Survivors Speak, Our Hearts Listen: Real and Inspiring Stories & Advice from Cancer Survivors

WORDS LIM TECK CHOON

THE DOCTOR’S STORY

Dr Zahrina Azian Zohadie’s world changed irrevocably when she was diagnosed with stage 4 colon cancer.

Since the cancer is at stage 4, it means that the cancer cells had spread from the colon to other parts of the body.

Staying strong for her children

“My cancer treatment was indeed challenging, but I had no other choice. I had to go through it,” Dr Zahrina said during a recent cancer survivor event at Columbia Asia Hospital–Bukit Rimau. “My children needed their mother. Despite the harsh effects of chemotherapy on my body, I persevered. In my mind, all this hardship will be worth it for those I love and those who love me.”

Once you have cancer, you have no option but to fight it

This was Dr Zahrina’s belief.

“The cancer is already in our bodies, so we must move forward because there’s nothing else we can do,” she elaborated. “We must continue with treatment.”

She was blessed to have encouragement and motivation from a close friend and colleague, an oncology specialist.  “Her advice, no matter the situation, is to keep going with the treatment. Her words of encouragement have been very helpful to me,” she said.

Having survived, she now offers her strength to others living with cancer

As a cancer survivor, Dr Zahrina felt that it was her vocation to offer her support to other cancer patients, bolstering their spirits with encouragement and support similar to what she received during her own cancer journey.

“During treatment, I felt like I was facing this painful challenge alone. But over time, I realize there are many others like me,” she shared.

Dr Zahrina is presently a member of the KanWork Cancer Support Association (link opens in a new tab).

THE BREAST CANCER SURVIVOR’S STORY

Norhaisnah Naian is a breast cancer survivor and a volunteer at KanWork.

Recalling her breast cancer journey, she shared: “In those days, I diligently sought information on how to get assistance from organizations like MAIS, Baitulmal, Lions Club, and many more.”

“When I attended chemotherapy sessions, I met other cancer patients from all walks of life,” she continued. “Naturally, I share information with them like where to find resources related to cancer. This is how I help other patients.”

Seek the company of supportive people with positive energy

“I fully understand how painful the experience of a cancer patient can be,” Norhaisnah said. “My advice is to find friends with positive energy and positive vibes.”

She pointed out that the volunteers at KanWork sought to be these allies for people living with cancer.

“I’ve been with Kanwork for over a year. We meet many former patients and current cancer patients whom we continue to motivate,” she told us.

A MEDICAL OFFICER REMINISCENCES ABOUT HER EXPERIENCES
FEATURED EXPERT
DR HEMA DARSHINEE JOHNSON
Oncology Medical Officer
Columbia Asia Hospital–Bukit Rimau

Dr Hema Darshinee Johnson revealed that a doctor’s approach to cancer patients is not as straightforward as prescribing medications.

She explained: “As doctors, we give treatment plans, and we tell patients to take certain medicine. On top of that, we tell them the side effects. Sometimes we tell them up front. But for them, even trivial things like brushing teeth can eventually become difficult at some point. It is always easier to say, ‘Be positive!’, but we will never understand what it’s like to be in their shoes. Their life turns upside down. That’s why it amazes me to see how they find the strength to continue.”

Grit and determination 

She recalled a domestic helper that had to travel back and forth to the hospital for treatment. “This lady took an 8-hour bus ride starting at midnight to arrive early at KL Sentral, then took a Grab to the hospital and then back. She knows the costs beforehand, so she cleans more houses to be able to afford the trip.”

Dr Hema felt humbled by these courageous people. “At the end of the day, my role as a doctor is only to assist them. I am only providing some form of lifeline, but they are the ones who are holding on to it and swimming across. It is all them.”

A reason to keep fighting

“It is beyond me to understand the grit they have but it is always about the ‘why’,” she mulled. “Everyone will have a reason to continue fighting whether it is their spouse, parents, children, or just not wanting to take life for granted and to give it their best. When you have found your reason; this journey becomes that much more purposeful. Together, we can surely win this.”

OVERCOMING THE STIGMA

Rozita Shafei, who has stage 1 cervical cancer, shared that people living with cancer often become stigmatized by others.

She said, “At first, I felt down. Friends distanced themselves because they fear they may get cancer. I felt isolated but thankfully, I received much support from my children and husband.”

