spend some time here and take part in activities with other patients.
“These activities can be simple like flower arrangement or handicraft.”
The day-care centre is open on Tuesdays and Thursdays. There are about 15 patients a day.
Meanwhile, the organisation also loans medical equipment, beds and wheelchairs to patients.
“We have these equipment ready and those who are in need of them could borrow it from us.
“Once the basement is completed, the available equipment such as oxygen tanks, beds and suction pumps will be stored in there. Right now, space is a restriction,” she added.
Funded by public donations and contributions, the organisation’s operations expenditure for a year is RM1.6mil.
Present during the cheque presentation was Cheras MCA secretary Dr Jeffrey Goh and Implementation Coordination Unit director Datuk Mohd Zaharil Kasim.
Those who wish to contribute to the organisation’s building fund can contact 03-9133 3936.
Saturday, February 28, 2009
Q and A
1. What forms the basis for the impedance mammography in diagnostics of breast disease?
A living organism does not only generate bioelectricity, but passively conducts the current, which occurs in it or is applied from outside. Electrical conductivity depends on the histological structure of the organ, its molecular and, finally, its elementary composition (structure and number of free electrical charges, their mobility). Electrical properties of many malignant formations considerably differ from the healthy tissues, surrounding them. If X-ray and ultrasound methods of diagnostics construct images using the level of contrast between healthy and malignant tissue, which amounts to several percent and less, in case of impedance diagnostics the electrical conductivity of such tissues might amount to several hundreds of percent. This phenomenon is used in detection and localization of tumours and other breast disease.
2. What is impedance?
It is a physical value, which characterizes the electrical resistance of the system (from Latin impedire — “to cause hindrance”. Electrical impedance is a total resistance of the electrical circuit to the alternative current passing through it. In general, it is a geometrical sum of active resistance of the electrical circuit and reactive resistance (reactance), measured in Om.
3. What parameters of electrical current can be used in medicine, and in mammology in particular?
In medical diagnostics, particularly in electroimpedance mammography, the alternative current of a rather high frequency is used (as a rule, over 1 kHz). Due to high polarization degree of the intercellular membranes and the working electrodes electrical conductivity, measurements of biological systems, using direct current, is extremely difficult. The permissible value of the current is limited by its biological impact on the cells of living tissue; the former grows with the frequency increase. The current used for scanning in the electroimpedance computer mammography “MEIK”® (5th version) is within the range of 0,5 mA, frequency 50 kHz. These parameters of the measurement systems are absolutely harmless for patients.
4. What are the outlooks for utilizing the multi-frequency scanning?
We studied possibilities of the multi-frequency scanning for visualization of mammary tumor. ("Electro-impedance mammography testing at some physiological woman's periods". A.Karpov, O.Trochanova, XI international conference on electrical bio-impedance. Oslo, Norway, 2001; �Changes in electrical conductivity of mammary gland at multi-frequency measurement�, A.Karpov, O.Trochanova, XVIII scientific and practical conference. Yaroslavl, 2001). But application of the current with frequency within the range of β- dispersion ( 102 � 108 Hz) for breast scanning failed to bring the expected results. The 5th version of �MEIK� comprises this possibility. We recommend using it only as a tool for research only.
5. How painful is the examination?
The examination, being absolutely painless during the diagnostics and after it, lasts about 30 seconds.
6. What are the indications for impedance mammography?
The electrical impedance can be utilized in the whole range of the breast diseases, namely: benign and malignant neoplasms, mastopathies, mastitis and so on. In addition electrical impedance can be used for dynamic monitoring of women, comprising a risk group, in order to check efficiency of treatment. The examination, done with the help of MIEK during pregnancy as well as after birth, supplies doctors with valuable information concerning particulars of lactation period. This method of screening is widely used for women who take oral contraceptives and undergo substitutive hormonotherapy in climacterical stages.
7. Do any contraindications exist for using the method of impedance mammography?
Impedance mammography is absolutely harmless for a human being; this is why it can be used at any age period, inclusive lactation and pregnancy.
8. How often can impedance mammography be used?
The examination can be used without time limitations, since it is not accompanied by any radiation exposure and is safe for patients. The examination can be carried out when recommended by the physician at any time intervals. It can be used during a menstrual cycle in order to define breast functional particulars (so called dynamic mammography). In perimenopause it should be done at least one a year.
9. Who should conduct the examination in question?
The examination, connected with impedance mammography, should be performed by doctors, familiar with breast anatomy, physiology and pathology, namely: mammologists, obstetricians, or specialists in radiodiagnostics. When carrying out the examination it is preferable to have a nurse�s assistance, since it speeds up the procedure and increases efficiency.
10. Is it possible to diagnose breast malignant growth?
Due to the difference in electrical conductivity of malignant and healthy tissues existing from the initial stage of the tumour process, the device is capable of performing early detection of the oncology pathologies.
11. What minimal size of a tumour can be detected with the help of impedance mammography?
According to the existing statistic data the smallest detected tumours were 3-5 mm.
12. What are the operational characteristics of impedance mammography (sensitivity, specificity, etc)?
Sensitivity amounts to.92%, specificity-.99%, prognostication of positive - 73%, prognostication of negative result - 99%.
13. What method should be used for detection of malignant diseases? — for benign diseases?
It is not correct to discuss preferences any method in detecting any disease. There are no 100% results in diagnostics either in case of benign or malignant diseases of breast anywhere in the world. When choosing the appropriate method one should be guided by the criteria of safety and appropriateness. Taking into account high degree of sensitivity and specificity of the impedance mammography and at the same time its absolute safety, we can recommend starting examination with this method in particular. It case of necessity a more detailed examination can be recommended.
