2020年6月18日 星期四

打工仔壓力大致胃酸倒流 醫生拆解胃病成因

根據醫管局最新發布的數據,胃癌是本港第6大常見癌症,本港每年亦有逾千宗胃癌新症。有醫生表示,不少人誤以為胃癌一定會嘔血,但其實胃癌初期徵狀不明顯,都市人常見的胃痛,已可能是胃癌的警號。三餐不定時、精神壓力大等,均有機會增加患胃癌的風險。

胃痛屬病徵之一

臨床腫瘤科專科醫生陳亮祖表示,胃癌的病徵不明顯,患者發現時可能已是後期, 部分人誤以為胃癌一定會嘔血,但其實未必,即使是都市人常見的胃痛,已可能是患胃癌的迹象,或要做胃鏡來確定是否患病。

此外,不少都市人的生活問題都有影響,例如三餐不定時有機會導致慢性胃炎,而精神壓力則有機會導致胃酸倒流、胃潰瘍等,均可能間接引致胃癌。










胃部的腫瘤有很多種,陳亮祖表示,常說的胃癌是胃腺細胞癌,此外常見的還有在胃部肌肉的腸胃基質瘤,以及在胃壁的胃淋巴瘤。他指出,幾種腫瘤有不同徵狀,胃癌患者常會感到飽滯、胃痛,容易出現貧血,大便呈黑色,徵狀與胃炎相似;胃淋巴瘤的徵狀與胃癌類似,會出現胃痛及胃炎徵狀;至於腸胃基質瘤,患者的胃、腹部感覺不明顯,大便亦未必有血。

三種腫瘤的成因及治療亦有不同,腸胃基質瘤成因不明,胃淋巴瘤可能與幽門螺旋桿菌有關,至於胃癌的高危因素則較多,例如長期吃太鹹、醃製食物,少吃菜,有吸煙習慣,體重過重,或遺傳因素等,都可能與胃癌有關。在治療方面,胃淋巴瘤以化療針為主,胃癌及胃腸道基質瘤則主要以手術切除。

食素無助防病

坊間對胃癌有不少謬誤,例如有指因少吃蔬菜容易有胃癌,有人卻稱全素可以預防胃癌;但亦有指食素容易缺乏維他命B12,反而容易導致胃癌。陳亮祖說,兩種做法都是誤解,


未有資料顯示食素可以防止胃癌,部分患者是因為遺傳因素,無法吸收維他命B12而導致貧血,而非因缺乏維他命B12而導致胃癌,所以也不能說食素就會導致胃癌。

此外,坊間亦有說法指,吃太熱的食物會燙傷消化道黏膜,長此以往有機會演變成癌症。陳亮祖指︰


理論上確是如此,但實際上應該是喉嚨和食道首先出事,其實食物到達胃部需要一段時間,通常都已冷卻。









 參考資料:https://topick.hket.com/article/1989089/%E6%89%93%E5%B7%A5%E4%BB%94%E5%A3%93%E5%8A%9B%E5%A4%A7%E8%87%B4%E8%83%83%E9%85%B8%E5%80%92%E6%B5%81%E3%80%80%E9%86%AB%E7%94%9F%E6%8B%86%E8%A7%A3%E8%83%83%E7%97%85%E6%88%90%E5%9B%A0
以上所提供的資訊僅作為教育及參考用途,如果你有任何醫療問題,
應向自己的腫瘤科專科醫生查詢,而不應單倚賴以上提供的資料。

2020年6月11日 星期四

26歲女工作太忙少食一餐當減肥 食慾變差大便全黑揭晚期胃癌

三餐不定時,隨時可引致胃病。內地一名女子因工作關係,經常不按時吃飯,還將少食一餐當減肥。近日她覺得肚子異常疼痛,大便很黑並伴有便血,服藥一周後仍無改善,求醫後確診晚期胃癌。有臨床腫瘤科專科醫生表示,胃癌病徵並不明顯,發現時可能已是後期,並提醒長期吃用醃製食物、少吃菜或遺傳等可致胃癌外,三餐不定時等亦有機會導致慢性胃炎,可間接引致胃癌。