She emphasized that emotional support is crucial for someone undergoing cancer treatment.

“My advice to those undergoing cancer treatment is to stay positive, strengthen your spirit, and believe in yourself.”

Her advice was echoed by Nurul Balqis, who was diagnosed with breast cancer since September 2023.

“All my children understand is that Mama always goes to the hospital. If I don’t go for a few days, they ask, ‘Mama didn’t go to the hospital today?'” she shared, adding that their concern strengthened her determination to continue her treatment.

“Besides that, I try to look forward and stay positive,” she further said.

RECOGNIZING THE RESILIENCE AND COURAGE OF CANCER SURVIVORS

This sharing session was held in conjunction with Cancer Survivors Month in June.

Additionally, Columbia Asia Hospital—Bukit Rimau announced a 3-year partnership with the Breast Cancer Welfare Association (BCWA) through a memorandum of understanding.

This partnership aspired to empower volunteers from KanWork, who are cancer survivor themselves, to provide emotional and moral support to cancer patients.

The ceremony was attended by guest of honour YB Puan Jamaliah Jamaluddin, the Selangor State Health & Environment Exco.

“Today, as we celebrate Cancer Survivors Day, we honor those who have fought and survived cancer, acknowledging their resilience and strength,” she said in her speech.



 

Experts Highlight the Urgent Need for Blood Donation in Malaysia and What We Can Do about This

WORDS DR FARZANA RIZWAN & DR IMAM SHAIK

FEATURED EXPERTS

DR FARZANA RIZWAN
Senior Lecturer
School of Medicine
Faculty of Health & Medical Sciences
Taylor’s University
DR IMAM SHAIK
Senior Lecturer
School of Medicine
Faculty of Health & Medical Sciences
Taylor’s University

Blood transfusion is a lifesaving medical intervention for patients undergoing complex surgeries, experiencing blood loss due to trauma or childbirth, suffering from chronic illnesses and blood disorders, and even during cancer management.

VOLUNTARY BLOOD DONATION PROGRAMMES ARE CRUCIAL FOR MAINTAINING A SAFE AND ADEQUATE SUPPLY OF BLOOD AND BLOOD PRODUCTS
  • That said, currently only 2.2 % of Malaysians donate blood in a year, compared to 3.5–5% in the developed countries.
  • The pre-pandemic blood donation rate was 22.8 donors per 1,000 people, which declined to 19.7 to 22.5 donors per 1,000 population between 2020 and 2022.
  • However, the demand of blood and blood products has increased due to a rise in motor vehicle accidents and the increase in the number of transfusion-dependent patients.

According to our Health Minister Datuk Seri Dr Dzulkefly Ahmad, the country needs more blood donors to maintain a ‘safe zone’ of blood stock to meet the nation’s daily demand of at least 2,000 blood bags.

The Ministry of Health targets 35 to 40 donors per 1,000 population by 2030.

HOW CAN WE ACHIEVE THIS TARGET?
  • Young people 17 years old and above are urged to come forward to help achieve this goal.
  • The community needs to choose the right direction, have a positive mindset, and move away from the myths and negative perception surrounding blood donation.
  • Seek guidance from the good practices that are in place in other countries. For example, we can focus more on ‘targeted recruitment’ to obtain donations from specific ethnic groups if there are certain blood groups that are difficult to find in others.
  • Adopt innovative methods of education and engagement of young students to promote school-, college-, and university-based blood donation drives.
  • The use of mobile apps to facilitate online bookings, reminders, re-scheduling, and appointment cancellation systems provides convenience to the community. The use of mobile technology in tracking the donor eligibility and getting donor feedback would be helpful to make blood donation experience more pleasant and smooth.
DO YOU KNOW THAT DONATING BLOOD CAN ALSO BE GOOD FOR YOUR HEALTH?
  • Improves blood circulation to your tissues and organs.
  • Maintains iron balance—the difference between the amount of iron taken up by the body and the amount lost—in the body.
  • Reduces the risk of hardening and narrowing of the arteries from the accumulation of iron in the artery walls.
  • Reduces the risk of heart attack by reducing arterial blockages.
  • Reduces excessive iron in the blood and decreases the risk of certain cancers. Iron is a source of cancer-causing free radicals, which can damage cells and alter their functions.
  • A therapeutic phlebotomy—a procedure to reduce the excessive iron and number of red blood cells in the body—for individuals with blood diseases such as hereditary hemochromatosis, polycythemia vera, and other rare conditions.

