17 August 2004
MOS set record straight!

We refer to the article “Cancer Awareness and Screening Drive,” published in the 10th August 2004 issue of The News Straits Times, City Life Supplement and “Study on Food Link to Cancer,” published in the 6th August 2004 issue of The Star.

The Malaysian Oncological Society (MOS) is made up of specialist doctors, both in the government and private sectors, who treat cancer. We note with grave concern the numerous erroneous and misleading statements in the article.

MAKNA is a non-profit organization that raises funds to help provide cancer-related services to the community. On the other hand, the MOS is set up to promote the practice of evidence-based cancer management and to help the public overcome their misconceptions about cancer.


We wish to clarify matters and set the record straight:

1. "The campaign is geared to reach the public with the opportunity to do general health and cancer markers" (NST)
   
   Tumour markers are not recommended to be used routinely for screening cancer, with the exception of PSA. The measurement of other markers such as CA19-9, CA15-3, and CEA may lead to false positive and false negative results. If the result is a false positive, the patient does not have cancer. This leads to unnecessary and expensive investigations, not to speak of the psychological burden of possibly having cancer. If the result is a false negative, the patient does have cancer. In this setting, the patient may be falsely reassured.
   
   A blood test by itself should never be taken as the definitive screening procedure.
   
   The National and International guidelines on tumour markers are very clear on this issue.
   
   
   
2. "The studies will also find out why the Chinese are more prone to stomach cancer and the Malays are more prone to lung and breast cancer."(The Star)
   
   The cancer statistics quoted in the article regarding the incidence of cancer in Malaysia are factually wrong. We advise MAKNA to refer to the 2002 Cancer Registry published by the Ministry of Health. For example, breast cancer is more common in Chinese and Indians and least common in Malay women according to the Registry.
   
   
   
3. On Digital Infrared Thermal Imaging Equipment
   
   The use of Digital Infrared Thermal Imaging is NOT recommended as a screening tool for breast cancer. The worldwide standard today is still mammography. MAKNA should not make its own recommendations. We in the MOS and members of the College of Radiology, Academy of Medicine of Malaysia (a group of specialist doctors in the imaging sciences) do NOT endorse the use of thermal imaging as a screening tool.
   
   
   
4. "Common ingredients in ikan bilis (anchovies), belacan (prawn paste), dried prawns and salted fish are being studied for possible link to cancer."*
   
   "took place a year ago, sampled over 100 patients suffering from cancers of the digestive system, from the mouth to the rectum."*
   
   "Another interesting finding is that the patients who have these dietary habits mostly live in coastal areas in the east and west coast,"*
   
   "making little changes to their diet as it is a well-known fact that eating too much of certain types of food is one of the causes of cancer"*
   
   * (The Star)
   
   
   
The above study is based on 100 cancer patients only. Studies involving dietary intake and cancer usually involve thousands of patients. Even with well-designed studies recruiting over 10,000 patients, it may still be difficult to prove directly or indirectly that a certain food causes cancer. Eating ikan bilis and belacan is a common dietary habit in Malaysia, regardless of the geographical location and race. There is no evidence to say that ikan bilis and belacan causes cancer. To make such statements without a proper study may be damaging to our local culinary habits and food industry.

We in the MOS strongly contend that such misleading articles could potentially do more harm than good. Confusion will be created in the community. It is important not to mislead the public with medically unfounded and sweeping statements. Cancer patients and their relatives have a lot to cope with, physically and emotionally. They do not need to be unnecessarily stressed by unsubstantiated statements.

The Executive Committee

Malaysian Oncological Society

Source by:   http://www.malaysiaoncology.org, August 17, 2004