Ask a Radiation Oncologist: Dr Johann Tang from Mount Elizabeth Novena Hospital Singapore

Ask a Doctor ForumCategory: OncologyAsk a Radiation Oncologist: Dr Johann Tang from Mount Elizabeth Novena Hospital Singapore
Dr Johann Tang asked 9 months ago
I am Dr Johann Tang, Radiation Oncologist practicing at Mount Elizabeth Novena Hospital Singapore and Farrer Park Hospital Singapore. Ask Me Anything!

I am the Senior Consultant & Medical Director of ME Novena Specialist Group Pte Ltd at Mount Elizabeth Novena Hospital and Assistant Professor at the Yong Loo Lin School of Medicine, National University Singapore.

I obtained my medical degree from the University of Newcastle, Australia in 1998 and completed my house officer training at the Hunter Area Health Service before returning to Singapore to complete my National Service in the Singapore Armed Forces Medical Corps. Thereafter, I did my specialty training in Radiation Oncology in Singapore at the National University Hospital(NUH).

After obtaining my fellowship from the Royal Australian College of Radiologist (FRANZCR) in 2007, I underwent breast brachytherapy fellowship at University of Wisconsin as well as prostate brachytherapy, skin and paediatric fellowships at Peter Maccallum Cancer Institute, Australia.

I was at NUH for 18 years and have a wealth of experience in treating a wide variety of cancers such as breast cancer, gynaecological cancer such as cervical, endometrial cancers, upper gastrointestinal cancers such as oesophageal, stomach, pancreatic cancers, lower gastrointestinal cancers such as rectal and anal cancers, head and neck cancers such as nasopharyngeal, oral and larynx cancers, prostate cancer, lung cancers, brain cancer, lymphomas, sarcomas and paediatric cancers.

I was radiotherapy service head for gynae-oncology, breast, paediatric oncology and brachytherapy. My subspecialty and main research interests included breast, gynaecological, brain and paediatric tumours.

As the Research Director at NUH Radiation Oncology Department, my accolades include developing and championing a strong research culture, authoring numerous publications and I was a committed referee for several international journals. I have won several research prizes and was awarded multiple research grants.

As a clinician committed to offering the best and latest treatment to all patients, I spearheaded and developed breast brachytherapy (Accelerated Partial Breast Irradiation APBI) as well as Interstitial Imaged Guided Cervical Brachytherapy services. These were the firsts of its kind, only available at NUH Singapore then.

On top of being a caring and experienced clinician, I am passionately involved in nurturing and developing the next generation of aspiring oncologists. I am the co-chair of the Euro Asia Breast Brachytherapy School, teaching faculty member of the Australian Paediatric Radiation Oncology Group and is an invited external examiner at the Bangladesh College of Physicians and Surgeons.

I formely served on national committees as the Vice President of the Chapter of Radiation Oncologist and executive member of the Academy of Medicine Singapore and Singapore Society of Oncology. I am currently Council Member of the Faculty of Radiation Oncology Council, Royal Australian and New Zealand College of Radiologist and the first Singaporean to be Associate Editor of the Journal of Medical Imaging and Radiation Oncology (JMIRO).

Learn more about me here: https://patients.smarterhealth.sg/specialist-doctor/johann-tang/

I am excited to be here to share/discuss Cancer Care with everyone. I will be actively sharing questions. If you’ve got questions about radiation therapy for breast, gynaecological, brain and paediatric tumours, ask me anything!

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15 Answers
Esther answered 9 months ago

My father was previously diagnosed with stage 1 lung cancer and went for chemotherapy and was in remission successfully. However he continued smoking heavily and 2 years later, was diagnosed with stage 3 lung cancer. His doctor is suggesting using a mix of chemotherapy and proton therapy to treat the cancer. My father also has scarring on his lungs. Do you think it is a good idea for us to pursue the chemotherapy and proton therapy path? I saw my father losing weight rapidly previously from the chemo. Can we just do proton therapy?

Dr Johann Tang
replied 8 months ago

Hi, it sounds like your dad’s disease has progressed. Usually, a formal re staging imaging using PET scans would be done to determine the stage of the disease. If the disease remains curable which from your query it is, then chemoradiation would be the choice of treatment over radiation alone. Before deciding on radiation treatment, usually an assessment of your dad’s lung function (especially if he is a smoker) would be required to determine his fitness for radiation. Whether your dad would benefit clinically from proton or normal radiation treatment, I would need to see him and review his imaging scans. Thanks

Shi hui answered 8 months ago

My husband has sarcoma and is now undergoing radiation therapy. He mentioned since the therapy started, his feet keep tingling and it affects his walking. Is this normal?

