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GLENEAGLES Medical Centre Penang HOC monthly newsletter

August 2005

Coping with nausea and vomiting - management

Next support group meeting: 7.30 pm, 11th August 2005 Topic for discussion: Clinical trials – Why do we need them? Should you participate? Speaker: Dr Lee Thong Chow

7th July 2005. Dr. Leong gave a short presentation on prevention and management of nausea and vomiting. In his experience, with good antiemetics, less than 10% of patients experience vomiting, but nausea remains a problem with about half of all patients on treatment. Depending on the type of cytotoxic chemotherapy needed, different potent antiemetics are used. There are there types of emesis, namely acute, delayed and anticipatory. The usual antiemetics include metochorpromide, dexamethasone, granisetron, odensteron, tropisetron and emend. Lorazepam is useful in managing anticipatory vomiting. There are non-medication methods that can help prevent or limit nausea and vomiting. See back page

5 rd Support Group Meeting Topic: Clinical trials – why do we need them? Should you participate? Speaker: Dr. Lee Thong Chow, Gleneagles Clinical Research Centre, Penang Time: 7.30 to 9.30 pm Date: 11 th August 2005, Thurs Venue: Lecture Hall, 6 th Floor, GMC Penang Only for patients, relatives and caregivers For catering purposes, your confirmation with Ms

Where there is Life, there is Hope. Prepared by the

Haematology – Oncology Centre, GMC Penang

GMC Penang celebrates its 32 nd anniversary this month of July. With it, the staff has a new look with new uniforms, featuring a pleasant batik design. Our staff, left to right: Sister Qym Ho, S/N Shiji, Ward Clerk Ms Priya, Clinical Assistant Ms Chew and Secretary Ms Mabel. Ms Chew has just joined us in July. Spot the new pink and white uniforms! S/N Punitha (not in pic) has gone for advanced training in KL for 6 months.

Focus website of the month: www.cancercare.org This is a very good site based in USA. This is a nonprofit organization since 1944. Very good write up on many topics.

GLENEAGLES Medical Centre Penang HOC monthly newsletter

Next support group meeting: 7.30 pm, 11th August 2005 Topic for discussion: Clinical trials – Why do we need them? Should you participate? Speaker: Dr Lee Thong Chow

Where there is Life, there is Hope Prepared by the

Haematology – Oncology Centre, GMC Penang

Back page, August 2005

Chronic myeloid leukaemia Chronic myeloid leukaemia, in short CML, is a cancer of the white cells which progresses slowly but definitely and is fatal if left untreated. It causes anaemia (lack of blood), enlarged spleen, bleeding spots, weight and appetite loss, and lethargy. Some patients are diagnosed when they have a routine checkup. For many years, the main stay of treatment was oral cytotoxic chemotherapy with hydroxyurea or busulphan. Even so, their lifespan is usually prolonged only to 3-4 years.Interferon given by injection became available in the 1990’s but had significant side effects. Haemopoietic stem cell transplant offers the best chance of cure for patients who have a donor. Unfortunately, less than 30% of patients can have a transplant. Since 1998, a new medication called Imatinib mesylate (also known as Glivec, Gleevec, STI571) has become available and is widely used. Most patients can tolerate the medication. When used early in the illness (chronic phase) >95% of patients benefit. It is estimated that with the medication >80% of patients will be well and alive after 5 years. It is indeed revolutionary. The pharmaceutical company, Norvatis started a patient support programme to ensure that every needy patient can get the medication, called GIPAP (Glivec International Patient Assistance Programme). Now under the programmes, >400 Malaysians have benefited. Internationally >10,000 patients are on the programme. 3 weeks ago, GIPAP Malaysia celebrated 3 years of its programme in Malaysia. If you know anyone with CML not receiving Glivec because of financial problems, alert them to the programme. GMC Penang is one of the centres running the programme.

Non-medication methods to limit nausea and vomiting Choice of foods – less spicy, oily. Take small and frequent meals. Distraction - occupy one’s time doing things. Play video games, enjoy a DVD at home, take walks. Have company during treatments. Join support groups and ally fears. Avoid lying down for at least half an hour after a meal.

Focus on medication Aprepitant (Emend, MSD) is a new antiemetic (prevent vomiting) medication that was brought into Malaysia last year. It is useful to prevent vomiting and nausea in both the acute and delayed setting. It is an add-on medication. Other antiemetics have still to be used during chemotherapy or radiotherapy. This improves our objective in trying to minise side effects during effective cytotoxic chemotherapy. Further information can be obtained at www.emend.com.