Additionally, there are many medical privileges offered to donors in Malaysia, such as free outpatient treatment and hepatitis B vaccination, among others.

BECOMING A BLOOD DONOR IS A SIMPLE WAY TO CONTRIBUTE TO YOUR COMMUNITY

Check with local hospitals or blood donation centers to find out where and when you can donate your blood.

A Study Reveals That Ubiquinol Can Support Our Cognitive Health? A Pharmacist Weighs In

WORDS LIM TECK CHOON

FEATURED EXPERT
GINA KOAY
Community Pharmacist
City Wellness Pharmacy
LET’S TALK ABOUT UBIQUINOL
What is it and what does it do?
  • Ubiquinol is a form of coenzyme Q10, a substance naturally found in our bodies.
  • It acts as an antioxidant that helps to protect our cells from damage.
  • It also plays a role in energy production within our cells.
  • Studies suggest that ubiquinol also plays a role in supporting heart health and reducing one’s risk of heart failure.
Where can one obtain ubiquinol?
  • Diet. Good sources include oily fish such as salmon and tuna, organ meats such as liver, and whole grains.
  • It is also produced by our body. However, as we age, the amount produced begins to decrease.
DOES UBIQUINOL SUPPORT OUR COGNITIVE HEALTH?

A study, of which the data was published in 2024, suggested that a daily dose of 100mg of ubiquinol may enhance cognitive health in older adults.

Benefits observed throughout the study included improvements in memory, attentiveness, and work processing ability in middle-aged and elderly people.

More about this study
  • Involved 90 adults aged between 50 and 83, monitored over a period of 34 weeks.
  • These participants were administered a daily dose of 100 mg of patented bioidentical ubiquinol ingredient made from a fermented yeast process.
  • Their cognitive performance was meticulously evaluated using established neuropsychological tests.
UBIQUINOL COULD BE BENEFICIAL TO MALAYSIA’S AGEING SOCIETY
The statistics
  • According to the Statistics Department, Malaysia will have an ageing population of 5.6 million, or 15% of the total population, by 2030.
  • The number of elderly persons with dementia is estimated to reach 353,000 cases in 2030.
Can ubiquinol be beneficial to the elderly population?

Gina Koay, a community pharmacist, tells us that these findings continue to support the role of ubiquinol in maintaining cognitive health, cardiovascular health and general well-being.

“As we age, the decline in cognitive function is a cause for concern as it impacts a person’s memory, recall, and processing, causing a decline in quality of life,” she says.

She then adds: “It is promising that supplementation can provide an option for those looking to maintain their cognitive health and support brain function as they age.”


References:

  1. Kinoshita, T., Shirakawa, H., Handa, E., Hino, M., Hashimotob, Y., & Maruyama, H. (2021). The effects of ubiquinol (reduced form of coenzyme Q10) on memory, attentiveness, and work processing ability in healthy middle-aged and elderly residents – a randomized, double-blind, placebo-controlled trial. Japanese pharmacology and therapeutics, 49, 1739-1747.
  2. Mutalib, Z.A., Ismail, M.F., & Miskiman, N. (2020). Spatial analysis: Ageing population of multi-ethnic in rural area, Malaysia. Retrieved June 25, 2024, from https://www.unescap.org/sites/default/files/70_Spatial_Analysis-Ageing_Population_of_Multi-ethnic_in_Rural_Area_Malaysia.pdf

Why Is the Dengue Vaccine Needed? An Associate Professor Answers More Questions About the Vaccine

WORDS ASSOCIATE PROFESSOR DR VERNA LEE KAR MUN

FEATURED EXPERT
ASSOCIATE PROFESSOR DR VERNA LEE KAR MUN
Family Medicine Specialist
IMU Healthcare
WHY IS THE QDENGA VACCINE NECESSARY? WE ALREADY HAVE PREVENTIVE MEASURES SUCH AS FOGGING TO PREVENT THE AEDES MOSQUITO FROM BREEDING.

Fogging is effective in killing the Aedes mosquitoes. Its effect is immediate, extending to an average of 72 hours.