14. Is it recommendable to use the method in question for screening purposes?
The method of impedance mammography meets all demands of screening: safety, affordability, comprehensiveness; it can be performed within a short period of time in a room with limited sizes.
15. Does impedance mammography examination require any special condition?
The impedance mammography doesn�t need any special procedures. The examination is carried out at a room temperature, in rooms with average humidity. The patient takes a lying position on the examination couch.
16. How long does the examination last?
The length of examination procedure is 30 - 35 seconds. The process of diagnostic examination from the moment of obtaining the case history to establishing a conclusion amounts to 15 minutes. Screening examination lasts about 5 minutes.
17. What is the cost of the examination procedure?
When comparing the cost of various equipment, utilized for the same purposes, it is possible to say that the examination in question is cheaper than X-ray mammography and ultrasound examination.
18. Can the impedance mammography provoke any complications?
We have never witnessed any complications after impedance mammography.
Copyright © 2008 OOO PKF “SIM-technika”
Developed by “Bondarenko & Voronov” studio
A living organism does not only generate bioelectricity, but passively conducts the current, which occurs in it or is applied from outside. Electrical conductivity depends on the histological structure of the organ, its molecular and, finally, its elementary composition (structure and number of free electrical charges, their mobility). Electrical properties of many malignant formations considerably differ from the healthy tissues, surrounding them. If X-ray and ultrasound methods of diagnostics construct images using the level of contrast between healthy and malignant tissue, which amounts to several percent and less, in case of impedance diagnostics the electrical conductivity of such tissues might amount to several hundreds of percent. This phenomenon is used in detection and localization of tumours and other breast disease.
2. What is impedance?
It is a physical value, which characterizes the electrical resistance of the system (from Latin impedire — “to cause hindrance”. Electrical impedance is a total resistance of the electrical circuit to the alternative current passing through it. In general, it is a geometrical sum of active resistance of the electrical circuit and reactive resistance (reactance), measured in Om.
3. What parameters of electrical current can be used in medicine, and in mammology in particular?
In medical diagnostics, particularly in electroimpedance mammography, the alternative current of a rather high frequency is used (as a rule, over 1 kHz). Due to high polarization degree of the intercellular membranes and the working electrodes electrical conductivity, measurements of biological systems, using direct current, is extremely difficult. The permissible value of the current is limited by its biological impact on the cells of living tissue; the former grows with the frequency increase. The current used for scanning in the electroimpedance computer mammography “MEIK”® (5th version) is within the range of 0,5 mA, frequency 50 kHz. These parameters of the measurement systems are absolutely harmless for patients.
4. What are the outlooks for utilizing the multi-frequency scanning?
We studied possibilities of the multi-frequency scanning for visualization of mammary tumor. ("Electro-impedance mammography testing at some physiological woman's periods". A.Karpov, O.Trochanova, XI international conference on electrical bio-impedance. Oslo, Norway, 2001; �Changes in electrical conductivity of mammary gland at multi-frequency measurement�, A.Karpov, O.Trochanova, XVIII scientific and practical conference. Yaroslavl, 2001). But application of the current with frequency within the range of β- dispersion ( 102 � 108 Hz) for breast scanning failed to bring the expected results. The 5th version of �MEIK� comprises this possibility. We recommend using it only as a tool for research only.
5. How painful is the examination?
The examination, being absolutely painless during the diagnostics and after it, lasts about 30 seconds.
6. What are the indications for impedance mammography?
The electrical impedance can be utilized in the whole range of the breast diseases, namely: benign and malignant neoplasms, mastopathies, mastitis and so on. In addition electrical impedance can be used for dynamic monitoring of women, comprising a risk group, in order to check efficiency of treatment. The examination, done with the help of MIEK during pregnancy as well as after birth, supplies doctors with valuable information concerning particulars of lactation period. This method of screening is widely used for women who take oral contraceptives and undergo substitutive hormonotherapy in climacterical stages.
7. Do any contraindications exist for using the method of impedance mammography?
Impedance mammography is absolutely harmless for a human being; this is why it can be used at any age period, inclusive lactation and pregnancy.
8. How often can impedance mammography be used?
The examination can be used without time limitations, since it is not accompanied by any radiation exposure and is safe for patients. The examination can be carried out when recommended by the physician at any time intervals. It can be used during a menstrual cycle in order to define breast functional particulars (so called dynamic mammography). In perimenopause it should be done at least one a year.
9. Who should conduct the examination in question?
The examination, connected with impedance mammography, should be performed by doctors, familiar with breast anatomy, physiology and pathology, namely: mammologists, obstetricians, or specialists in radiodiagnostics. When carrying out the examination it is preferable to have a nurse�s assistance, since it speeds up the procedure and increases efficiency.
10. Is it possible to diagnose breast malignant growth?
Due to the difference in electrical conductivity of malignant and healthy tissues existing from the initial stage of the tumour process, the device is capable of performing early detection of the oncology pathologies.
11. What minimal size of a tumour can be detected with the help of impedance mammography?
According to the existing statistic data the smallest detected tumours were 3-5 mm.
12. What are the operational characteristics of impedance mammography (sensitivity, specificity, etc)?
Sensitivity amounts to.92%, specificity-.99%, prognostication of positive - 73%, prognostication of negative result - 99%.
13. What method should be used for detection of malignant diseases? — for benign diseases?
It is not correct to discuss preferences any method in detecting any disease. There are no 100% results in diagnostics either in case of benign or malignant diseases of breast anywhere in the world. When choosing the appropriate method one should be guided by the criteria of safety and appropriateness. Taking into account high degree of sensitivity and specificity of the impedance mammography and at the same time its absolute safety, we can recommend starting examination with this method in particular. It case of necessity a more detailed examination can be recommended.