大便變黑無食慾  26歲女確診晚期胃癌

據內地媒體報道,內地一名26歲女子小溫(化名)近日晚上加班時,覺得肚子異常疼痛,上廁所時發現大便很黑並伴有便血。初以為只是吃壞肚子,遂自行服食能治腹瀉的藥物,一周後情況卻未有改善,且食慾愈來愈差,驚覺有異立即求醫,並確診晚期胃癌。

醫生經詳細問診後發現,小溫已不太記得自己多久沒按時吃飯,即使食飯都是點最便宜的外賣。小溫坦言有時工作太忙,有一頓沒一頓,更當做是在減肥,「有時候早上剩的饅頭,中午就拿來配榨菜吃,非常節省。」據悉,現時小溫已辭去工作,每天往返家裡及醫院接受治療。

胃癌病徵不明顯


臨床腫瘤科專科醫生陳亮祖接受《晴報》訪問時曾表示,胃癌病徵並不明顯,患者發現時可能已是晚期。他指胃部腫瘤有很多種,一般所指的胃癌為胃腺細胞癌,患者通常會感到飽滯、胃痛,容易出現貧血,大便呈黑色,徵狀與胃炎相似,主要以手術切除治療。

4大飲食壞習慣  可間接引致胃癌


陳醫生表示,胃癌高危因素較多,例如長期吃太鹹、醃製食物,少吃菜等,都可與胃癌有關。此外,不少都市人的生活習慣都有影響,例如三餐不定時有機會導致慢性胃炎,可間接引致胃癌。










參考資料: https://skypost.ulifestyle.com.hk/article/2501114/26%E6%AD%B2%E5%A5%B3%E5%B7%A5%E4%BD%9C%E5%A4%AA%E5%BF%99%E5%B0%91%E9%A3%9F%E4%B8%80%E9%A4%90%E7%95%B6%E6%B8%9B%E8%82%A5%20%20%E9%A3%9F%E6%85%BE%E8%AE%8A%E5%B7%AE%E5%A4%A7%E4%BE%BF%E5%85%A8%E9%BB%91%E6%8F%AD%E6%99%9A%E6%9C%9F%E8%83%83%E7%99%8C
以上所提供的資訊僅作為教育及參考用途,如果你有任何醫療問題,
應向自己腫瘤科專科醫生查詢,而不應單倚賴以上提供的資料。

2020年6月4日 星期四

How blending Western and traditional Chinese medicine can boost cancer treatment in Hong Kong

When his doctor told him that the sharp pain in his back was stage four lung cancer, Rocky Yiu, 57, could not bring himself to ask how long he had left to live. “It felt pointless asking because they practically gave me a death sentence,” he says.

Five years on, Yiu’s battle continues, aided by traditional Chinese medicine (TCM), which he believes has helped slow the spread of the disease.

The number of people diagnosed with cancer in Hong Kong is increasing every year, partly due to an ageing population. In 2016, according to the Hong Kong Cancer Registry under the Hospital Authority, 31,468 new cancer cases were diagnosed locally, while 14,209 Hongkongers lost their lives to the city’s No 1 killer.

Medical experts believe that, when used correctly, TCM might be more ideal than Western treatments for some, and it can play a complementary role in treating the condition for others. This has led to calls for more collaboration involving both forms of medicine.

Although Yiu had received 25 rounds of electrotherapy, nine months’ worth of targeted therapy and four cycles of chemotherapy, all failed to shrink the tumour in his lung.

By the time he completed the fourth cycle of chemotherapy, the tumour had grown from 5cm to 8cm. Yiu stopped all Western medical treatment, but continued with TCM, which he had been using to manage the side effects of the cancer treatment.

“Targeted therapy left my skin so sensitive that I couldn’t use warm water in the shower, not even during winter. TCM helped reduce the sensitivity, and also helped me manage the pain, constipation and tingling sensations from Western treatments,” he says.

During a check-up in 2016, six months after he discontinued chemotherapy, his doctor noticed that the growth had shrunk back to 5cm. Yiu credits TCM with the good news.

Although his prognosis still looks bleak – the cancer has spread, causing him pain in his bones and constipation – he says TCM has kept the more dire consequences of his illness in check.

