Preventing Premature Death

This write up on the particular product is based upon the author's own initiative, and not being influence in any way or given any remuneration in any form or manner by the manufacturer of the product. The views given are based upon medical journals conducted and information written here are from medical articles found by the author's effort and had not being helped in any way by the manufacturer.

Mankind and disease has come a long way and through out the course of history, humans had faced multiple diseases which were pandemic and had claimed millions of lives. Some of these deadly disease were so wide spread and claimed a biblical amount of lives worldwide that some faith believe it was the wrath of God. These deadly disease includes The Black Death, poliomyelitis,malaria,smallpox,cholera,Ebola,Bubonic plaque,The Spanish Flu, Influenza, and AIDS. History is marked with significant achievements that is forever immortalized as highlights in the course of science and medicine with discovery of vaccines that protects and prevents, and medicine to cure and control some of these deadly diseases that inflicts mankind. While most of the diseases I've mentioned can be prevented, while some has totally been eradicated, unfortunately there are those that its treatment or prevention are yet to be discovered. I believe it's just a matter of time before it's discovery. A promising fact is the nature of these diseases is known, and while medicine for cure and prevention is yet to be found, its methods of prevention is known.

At present the three most feared diseases with no known cure if influenza, AIDS, and cancer. 

While there are antiviral drugs and vaccines that were developed for previous influenza attacks, yet new mutated strains emerges from time to time. The latest being H1N1, and not too long ago SARS. While HAART(highly active antiretroviral treatment) regime prolongs and increases the quality of life, it's not curative. The quest for its vaccine is currently under research with it's recently published human trial on HIV type B and E, conducted in Thailand indicated 26% drop in infection rate. A promising number, yet far from being deemed an effective one.

Advancement in the field of medicine has come a long way with its progress forges on in steps.It's progress occasionally occurs by leaps and bounds with discoveries of vaccines and medicine that cures. One of the most significant moments as such by the turn of the century is the discovery of vaccine for cancer. 

(there are currently 2 brands available in the market for Cervical Cancer Vaccine, Gardasil by MSD, and Cervarix by GSK)

Perhaps(in my opinion) the fact that mortality rate and statistics presented in figures, percentages,and charts in medical conventions or symposium to highlight the impact of the disease on us fails to convey to doctors that cancer is a disease that affect the patient as well as the family members psychologically, financially, and emotionally,and not just merely numbers and figures. 

 From time to time, pharmaceutical company organizes symposiums and medical conventions for the purpose of sharing new data on latest studies conducted, it's efficacy, latest figures in mortality for a given year. 

 

Most presentation are on facts and figures, presented in the form of charts and graphs. These symposiums automatically becomes "logistically" orientated, instead of "patient" orientated.  

Personally(As this is purely a personal blog, contents of this write up is based on facts and figures presented are from the pharmaceutical company as well as independent health organizations. However opinion deducted is entirely based on the author's own personal opinion)  I feel these presentations ought to be more patient orientated. Instead of showing slides with charts and graphs, which I doubt interests majority of doctors present, they should perhaps consider showing this instead:-

Why can't medical conventions highlight upon the humanity side of the patient? Very often doctors forget the essence of medicine, their role in society, the impact they have on the patient and their family members, that certain decision which was made with much cavalier actually at times determines the outcome of patient's life. 

(Again, I would like to remind fellow readers that this post is written based on my personal point of view,ideas, and opinion. It may not be applicable for general public whether sharing the same profession or not. THIS IS A PERSONAL BLOG)

Perhaps one wouldn't understand why am i being so excessive in this matter. I wouldn't view it as being excessive. I think it's my deep rooted passion on this revolutionary discovery . Come on! This is cancer we're talking about. The disease that kills more than half a million woman worldwide out of which more than 270,000 is from Asia. A disease that potentially occurs on every woman irrespective of race, social status, religion, and age. Its a disease that reportedly affect approximately 4700 woman annually.  