14. Is it recommendable to use the method in question for screening purposes?
The method of impedance mammography meets all demands of screening: safety, affordability, comprehensiveness; it can be performed within a short period of time in a room with limited sizes.
15. Does impedance mammography examination require any special condition?
The impedance mammography doesn�t need any special procedures. The examination is carried out at a room temperature, in rooms with average humidity. The patient takes a lying position on the examination couch.
16. How long does the examination last?
The length of examination procedure is 30 - 35 seconds. The process of diagnostic examination from the moment of obtaining the case history to establishing a conclusion amounts to 15 minutes. Screening examination lasts about 5 minutes.
17. What is the cost of the examination procedure?
When comparing the cost of various equipment, utilized for the same purposes, it is possible to say that the examination in question is cheaper than X-ray mammography and ultrasound examination.
18. Can the impedance mammography provoke any complications?
We have never witnessed any complications after impedance mammography.
Copyright © 2008 OOO PKF “SIM-technika”
Developed by “Bondarenko & Voronov” studio
Development of electrical impedance tomography
The works on development of electrical impedance tomography started in Russia in the 90s of the last century. A group of scientists from the Institute of Radiotechnology and Electronics of the Russian Academy of Science (director — an academician, professor, an honoured worker of science and technology, Doctor of Physico-Mathematical Science Guliaev Yu. V.) comprising Doctor of Science (Physics and Mathematics) Cherepenin V.A., Candidate of science (Physics and Mathematics) Korzhenevskiy A.V., Candidate of science (Physics and Mathematics) Kornienko V.A. and others in 1997 — 1998 were able to solve a mathematical problem of imaging internal tissues of human body utilizing electrical impedance tomography.
Their efforts resulted in development of a pilot model of the device for diagnostics of the mammary gland, which was later handed over to Karpov A.Yu,, doctor of the higher category, head of the perinatal department of the Clinical Hospital # 9 in Yaroslavl, whose painstaking work allowed him to develop medical basics of electrical impedance mammography.
Head of the medical department
of the OOO PKF “SIM-technika” (ltd),
originator of the medical principles
of the electrical impedance
mammography Karpov A.Yu.
The first variant of the diagnostic device was called “The Electrical Impedance computer Mammograph EIM-003 “Korvet”. The electrical impedance mammograph “MEIK” was covered by the patent of the Russian Federation No. 2153285 and No. 2127075, as well as the USA patent No. 6,167,300 and No. 6,236,886. The invention, which forms the basis of the device, was awarded a golden medal at the World�s Fair of Inventions in Brussels at the exhibition “Eureka '99”.
In 2003 PKF “SIM-technika” on the basis of the OAO “Yaroslavl Radio Works” set up commercial production and manufactured the first batch of the electrical impedance computer mammograph “MEIK” (version 3.0).
The device underwent a successful period of testing and trials at the All-Russia Research Centre for X-ray and Radiology of the Ministry of Public Health in Moscow and at the Regional Oncology Centre of the 9th clinical hospital of Yaroslavl..
After obtaining the relevant approval documentation, starting from 2003 the electrical impedance mammography “MEIK”® has been used in medical practice at various medical institutions of Russia, the CIS, as well as in the countries of Europe and Asia.
Scientific and research work conducted by the PKF “SIM-technika” with involvement of mathematicians for the Yaroslavl State Demidov University as well as programmers and specialists in electronics from the Scientific and Production Enterprise “Spetspribor” enabled SIM-technika to start production from April 2007 of the 5th version of the device. This version differs from the previous modes by high degree of protection from noise and interference, perfect circuit design, high reliability in operation; in addition a fundamentally new software was developed as well, which was highly appreciated by doctors.
The electronics of the devices underwent principle alterations (the electrical circuit, isolation of printed circuit boards, power supply of active components; a block for preliminary filtration of signals from interference, noises and stray conductor-to-conductor flow of current; in addition, thanks to gold electroplating of the circuit boards and current-carrying parts, the jump potentials on the boarder of dissimilar metals was minimized).
As the production testing of the pilot batch of “MEIK”® proved, the abovementioned steps facilitated achievements of the following positive effects:
1. Elimination of noises and disturbances, which overlaying the main signal, led to deterioration of the obtain mammograms resolution capability, sometimes completely degrading the image.
2. Absence of need for calibration since stability of the obtained images and their numeric derivative characteristics are inbuilt into the electronic circuit itself.
3. Existence of independent channels (injecting and measuring) with individual power supply from the secondary sources DC-DC of the THI type with high insulation resistance and low level of interference make the device extremely reliable and electrically safe.
The software for the device (version 5.0) enables the user to perform the following:
to monitor correct positioning of the electrode matrix on the breast;
to control the procedure of measurement, data processing and archiving;
to change the image parameters (colour scale, contrasting, noise filtering, image softening, a 3-D layer-specific image);
to analyze electrical conductivity distribution, frequency distribution of electrical conductivity;
to assist the doctor in the process of diagnostics (automatic prompting).
Copyright © 2008 OOO PKF “SIM-technika”
Developed by “Bondarenko & Voronov” studio
Their efforts resulted in development of a pilot model of the device for diagnostics of the mammary gland, which was later handed over to Karpov A.Yu,, doctor of the higher category, head of the perinatal department of the Clinical Hospital # 9 in Yaroslavl, whose painstaking work allowed him to develop medical basics of electrical impedance mammography.
Head of the medical department
of the OOO PKF “SIM-technika” (ltd),
originator of the medical principles
of the electrical impedance
mammography Karpov A.Yu.
