CANCER, coronary heart disease and pneumonia are the top three killer diseases in Singapore, according to the Ministry of Health.
Screening can alert doctors on who are at risk and the severity of infection for those who are already ill. Early detection will boost the chances of recovery.
Breast and colorectal cancer
More women succumb to breast cancer than to any other cancer. Among men, it's colorectal cancer.
Figures from the National Cancer Centre show that colorectal cancer is the most prevalent cancer in Singapore, with more than 1,000 patients diagnosed each year.
Dr Denis Nyam wants to dispel the myth that colorectal cancer is a man's disease.
"With 48 per cent women and 52 per cent men suffering from it, it's a close ratio," says the consultant surgeon of Nyam Colon, Rectal & General Surgery.
He says colorectal cancer can arise in the large intestine or rectum and it begins as polyps (growths) which may remain pre-cancerous for between three and eight years.
In the early stages, there are no symptoms, which is why screening is so important, he explains.
A person with colorectal cancer may experience a change in bowel habits, such as increased frequency or constipation, bloody or black stools from the bleeding tumour, fatigue, appetite and weight loss, abdominal pains, cramps or bloating.
There are four types of screening options for colorectal cancer. "Colonoscopy is the gold standard - it can detect polyps that are only 2mm or 3mm.
"It is also the only screening test that addresses prevention. If performed well, the procedure is painless," says Dr Nyam.
"The other three - faecal occult blood test, barium enema and CT colonoscopy - can only help to detect growth, but not prevent it." They are also not as accurate, he adds.
People over the age of 50 should be screened for colorectal cancer even if they have no symptoms.
Fees range from under $10 for a faecal occult blood test to $1,000 or more for a colonoscopy. About 90 to 95 per cent of the cost of a colonoscopy can be paid for with Medisave.
If there are no danger signs, the next screening can be done 10 years later.
Heart disease
Coronary heart disease is a disorder where the network of blood vessels of the three main coronary arteries are narrowed or blocked by the build-up of fatty deposits.
If left untreated, the decrease in the amount of blood and oxygen to the heart muscle can cause irreparable damage. Severe blockage can lead to a heart attack and death.
According to cardiologist Dato Dr Leslie Lam from The Cardiac Centre, the top five causes of coronary heart disease in Singapore are heredity, elevated cholesterol, smoking, diabetes and high blood pressure.
"We'd rather prevent than treat a heart attack where the mortality rate tends to be high. My advice is early diagnosis to prevent a heart attack at all costs," he says Dr Lam.
Tests that can help determine the presence and severity of coronary heart disease include the blood test, electrocardiogram, stress test, CT and nuclear scans, ultrasound and angiogram.
Pneumonia
"Pneumonia, an infection of the lungs, is the number three killer disease in Singapore. It is also one of the top causes of death among the elderly above 65 years and very young who are below two years," says Dr Chong Yeang Chern, wellness physician at Wellness & Aesthetics Centre, Asia HealthPartners.
"The mortality rate is so high largely because people tend to leave it alone till it's too late and their lungs fail or they succumb to complications. The common symptoms of pneumonia are a spiking fever (above 38.5 deg C), very bad cough that won't go away after more than two weeks, shortness of breath (due to infection of lower respiratory tract/ lungs) and chest pain, which is worsened by breathing and coughing.
"Pneumonia is serious. It can lead to other complications when infection in the lungs spreads to the blood. Respiratory distress (lung failure) can put a person in ICU and on the breathing apparatus for a month," she cautions.
Vaccinations against influenza and certain types of pneumonia are easily available in Singapore.
This article was first published in Health & You, The Straits Times on July 2, 2008.
