Cover Breast cancer is the most common cancer among women in Malaysia (Photo: iStock)
Breast cancer is the most common cancer among women in Malaysia (Photo: iStock)
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In conjunction with Pink October, Tatler speaks to Dr Chong Kwang Jeat, clinical oncologist at Mahkota Medical Centre Melaka, about living well while battling advanced breast cancer
Conversations during Pink October often focus on raising breast cancer awareness, emphasising the importance of education on early detection, signs, and symptoms. However, discussions about metastatic or advanced breast cancer—a condition that affects many—are less common. In 2022, the World Health Organization reported that approximately 2.3 million women globally were diagnosed with breast cancer, leading to 670,000 deaths.
In Malaysia, breast cancer is the most common cancer among women, with one in 19 women and one in 100 men at risk of developing the disease in their lifetime. A report from the Malaysia National Cancer Registry, published by the Ministry of Health, revealed that out of the 21,634 female breast cancer cases diagnosed between 2012 and 2016, 47.9 per cent were detected at late stages (III and IV). In a later report assessing cases diagnosed between 2017 and 2021, the percentage diagnosed at late stages had increased to 50.5 per cent.
Read more: What we learned from Olivia Munn’s breast cancer diagnosis
Dr Chong Kwang Jeat, a clinical oncologist at Mahkota Medical Centre, has spent more than 27 years treating cancer patients. “Seeing my patients live well and longer, knowing I have contributed to their health and well-being, is incredibly fulfilling,” says Chong, who was drawn to specialise in treating advanced breast cancer due to the significant need for more specialists in the field. He notes that oncology is a constantly evolving discipline that requires continuous learning and problem-solving.
Above Clinical oncologist Dr Chong Kwang Jeat (Photo: Mahkota Medical Centre Melaka)
Clinical oncologist Dr Chong Kwang Jeat (Photo: Mahkota Medical Centre Melaka)
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Advanced breast cancer can be categorised into three main groups, each with varying survival rates. The largest group, comprising 70 to 80 per cent of diagnosed cases, is hormone receptor-positive and HER2-negative. Hormone receptor-positive cancer, which may have oestrogen and/or progesterone receptors, allows for treatments that block these hormones from feeding the cancer cells, thereby slowing the cancer’s growth and spread.
Human epidermal growth factor receptor 2 (HER2) controls cell growth in healthy cells. HER2-negative cancers do not produce extra HER2 protein, making them less aggressive and with a more favourable prognosis. “With up-to-date treatments, the median survival in advanced metastatic stage IV of this type of cancer is more than five years,” Chong explains.
See also: Melinda Looi and more Malaysian creatives supporting breast cancer awareness
The HER2-positive subtype, accounting for about 20 per cent of advanced breast cancer cases, has a median survival rate of three to six years. Meanwhile, the triple-negative subtype—negative for HER2 and both types of hormone receptors—constitutes 10 to 20 per cent of advanced breast cancer cases and has a median survival rate of one to two years at stage IV. Triple-negative breast cancer patients have fewer treatment options as their cancer cells lack the necessary receptors for hormone therapy or targeted HER2 drugs to be effective.
“The current trend in cancer care is ‘precision medicine’ where the goal is to provide the right treatment to the right patient at the right time,” Chong says. He highlights new therapies, including CDK4/6 inhibitors, PARP inhibitors, and HER2-targeted treatments, which have significantly improved outcomes for advanced breast cancer patients by offering more effective and less toxic treatment options than conventional therapies.
Above In Malaysia, one in 19 women and one in 100 men risk developing breast cancer in their lifetime (Photo: iStock)
In Malaysia, one in 19 women and one in 100 men risk developing breast cancer in their lifetime (Photo: iStock)
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“Moreover, immunotherapy, particularly checkpoint inhibitors, have shown promise in treating triple-negative breast cancer, extending survival while minimising side effects and improving the quality of life during treatment,” he adds. These advancements have been a game changer, especially as options for treating advanced breast cancer were limited in the past.
Many patients, understandably, fear the short-term side effects of chemotherapy, such as hair loss, fatigue, nausea, nerve damage and increased risk of infection. However, Chong points out that targeted therapies focus on attacking specific cancer cells, leading to fewer side effects than traditional chemotherapy.
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Chong emphasises the importance of lifestyle in managing late-stage breast cancer. “Many of my patients find that staying active and engaged in their daily lives not only helps them live better but also live longer. Gentle activities like qigong, yoga, tai chi, or even a simple walk in the park can boost energy levels and improve mood. Eating a healthy diet tailored to their needs ensures they get the right nutrients to support their body during treatment.”
In addition to physical care, Chong stresses the importance of emotional well-being. “Some patients find solace in support groups, counselling sessions, or meditation to manage the stress of their diagnosis,” he says. Maintaining strong connections with family and friends, cultivating a positive mindset, and pursuing hobbies can also provide a sense of purpose and strength throughout this challenging journey. “By embracing these lifestyle changes, patients often improve their quality of life and extend their survival, proving that a holistic approach to cancer care can truly make a difference,” he says.
Above Women should start performing self-breast examinations in their 20s (Photo: Pexels)
Women should start performing self-breast examinations in their 20s (Photo: Pexels)
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For those facing a diagnosis of advanced breast cancer, Chong advises prioritising proper medical care from a trusted oncology team specialising in current treatments. “While it may be tempting to explore alternative therapies, it’s important to stick to scientifically proven treatments recommended by your doctors,” he cautions. He also recommends having a dedicated nurse navigator to help manage appointments, understand treatment plans, and provide emotional support. Additionally, Chong advises patients to be discerning when researching information online, especially on social media, as not all sources are committed to sharing true facts.
He also underscores the importance of early detection. Women should start performing self-breast examinations in their 20s. “While self-exams alone are not sufficient for early detection, they help women become familiar with their breasts, enabling them to notice any changes and report them to their doctor,” he notes. A biennial mammogram is recommended for the general population of women aged 50 to 74 years; annual mammograms for women in the moderate risk group (40 to 49 years old), annually or biennially between 50 to 59 years, and biennial from 60 onwards. Those at higher risk may need to start earlier, depending on their doctor’s advice. “Ultrasounds are not typically used for routine screening but may be recommended for younger women with dense breast tissue as an additional tool to mammograms.”
Chong reminds us that despite the challenges of advanced breast cancer, it is important not to lose hope. “Seek proper medical care—while the disease may not be curable, modern treatments can often extend survival by years with excellent quality of life. With the right care, a supportive team, and a positive mindset, thriving and finding joy in life is possible, even during the most challenging times. Focus on what matters most to you.”
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Images: iStock, Pexels
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