Don't the public realize the impact this discovery has? It's advancement in medicine by leaps and bounds, it's a milestone in human history. My previous post, I mentioned that it's significance is in par with the landing of the first man on moon. I would like to rephrase that. It's more important than the landing of the first man on moon. Did Neil Armstrong "one step of man, giant step for mankind" save any live?? NO!!

I remember back in early 2006, when the first cervical cancer vaccine, Gardasil was launched. Not many doctors(mostly GPs) was keen on promoting this product for several factors. First, the doctors themselves aren't well versed to provide counselling to potential recipients, being the first of its kind- the price was most of the time unaffordable by middle class income group, even those who can afford it had to think twice as it cost  between RM1600-RM2400 for complete vaccination, and last but not least, it's difficult to even begin introducing the vaccine to patients as they perceived that the doctor have the impression that they lead a sexual promiscuous life. 

Personally,I felt the pharmaceutical company who manufactured this product which IS revolutionary that marked man's first step in the effort to have control over cancer, a disease that one shudders and dreaded upon being diagnosed to have and totally change the perspective of one's view towards life, shouldn't have put such an unaffordable price tag.

There's nothing wrong being financially orientated. Hey, which stake holders wouldn't want that? I wasn't forming any opinion in my head when Viagra was launched in 1998. No one dies as a result of erectile dysfunction. They can charge a few hundred dollars a tablet for all I care, but when it comes to life saving drugs, I felt there is a moral obligation one needs to consider. Cancer accounts for 14% of causes of death worldwide. Cardiovascular disease ranked 1st in the cause of death for many years, but it is primarily a disease that stems

from the lifestyle, which is within one's ability to control. Right from the beginning I felt it's morally wrong to commercialize such product, making it into a drug of exclusivity.

A significantly huge percentage of people cannot afford this vaccine, even if they genuinely longed for it. But it's a fact of life. Only the rich and financially capable group enjoys better health care. Why is that so?  Just because one is poor, does it mean they aren't as humane as the upper class people? This is absolutely ridiculous!

There are many opportunity to earn a good financial return, but to my opinion, by simply hike up the price since there is no competitor is a simple act of exploitation. 

I was most delighted when another well respected pharmaceutical giant came out with their own vaccine,Cervarix.

Right in the early phase after the launch of Cervarix, the manufacturer announced their intention to lower the cost price, with the intention of making this vaccine affordable to the masses.Cheers to this company! This company is known to produce superior quality medical products. Another product from this company that I endorse in the midst of H1N1 pandemic would be Relenza. This product is far superior than the alternative Tamiflu. Why?

Why not you google or read on Tamiflu's side effect in Wikipedia? You wouldn't even want it even if it's being given free to you!

the fact that the company decides to lower the cost price shows that being a pharmaceutical company where their products contributes to health care, they uphold their integrity and nobility, when their version of cancer vaccine is far superior than the previous in so many expects, could have easily raise the price a higher, but they chose not to. 

 

 Immediately, I knew without doubt this product would definitely be my choice. Right from it's pricing, awareness campaign, continuous support provided towards doctors, the multiple symposiums to keep health care workers up to date with the latest data on the product, their efficacy,degree, and duration of immunity,etc... are by far more superior to the previous.......by many folds i might add!

Good patient information pamphlet.

Excellent support to doctors.

Regular symposium organized for latest updates.

its superior quality acknowledged and approved by renown leaders in Gynaeoncology...

Regular updates by the medical representatives that supports the doctors....

 Though being advertised as a bivalent vaccine, it gives protection against the 5 most high risk cancer causing subtypes of Human Papilloma Virus.(HPV).. while the previous provides immunity to only 2 subtypes.

