Tuesday, June 9, 2009

STI: Sleuth on the prowl

June 4, 2009

The Pro

Sleuth on the prowl

Dr Quek Swee Chong, 45, a senior consultant at the department of gynaecological oncology, KK Women's and Children's hospital, tells POON CHIAN HUI why an abnormal Pap smear result is like evidence that a crime has been committed

I decided to specialise in gynaecological cancer prevention because...

Many women suffer unnecessarily from cancer as they are unaware that there are simple tests to prevent it. For instance, cervical cancer is almost completely preventable. Despite this, it still affects more than half a million women worldwide every year.

In the early years of my career, a close friend from school died of cervical cancer before she turned 30, leaving behind a young child.

The cervix is fascinating because...

It is the part of the female reproductive tract that undergoes the most changes in a woman's life. During puberty, the cervix matures and expands, allowing menstrual blood to flow through. During childbirth, it dilates from less than 1cm to 10cm to allow the baby to pass through.

Unfortunately, it is most susceptible to infection by the Human Papillomavirus (HPV). Certain strains of HPV are known to cause cancer. While the infection is very common and usually resolves without problems, in some women, HPV causes cervical cells to change into pre-cancer cells and eventually to cancer cells.

If I were to give an analogy for what I do, I'd be a...

Crime scene investigator. A major part of my work involves an examination called colposcopy, which is done for women with abnormal Pap smear results in order to find out what is wrong. In a sense, the Pap smear indicates whether a 'crime' has been committed and the colposcopy pinpoints the location and identifies the 'culprit'.

I have come across all types of cases...

Cervical cancer does not respect age nor station in life. My patients come from all walks of life, from as young as 16 years old to as old as 80.

A typical day for me would be...

My 13-year-old daughter Rachel wakes me up at 6.45am to kiss me goodbye before she goes to school. Breakfast is a rushed affair while reading The Straits Times.

I arrive at the hospital at 8am. I see patients in the wards and outpatients in the clinic. Afternoons are spent in the operating theatre, where I perform laser treatment, Caesarean sections and other gynaecological surgery. I also teach medical students, nurses and doctors once or twice a week in the evenings, sometimes over dinner.

Otherwise, I try to get home for dinner by 7pm and to play with my four-year-old daughter Olivia before she goes to bed.

To the annoyance of my wife Karen Tan, 42, a theatre actress, I usually fall asleep in front of the TV until the 9.30pm news comes on. I work on the computer from 10pm to 1am before going to bed at 1.30am, unless I am called to attend to a delivery.

I love patients who are...

Open-minded and have realistic expectations about their treatment. It also helps if they are chatty because talking makes them more relaxed.

Patients who get my goat are...

Those who come with a stack of Google search articles and insist on going through every page.

One little known fact about cervical cancer is...

It hardly ever occurs in women who have not had sex. They do not need to have Pap smears but will benefit from HPV vaccination which protects them from future infections when they start having sex.

Things that put a smile on my face are...

The look of relief on patients' faces when I tell them that abnormal Pap smear results do not mean that they have cancer; when they realise that the colposcopy examination is not painful; and when I tell those who have had cancer that they are cured of it.

It breaks my heart when...

I have to tell a patient and her family that she has cervical cancer. It means we have somehow failed to get the message across that such cancers are preventable.

I wouldn't trade places for the world because...

I love my job.

My best tip...

If you are sexually active, have regular Pap smears once you reach 25 years of age. Secondly, ask your doctor whether the HPV vaccination is suitable for you.

chpoon@sph.com.sg

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