Dr Johann Tang
replied 8 months ago

Hi, it is unusual for the radiotherapy to cause significant tingling that affects his walking. I would advise him to check with his doctor. Thanks

Vivian answered 8 months ago

My husband is scheduled to have radiation therapy for his lymphoma. I have heard that radiation therapy has risks for pregnant women. I am now 4 months old pregnant. Should I keep a distance from him for a while? At the same time, I want to support him and accompany him for his doctor visits. Do you have any advice for me?

Dr Johann Tang
replied 8 months ago

Hi, as your husband is undergoing external beam radiotherapy (EBRT), it is safe for you to accompany him for his treatment. There is no radioactive source being placed or Injected into him for EBRT treatment.

As long as you do not go into the radiation treatment bunker, you should be safe to accompany him for treatment.

If your husband is having a PET CT scan, where a radioactive tracer is injected into the body, then you should keep a distance from him for a while as he is potentially “radioactive”.

Tracy answered 8 months ago

My husband has stage 3 lung cancer. Would radiation therapy help him at this point considering his stage of cancer? What is the success rate of treating his cancer with radiation therapy combined with chemotherapy?

Dr Johann Tang
replied 8 months ago

Need more details

Janis Lim answered 8 months ago

My husband has been diagnosed with stage 1 throat cancer and his doctor has gotten him on 30 fractions of VMAT radiotherapy over a 6 week period. Does this sound suitable? I am worried about the side effects for him.

Dr Johann Tang
replied 8 months ago

I assume that this is laryngeal carcinoma that you are talking about?
Or is it oropharyngeal carcinoma?
Is this pre or post surgery?

Paresh answered 8 months ago

Is radiotherapy safe for children? My son is 6 years old and he has a brain tumor. I am worried it will harm his brain function.

Dr Johann Tang
replied 8 months ago

For childhood brain cancers, treatment usually follows a protocol, usually either the COG protocols (USA) or the SIOP protocols (European). Most protocols usually involve a combination of modalities such as surgery, chemotherapy and radiotherapy, depending on the type of tumor. Radiotherapy usually have acute as well as late side effects – depending on the radiation dose, irradiated volume, location of the treated area and age of patient at the time of radiation. It would be best to discuss such late effects with a radiation oncologist specialising in pediatric cancers.

Judy answered 8 months ago

I heard that a combination of lumpectomy with radiation therapy is the best way to prevent breast cancer from returning. Is that true? What are the chances of stopping the relapse with this combination? How soon should the radiotherapy start after lumpectomy?

Dr Johann Tang
replied 8 months ago

Hi, it is true that for patients who have chosen breast lumpectomy, radiation therapy post surgery is an important treatment in preventing breast recurrence. Numerous clinical trials have shown that in women undergoing adjuvant radiotherapy after lumpectomy, the relative risk reduction is about 60-70% compared to lumpectomy at 5 years. For patients who do not undergo chemotherapy, radiation usually commences about 2-4 weeks postop once the wound is healed. For patients who have to undergo chemotherapy, radiation usually commences about 3-4 weeks after the last cycle of chemotherapy.

Weekiat answered 8 months ago

My father was diagnosed with stage 2 non-small cell lung cancer. He was considered unfit for surgery due to his stroke history. Is radiotherapy a solution for him? Are there any risks we should be aware of if we decide to go with it?

Dr Johann Tang
replied 8 months ago

For patients who are medically unsuitable for surgery, radiotherapy can be used as an alternative. Side effects of the radiotherapy will depend on factors such as your dad’s current condition and his current lung function, whether he was a smoker, the intent of treatment, site and volume of the tumor irradiated and the dose / fractionation of the treatment schedule. Would be best to discuss this with your doctor.

Sheryl Wong answered 8 months ago

I am a 42 year old woman who has been diagnosed with skin cancer. My oncologist brought up radiotherapy. However, I am worried this would have a side effect on my face. I have sensitive skin and have been undergoing acne treatment since my teens and into my 30s. Would radiotherapy make my skin worse?

Dr Johann Tang
replied 8 months ago

As an alternative to surgery, for certain types of skin cancers and depending on where the skin tumor is on the face, radiotherapy can be used. Side effects of treatment can include skin redness and pigmentation, which usually are temporary. Given your history of sensitive skin, it would be best to talk to your doctor about it.

Caslista answered 8 months ago

My husband is undergoing radiotherapy for his pancreatic cancer currently. Are there any supplements you would recommend or any changes in his diet we need to watch out for?

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