It's unique formulation in making this vaccine that is by integrating aluminium hydroxide that acts as an adjuvant to boost up and maintain body's immunity for at least 20 years... I say again, AT LEAST 20 YEARS! The use of aluminium hydroxide is the first of its kind in Malaysia. The only other vaccine that uses the similar adjuvant is vaccine for Hepatitis B in Europe that is designed for immunocompromised patients.

Now tell me which among the two would you chose?

Why am I being so passionate about this matter? Why am I so concerned about this issue? 

Perhaps my direct encounter with family members of patients who had succumbed to cervical cancer, despite Pap Smear reported negative/normal. I felt their sense of frustration as to how is it possible when they undergo annual Pap Smear religiously. The question kept on lingering in the mind of family members as to why and how it  happened so suddenly?

How was it possible when the report came back normal? When there's no history of cancer within the family? It was apparently clear to me the distress and psychological trauma they had gone through seeing their helpless sister,wife,daughter, or wife dying. They just simply couldn't accept the fact. That they must be some mistake. There was no and will never be a closure for them.

At the same time, maybe perhaps due to the fact that I had experienced first hand how it felt like to have your own family member being diagnosed to have cancer and the traumatic one sided battle that dampens your spirit, leaving behind psychological and mental scars seeing your love ones dying as time passes by. The repeated hospitalization, the regrets that you have not lived a fulfilling life with them, and now being too late.

My aunt recently passed away from pancreatic tumour. I diagnosed her with possible pancreatic tumour when she came to me with post hepatic jaundice. 

I remember praying hard that I made the wrong diagnosis. Sadly, it was confirmed to be carcinoma of head and body of pancreas after CT Scan of abdomen being done in Selayang Hospital. 

It was heart wrenching to see my aunt getting emaciated each time she sees me from time to time. I stood by her deathbed during those final hours of her life. I see how the pre mature passing of her has affected my uncle whom I was with just last week and told me he has difficulties sleeping at night. No matter how hard he tries to hide his feelings, its rather obvious that he's traumatized by her passing. My cousin told me he would suddenly break into tears. No medication, sleeping aid, anti depressant, or anti anxiety can relieve the pain he is experiencing. 

I do not wish anyone else whether I know or don't to experience the same thing as any cancer patient and their family members endured. 

Right from the beginning, my inner consciousness tells me it's the right thing to do to make this vaccine affordable to all walks of life. 

It doesn't matter if I do not profit from this vaccine. What else is more satisfying and gratifying than knowing that you are living in an era that witnessed the discovery of a vaccine against a disease that previously deemed incurable and certain death for those who were diagnosed to have? Not only am I privileged enough to be living in this era, but to be given the opportunity to contribute to create awareness among the community on the importance of prevention of this killer disease. It's history in the making, and being part of it is certainly an opportunity not to be missed. 

When I announced that I am charging RM165 per dose, i received mixed reactions almost immediately.

I was sort of frustrated as despite the lowered price, not many people are interested to even inquire about it! 

Perhaps maybe the community do not realize how rampant the incidence of cervical cancer is. Maybe perhaps they weren't aware as they weren't informed by their doctors? Maybe it's the common attitude that ignorance is bliss and the delusional belief that it would not happen to them. Having such thoughts is akin to playing Russian Roulette! No kidding! It's like holding a revolver to your head hoping each time you pull the trigger, it would be an empty chamber. 

I have written numerous post in my blog, repeatedly emphasizing the importance of vaccination. It doesn't matter if I had to post repeatedly, as long as I am able to reach out to the public, I knew I had contributed to decreasing cervical cancer morbidity and mortality, even by an insignificant amount. 

The challenge of creating awareness among the public and to educate them became personal to me. Don't ask me why. Soon I begin to realized why am I not able to reach out to public. 

First of all, significant number of those who are considering the vaccination thought they would need to perform a Pap Smear prior to vaccination. -- NO YOU DON'T HAVE TO!!

Second factor being, they feel obliged to be followed up by me since they got vaccinated here!--NO YOU DON'T HAVE TO!

