Icon Cancer Centre Medical Oncologist, Dr Lee Guek Eng specialises in young women cancers and believes more needs to be done to help support this cohort of patients.

“When young women are diagnosed with cancer they are often at a vulnerable or pivotal time in their lives. They might be trying to start a family, or focussing on their career and juggling other life factors. As an oncologist, I want to ensure they are supported from the start of their diagnosis through to treatment and survivorship this includes linking them to the right support services,” Dr Lee said.

There are a number of different treatment paths women can take when diagnosed with cancer, these range from surgery to chemotherapy, radiation therapy and/or endocrine therapy and targeted therapies. Side effects vary for each treatment type with a number of factors to consider particularly for young women. Chemotherapy can potentially bring about early menopause which can affect fertility and can sometimes render women infertile. For young women planning to start a family, or have more children it is important for them to understand the implications of treatment and ensure they receive all the necessary information.

“There is a need to work closely with fertility experts and gynaecologists to ensure patients seeking advice are able to receive a comprehensive fertility plan before they start cancer treatment. Connecting patients with specialists to discuss their options and potentially undergo fertility preservation procedures is an important step in caring for young female cancer patients.”

Currently the gold standard for fertility preservation is embryo cryopreservation, which has evolved over the past few years, with the procedure now only taking two to three weeks compared to one to two months. In Singapore patients have to be legally married to undergo this procedure and should consider this as a form of fertility preservation before starting cancer treatment.

Genetic testing and counselling is also a factor to consider when diagnosed with cancer at a young age. Oncologists should discuss the risk of hereditary cancer and provide options of genetic counselling and testing, including advice to patient’s relatives. For breast cancer it is important to understand the different risks associated with the BRCA1 and BRCA2 gene. BRCA – an abbreviation for ‘BReast CAncer gene have been found to impact a person’s chances of developing breast cancer. The BRCA gene is responsible for producing tumour suppressor proteins which are needed to maintain stability of cells. Without this gene cells are liable to become unstable because they cannot repair, which can lead to cancer cells developing and the growth of tumours. Women who test positive for the BRCA1/2 gene are at a higher risk of breast and ovarian cancer, as well as triple negative breast cancer – a more aggressive form of cancer.

If tested positive for the BRCA gene, women should consult their Medical Oncologist regarding risk reduction surgery such as a mastectomy.

Young women with cancer are also more prone to psychological stress. Patients of this age group can often feel a great deal of peer pressure to conform or meet certain societal and economic expectations and can also have concerns about the affect cancer treatment may have on their body and self-image.

“A cancer diagnosis is often an emotional time in someone’s life. Young women already have to navigate a multitude of factors from balancing family and work to pressures of image, financial concerns and social commitments. When you add in a cancer diagnosis it can often become too much for patients, so it is important to maintain a strong support network and seek counselling options.”

Icon Cancer Centre’s Young Women Cancer Program helps address these challenges and better care for patients throughout their cancer. The program is designed to ensure patients are connected with the right support at each step of their journey. By employing a multidisciplinary approach to care that recognises the psychosocial, financial and medical considerations of young female cancer patients, Icon’s unique program aims to alleviate some of these challenges and provide a personal, holistic model of care.

“We are dedicated to providing the best possible care to all our patients. We started this program to provide better support to young women and their families during a difficult time in their lives. By seamlessly connecting them with other medical specialists and personalising their care to address each individual concern we are able to deliver a truly integrated approach to care.”

The program is also designed to empower young women throughout their cancer journey and create a supportive environment to share their experience.

“Peer-to-peer support is shown to improve emotional well-being and is a proven support network for cancer patients. We have a network of young female cancer survivors who connect with newly diagnosed cancer patients to share their stories and advice.”

Like any cancer, early diagnosis is key to better outcomes. Dr Lee encourages women to ensure they familiarise themselves with family history, maintain regular health checks and continue self-breast examinations at regular intervals to promote breast awareness so that they can seek timely medical attention if any abnormalities arise.

“Regularity is the key. Women should be performing self-breast examinations once a month after menstruation and ensure all areas of the breast is covered, including under the nipple and armpit. Look out for lumps, dimpling of skin, changes in share and any discharge. Maintain recommended screening and always ask your doctor if you have any concerns. Early detection saves lives.”

With cancer incidence continuing to rise globally there is no better time to focus on the ongoing improvement of healthcare services and understand the personal concerns of patients. Many young women with cancer can feel isolated and lack access to relevant support networks and services. By offering a holistic approach to care and bespoke services to address challenges they face we are able to help improve outcomes and help patients now and into the future.

“As health professionals we need to continue to champion cancer awareness, be at the forefront of cancer research and focus on developing unique models of care to deliver the best possible care to patients and their families,” Dr Lee said.