The first variant of the diagnostic device was called “The Electrical Impedance computer Mammograph EIM-003 “Korvet”. The electrical impedance mammograph “MEIK” was covered by the patent of the Russian Federation No. 2153285 and No. 2127075, as well as the USA patent No. 6,167,300 and No. 6,236,886. The invention, which forms the basis of the device, was awarded a golden medal at the World�s Fair of Inventions in Brussels at the exhibition “Eureka '99”.
In 2003 PKF “SIM-technika” on the basis of the OAO “Yaroslavl Radio Works” set up commercial production and manufactured the first batch of the electrical impedance computer mammograph “MEIK” (version 3.0).
The device underwent a successful period of testing and trials at the All-Russia Research Centre for X-ray and Radiology of the Ministry of Public Health in Moscow and at the Regional Oncology Centre of the 9th clinical hospital of Yaroslavl..
After obtaining the relevant approval documentation, starting from 2003 the electrical impedance mammography “MEIK”® has been used in medical practice at various medical institutions of Russia, the CIS, as well as in the countries of Europe and Asia.
Scientific and research work conducted by the PKF “SIM-technika” with involvement of mathematicians for the Yaroslavl State Demidov University as well as programmers and specialists in electronics from the Scientific and Production Enterprise “Spetspribor” enabled SIM-technika to start production from April 2007 of the 5th version of the device. This version differs from the previous modes by high degree of protection from noise and interference, perfect circuit design, high reliability in operation; in addition a fundamentally new software was developed as well, which was highly appreciated by doctors.
The electronics of the devices underwent principle alterations (the electrical circuit, isolation of printed circuit boards, power supply of active components; a block for preliminary filtration of signals from interference, noises and stray conductor-to-conductor flow of current; in addition, thanks to gold electroplating of the circuit boards and current-carrying parts, the jump potentials on the boarder of dissimilar metals was minimized).
As the production testing of the pilot batch of “MEIK”® proved, the abovementioned steps facilitated achievements of the following positive effects:
1. Elimination of noises and disturbances, which overlaying the main signal, led to deterioration of the obtain mammograms resolution capability, sometimes completely degrading the image.
2. Absence of need for calibration since stability of the obtained images and their numeric derivative characteristics are inbuilt into the electronic circuit itself.
3. Existence of independent channels (injecting and measuring) with individual power supply from the secondary sources DC-DC of the THI type with high insulation resistance and low level of interference make the device extremely reliable and electrically safe.
The software for the device (version 5.0) enables the user to perform the following:
to monitor correct positioning of the electrode matrix on the breast;
to control the procedure of measurement, data processing and archiving;
to change the image parameters (colour scale, contrasting, noise filtering, image softening, a 3-D layer-specific image);
to analyze electrical conductivity distribution, frequency distribution of electrical conductivity;
to assist the doctor in the process of diagnostics (automatic prompting).
Copyright © 2008 OOO PKF “SIM-technika”
Developed by “Bondarenko & Voronov” studio
EIT system overview
Three-dimensional EIT imaging of breast tissues: system design and clinical testing
Cherepenin, V.A.; Karpov, A.Y.; Korjenevsky, A.V.; Kornienko, V.N.; Kultiasov, Y.S.; Ochapkin, M.B.; Trochanova, O.V.; Meister, J.D.
Medical Imaging, IEEE Transactions on
Volume 21, Issue 6, June 2002 Page(s):662 - 667
Digital Object Identifier 10.1109/TMI.2002.800602
Summary:Results of development and testing of the new medical imaging system are described. The system uses a planar array consisting of 256 electrodes and enables obtaining images of the three-dimensional conductivity distribution in regions below the skin's surface up to several centimeters deep. The developed measuring system and image reconstruction algorithm can be used for breast tissue imaging and diagnostics, in particular for malignant tumor detection. Examples of tomographic images obtained in vivo during clinical tests are presented. The mammary gland, being an organ-target, alters at the background with such physiological events as menstrual cycle, pregnancy, lactation, and postmenopause. The objectives of this paper include estimation of the possibilities of electrical impedance mammography for investigation of mammary glands' state among women with different hormonal status. We found that electrical impedance mammograms from different groups had clear visual distinctions and statistically significant differences in mammary glands' conductivity. Our data on conductivity distribution in the mammary gland during different physiological periods will allow us to use it as normal values in the future, to continue this research on mammary glands with different pathology.
» View citation and abstract
Cherepenin, V.A.; Karpov, A.Y.; Korjenevsky, A.V.; Kornienko, V.N.; Kultiasov, Y.S.; Ochapkin, M.B.; Trochanova, O.V.; Meister, J.D.
Medical Imaging, IEEE Transactions on
Volume 21, Issue 6, June 2002 Page(s):662 - 667
Digital Object Identifier 10.1109/TMI.2002.800602
Summary:Results of development and testing of the new medical imaging system are described. The system uses a planar array consisting of 256 electrodes and enables obtaining images of the three-dimensional conductivity distribution in regions below the skin's surface up to several centimeters deep. The developed measuring system and image reconstruction algorithm can be used for breast tissue imaging and diagnostics, in particular for malignant tumor detection. Examples of tomographic images obtained in vivo during clinical tests are presented. The mammary gland, being an organ-target, alters at the background with such physiological events as menstrual cycle, pregnancy, lactation, and postmenopause. The objectives of this paper include estimation of the possibilities of electrical impedance mammography for investigation of mammary glands' state among women with different hormonal status. We found that electrical impedance mammograms from different groups had clear visual distinctions and statistically significant differences in mammary glands' conductivity. Our data on conductivity distribution in the mammary gland during different physiological periods will allow us to use it as normal values in the future, to continue this research on mammary glands with different pathology.
» View citation and abstract
What is the role of Electrical Impedance Tomography (EIT) in Early Detection of Breast Cancer?
What is the role of Electrical Impedance Tomography (EIT) in Early Detection of Breast Cancer?