I insist that they can continue to be follow up with their regular doctors and not at all need to feel obliged to be follow up by me. However I always insist that they should ask for a Thin Prep pap Smear instead of conventional Pap Smear as it is significantly more accurate in detecting adenocarcinoma. 

Reason being conventional Pap Smear is not reliable in detecting adenocarcinoma as the sampling method is faulty. Thin Prep Pap Smear is an improvised version of Pap Smear. 

Notice the ectocervix and the endocervix? Adenocarcinoma is tumour that mostly arises from the inner part of the cervix, the endocervix, where conventional Pap Smear is unable to get a good sample. 

Wooden spatula used in conventional Pap Smear that fails to get a good sample from the endocervix and while smearing the sample onto the slides, only 20% of the collected samples are deposited, while the other 80% is left on the spatula.

The answer to the false negative from conventional Pap Smear.

The brush used in Thin Prep Pap Smear is designed for a more effective sample collection. I know what is in your mind now.THE ANSWER IS NO, ITS NOT ANY MORE PAINFUL THAN CONVENTIONAL PAP SMEAR.

So,please next time insist on Thin Prep Pap Smear. The fact is, not many doctors especially general practitioners are aware of the availability of such test. 

According to head of Cytology and Histology Department, Gribbles Lab(Malaysia), out of the samples they received, only 30% are Thin Prep Pap smear, out of which only 20% out of those Thin Prep Pap Smear samples are from General practitioner.

Its an alarming fact that indicates the depth on knowledge general practitioners have on Cervical Cancer and it's screening. 

What is more alarming is the fact that 8% of the doctors who attended a symposium on Cervical Cancer held at Le Meridien Hotel recently were strongly against vaccination of girls age between 10-15 years old! Aiikk!! that is the best time to vaccinate, before their first intercourse.

Determined to be more pro active, I thought perhaps woman who were contemplating the vaccination but holding back at the fact that it's being done by a male doctor, hence shy away.  

I've made a new poster announcing that our clinic provides free counselling, and if you feel hesitant on seeing me, you could always check out the URL written in blue. 

I've also prepared a notice informing passerby to snap a picture with their handphone  in case they can't remember the UR

Another reason for the low reception was the fact that the price I offered was so low that some actually question whether do I use the "real product"! No. That's a sensible, reasonable doubt to have considering my unreasonably low price! You SHOULD HAVE DOUBTS! 

One way to ensure you are receiving the genuine product is to insist on the doctor to open the box containing the prefilled syringe right in front of you.

Inside the box, the prefilled syringe comes along with 2 needles.Please take notice of the colour or the needle. One Blue and One Orange. Both the needles and the syringe is sealed with another layer of plastic. Make sure the doctor peel out the plastic IN FRONT OF YOU!

Don't feel awkward in insisting to inspect the syringe and its content. The vaccine is not entirely clear and transparent. It's a has a little murky look. 

The moment you decide to get the vaccination, you have already taken a huge step in preventing cervical cancer. Now that you are sitting in the consultation room, made sure that the doctor opened the box, peel the plastic, connect the needle, and had inspected the colour of the vaccine, you are 95% sure that it is the genuine stuff. But to be 100% sure, well, I know its silly but out of so many times you've received vaccination which was administered through intramuscular injection, I would assure you that you had received the original stuff when you notice this vaccination is OUCH!! more painful compared to others, due to its formulation, aluminium hydroxide. 

This is as far as I can think of in my effort to reach out to the public to create awareness  in the importance of getting vaccinated. 

GO TO YOUR NEAREST CLINIC THAT OFFERS VACCINATION FOR CERVICAL CANCER TODAY!

How accurate is the conventional method of screening for Cervical Cancer?

