Ask a Paediatric Haematologist-Oncologist: Dr LeLe Aung from Icon Cancer Centre Singapore

Ask a Doctor ForumCategory: HaematologyAsk a Paediatric Haematologist-Oncologist: Dr LeLe Aung from Icon Cancer Centre Singapore
Dr LeLe Aung asked 1 year ago
I am Dr LeLe Aung, Paediatric Haematologist-Oncologist practicing at Icon Cancer Centre- Singapore. Ask Me Anything! I am an American Board Certified Paediatrician and the only Board Certified Paediatric Haematologist-Oncologist in Singapore. I am a Fellow of the American Academy of Paediatrics and I am accredited by the Singapore Accreditation Board in both Paediatric Medicine and Paediatric Haematology-Oncology. I have been practicing for more than 20 years and am happy to be a part of the ICON Cancer Centre family. I obtained my Bachelor of Science (BSc, Biology) from the State University of New York, USA and my Doctor of Medicine (MD) degree from Meharry Medical College, USA. I completed my three years of General Paediatric Residency at the University of Minnesota, USA, and three years of Fellowship in Paediatric Haematology-Oncology at the world-renowned Memorial Sloan Kettering Cancer Centre and Weil Cornell Medical College-New York Presbyterian Hospital in New York, USA. I was also a Chief Fellow at MSKCC. Since making Singapore my home in 2006, I am most passionate about providing holistic, evidence-based care for children in Singapore and surrounding regions who have challenging solid tumours. I have also published several studies in the Journal of Clinical Oncology, Cancer, and Pediatric Blood and Cancer journals, in addition to local medical journals with a focus on childhood cancers in Singapore, namely osteosarcoma, neuroblastoma and various childhood solid tumours. I am committed to sharing my knowledge through teaching and clinical research, having served as a clinical tutor at the National University of Singapore, Adjunct Assistant Professor at Duke-NUS Graduate Medical School, and as a guest lecturer of Advanced Nursing at Ngee Ann Polytechnic and an award recipient of many research grants. I accept referrals for all blood and cancer diagnoses in children, adolescents and young adults, with a special clinical interest in brain cancer, kidney cancer, liver cancer, neuroblastoma and sarcoma. I am also excited to be a part of a Multi-institutional International clinical trial for children with high-risk Neuroblastoma which will begin in a few months here at Icon Cancer Centre. Learn more about me here: I am excited to be here to share and discuss about cancer in children with everyone. I will be actively answering questions. If you have any questions about cancer or blood problems in children, 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
Fauziah answered 1 year ago

I have a 6 year old niece who was just diagnosed with stage 2 ALL. She has been living with congenital heart disease. Would her heart condition affect the effectiveness of the chemotherapy and stem cell transplant? Can those treatment options even be considered with her heart defect?

Dr LeLe Aung replied 1 year ago

For ALL the stages are grouped into Standard or Low risk (SR); Intermediate Risk (IR); and High risk (HR). The most common type of ALL in children are Standard/Low Risk (SR). Up to 90-98% of children with ALL-SR are cured from their leukemia with chemotherapy alone. Stem cell transplant is only needed if the leukemia relapses multiply or in certain high risk leukemia. Some of the chemotherapy drugs, e.g. doxorubicin, used as apart of the treatment for ALL, can affect the way that the heart functions, hence we usually do a baseline and follow-up ultrasound of the heart called Echocardiogram to look at the heart function before these drugs are given and during and after treatment is completed. Depending on your niece’s exact congenital heart disease type and the current heart function status, and her ALL, your oncologist will discuss with you on how to proceed, and on the options available.

Tessa Lim answered 1 year ago

Hi Doctor Aung,it has been 6 months since my son went for surgery for a benign brain tumor. He has been complaining about getting painful headaches these days. He also says his sight is blurry. He is 8 years old this year. Does this sound like a relapse to you? Or is it a common side effect of the surgery?

Dr LeLe Aung replied 1 year ago

Brain tumors are the second most common type of cancer in children. There are many subtypes of brain tumors in children, for example: astrocytoma, low grade glioma, high grade glioma, medulloblastoma, ependymoma, or germ cell tumor. Treatment differs depending on the exact type of tumor- e.g. surgery only, or additional treatment such as chemotherapy and radiation therapy. Even after surgery, benign’ brain tumors still need monitoring by the Pediatric Oncologist or Pediatrician and by MRI brain scans, frequently especially during the first 2 years, and less frequently later on until five years from diagnosis. Depending on the ‘specific type of benign tumor’ that your child had, as he is having some complaints, it will be good to see your Pediatric Oncologist or Pediatrician and consider a repeat MRI of brain with IV contrast.