An online interview with Alexander Hartov PhD, Thayer School of Engineering, Dartmouth College, Hanover, USA. 27 Jan 2006
About Alexander Hartov
Alexander Hartov is an electronics and biomedical engineer by training. He is the Research Associate Professor of Engineering at Dartmouth College in the USA, where he works in collaboration with physicians. His area of specialisation concerns instrumentation for medical application and more specifically the use of impedance measurements to screen for cancer. He also works in the field of image guided surgery. His involvement with electrical impedance tomography started in 1996 when he joined the faculty at Dartmouth.
Alexander Hartov in this online interview speaks from the view point of a scientist and Radiology Malaysia thanks him for sparing time to talk about his research in EIT.
The views expressed are his and does not necessarily represent or reflect the views or policies of the institution where he works. The content in this article does not replace consultation with your health professional.
Question: In Malaysia, EIT appears to have invaded the market, and used even in beauty and slimming saloons as part of their package of value added services for women. Advertisements alluding to “breast cancer screening” without pain and radiation have surfaced. Younger women, even in their late teens (from 15 years) have been included in the group that can benefit from Breast EIT.
Hartov: I concur with your outrage at screening wantonly women as young as 15. This is preposterous, no matter how innocuous the technology. In the US the recommended age for starting screening with mammography is somewhere between 40 and 50 years. Of course family history and other factors indicating a predisposition may require starting screening mammograms at a younger age. Screening the 20-40 years group is simply a waste of time if no indications exist. I will add that it's a waste of resources from a public health policy perspective, but it's also lucrative from the provider's perspective, which explains why it is offered as part of packages by businesses such as beauty and slimming salons.
Question: What exactly is electrical impedance tomography, especially with reference to the breast? I note there are a variety of terms used for the scans – T scan, Electrical Impedance scanning, Electrical impedance tomography. Is there a difference between these various types of “equipment used”?
Hartov: Here is a brief explanation of electrical impedance and how it relates to breast cancer screening. All tissue exhibit electrical properties which affect how well they conduct electrical currents (conductivity) and how well they can retain electrical charge (permittivity). This is not a special attribute of tissues, all materials have those properties and their magnitude qualifies them as conductors (very high conductivity) or isolators (very low conductivity). Materials with very high permittivity are used in the electronics industry to make capacitors, for example.
By applying a current on a person's skin, one can measure the effective impedance of the tissue traversed by the current. The impedance represents the effect of both conductivity and permittivity on the current flow. By applying many electrodes to a patient's breast (for example) and measuring the currents flowing through each electrode, it is possible to reconstruct a "map" of the tissue impedance variation. This image can reveal areas of high conductivity, which in the breast are associated with tumors. The whole process is non-invasive and innocuous, since the currents are too small to cause any harm and no radiation is involved.
There remain quite a few issues regarding the use of impedance measurements. First it has not been established clinically that it can discriminate reliably between benign (non cancerous) and malignant (cancerous) abnormalities in the breast. It is clear from direct invasive in-vivo (within a living organism) measurements that differences exist that may be used for screening. However, when making measurements non-invasively, the spatial resolution and sensitivity may not be sufficient to discriminate reliably. We are precisely in the process of conducting such clinical studies.
There are a few techniques to perform the measurements and the reconstruction of the impedance maps. We use a tomographic reconstruction approach. The Russian device uses a much simpler approach in which the electrode array is presented the way it looks spatially with the impedance magnitude reading represented in a gray scale image. A light spot (high conductivity) is considered an anomaly.
The T-scan device belongs in the same category, although its reconstruction method is somewhat more sophisticated in that it can reconstruct planes parallel to the electrode array at various depths. The thing to know about those planar array devices, the T-scan in particular is that they are not approved for screening by themselves (in the US). The studies that have been conducted with these devices were based on coupling the use of the T-scan with mammography. When used in this manner, that is the T-scan is used only on patients with an abnormal mammographic finding, the combination of mammo + T-scan improves the overall accuracy of screening. By itself, it does not qualify as a screening device.
Question: There has been some reports – eg Electrical Impedance Scanning for the Early Detection of Breast Cancer in Young Women: Preliminary Results of a Multicenter Prospective Clinical Trial, Journal of Clinical Oncology, Vol 23, No 12 (April 20), 2005: pp. 2703-2715 & Technology review: The use of electrical impedance scanning in the detection of breast cancer, Breast Cancer Res 2004, 6:69-74. There may be a role for young women with dense breasts. What are your comments?
Hartov: Also important, as I'm sure you know, is the fact that x-ray mammography is far from perfect and results in significant numbers of false positives and a few false negatives, which is why people are striving to find better screening methods. Not much in the way of improvement has been found to date. One category of patients in which it fails at an even higher rate is those women with denser breasts. It is thought that EIT may constitute to improve screening in that group.
Question: Does this problem of misleading advertisements (to the best of your knowledge and experience) exist in other countries? If so, what steps are being done elsewhere to curb misleading claims and what legislation or rules are there in place.
Hartov: As for curbing unsubstantiated claims, lying and cheating to make a buck is going to be with us for some time, I'm afraid. Strong legislation regarding devices for medical use does help, when it comes to public health policies.
Question: Perhaps, you have at take home message for Malaysians on the issue of electrical impedance?
Hartov: My take home message for people considering undergoing EIT is that it's still experimental. If your local beautician is offering it, you should ask yourself what are that person's qualifications to operate such a device and interpret the results it produces. I would recommend you change beautician and talk to a bona fide health care worker about your needs for screening. If you are under 40 and no one in you family has had breast cancer, you most likely don't need to worry about it yet.
