Supporting young women facing cancer
Navigating a unique and challenging landscape
In western societies young women with breast cancer only
account for 4-7% of the population, compared to as high as
14% in Asian populations. In an annual National Registry of
Disease Office report from 2015, 19% of breast cancers in
Singapore were women aged 44 years and under.
These sobering statistics urge healthcare professionals to
focus on the unique challenges young women face when
diagnosed with cancer and the best possible treatment
paths for optimal patient outcomes. 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 affects 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. This 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 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 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 recently launched a Young Women
Cancer Program to help 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 better support
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 holistic
approach to care.”
The program is also designed to empower young women
throughout their cancer journey and create a supportive