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The Ikan Bilis and Belacan Story 27August 2004

We, breast cancer survivors are responding to a news release on The Star on Friday, 6 th August2004 under the Health section entitled Study on food link to cancer. Are we misleading the

public? Instead of getting accurate and scientifically proven information across to the Malaysianconsumer we are disseminating information that is not validated and substantiated. In a rapidlydeveloping country like Malaysia we cant be regressing and listening to such inaccurate anddamaging information regarding an important health issue. It is a shame that Malaysia has worldclass medical experts and yet we get such information being disseminated in the majornewspapers by non medical bodies.

It was stated that 65% to 75% of cancer patients surveyed had been eating foodstuffs such asikan bilis (anchovies), belacan (prawn paste), dried prawns and salted fish for the past 10 to 15years which is being considered as a possible link to cancer. A study conducted on 100 cases isNOT clinically and statistically significant to deduce the link. The number of NON-cancer patientsthat consume this ikan bilis and the like has not been mentioned or compared statistically. Maybe

the ratios are the same (that is to say the general population also consumes ikan bilis atapproximately 65-75% of the population) and therefore ikan bilis cannot be associated directly tocancer.

In the same article, the Digital Infrared Thermal Imaging (DITI) was considered an effectivescreening method for breast cancer. All this while, during our talks on breast health awarenessand breast examinations we have been advising women to practise monthly breast self-examination and annual mammograms. Now, with the above information in the papers, it seemsthat the public is recommended to seek the technique of DITI as an effective screeningmethod for breast cancer . Many different parties are trying to sell their products andunproven methods of screening or treatment for cancer. They are abusing the system bystating that the FDA has approved the equipment. We, the consumers should be a step ahead of such claims. Yes, the equipment is FDA approved but not necessarily for the function claimed bythe said party. We need to ask whether FDA has approved the use of the equipment forscreening. As breast cancer survivors, my friends and I from Breast Cancer Welfare Associationare troubled by such unprofessional ways of misleading the Malaysian consumer. Firstly, did anauthoritative scientific or medical body endorse this method? The survivors of BCWA and otherpublic educators on breast health issues now have another task of reeducating the public that theuse of DITI for breast cancer screening has no scientific evidence whatsoever. Would anyonewant to take the risk of undergoing this test when it can be misleading causing anxiety andemotional discourse to the woman irrespective of whether the reading is positive or negative?

Medical technology has advanced such that one can live with the disease after it has been treatedmedically by scientifically proven methods. As I have always introduced myself: I am living withbreast cancer, it proves that one can continue with ones role and function in society quite

normally. Scientifically proven screening methods will help detect breast cancer early. Of courseearly detection and prompt medical treatment are essential components of an improved quality of life and survival in breast cancer. To get to this stage, one should not leave any stone of medicalscreening, diagnostic and treatment unturned.

In the same article, statistics were published without checking the facts on the incidence of breastcancer in Malaysia which by the way is more prone amongst the Chinese population and not theMalay community. According to the Penang Cancer Registry the incidence is highest among theChinese (44.5), followed by the Indians (27.2) and the Malays (18.1). There are on average4,171 discharges and 209 deaths from breast cancer annually for the last 5 years (1997-2001),as reported from government hospitals nationwide. This is concurred by the National Cancer

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Registry 2002, which stated that the lifetime risk for Chinese women is 1 in 14, Indian women 1in 15 and Malay women 1 in 24. The lower incidence in Malay women needs further investigation.The incidence in Malay women is almost half that in the Chinese women.

Numerous medical experts have informed us that a blood test cannot be a screening tool forcancers. If blood test can be used for screening cancers then we just need a shot (injection in thearm) to draw the blood to determine whether we are clear of the disease. Is that what we want

the public to seek instead of mammograms and other scans? Then what are the scans for?

For details on Blood Test for Cancer Markers please refer to

www.acadmed.org.my

http://micronet-srv04/Content/Public/TopicOfTheMonth/200408/index.html

http://www.sydpath.stvincents.com.au/tests/InfSheets.htm

If we are interested in enabling all Malaysians to enjoy good health in their lifetime, the Ministryof Health could work closely with reputable professional bodies such as the Academy of Medicine,

Malaysian Oncological Society, College of Radiology, Malaysian Medical Association; and, NGOsincluding Hospis Malaysia, National Cancer Society of Malaysia and Malaysian Breast CancerCouncil, to prevent misguided and derogatory information from reaching the members of thepublic.

As survivors of cancer and consumers of the medical services, we are recommending thefollowing strategies:

Make it mandatory for General Practioners to update their knowledge skills every one or twoyears to prevent the patients from being misled with outdated information and technology andencourage improved quality of health of Malaysian residents. The practising license can berenewed only after satisfactory certification of updating oneself.

The Ministry of Health should appoint reputable and appropriately qualified organisations tobe its Consultative Body in Cancer Issues to verify the information in any publicity eventbefore the Minister and other senior officials officiate the said event. The members of theConsultative Body could include the Academy of Medicine, Malaysian Oncological Society,College of Radiology, Malaysian Medical Association; and, representatives of Hospis Malaysia,National Cancer Society of Malaysia and Malaysian Breast Cancer Council.

The recognition and endorsement of superspecialities by the Ministry of Health. These includebreast surgeons, breast care nurses, at the same time giving value to the profession, and,creating and developing a career path for them including attractive monetary benefits

Develop and make available for the public a datalist of medical specialists andsuperspecialists to prevent the gray areas of which kind of specialist to consult whendiagnosed with cancer. This datalist can also prevent Malaysians from spilling out their hardearned money into the revenue of neighbouring countries.

As breast cancer survivors we are confident that in the spirit of MALAYSIA BOLEH, the MalaysianGovernment will take definitive steps to enable Malaysians to enjoy an improved quality of life,with or without cancer.

This letter is signed by all the breast cancer survivors who are members of Breast Cancer WelfareAssociation.

http://www.acadmed.org.my/http://micronet-srv04/Content/Public/TopicOfTheMonth/200408/index.htmlhttp://www.sydpath.stvincents.com.au/tests/InfSheets.htmhttp://www.acadmed.org.my/http://micronet-srv04/Content/Public/TopicOfTheMonth/200408/index.htmlhttp://www.sydpath.stvincents.com.au/tests/InfSheets.htm

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