Have your say! Discuss this at the Radiology Malaysia Forum
An online interview with Alexander Hartov PhD, Thayer School of Engineering, Dartmouth College, Hanover, USA. 27 Jan 2006
About Alexander Hartov
Alexander Hartov is an electronics and biomedical engineer by training. He is the Research Associate Professor of Engineering at Dartmouth College in the USA, where he works in collaboration with physicians. His area of specialisation concerns instrumentation for medical application and more specifically the use of impedance measurements to screen for cancer. He also works in the field of image guided surgery. His involvement with electrical impedance tomography started in 1996 when he joined the faculty at Dartmouth.
Alexander Hartov in this online interview speaks from the view point of a scientist and Radiology Malaysia thanks him for sparing time to talk about his research in EIT.
The views expressed are his and does not necessarily represent or reflect the views or policies of the institution where he works. The content in this article does not replace consultation with your health professional.
Question: In Malaysia, EIT appears to have invaded the market, and used even in beauty and slimming saloons as part of their package of value added services for women. Advertisements alluding to “breast cancer screening” without pain and radiation have surfaced. Younger women, even in their late teens (from 15 years) have been included in the group that can benefit from Breast EIT.
Hartov: I concur with your outrage at screening wantonly women as young as 15. This is preposterous, no matter how innocuous the technology. In the US the recommended age for starting screening with mammography is somewhere between 40 and 50 years. Of course family history and other factors indicating a predisposition may require starting screening mammograms at a younger age. Screening the 20-40 years group is simply a waste of time if no indications exist. I will add that it's a waste of resources from a public health policy perspective, but it's also lucrative from the provider's perspective, which explains why it is offered as part of packages by businesses such as beauty and slimming salons.
Question: What exactly is electrical impedance tomography, especially with reference to the breast? I note there are a variety of terms used for the scans – T scan, Electrical Impedance scanning, Electrical impedance tomography. Is there a difference between these various types of “equipment used”?
Hartov: Here is a brief explanation of electrical impedance and how it relates to breast cancer screening. All tissue exhibit electrical properties which affect how well they conduct electrical currents (conductivity) and how well they can retain electrical charge (permittivity). This is not a special attribute of tissues, all materials have those properties and their magnitude qualifies them as conductors (very high conductivity) or isolators (very low conductivity). Materials with very high permittivity are used in the electronics industry to make capacitors, for example.
By applying a current on a person's skin, one can measure the effective impedance of the tissue traversed by the current. The impedance represents the effect of both conductivity and permittivity on the current flow. By applying many electrodes to a patient's breast (for example) and measuring the currents flowing through each electrode, it is possible to reconstruct a "map" of the tissue impedance variation. This image can reveal areas of high conductivity, which in the breast are associated with tumors. The whole process is non-invasive and innocuous, since the currents are too small to cause any harm and no radiation is involved.
There remain quite a few issues regarding the use of impedance measurements. First it has not been established clinically that it can discriminate reliably between benign (non cancerous) and malignant (cancerous) abnormalities in the breast. It is clear from direct invasive in-vivo (within a living organism) measurements that differences exist that may be used for screening. However, when making measurements non-invasively, the spatial resolution and sensitivity may not be sufficient to discriminate reliably. We are precisely in the process of conducting such clinical studies.
There are a few techniques to perform the measurements and the reconstruction of the impedance maps. We use a tomographic reconstruction approach. The Russian device uses a much simpler approach in which the electrode array is presented the way it looks spatially with the impedance magnitude reading represented in a gray scale image. A light spot (high conductivity) is considered an anomaly.
The T-scan device belongs in the same category, although its reconstruction method is somewhat more sophisticated in that it can reconstruct planes parallel to the electrode array at various depths. The thing to know about those planar array devices, the T-scan in particular is that they are not approved for screening by themselves (in the US). The studies that have been conducted with these devices were based on coupling the use of the T-scan with mammography. When used in this manner, that is the T-scan is used only on patients with an abnormal mammographic finding, the combination of mammo + T-scan improves the overall accuracy of screening. By itself, it does not qualify as a screening device.
Question: There has been some reports – eg Electrical Impedance Scanning for the Early Detection of Breast Cancer in Young Women: Preliminary Results of a Multicenter Prospective Clinical Trial, Journal of Clinical Oncology, Vol 23, No 12 (April 20), 2005: pp. 2703-2715 & Technology review: The use of electrical impedance scanning in the detection of breast cancer, Breast Cancer Res 2004, 6:69-74. There may be a role for young women with dense breasts. What are your comments?
Hartov: Also important, as I'm sure you know, is the fact that x-ray mammography is far from perfect and results in significant numbers of false positives and a few false negatives, which is why people are striving to find better screening methods. Not much in the way of improvement has been found to date. One category of patients in which it fails at an even higher rate is those women with denser breasts. It is thought that EIT may constitute to improve screening in that group.
Question: Does this problem of misleading advertisements (to the best of your knowledge and experience) exist in other countries? If so, what steps are being done elsewhere to curb misleading claims and what legislation or rules are there in place.
Hartov: As for curbing unsubstantiated claims, lying and cheating to make a buck is going to be with us for some time, I'm afraid. Strong legislation regarding devices for medical use does help, when it comes to public health policies.
Question: Perhaps, you have at take home message for Malaysians on the issue of electrical impedance?
Hartov: My take home message for people considering undergoing EIT is that it's still experimental. If your local beautician is offering it, you should ask yourself what are that person's qualifications to operate such a device and interpret the results it produces. I would recommend you change beautician and talk to a bona fide health care worker about your needs for screening. If you are under 40 and no one in you family has had breast cancer, you most likely don't need to worry about it yet.