This post is written based upon the observation and personal experience of the author, and not influenced by means of payment or any other form of remuneration by any pharmaceutical companies or parties.
With the discovery of Pap smear more than 50 years ago, death due to cervical cancer has been reduce significantly throughout the years worldwide. With the production of first ever Cancer vaccine back in February 27,2006, it marked  a milestone in the history of medicine where personally I felt its significance is in par with the landing of the first man on moon.
With the second vaccine produced by pharmaceutical giant, GSK, it added on to the arsenal at our disposal in the fight against cervical cancer. However, despite these development over the years, even with the marked reduction of mortality, it makes no difference to the family member and patients who was diagnosed with this killer disease.
Somehow, with the presence of these vaccines, some individuals developed this false sense of security that their immunity against cervical cancer last forever, in actual fact false. These vaccines prevent future infection of HPV(Human Papilloma Virus), but does not cure the already existing HPV.
Though vaccinated, one still needs to be screened annually. Last year alone, I had three patients who has sisters who never missed any of their annual Pap Smear, and each time was told to be normal, unfortunately, 5-6 month later, died of cervical cancer.
Despite the marked reduction of occurrence over the years, it makes no difference to these family members and victims who had succumbed to this killer disease which is currently ranked number 2 as the cause of death among women.
In my previous post, I had wrote on why Cervarix is far superior to Gardasil.

Deciding on getting the vaccination done is by far one of the best decision made in a woman's life. If you have decided to totally avoid from contracting this killer disease, vaccination MUST be followed up with annual Pap smear.
Unfortunately, the conventional Pap smear which most clinics perform have a high incidence of false negative. (when a patient have an early changes in the endocervix, which conventional Pap smear fails to detect, and hence its reports comes back as normal)
Such error is tragic to the victim and their family member.

Error occurs especially when cervical carcinoma arises from the inner part of the cervix, where conventional Pap smear's methodology of sampling is relatively poor, hence yields an inaccurate result, which gives a false sense of security to the unfortunate patient. This form of cervical carcinoma is called cervical adenocarcinoma.

While sampling from carcinoma that arises from the ectocervix as illustrated on the diagram above, cancer arising from the endocervix is not easily detectable.

A conventional Pap Smear kit.

The sampling is done using a wooden spatula which is then smeared on a glass slide, which then "fixed" with a chemical called cytospray which then is then looked at under a light microscope by a pathologist.
This method is proved to have high incidence of false negative due to several factors:-
1.majority of cells not collected
2.Non- representative transfer
3.Clumping and overlapping of cells
4.Obscuring materials
Hence since 1996, an improvised version that lessen the false negatives up to 30% was introduced. It is called Thin Prep Pap Smear.

The Thin Prep Pap Test is a liquid-based pap test that employs a fluid transport medium to preserve cells and an automated process to eliminate debris and distribute a representative portion of cells on a slide in a uniform, even layer. A Thin Prep Pap Test slide is clearer, easier to read, and minimizes obscuring blood, mucus, and non-diagnostic debris, enabling increased accuracy for both manual assessment and computerized assessment of the cells. The Thin Prep Pap Test process improves the quality of the sample, preparing a slide that is more appropriate for diagnostic review.

The additional advantage of Thin Prep Pap Smear is that if there exist any abnormality in the cytology report, the same sample can be sent for HPV DNA testing to determine the subtype of HPV(Human Papilloma Virus), or for further test for sexual transmitted diseases.

Hence ladies, with the availability of an improvised Pap Smear, insist upon it to your doctor that you want this method instead of the conventional Pap smear.

Cervical Cancer Vaccine...

I have written several post on Cervical Cancer in my blog as I felt the need to create an awareness among the public on how rampant it is, being ranked number 2 killer among causes of mortality among women in Malaysia.
However, I felt the level of awareness is still very limited, and despite our effort of lowering the price down to RM165 per dose(there are some clinics that charge RM500 per dose), very few number of women showed interest.
With the availability of Cervarix, which personally I think is far superior compared to Gardasil, women now have a choice, on which to chose from. Unlike several years ago when Gardasil was first launch, being the only cancer vaccine available, the price wasn't affordable to the masses. Unfortunately, despite such drastic price reduction purely for the purpose of providing an excess towards a more affordable health care, many women still remain ignorant.