Yiu’s TCM practitioner Tina Lee, who works at Tung Wah Hospital, says that because his cancer was advanced, her treatment plan was to help him improve his quality of life, and to counter some of the toxins left from the chemotherapy and targeted therapy.

“TCM is about promoting overall health, disease prevention, and boosting the body’s ability to heal to achieve harmony and balance,” Lee explains.

“But TCM has its limitations. We can’t determine whether a person has cancer just by taking their pulse or asking them a few questions. Patients are always diagnosed by Western medical methods, such as blood tests, biopsies and scans.”

Dr Liu Yulong, principal lecturer at the Baptist University’s School of Chinese Medicine, adds: “We wouldn’t encourage patients to rely solely on TCM for cancer, unless they are very old or too weak to endure conventional cancer treatments, such as chemotherapy.”

Liu says TCM could help some patients complete their Western treatment as planned. “TCM can help them manage their side effects so they can finish their cycles on time, which is essential to recovery.”

Dr Chan Leung-cho, a specialist in clinical oncology, agrees. He says TCM can help relieve nerve problems and dry mouth resulting from chemotherapy.

Chan and Liu both practise at the Hong Kong Anti-Cancer Society Dr and Mrs Michael S.K. Mak Integrated Chemotherapy Centre, which has been offering integrated Chinese and Western services since 2012. Both doctors have served some 400 patients.

Chan believes clear and direct communication between TCM practitioners and doctors is key to designing a successful integrated treatment plan for patients.

“Doctors of Western medicine are often worried something might go wrong if their patients also take TCM because they don’t know much about it – I don’t either. And patients may not be able to properly convey the kinds of treatment they’re undergoing.”

While Chan warns that patients can run serious risks if they withhold information about their TCM treatment from doctors, both he and Liu agree that Hongkongers could benefit from more direct collaboration between TCM and Western medicine.

In 2014, the Food and Health Bureau launched the Integrated Chinese-Western Medicine Pilot Project to study the operations at government hospitals.

The findings of the programme would help officials formulate the model for the city’s first Chinese medicine hospital, which is expected to open in late 2024.

“We want to show patients that integrated medicine can help them, and convince sceptical Western doctors that TCM can help their patients.

“It’s not about choosing sides, but what we can do for patients,” Liu says.

Yiu’s TCM practitioner Lee says she thinks this could also help patients identify trustworthy TCM practitioners, instead of turning to expensive and unlicensed healers.

“On the mainland, there are many hospitals with integrated Western and Chinese medical services. I think Hong Kong should follow its example.”

As for Yiu, he is trying to find hope in the time he has left.

“Sometimes I get better, which gives me hope. Then the pain comes back. I know it’s too much to ask for a miracle. All I can do now is treat every day as a reward.”










Reference information: South China Morning Post
The information aims to provide educational purpose only. Anyone reading it should consult Oncologist before considering treatment and should not rely on the information above.

2020年5月27日 星期三

癌症康復者重踏職場路難行

近年治癌藥物成效更好,癌症病人有更高存活率,可是活下來,卻要面對職場上的難關。有曾任職物業管理的癌症康復者,完成治療後,求職時主動「降職」,人工要求大減一半,可是面試來到最後階段,僱主卻因她過去的癌病而「變臉」。有癌症關注組織直言,近年愈來愈多康復者需面對「第二人生」,可是花光積蓄治病後,才發覺已經無法重踏職場,生活更艱難。 

八十後唐天鳳原在物業管理公司擔任高級物管助理,有四年工作經驗,主要負責接收電話投訴、查詢、文書等工作。一三年,她確診何傑金氏淋巴癌,花了一年多時間治療,直到一五年再度求職時,發現重拾昔日生活波折不斷。

求職薪金減半 仍難求一職

她為求重投物管行業,刻意申請人工較以往低一半、職級降一級的職位,未向面試人員表達自己的病歷時,順利過了第一關,「面試過程一直都好正常。」不過,來到第二輪面試,她提到自己是康復者時,面試人員立即「變臉」,問她長時間工作會否有問題、要不要經常請假等。唐天鳳說:「其實我相隔兩三周朝早才去看中醫一次,請假不會太多,而且我工作能力根本無問題。」

