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如何减低患癌的风险？ 癌症有哪些治疗方法？ 手术后癌症会复发吗？ 癌症是绝症吗？ 可以“饿死”癌细胞吗？ 这些是许多人心中的疑惑。 在现今社会，每三个人当中，便有一人在其一生当中会罹患癌症。癌症显然已经成为常见疾病，唯有多加认识，才能远离癌症威胁，一旦确诊也可以勇敢面对，接受正确的疗法，对抗癌症。 毫无根据的治疗法，只会让病情加剧。本书旨在让你了解正确的癌症知识，解开你心中的疑惑。让黄醒荣医生以简单易懂的方式，带你走出癌症治疗的误区。 How can we reduce our risk of getting cancer? What kind of cancer treatments are there? Will cancer relapse even after surgery? Is cancer a death sentence? Can you “starve” cancer cells to death? These are the questions haunting the minds of many. In this developed society, every one in three people will develop cancer within his or her lifetime. Cancer is now a common disease. Having a better understanding about cancer helps one keep a distance from it. However, in the case of a diagnosis, face it bravely and obtain the right treatment to fight cancer. Baseless treatment methods will only worsen one’s condition. This book aims to impart correct knowledge on cancer and answers to questions many have about this much-misunderstood disease. Let Dr. Wong Seng Weng enlighten you with his straightforward and easy-to-understand explanations.
黄醒荣 Wong Seng Weng 新加坡国立大学医学和外科医学学士、英国皇家内科医生学会会员、新加坡医学院院士（肿瘤内科） 新加坡医疗集团癌症中心医务总监兼肿瘤内科医生 黄醒荣医生目前在新加坡医疗集团癌症中心百丽宫及伊丽莎白山诺维娜专科中心担任医务总监兼肿瘤内科顾问医生。他亦是新加坡医疗集团的执行董事和医疗委员会主席。 在此之前，黄医生以林文庆和陈锡九奖学金，在新加坡国立大学考获医学学士学位，并以杰出的学术成就，被列入院长嘉许名单。他在内科完成了培训实习，并成为英国皇家医生学会会员。之后，他获得新加坡卫生部专科认证，同时获认可为新加坡医学会会员，并考获新加坡医学院院士。黄医生接着在新加坡国立大学医院从事临床医疗工作，并受聘为新加坡国立大学肿瘤内科临床导师。除此之外，黄医生热忱投身于科研，积极参与了二十多例临床实验，探索新的癌症治疗方法。黄医生曾担任莱佛士医院肿瘤内科顾问医生及资深伙伴，负责所有内科肿瘤科服务。 除了癌症中心，黄医生现在也是伊丽莎白山医院及伊丽莎白山诺维娜医院的肿瘤内科客座顾问医生。 在研究方面，他受委为新加坡科技研究局属下生物工程与纳米科技研究院的附属临床科学家。 黄医生是肿瘤学报刊《MIMS Oncology》的编辑顾问委员会成员。 黄医生是美国临床肿瘤学会、欧洲临床肿瘤学会和新加坡肿瘤学会的活跃会员。他经常在越南、菲律宾、泰国、缅甸、中国、印度、孟加拉、马来西亚及印尼举行的国际癌症研讨会上发表演讲。 黄医生擅长于成人癌症的诊断与治疗，尤其专长于乳腺癌、肺癌和消化道癌症。 MBBS (S’pore), MRCP (UK), FAMS (Medical Oncology) Medical Director, Medical Oncologist, The Cancer Centre Dr Wong Seng Weng is currently the Medical Director and Consultant Medical Oncologist of The Cancer Centre (Singapore Medical Group) at the Paragon and Mount Elizabeth Novena Specialists’ Centres. He is an executive member of the Board of Directors and chairman of the Medical Board of the Singapore Medical Group. Dr Wong obtained his basic medical degree from the National University of Singapore (NUS) under the Lim Boon Keng and Tan Siak Kew Scholarships and graduated on the Dean’s List for outstanding academic achievement. He completed his post-graduate training in Internal Medicine and obtained his Membership of the Royal College of Physicians of the United Kingdom (MRCP UK). Thereafter, he achieved Specialist Accreditation with the Ministry of Health Singapore and was admitted as Fellow of the Academy of Medicine of Singapore (FAMS) and College of Physicians of Singapore. Dr Wong continued his practice in the National University Hospital and was appointed clinical tutor of the clinical faculty of the National University of Singapore. Apart from pursuing his clinical practice, Dr Wong was keenly involved as an investigator in over twenty clinical trials exploring novel methods of cancer treatment. He previously held the posts of Consultant Medical Oncologist and Senior Partner of the Raffles Cancer Centre in charge of all oncology services at the Raffles Hospital. Apart from his practice at The Cancer Centre, Dr Wong is currently a visiting consultant medical oncologist of Mount Elizabeth Hospital and Mount Elizabeth Novena Hospital. In the area of research, he holds the appointment of Adjunct Clinician Scientist of the Institute of Bioengineering and Nanotechnology (IBN) in the Agency for Science, Technology and Research (A*STAR). Dr Wong is part of the editorial advisory board of the oncology newspaper MIMS Oncology. Dr Wong is an active member of the American Society of Clinical Oncology (ASCO) as well as the European Society for Medical Oncology (ESMO) and Singapore Society of Oncology. He lectured widely at international cancer conferences in Vietnam, the Philippines, Thailand, Myanmar, China, India, Bangladesh, Malaysia and Indonesia. Dr Wong specializes in the diagnosis and treatment of adult cancers with special interest in breast cancers, lung cancers and gastrointestinal cancers.