Fogging Works, but There Are Some Drawbacks

While fogging has been the main means to mitigate dengue infection in Malaysia, however, health offices are usually informed after the infection have been notified. As a result, fogging by itself does not reduce severe dengue infection that requires hospitalizations.

Furthermore, the resistance of the Aedes mosquitoes to insecticides is increasing. This decreases the effectiveness of fogging to control the population of these mosquitoes.

The Role of Dengue Vaccines

On the other hand, dengue vaccines have been proven to be effective in reducing the numbers of severe dengue infection requiring hospitalizations.

THERE WAS SOME CONTROVERSY WITH REGARDS TO THE SAFETY PROFILE OF THE PREVIOUS DENGUE VACCINE. SHOULD WE BE CONCERNED ABOUT THE QDENGA VACCINE?

Just like any new drug or new medical technology, there is very limited data from clinical practice in the early days. There would be many concerns.

Dengvaxia, the First Dengue Vaccine

The first dengue vaccine, Dengvaxia, was approved in April 2018.

It is safe in persons who have had dengue virus infection in the past (seropositive individuals), but it also increases the risk of severe dengue in those who experience their first natural dengue infection after receiving their vaccination (seronegative individuals).

Hence, pre-vaccination screening for past dengue infection is recommended before one receives the Dengvaxia vaccine. Only people with evidence of past dengue infection—indicated by the presence of dengue IgG antibody in their blood—would receive this vaccination.

About the Newest Vaccine, Qdenga

A second vaccine for dengue, Qdenga, received prequalification from the World Health Organization (WHO) on 10 May 2024.

Is it safe?

  • Overall, during the clinical trials, the vaccine was well tolerated. The most frequent reported vaccine-related adverse events were injection site itchiness, bruising, and fever.
  • An excess of hospitalized dengue virus serotype 3 (DENV3) infections was reported among baseline seronegative children, but it was not statistically significant.
  • There was also an excess of cases of severe dengue among seronegative vaccinees, all of which were caused by DENV3, but, again, the difference was not statistically significant.
  • An increase in the risk of dengue infection requiring hospitalization or severe dengue due to DENV3 in vaccinated seronegative subjects cannot be conclusively ruled out. We probably need to wait for more data.

How about allergy reactions?

During the clinical trial, no cases of severe allergy reaction or anaphylaxis were observed.

However, cases of anaphylaxis associated with this new vaccine occurred following the vaccine’s introduction to children between the age of 10 and 14 years in Brazil since February 2024, with 16 cases were reported (4.4/100,000 doses administered), including 3 cases of anaphylactic shock (0.8/100,000 doses administered).

The currently approved package insert for the vaccine describes precautionary measures to mitigate the risk of anaphylaxis. A full assessment of the national immunization programme is underway.

THE QDENGA VACCINE IS SAID TO BE ABLE TO IMMUNIZE AGAINST ALL FOUR SEROTYPES OF DENGUE VIRUS. WHY IS THIS A GOOD THING?

Dengue viruses belong to the genus Flavivirus.


The dengue virus. Click on the image for a larger, clearer version.


Flaviviruses are lipid-enveloped, single-stranded RNA viruses. The structural pre-membrane (prM) and envelope (E) proteins are embedded in the lipid envelope and are displayed on the surface of virions.

There are 4 dengue virus serotypes (DENV1, DENV2, DENV3, and DENV4); the serotypes share structural proteins (prM and E) but are genetically and serologically distinct.

Infection with 1 serotype induces sustained protection against the same serotype only. Although uncommon, an individual without a vaccine can be infected by each serotype for a total of 4 infections during their lifetime.

Serotypes and Infections

People who acquire a second dengue infection caused by a different serotype are at a higher risk for severe dengue once cross-protection induced by the first infection wanes.

Potential mechanisms for increased risk of severe dengue caused by a second infection include:

  • Cross-reactive antibodies binding to a different DENV serotype, which then enable uptake in inflammatory cells. This leads to higher and more prolonged virus count in the blood circulation (higher temperature and prolonged fever) that induces imbalanced pro-inflammatory and anti-inflammatory responses often referred to as antibody-dependent enhancement.
  • The action of the non-structural protein 1 (NS1) on the blood vessel wall or endothelium can trigger the release of active chemicals from immune cells.
  • Both the above will result in endothelial hyperpermeability and vascular leak (leading to hypovolemic shock and bleeding).