物管常被指是朝陽行業,唐天鳳也說行內經常請人,不料該物管公司仍然轉軚不請,「見完工之後覺得自己好失敗,哭了出來,以後不敢再見工。」她坦言,人力資源部為免被老闆質疑聘請原因,自然不會嘗試聘請癌病康復者,在此情況下,康復者求職之路寸步難行,「有得請都揀個正常的。」

唐天鳳的故事只是冰山一角。社企癌症資訊網創辦人吳偉麟說,以往患癌等於生命走上了末路,惟近年隨着醫療技術進步,病人有更大機會康復,也有更多康復者踏上求職路,「十年前很多病都無藥醫,我們不用討論康復者的求職之路,但現在存活率高了,康復者如何面對第二人生,成為重要問題。」

社企指配套不足 難重投社會

近年病人可以得到精準醫療,針對性藥物也愈出愈多,吳偉麟說,病人為求延續生命,會採取更好的治療方法,惟光是買針對性藥物,每月花費已達五至六萬元,部分治療方法,更要月花十萬元,在工作缺乏保障下,生活更為艱苦,「近幾年新藥愈出愈多,效果理想,可是價格高到中產都付不起。」

他認為,癌症病人及康復者,更需要工作,以支持其經濟收入,而不少癌症康復者患病前是專業人士,康復後工作能力無大分別,只是不想再像以往一樣承受壓力,長時間工作,而會更着重工作和生活之間的平衡,「例如以前做老師的人,康復後或不能再企足一日,但教學生其實無問題。」

不過,他認為本港各大機構,仍未有足夠配套讓康復者重投社會,「各公司老闆還是覺得打工仔應該二十四小時工作。」他續說,政府外科病如肢體殘障,尚能得到政府支援,惟內科病康復後,社會反而會歧視,「如果政府能帶頭宣傳和聘請癌病康復者,社會上各機構會更留意這個問題。」

臨牀腫瘤科專科醫生陳亮祖亦說,癌症病人經治療後,仍然會擔心自己「異於」常人,將來會復發,對自己失去信心,「找工作時要面對僱主都好困難。」對於治癌藥物,他則表示新出的藥物價格高昂,惟為了治療順利,病人也只能盡力試用,經濟負擔變得沉重。









參考資料: 星島日報
以上所提供的資訊僅作為教育及參考用途,如果你有任何醫療問題,
應向自己的腫瘤科專科醫生查詢,而不應單倚賴以上提供的資料。

2020年5月26日 星期二

放射治療期間的皮膚護理






  •      食物切忌過熱或太冷。
  •     避免辛辣、太酸及油膩之食物。
  •     如吞嚥有困難,可先將食物攪碎,製成糊狀,方便吞嚥。
  •     多喝飲料,補充水份。
  •     少食多餐,以利消化。
  •     額外飲營養奶以補充熱量。
  •     若同時需接受化學治療之病人,可能會有味覺改變的情況,可吃略帶酸味的糖果以刺激食慾。
  •     香薰治療亦可增加食慾,可在進餐前吸入檸檬精油,或以新鮮檸檬刨皮後吸入,亦可獲得相同效果。
  •     戒煙,避免酒精類飲品。









參考資料: http://www.cancerdoctor.hk/radiotherapy-nutrition.html
以上所提供的資訊僅作為教育及參考用途,如果你有任何醫療問題,
應向自己的腫瘤科專科醫生查詢,而不應單倚賴以上提供的資料。

2020年5月21日 星期四

乳癌患者罨草藥延誤治療不治 醫生拆解乳癌謬誤 (下)




隆過胸更容易患上乳癌?

理論上不會。從前一種用作胸部整形手術的物料「矽膠」,因安全問題被回收;另外,某些物料因其化學物質容易滲入乳腺組織,增加乳腺發炎的機會,長久的慢性發炎會增加致癌風險。如使用一些通過國際品質認可的胸部整形物料,一般是安全的。


患上胸癌一定要切除整個乳房?


