Ask a Medical Oncologist: Dr Shang Yeap from Icon Cancer Centre Singapore

Ask a Doctor ForumCategory: OncologyAsk a Medical Oncologist: Dr Shang Yeap from Icon Cancer Centre Singapore
Dr Shang Yeap asked 1 year ago
I am Dr Shang Yeap, Medical Oncologist practicing at Icon Cancer Centre- Singapore. Ask Me Anything! I am a specialist in medical oncology at Icon Cancer Centre. I received my Bachelor of Medicine and Surgery degree from The University of Sydney and was awarded the Faculty of Science International Merit Scholarship for outstanding academic achievement. I was also granted membership into the Golden Key International Honour Society for being in the top performing students of my class. I completed my specialist training in medical oncology at the Crown Princess Mary Cancer Centre, Sydney. I then furthered my passion in cancer care with a fellowship in clinical research at the Sydney West Clinical Trials Centre. In that time, I developed multiple clinical trials for breast cancer, urogenital cancer, novel cancer drugs and pharmacogenomics. I have since presented my research findings at many international conferences and also published these results in acclaimed scientific journals including the Journal of Clinical Oncology. I worked as a consultant in medical oncology at Johns Hopkins Singapore and Tan Tock Seng Hospital from 2011 until 2015. I was in charge of the Tan Tock Seng oncology clinic and was involved in research and was the principal investigator of multiple clinical trials for cancer patients. I am a fellow of the Royal Australasian College of Physicians and the Academy of Medicine Singapore. I am an active member of the American Society of Oncology and a past member of the Clinical Oncology Society of Australia. I have over 10 years of clinical practice in medical oncology. I passionately believe that caring for patients with cancer involves caring for their physical, emotional and spiritual health. Kindness, compassion and providing each of my patients with the best evidence based treatments are the heart of my practice. I accept referrals for all cancer types, with a special clinical interest in breast cancer, gastrointestinal cancer, lung cancer, melanoma and urogenital cancer. Learn more about me here: I am excited to be here to share/discuss Cancer with everyone. I will be actively answering questions. If you've got questions about cancer, whether it's breast cancer, gastrointestinal cancer, lung cancer, melanoma or urogenital cancer, feel free to ask me! === Want to ask a question? Submit your question at the bottom of this page. Don’t forget to include your name and email address to get notified when the doctor answers your question.
17 Answers
Iswanti answered 1 year ago

My 38 year old sister is undergoing hormone therapy for her stage 3 breast cancer. Her menstruation has stopped for these 2 months. Her doctor has mentioned that this is likely one of the possible side effects and asked her to observe her cycle. Is hormone therapy the most beneficial treatment for her stage of cancer, in comparison to the side effects? She still wants to have more children in the future.

Dr Shang Yeap replied 1 year ago

Hi Iswanti. Hormone therapy is needed for hormone sensitive breast cancer to reduce the risks of relapse of her breast cancer. Her breast cancer is likely to relapse without hormone therapy. The benefit of hormone therapy usually outweighs the side effects risks. However she will not be able to have children while she is on hormone therapy. She should have a discussion with her oncologist if she is planning to have more children.

Yvonne answered 1 year ago

My uncle’s lung cancer is relapsing. Previously, it was treated with targeted therapy. Would this be effective again for post-relapse treatment?

Dr Shang Yeap replied 1 year ago

Hi Yvonne. Targeted therapy may be effective again if there is a new mutation discovered in your uncle’s lung cancer. Next generation sequencing to check the genetic profile of his lung cancer can be done at this time of relapse. If next generation sequencing shows a new mutation, there may be targeted therapy agents suitable for his lung cancer. If there are no new mutations, then targeted therapy is unlikely to be effective again.

Benson Goh answered 1 year ago

My father in law has prostate cancer that recently developed to stage 4. He complains about pain while urinating and sometimes has blood in his urine. His scrotum is also swollen, and he said the chemotherapy drugs he is taking are making his stomach and groin burn. At this stage, is chemotherapy still beneficial? Should we stop and try another treatment option? How long does he have in his current state?

Dr Shang Yeap replied 1 year ago

Hi Benson. Chemotherapy is proven to improve survival for stage 4 prostate cancer. However there are side effects from chemotherapy and symptoms like “stomach burning” is common during chemotherapy. There are also many other treatment options for stage 4 prostate cancer including hormone therapy such as Abiraterone and Enzalutamide. Hormone therapy is generally much better tolerated than chemotherapy. These options of treatment should be discussed with his oncologist. With regards to his prognosis, I am unable to comment accurately without knowing more details about his condition.