Cervarix even though being advertised as being a bivalent vaccine, (provides immunity to two subtypes of HPV that causes Cervical cancer), latest date shown that it provides cross protection against three other subtypes,hence making it actually a pentavalent vaccine!)

Initially being advertised that it provides protection against HPV type 16, and type 18, now data shown that it provides additional 3 subtypes, that are type 31, 33, and 45. (the top 5 most oncogenic types)
Unlike Gardasil, it uses an adjuvant in its formulation, AsO4, which gives a rapid and a prolonged immunity against these viruses.

As you can see, cervical cancer being ranked second amongst all cancer as well as overall that affects women.

It's prevalence is the most between the age group of 30-60 years old. Note that quite a significant figure is from the age group of 70s and more.

Hence, since the recommended period of injection for Cervarix is between the age of 10-45, I would still recommend injection amongst the age group exceeding 45 years old.

Cancer does not recognized age of its victim. It spreads and kills irrespective of age.

In Klinik Wan dan Keluarga, we council patient's on importance of getting vaccinated.

Do not procrastinate anymore. While being a revolutionary drug that made a mark in the milestone in the field of medicine, it still receives poor response, unfortunately.

So,ladies, get your jab right away. Never think that it can never happen to you.

I bet Anita Mui and Farrah Fawcett never thought they would contract cervical cancer, until when it's too late.

New Data on Cervarix

**This post is written based upon the author's personal view, and not sponsored nor received any form of incentives by the respected pharmaceutical company.**

It has been known to be of utmost significance, at par in my opinion to the landing of the first human on the moon  back in 1969 as in the field of medicine, the discovery of the first ever vaccine against cancer. February 27 2006 marked as a milestone in the history of medicine when the first ever Cervical Cancer Vaccine, Gardasil, was launched. It was advertised as a tetravalent vaccine, which means it provides immunity against 4 subgroups of HPV virus,(Human Papilloma Virus)subunit 6,11,16, and 18. 
There are over 100 subgroups of HPV identified and each is given a number. 
Generally, HPV virus is divided into oncogenic and non oncogenic groups. HPV is transmitted through sexual contact. Based on a study conducted locally, more than 70% of women would have experienced sexual intercourse before the age of 25. While 70% of HPV resolves by the first year and 90% resolves by the second year, the other 10% stays within the skin and lays dormant for years. It does not travel within the bloodstream, hence undetectable by blood investigations. When Gardasil was launch, it was accepted worldwide, but not without controversy.Some school of thoughts claimed with the vaccine it gives a false sense of security that encourage sexual promiscuity amongst young women. 
As mentioned earlier, HPV is classified either oncogenic or non oncogenic. Subgroup 16,18,31,45 being the highest risk, 33,35,39,51,52,56,58,59 being high risk, and 26,53,66,68,73,and 82 being classified as probable high risk. 
The others cause genital,plantar,or anogenital warts.
In 2009, Pharmaceutical Giant, GSK launched Cervarix, a bivalent vaccine, that provides immunity against subgroup 16 and 18. Upon the launch of Cervarix, the cost per dose for Gardasil drastically dropped. 
Both vaccines are administered over a period of 6 months in 3 doses, difference being on the second dose where Cervarix is given 1 month after the first dose while Gardasil being 2 months. 
My personal preference would be undoubtedly Cervarix.

 

Based upon the formulation on which the vaccine are made, you'll notice that GSK's Cervarix is far more superior than Gardasil. Cervarix's formulation includes the use of AsO4  as adjuvant that gives the immune system a boost in formation of antibodies and is maintained at a higher level for a longer period of time. 

