Cancer during pregnancy is a rare condition. We report here a case of a lady diagnosed with nasopharyngeal carcinoma (NPC) at University of Malaya Medical Centre during her first pregnancy conceived via In Vitro Fertilisation (IVF). A multidisciplinary (MDT) meeting among Oncology, Obstetrics, Rheumatology and Otolaryngology teams was conducted to discuss her treatment options. She opted for treatment with Complementary and Alternative Medicine (CAM). This case illustrates the unique challenges in the oncological management of a patient diagnosed with NPC during pregnancy. It also serves as a reminder that the use of CAM in cancer patients is prevalent. It is important for doctors to inquire about use of CAM and to be well-informed about it. Transparent communication and taking cognizance of the goals and concerns of the patients are essential in delivering patient-centred care.
Adjuvant breast radiotherapy is offered to patients with localized breast cancer. We performed a retrospective review of older women receiving adjuvant breast radiotherapy in University Malaya Medical Centre, Malaysia (UMMC) in 2014. Out of 191 women, 23% (43) were 60 years old and above. At a median follow up of 6.6 years, 4.6% (2) had local recurrence and 19% (8) distant metastasis. In a subgroup of low risk older patients with hormone-sensitive, HER2 negative, T1N0 disease, all (3/43) are still alive with no local recurrence. We propose further research for treatment de-escalation in low risk elderly patients.