Chinkiat answered 1 year ago

Dr Shang, for stage 2B cervical cancer, what is the percentage of improvement if the patient undergoes post-surgery radiotherapy? My mother has undergone surgery and is still undergoing chemotherapy, but her condition doesn’t seem to improve. Thank you for your answer.

Dr Shang Yeap replied 1 year ago

For stage 2B cervical cancer, the long term survival rates are very good – around 90% 5 year survival rates. Your mom may just be feeling the side effects from chemotherapy and radiation at the moment but should feel better once her treatment is completed.

LC answered 1 year ago
Will polyps always occur in esophagus etc if found in cervix? Can cancer happen without polyps at all?
Dr Shang Yeap replied 1 year ago

Polyps will not occur in the oesophagus if they are found in the cervix – they are not related to each other. Cancer can happen without polyps.

Jeremy answered 1 year ago
Hi Dr Shang. My wife has been taking tamoxifen for a year. Although it doesn’t affect her menstruation cycle significantly, it causes vaginal discharge and excessive bleeding during her period. I heard that patients who take tamoxifen are advised not to get pregnant during the therapy. My concern is would her fertility still remain normal after taking the drug long term, with all the side effects I mentioned above?
Dr Shang Yeap replied 1 year ago

Patients are advised not to fall pregnant while taking Tamoxifen because Tamoxifen is teratogenic – that means that the drug may cause abnormalities to the foetus. Her fertility would not be affected by Tamoxifen after taking the drug long term but fertility may be affected by her age by the time she comes off Tamoxifen. I would advise you to speak to her oncologist to discuss fertility issues in more detail if you are keen to have children in future.

Jolin answered 1 year ago
Hi doctor. I am a 41 year old woman. Two years ago, I managed to get remission  from stage 2A breast cancer. And not long after that, I had my menopause. Since then, I sometimes still feel the side effects of hormonal imbalance. My body sometimes feels hot and my back hurts. I also easily feel nauseated and will vomit, for example after eating something oily. A few days ago, I have been feeling breast pain. I am worried if this is a sign of recurrence of the cancer and not a hormone condition. Can I have your opinion about my symptoms? Should I give it a check?
Dr Shang Yeap replied 1 year ago

Hi. Many of your symptoms may indeed be related to menopause. However I would still recommend that you see your doctor about these symptoms and the recent breast pain to make sure that it is not due to other conditions.

Des answered 1 year ago

My father is 78 years old and has heart problems. He has stage 3 lung cancer. He is considered unfit for surgery, so his doctors have recommended chemotherapy combined with radiotherapy. How effective would this be without surgery? Or would you suggest other types of therapy? Thank you for your answer.

Dr Shang Yeap replied 1 year ago

Surgery or chemo-radiation are both recommended treatments for stage 3 lung cancers. The effectiveness of chemotherapy with radiation has improved in recent years with the addition of new treatments like immunotherapy and targeted therapy. Your father will most likely be recommended to have immunotherapy or targeted therapy after he has completed his chemotherapy and radiation.

Rachael answered 1 year ago

Doctor, my mother is 60 years old. She takes aromatase inhibitors for her breast cancer treatment. She had her menopause one year before treatment. However after taking the drugs, she experiences vaginal bleeding almost once a month. Is this menstruation or some other condition? If her body doesn’t respond well to aromatase inhibitors, are there any other hormonal drugs she could try?

Dr Shang Yeap replied 1 year ago

Vaginal bleeding after commencing aromatase inhibitors should be investigated further with a gynaecologist review. Some reasons for vaginal bleeding include incomplete menopause or side effects from aromatase inhibitors. If she is found to be unsuitable for aromatase inhibitors, there are other options like Tamoxifen that also work well for breast cancer patients.

Chee Sim answered 1 year ago

Hi Dr Shang Yeap. My father has a history of diabetes. During his chemotherapy, the drugs often spike his sugar levels. Although his tending doctor said it is still controlled, I am worried about this. Do you think this will cause long term harm on him?

Dr Shang Yeap replied 1 year ago

Patients with diabetes undergoing chemotherapy often have higher blood sugar levels during chemotherapy. This should certainly be closely monitored and his diabetic medications may have to be adjusted during this period to prevent complications such as diabetic ketoacidosis. Usually there are no long term harmful side effects if his glucose is well monitored and controlled during chemotherapy.

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