To date,a study continues to be conducted and has been 7 1/2 years now. Modeling of Cervarix long term antibody kinetics predicts it's immunity remain detectable for at least 20 years, while immunity by Gardasil  begin to dwindle by the 5th year upon administration. 

 

Study on Cervarix is still ongoing today. 

 

Aluminium Hydroxide as the "key factor" for its rapid and sustainability of high antibody level against oncogenic HPV strains. 

The other important factor being that the latest studies conducted by GSK on more than 18,000 women indicated Cervarix does more than only provide immunity against HPV 16, and 18, but cross protection against HPV 31,33, and 45 as well! 

Hence, it provides immunity against the top 5 oncogenic subtypes of HPV. While Gardasil gives protection against subtype 16 and 18, subtype 6 and 11 aren't oncogenic but instead causes genital warts, which is a curable condition.

Therefore, ladies and gentlemen, in that sense, Cervarix would be a pentavalent  vaccine while Gardasil being a bivalent vaccine. 

Which vaccine then would you chose then?

Insist upon the box to be opened right in front of you, just to make sure you receive the right vaccine since you have paid for it. 

Original packaging comes in a pre-filled syringe of 0.5ml of vaccine. Enclosed are two needles of different sizes. 

It would be unbelievable but as I've worked in a  clinic (a well established clinic in Sri Petaling) which is a panel clinic to many restaurants that regularly sends their workers for typhoid vaccination, and since they've ran out of stock, and to save money, instead of injecting typhoid vaccine, the owner actually pre filled an empty typhoid vaccine ampoule with normal saline, and started injected patient with it. Unbelievable, but its true.

Hence, ladies, please make sure that your doctor opens the box right in front of you, and the plastic container that holds the syringe and needles is sealed. Make sure the doctor opens the seal in front of you!

The colour of the vaccine would be slightly cloudy, and not entirely transparent. 

Being ranked number 2 killer among women in Malaysia, with more prevalence among the Chinese, please go to the nearest clinic to inquire about the vaccine. 

Though the recommended age of vaccination is between the age of 10-45, but since occurrence of Cervical Cancer among the elderly of age between 65-70 form a significant percentage out of the overall number, I would still recommend vaccination even in individual above the age of 45.(Remember that HPV is non detectable from blood investigation, but only through HPV DNA Genotype test that identifies not only the presence of HPV, but it's subtypes as well, upon discovering abnormality in Pap smear. 

Love yourself, ladies. Don't think it won't happen to you. The fact that it is ranked 2nd as the cause of morbidity in Malaysia speaks for itself. 

Current market cost per dose is RM230-250. As part of our effort to promote this life saving 

revolutionary vaccine, Klinik Wan dan Keluarga, Bandar Sri Damansara charges only RM165 per dose or RM480 if paid together for the three doses. 

Call us at 62722678 (working hours Mon-Sat 9am - 7pm) for an appointment. It is part of our clinic policy to create an awareness among community on latest development in medicine that is available today.

Wondering why only RM165? No, we don't use fake or "other substitute". It's original Cervarix from GSK. 

Ever heard of cases where woman who regularly goes for annual Pap smear and was told to be normal, but died few months later of Cervical Cancer? Ever wonder why? Look out for out next post!

   

More accurate method of screening for cervical cancer

Now that our government has taken the initiative to provide free Cervical Cancer Vaccine to school children, i felt happy that the Ministry of Health recognize the need to take action against this number 2 killer among Malaysian women. I felt disappointed that doctors are not taking their time explaining the need, implication, protection rate ,screening method, and many more related to the vaccination and follow up on the screening as such.
Its rather unfortunate to know that most doctors in Malaysia in the private sector are still using the conventional "Pap smear" for screening for cervical carcinoma.
Have you heard of stories of patients who regularly goes for their annual pap smear and was told to be normal, but died after a few months? ......due to cervical cancer?
Do you know that false negative results (which means patient has cancer or pre cancerous lesion but was not detected by conventional pap smear) is between 10%-50%!