Have your say! Discuss this at the Radiology Malaysia Forum
CANCER SOCIETY OF SABAH (CSS)
Homepages of Member Organisations of
Sabah Council of Social Services
--------------------------------------------------------------------------------
CANCER SOCIETY OF SABAH (CSS)
Formation
Aims & Objectives
Membership
Membership Application Form
Management Committee
Activities
Activities
MAIN ACTIVITIES OF THE SOCIETY
1. Public Forum and education.
This is carried out regularly to disseminate information about cancer, its risks factors and ways of prevention. This is usually done by giving public lectures and the display of posters depicting various types of cancer.
2. Rural Health Clinics
This is one of our major activities. A group of volunteers consisting of doctors, nurses and other volunteers go to the rural areas to promote awareness of cancer amongst the rural people. During these visits talks on cancer in the local dialect as well as screening for cancer, e.g. Pap smear, are carried out. Sometimes difficult terrain have to be negotiated in order to reach these rural people who are living in isolated areas.
3. Breast Cancer Support Group
This self-help group initiated by members of the Society deals with women who have breast cancer or who have had breast cancer operation. This group works closely with the surgeons at our General Hospital. They will visit patients prior to breast cancer surgery and share personal experiences with one another. The trust and rapport established during these visit to patients whilst in hospital as well as in their homes make affected women emotionally and physically prepared.
4. Home Hospice Programme
This is a project which we have added to our on-going programme. It was formed in March 1993, with the aim of providing palliative care to patients with advanced cancer in their own homes. There are three tiers of volunteers involved in this programme, and consists of doctors, nurses and lay volunteers. They are all under the co-ordination of a Nurse Co-ordinator who arranges groups of volunteers to visits patients in their homes. These volunteers administer care and support to the patients after appropriate training, e.g. a nurse may administer injectable morphine. Due to the non-cooperation of one or two surgeons in Q.E.H. no patients were referred to the Society recently and so this programme has stagnated. The Societ is depending on self referrals and referrals from Private Practitioners.
5. FINANCIAL AID
The Cancer Society of Sabah also provide financial aid to needy patients and their relatives. This occurs when cancer patients from the rural areas have to come to Kota Kinabalu for Radiotherapy or for the administration of anti-cancer drugs. Financial Aid is usually used to pay for transport or to buy food for the relatives who accompany these patients. In some cases financial aid is also given to buy a special device such as a chemoport.
6. CANCER SCREENING CLINIC
A regular cancer screening clinic is held on every Saturday afternoon in our Society's office. The aim of this is to provide an avenue for people who are worried about cancer to be examined and to be counselled on the ways to prevent cancer. The clinic is usually manned by a doctor with the assistance of a nurse.
--------------------------------------------------------------------------------
K.J.Joseph cansab@tm.net.my , rijo@pc.jaring.my
Sabah Council of Social Services
--------------------------------------------------------------------------------
CANCER SOCIETY OF SABAH (CSS)
Formation
Aims & Objectives
Membership
Membership Application Form
Management Committee
Activities
Activities
MAIN ACTIVITIES OF THE SOCIETY
1. Public Forum and education.
This is carried out regularly to disseminate information about cancer, its risks factors and ways of prevention. This is usually done by giving public lectures and the display of posters depicting various types of cancer.
2. Rural Health Clinics
This is one of our major activities. A group of volunteers consisting of doctors, nurses and other volunteers go to the rural areas to promote awareness of cancer amongst the rural people. During these visits talks on cancer in the local dialect as well as screening for cancer, e.g. Pap smear, are carried out. Sometimes difficult terrain have to be negotiated in order to reach these rural people who are living in isolated areas.
3. Breast Cancer Support Group
This self-help group initiated by members of the Society deals with women who have breast cancer or who have had breast cancer operation. This group works closely with the surgeons at our General Hospital. They will visit patients prior to breast cancer surgery and share personal experiences with one another. The trust and rapport established during these visit to patients whilst in hospital as well as in their homes make affected women emotionally and physically prepared.
4. Home Hospice Programme
This is a project which we have added to our on-going programme. It was formed in March 1993, with the aim of providing palliative care to patients with advanced cancer in their own homes. There are three tiers of volunteers involved in this programme, and consists of doctors, nurses and lay volunteers. They are all under the co-ordination of a Nurse Co-ordinator who arranges groups of volunteers to visits patients in their homes. These volunteers administer care and support to the patients after appropriate training, e.g. a nurse may administer injectable morphine. Due to the non-cooperation of one or two surgeons in Q.E.H. no patients were referred to the Society recently and so this programme has stagnated. The Societ is depending on self referrals and referrals from Private Practitioners.
5. FINANCIAL AID
The Cancer Society of Sabah also provide financial aid to needy patients and their relatives. This occurs when cancer patients from the rural areas have to come to Kota Kinabalu for Radiotherapy or for the administration of anti-cancer drugs. Financial Aid is usually used to pay for transport or to buy food for the relatives who accompany these patients. In some cases financial aid is also given to buy a special device such as a chemoport.
6. CANCER SCREENING CLINIC
A regular cancer screening clinic is held on every Saturday afternoon in our Society's office. The aim of this is to provide an avenue for people who are worried about cancer to be examined and to be counselled on the ways to prevent cancer. The clinic is usually manned by a doctor with the assistance of a nurse.
--------------------------------------------------------------------------------
K.J.Joseph cansab@tm.net.my , rijo@pc.jaring.my
Laws on healthcare devices in the works
Sunday April 6, 2008
Laws on healthcare devices in the works
I REFER to the letter, The need to protect consumers of healthcare services (Your Say, StarMag March 23).
In that letter, Ms Ranjit Kaur, president of the Malaysian Breast Cancer Council, called upon the Ministry of Health (MOH) to protect the consumers by regulating medical devices and non-evidence-based approaches.