TABLE OF CONTENT
004 Preface 006 Profile PART 1 DEVELOPMENT AND CAUSES 010 Chapter 1 Cancer is More Common than You Think 016 Chapter 2 Terrorists in the Body - The Nature of Cancer 023 Chapter 3 Roots of Terrorism - The Causes of Cancer PART 2 PREVENTION AND SCREENING 034 Chapter 4 Avoiding the Deadly Crab - The Prevention of Cancer 049 Chapter 5 Better Early than Late - Screening for Cancer PART 3 TREATMENT 064 Chapter 6 Weapons of War: Different Modalities of Treatment 086 Chapter 7 Strategies of War: Localised Treatment vs Whole Body Treatment; Short Treatment vs Extended Treatment 103 Chapter 8 Cancer Treatment Custom-made: Tailoring the Treatment to Fit Each Patient / Encountering Resistance to Treatment 120 Chapter 9 A Hundred Schools of Thought: Life After the Diagnosis of Cancer 128 Chapter 10 Last Leg of the Journey: Handling End-of-Life Matters 134 Chapter 11 Obstacles to Treatment: Issues of Cost and Age 142 序 144 作者简介 第1章 形成及因素 148 第1节 癌症比你想象中更常见 153 第2节 癌症本质：身体里的恐怖分子 158 第3节 癌症的源由：恐怖主义的根源 第2章 预防及筛检 166 第4节 预防癌症：如何避开致命之“蟹” 176 第5节 癌症的筛检：宁早勿迟 第3章 治疗 190 第6节 癌症的治疗：抗癌的武器 203 第7节 对抗癌症的策略：局部治疗与全身治疗；短期治疗与延长治疗 214 第8节 量身定制的治癌疗程：当癌症抗拒治疗怎么办？ 226 第9节 确诊后的生活：众说纷纭 232 第10节 人生的终点：充实地度过每一天 236 第11节 治疗的障碍：金钱与年龄
PREFACE/READING GUIDANCE
在先进社会如新加坡，每三个人当中，便有一人在其一生当中会罹患癌症。这意味着将近30%的新加坡人有死于癌症的风险。癌症显然已经成为常见疾病，我们不能再以鸵鸟心态试图回避这严峻的课题。 然而，要真正了解癌症是个艰难的任务。多年来针对癌症的深入研究，为医学界提供了丰富的专业知识。我们需要层层剖析，才能全面理解这复杂的课题。 那些向没有医学背景的读者解释癌症的书，通常内容不是过于花俏，就是过于简化。细节过于花俏及复杂，会使原本就复杂的课题更加难以理解；内容过于简化则会导致误解，使读者小觑值得认真对待的课题。 本书综合了我超过20年来在日常门诊向癌症病人及其家属讲解病情的经历，加上在公开讲座及研讨会上的说明，以及在报纸专栏为一般读者撰写文章的经验，是我对这项艰巨任务的诚挚努力。 正是因为我必须一再解释癌症的复杂性，让我了解到使用比喻手法的重要性。 只有比喻手法可以简化复杂的癌症概念，让读者能够以全新的观点看待癌症，学习到新的癌症知识。 比喻，也可以让读者容易记住这些新学的癌症知识。 除了在本书中大量使用比喻手法，我也会述说治疗病人的个人经历，以及病人抗癌的故事，让癌症课题更人性化。人们其实对癌症的学术知识不会太感兴趣，反而比较有兴趣知道个人生命风险问题。即使我们自己没有患上癌症，身旁或许会有亲友需要面对这个难题。 最后，我把这本书献给我的所有癌症病人和他们的家人。他们对抗癌症的勇气与毅力是我每一天的启发。 黄醒荣医生 Every one in three people within his or her lifetime, in a developed society such as Singapore, will develop cancer. Almost 30% of Singaporeans will die of cancer. Cancer is a clear and present danger. A head-in-the-sand attitude of trying to avoid the dreaded subject will no longer do. And yet, the task of gaining a better understanding of cancer is formidable. Intensive research into cancer over the years has built up a wealth of knowledge. Obtaining a good understanding of the subject requires one to peel through layer upon layer of complexity. Any book written to present the story of cancer to readers outside the trained medical profession has to walk the tightrope between over-indulgence and over-simplification. Over-indulgence in details and complexities risks making an already complex topic more befuddling to readers. Over-simplification leads to misunderstanding and trivialises a subject worthy of more serious treatment. This book is a sincere attempt at such a daunting task. It is the culmination of the experience I gained over a period of more than two decades, explaining the subject of cancer to patients and their families in day-to-day clinic sessions, to the general public in public lectures and seminars, as well as to the general readership of my columns in newspapers. It was my repeated attempts to explain the complexities of cancer that led me to realise the power of analogies and metaphors. Analogies and metaphors cast illumination on difficult to grasp concepts in cancer like no others. Readers will see the topic in new light with undoubtedly many oh-my moments. Analogies and metaphors also have the uncanny ability to make the new understanding and information stick to the memory, again, like no others. Apart from the generous use of analogies and metaphors in the chapters to follow, I have peppered the book with personal anecdotes and stories of patients who have fought cancer, to put a human face to the subject. After all, our interest in the topic of cancer stems, not from the academic aspects, but from the fact that we ourselves are individuals at risk. Even if we need not face cancer ourselves, we would invariably have had a loved one or acquaintance who had to confront such a catastrophe. Finally, I would like to dedicate this book to all my patients and their families, whose courage in their battle against cancer never cease to be an inspiration in everything that I do, everyday. Dr. Wong Seng Weng