How the Vaccine Is Beneficial

Both dengue vaccines are tetravalent live-attenuated vaccines.

The new vaccine, Qdenga, induces a broad spectrum of immune responses which include:

  • Neutralizing antibodies with a 50% reduction against all 4 dengue virus serotypes.
  • Cross-reactive antibodies that block the activity of the NS1 protein.
  • Type-specific memory B cells to all four serotypes.

This means the vaccine can protect us from severe dengue infection by all the 4 serotypes. This is a good thing.

Expert Answers All the Important Questions You Have about the New Dengue Vaccine

WORDS LIM TECK CHOON



With the Qdenga® dengue vaccine officially launched by pharmaceutical company Takeda Malaysia in Malaysia on 11 June 2024, we manage to get some important answers from Dr Goh Choo Beng about dengue and this vaccine.

FEATURED EXPERT
DR GOH CHOO BENG
Head of Medical Affairs
Takeda India & Southeast Asia
What does it do?

Prevention of dengue caused by any of the 4 dengue serotypes.

The clinical trial of the vaccine found that it can:

  • Prevent 80.2% of symptomatic dengue cases at 12 months after receiving the vaccination.
  • Prevent 90.4% of hospitalizations at 18 months after vaccination.
Who can receive the vaccine?

Qdenga® can be administered to individuals 4 years old and above.

How many doses do I need?

Two doses. The second dose will be given three months after the first dose.

Where can I get it?

Currently it’s available at general practitioner or GP clinics as well as private hospitals.

How much is the vaccine?

The price will be set by the clinic or the hospital, so it’s best to consult them about the price.

How does this vaccine work?

Dr Goh explains that the Qdenga® vaccine has a backbone that is based on the live-attenuated DENV2 serotype of the dengue virus, with recombinant strains expressing surface proteins for DENV1, DENV3 and DENV4.

This way, the vaccine will protect an individual from all 4 dengue serotypes.

Is it safe for individuals that have not contracted dengue before?

Yes. People that have no history of dengue fever as well as people that have had dengue can safely receive the vaccine.

No blood tests are necessary before receiving the vaccine.

What are the side effects?

Short term side effects are common ones associated with vaccination, such as redness and soreness at site of injection. These side effects are mild and temporary.

At the time of writing, there is an ongoing clinical trial that is monitoring and closely following selected individuals that have received the vaccine since about 4.5 years ago. So far, the investigators have found that:

  • The protection afforded by the vaccine persists 4.5 years after receiving the vaccine.
  • There is no long-term serious side effect seen so far.

Ovarian Tissue Cryopreservation Offers Hope for Women with Cancer to Preserve Their Fertility

WORDS LIM TECK CHOON

FEATURED EXPERT
ASSOCIATE PROFESSOR DR MOHD FAIZAL AHMAD
Consultant Obstetrician & Gynaecologist and Fertility Specialist
Sunfert International Fertility Centre

Ovarian tissue cryopreservation or OTC is a technique that allows female cancer patients the opportunity to preserve their fertility.

5 FACTS ABOUT OVARIAN TISSUE CRYOPRESERVATION
  1. It was introduced in Denmark and Europe over 25 years ago.
  2. This technique involves the harvesting the woman’s entire ovary and dissecting the cortical layer containing eggs through a process called laparoscopic procedure.
  3. The ovary is then frozen in a specialized titanium device and stored in a cryopreservation tank at -190º Celsius. It can be safely kept in good condition for up to 20 years.
  4. No medications needed.
  5. This is a quick procedure, taking only about 15 to 20 minutes.
WHAT HAPPENS AFTER THE OVARY IS FROZEN?

Once the woman is cleared of cancer and is ready to start a family, the ovary will be thawed and eventually transplanted back into her body.

WHO SHOULD CONSIDER OVARIAN TISSUE CRYOPRESERVATION?

According to Associate Professor Dr Mohd Faizal Ahmad, OTC is well-suited for:

  • Pre-pubescent girls who may be diagnosed with cancer, as they typically lack mature eggs suitable for freezing.
  • Women in their reproductive years that are diagnosed with cancer and need to start chemotherapy or radiotherapy treatments right away.
HOW IS THIS PROCEDURE DIFFERENT FROM CONVENTIONAL EMBRYO AND EGG FREEZING?
  • It is less invasive.
  • It is a faster procedure.