Jessilyn answered 1 year ago

What are the chances of cure and recovery for stage 2 Wilms’ tumor in a child? My daughter was diagnosed with it. She has undergone radiotherapy and also surgery. She is about to start on her chemotherapy. What is the gold standard of treatment?

Ahari answered 1 year ago

Afternoon, Dr Aung. My 8 year old daughter has swelling in several areas of her body such as the abdomen, arms and neck. Is this a symptom of leukemia? She also often complains about joint pain. What check should I bring her to do?

Connie answered 1 year ago

My 13 year old daughter is currently in remission from ALL. Would she be prone to other types of cancer in the future?

Dr LeLe Aung replied 1 year ago

Because of major advances in treatment, many children with ALL are cured and continue to live normal lives into their adulthood.

The risk of developing a second cancer depends on several factors: type of chemotherapy drugs (e.g. cyclophosphamide, nitrogen mustard, doxorubicin, etoposide) that the child received for treatment of their first cancer, whether they received radiation esp. at a young age, and those who have a family history of cancers (inheritable mutations). For ALL there is a small risk of developing a second cancer.

All children who have survived their cancer should have yearly follow-up beyond the first 5 years after treatment is completed, into their adulthood. Be sure to report to your doctor if there are any of these symptoms such as: easy bruising or bleeding, fatigue, paleness, blood in urine or stool, bone pain, lumps, persistent headaches, etc.

Kathleen answered 1 year ago

Doctor, after having a bone marrow transplant, my son’s reflexes has become a bit slow. He always seems lost in his thoughts and responds very slowly to conversation or touch. Is this normal? Do you think I need to consult a psychologist?

Dr LeLe Aung replied 1 year ago

Providing good mental health for children undergoing treatment for cancer is often missed. It is always good for a psychologist/psychiatrist or a social work counselor to also be a part of the treatment team just like the nurses and doctors. Having said that, Bone marrow transplant (BMT) has many different side effects depending on the underlying cancer diagnosis, type of conditioning regimen (chemotherapy used before the infusion of stem cells) and the child’s baseline physical condition prior to BMT. It is best to discuss in detail your concerns together with your Transplant physician.

Aida answered 1 year ago
Doctor, my son underwent surgery for Pilocytic astrocytoma. Can this kind of tumor metastasize after the surgery? Is there any thing we can do to prevent it from spreading?
Dr LeLe Aung replied 1 year ago

Pilocytic astrocytoma is a low grade or slow-growing type of brain tumors. It is also one of the common brain tumor types in children. It is a highly curable with surgery alone and they rarely metastasize to other parts. Because they are slow growing, your doctor will recommend following up with MRI of the brain for many years.

Rein answered 1 year ago

My daughter has had problems with seizures since she was a toddler. There is also a strong history of cancer in my family. I have done some research on seizures and the research mentioned one of the symptoms of childhood leukaemia is seizures. Is this true? Do I need to be worried and take her in for tests?

Dr LeLe Aung replied 1 year ago

Leukemia is a type of cancer that starts in the bone marrow, the factory in our body that makes white blood cell, red blood cell and platelets. Most common symptoms/complaints for leukemia are looking pale, fatigue, bleeding bruising, persistent fevers or limping. Seizures can be one of the symptoms if the leukemia is involving the central nervous system (brain). But is it usually acute, fast and does not take years. I am not sure how long she has had seizures. But it is good to discuss with her pediatrician who is treating her seizures.

Kiat Keng answered 1 year ago

If a child is experiencing severe nosebleeds when going through chemo for leukaemia, is it still safe to continue the chemo?

Dr LeLe Aung replied 1 year ago

Leukemia itself and treatments given can lower the platelet count that can lead to easy bruising and bleeding. Depending on the extent of bleeding and whether leukemia is in remission, we do proceed with its treatment. If the bleeding is extensive or platelet counts are extremely low, there are times when the child may need platelet transfusion or medicines that help to clot the blood to lower risk of bleeding. It will be good to discuss together with your treating oncologist the options.

Jolin answered 1 year ago

What is the early sign of brain tumor in children? My 9 year old son has been telling me about severe headaches lately. He said they make him nauseous. I noticed too that when he stands up from a sitting position, he cannot keep his balance.

Dr LeLe Aung replied 1 year ago

Depending on the location of the tumor in the brain, symptoms and signs vary persistent headaches, vomiting especially worse in the morning, balance or vision problems, walking or movement problems, personality changes can all be warning signs. It is important to write down the events in a diary, see your doctor for a detailed history and physical examination and to discuss whether there is a need to do a brain scan such as an MRI.

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