The above two pictures are the conventional Pap smear kit, where by using a spatula inserted into the vagina until the end of the wooden spatula touches the cervix, a rotatory movement to get samples from the surface of the cervix.
However, the high false negative result is due to missed or inadequate sample collection from the endocervix.(the deeper part of the cervix).
Thin prep pap smear is an improvised version of Pap Smear.
Thin prep pap smear was introduce back in 1996, and currently being widely used in the US where conventional Pap Smear is almost obsolete. In view of the faulty collection of samples and high percentage of misinterpretation of the result, Thin Prep was designed to solve the problem.

Unlike conventional Pap Smear, where the samples are fixed on a slide, the sample collected from Thin Prep are placed in a solution medium.
As Pap smear's result is purely based on human's ability to detect the abnormal cell, Thin Prep undergoes two process instead. First, they would be subjected to a Thin Prep imaging, where a computer will scan through the sample to look for presence of abnormal cells. Upon completion of the first step, then a review by experienced pathologist to confirm the finding.
As you can see, the designed of the collection brush for Thin Prep pap smear is designed differently (on the right) where the central longer bristles are made to reach the endocervix, while the peripheral outer shorter ones are for the ectocervix.
This enable Thin Prep sample collection to be far more efficient and a more complete sampling obtained.






Hence whenever you are going for your routine check up, be sure to ask for Thin Prep Pap smear instead. It is surprising to know not many general practitioner do not know about the availability of such improvised Pap smear.
In conclusion, insist on Thin Prep method to prevent the possibility of a false negative. It gives a more accurate for diagnosing intraepithelial lesions, higher degree of accuracy detecting high grade lesions in the genital tract, decreased number of misinterpretations of Pap results, improved sample collection noted with use of Thin Prep preparation, amd the same sample can be used to test for other problems and disease including HPV and sexually transmitted diseases without having need to collect another sample.

What do i think about Cervarix.

It a pity whenever a new revolutionary drug is made available, there is almost always a number of individuals who aren't from medical background started passing negative remarks about this drug based on what they've read from postings in the internet by another non medical background individual. They would come up with paranoid ideas that these drugs are part of the government conspiracy for population control, accusing these giant pharmaceutical companies for producing these useless and potentially harmful drug just for the sake of financial gains.
People.....use your God given grey matter!(brain)
1. Population control, Jezz.... isn't easier to pass out law like in China where one couple-one child policy?
2. Why would Government approve of them if they don't meet certain safety criteria and felt the need to have such a drug?
3. These companies spent hundred of million of dollars conducting test for years to establish a standard of efficacy and safety for the consumers.
4. Yes, 32 people died as reported after receiving the vaccine. that's 32 out of tens of millions of people.
Well, does that means road traffic fatalities which increases yearly, the government should ban the use of vehicles?
5. I stand by the new vaccine Cervarix, based upon the data of their medical case studies. What studies was conducted to prove otherwise?
6. Dr Quek, who is the world renowned consultant gynaecologist who specializes in pre cancer screening who is not affiliated to any of these pharmaceutical companies urges doctor to create awareness among the community about Cervarix and cancer screening. Do you seriously think he is part of the "Government Conspiracy" too?
7. What about Professor Peter Leslie. You can check his profile in the internet. Why would he even bother to come down to Malaysia to give talks and held seminars about these vaccines? Are these two mentioned intellectuals are part of the government conspiracy??/
8.Considering the fact that Cervical cancers is the number 2 killer among all cancers affecting women at their prime of their life. This vaccine marks a quantum leap in science and medicine, its important is unparallel to other medical milestones, like the discovery of Penicillin, Eradication of small pox. The only other discovery which its significance is in par with discovery of cancer vaccine is vaccine against HIV.
9. I am sure you would not be passing out bold remarks about how bad and harmful these vaccines are if someone you know, you friends, family members was diagnosed with cervical cancer.