The MOH is well aware of the issues associated with medical devices in this country. These include, among others, the following:
1. The absence of pre-market controls to assess safety, effectiveness, and quality of medical devices prior to making these devices available on our market.
2. Inadequate information to guide the public and health professionals in making informed choices about medical devices that can be used safely and effectively to diagnose and treat illnesses.
3. The absence of a formal post-market reporting system to identify and monitor medical devices with problems in the market for follow-up action.
The MOH recognises the need to develop and implement a medical device regulatory system to address and manage these and other issues associated with medical devices.
In 2005, a proposal to develop and implement such a system in Malaysia was presented by the MOH to the Cabinet, which agreed to the proposal.
The proposed system is aimed at protecting the public as well as ensuring the safety of such devices, while, at the same time, facilitating trading activities to allow for the timely availability of beneficial new technologies to the medical community and the public.
The regulatory system encompasses the following components:
1. Medical Devices Act and its subsidiary legislations to provide legislative support for the medical device regulatory system.
2. An appropriate agency to implement and enforce the regulatory system.
3. Appropriate infrastructure and mechanisms for effective and efficient implementation of the regulatory system.
4. Medical Devices Registration and Surveillance/Vigilance System.
The ministry is currently in the midst of developing a medical device regulatory system based on international practices and standards.
As an initial step towards a regulated environment, the ministry initiated in 2006 a voluntary registration scheme for companies dealing with medical devices in Malaysia. The ministry has also started a reporting system for problematic devices on the market.
Voluntary registration of medical device products will start by the middle of this year.
With the implementation and full enforcement of the regulatory system, only medical devices that have met essential safety and performance requirements will be permitted in the market.
At the same time, the MOH has been actively conducting health technology assessments and technology reviews of new technologies since 1995. Health technology assessments are the systematic evaluation of the properties, effects or other impacts of technology, using evidence-based processes.
More importantly, this systematic evaluation will be benchmarked with international health technology assessment groups such as the International Networking Agencies of Health Technology Assessment, etc.
The MOH has also developed evidence-based Clinical Practice Guidelines (CPGs) since 2001. This is to ensure technologies used in our facilities are safe, cost-effective, and evidence-based.
We have so far produced 42 health technology assessment reports, 133 technology review reports and 43 evidence-based CPGs. All these reports can be accessed at the MOH website at moh.gov.my.
We also update the CPGs from time to time. A version of the CPG for patients has also been initiated.
With all these initiatives, we hope consumers will not only have access to evidence-based information on new technologies and practices but also that all medical devices introduced in this country will be safe and of high quality, and used only after stringent appraisal based on scientific evidence.
Tan Sri Dr Mohd Ismail Merican
Director General of Health
Malaysia
Laws on healthcare devices in the works
I REFER to the letter, The need to protect consumers of healthcare services (Your Say, StarMag March 23).
In that letter, Ms Ranjit Kaur, president of the Malaysian Breast Cancer Council, called upon the Ministry of Health (MOH) to protect the consumers by regulating medical devices and non-evidence-based approaches.
The MOH is well aware of the issues associated with medical devices in this country. These include, among others, the following:
1. The absence of pre-market controls to assess safety, effectiveness, and quality of medical devices prior to making these devices available on our market.
2. Inadequate information to guide the public and health professionals in making informed choices about medical devices that can be used safely and effectively to diagnose and treat illnesses.
3. The absence of a formal post-market reporting system to identify and monitor medical devices with problems in the market for follow-up action.
The MOH recognises the need to develop and implement a medical device regulatory system to address and manage these and other issues associated with medical devices.
In 2005, a proposal to develop and implement such a system in Malaysia was presented by the MOH to the Cabinet, which agreed to the proposal.
The proposed system is aimed at protecting the public as well as ensuring the safety of such devices, while, at the same time, facilitating trading activities to allow for the timely availability of beneficial new technologies to the medical community and the public.
The regulatory system encompasses the following components:
1. Medical Devices Act and its subsidiary legislations to provide legislative support for the medical device regulatory system.
2. An appropriate agency to implement and enforce the regulatory system.
3. Appropriate infrastructure and mechanisms for effective and efficient implementation of the regulatory system.
4. Medical Devices Registration and Surveillance/Vigilance System.
The ministry is currently in the midst of developing a medical device regulatory system based on international practices and standards.
As an initial step towards a regulated environment, the ministry initiated in 2006 a voluntary registration scheme for companies dealing with medical devices in Malaysia. The ministry has also started a reporting system for problematic devices on the market.
Voluntary registration of medical device products will start by the middle of this year.
With the implementation and full enforcement of the regulatory system, only medical devices that have met essential safety and performance requirements will be permitted in the market.
At the same time, the MOH has been actively conducting health technology assessments and technology reviews of new technologies since 1995. Health technology assessments are the systematic evaluation of the properties, effects or other impacts of technology, using evidence-based processes.
More importantly, this systematic evaluation will be benchmarked with international health technology assessment groups such as the International Networking Agencies of Health Technology Assessment, etc.
The MOH has also developed evidence-based Clinical Practice Guidelines (CPGs) since 2001. This is to ensure technologies used in our facilities are safe, cost-effective, and evidence-based.
We have so far produced 42 health technology assessment reports, 133 technology review reports and 43 evidence-based CPGs. All these reports can be accessed at the MOH website at moh.gov.my.
We also update the CPGs from time to time. A version of the CPG for patients has also been initiated.
With all these initiatives, we hope consumers will not only have access to evidence-based information on new technologies and practices but also that all medical devices introduced in this country will be safe and of high quality, and used only after stringent appraisal based on scientific evidence.
Tan Sri Dr Mohd Ismail Merican
Director General of Health
Malaysia
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