不一定,主要視乎腫瘤大小、數量及分布位置。一般而言,全乳房切除適合腫瘤較大或接近乳頭,或癌細胞出現於不同部位,或已影響皮膚的患者。醫生會將整個乳房,連同腋下的淋巴腺一併切除。

至於乳房保留手術,則適合腫瘤較小及生長在乳房外圍的患者,醫生會將腫瘤及周邊組織切除,並作腋下前哨淋巴取樣檢測,手術後輔以放射治療。

另外,部分患者可於手術前進行前置化療,縮小腫瘤後才以手術切除,可增加保留乳房的機會。

《癌症謬誤100解 ─ 把握治療黃金期》


癌症患者不可吃雞肉?鹼性體質可防癌?治療期間不可做運動?輻射跟著你回家?

市面上大量的癌症謬誤模糊了大眾對癌症的了解,甚至延誤了病人治療的黃金時間。因此癌症資訊網推出 2017 新作《癌症謬誤100解:把握治療黃金期》請來臨床腫瘤科陳亮祖醫生拆解 100 個常見的癌症謬誤,釐清各項相關資訊,讓病人不再錯過治療黃金期。此外,書中亦請來 8 位癌症同路人分享抗癌經歷,為一眾同行患者打打氣。本書收益將不扣除成本全數捐贈予香港防癌會。




參考資料: https://topick.hket.com/article/1860550/%E4%B9%B3%E7%99%8C%E6%82%A3%E8%80%85%E7%BD%A8%E8%8D%89%E8%97%A5%E5%BB%B6%E8%AA%A4%E6%B2%BB%E7%99%82%E4%B8%8D%E6%B2%BB%E3%80%80%E9%86%AB%E7%94%9F%E6%8B%86%E8%A7%A3%E4%B9%B3%E7%99%8C%E8%AC%AC%E8%AA%A4
以上所提供的資訊僅作為教育及參考用途,如果你有任何醫療問題,
應向自己的腫瘤科專科醫生查詢,而不應單倚賴以上提供的資料。

2020年5月20日 星期三

乳癌患者罨草藥延誤治療不治 醫生拆解乳癌謬誤 (上)

乳癌是繼肺癌和大腸癌之後,本港女性第三位致命的癌症。不過不少人對乳癌有疑問,如有傳穿戴不合適胸圍會增加患癌風險,或以為患癌就一定要切除整個乳房。臨床腫瘤科專科醫生陳亮祖花大半年時間撰寫《癌症謬誤100解—把握治療黃金期》一書,希望為大眾,尤其是癌症病人釋除疑慮。


陳亮祖醫生指,曾有一名病人被診斷患上乳癌第一期,手術切除9成可根治,但她卻不願接受西醫治療,堅持看中醫及自然療法。

   
罨草藥幾個月,她的腫瘤由小於2cm增大至穿過皮膚,已擴散至第4期,最後一年多後就過身了。

因此把握時機接受治療十分重要,否則癌症擴散後就更難根治。以下為書中提及有關乳癌的迷思:


穿戴不合適胸圍會增加患癌風險?


這是沒有根據的說法,穿戴不合適胸圍只會令人不舒適,但不會增加患乳癌風險。患乳癌風險因素包括:

    近親中有50歲以下的乳癌患者,如母親、姊妹或女兒
    初經發生在12歲前、更年期停經出現在55歲後
    從未生育或35歲後才首次生育
    接受荷爾蒙補充療法達5年以上
    有吸煙或嗜酒習慣
    運動不足(每周少於3小時)
    帶有遺傳性的BRCA1或BRCA2基因變異

............續









參考資料: https://topick.hket.com/article/1860550/%E4%B9%B3%E7%99%8C%E6%82%A3%E8%80%85%E7%BD%A8%E8%8D%89%E8%97%A5%E5%BB%B6%E8%AA%A4%E6%B2%BB%E7%99%82%E4%B8%8D%E6%B2%BB%E3%80%80%E9%86%AB%E7%94%9F%E6%8B%86%E8%A7%A3%E4%B9%B3%E7%99%8C%E8%AC%AC%E8%AA%A4
以上所提供的資訊僅作為教育及參考用途,如果你有任何醫療問題,
應向自己的腫瘤科專科醫生查詢,而不應單倚賴以上提供的資料。