Palliative care and surgery encouraged for advanced cancer patients under new initiative

Cancer patient Gerald William Pereira (second from right) with (from left) Clinical Associate Professor Shirlynn Ho, Associate Psychologist Perlie Ng and Assistant Professor Jolene Wong.

ST PHOTO: KELVIN CHNG

Published Sep 03, 2026, 07:05 PM

Updated Sep 03, 2026, 07:05 PM

Surgeons at the National Cancer Centre Singapore now integrate basic palliative care early in treatment, benefiting 226 advanced cancer patients since August 2025, with plans to help 1,000 more.

The Oncordance programme improves communication between surgeons and patients, addressing pain, anxiety, and social concerns while tailoring surgery to patient preferences.

This approach fosters better patient-surgeon relationships and informed decisions, as shown by patients like retiree Gerald William Pereira who valued early discussions about treatment risks and personal planning.

SINGAPORE – Around 1,000 advanced cancer patients will receive palliative care for their symptoms early along with routine surgical care under an initiative at the National Cancer Centre Singapore (NCCS).

The palliative programme, called Oncordance, has benefited 226 patients with advanced cancer since it was introduced in August 2025. Nearly 80 per cent of these patients received palliative care assessments before surgery.

Oncordance was officially announced on Sept 3.

With a $1 million investment from Lien Foundation, it is expected to benefit 1,000 advanced cancer patients over a two-year period.

Surgery for advanced cancer and palliative care used to exist in different spheres. The former aims to remove tumours or extend life despite high physical risks, while the latter focuses on easing pain and improving daily comfort when a cure is no longer possible.

These days, surgeons are encouraged to integrate the two, and Oncordance is helping them do just that.

Cancer is a leading cause of death in Singapore, accounting for more than one in four deaths.

There are more than 18,000 new cancer cases diagnosed each year, and the majority of patients with advanced cancer require surgery to treat cancer or its complications.

Cancer surgeon Jolene Wong said the surgeon is the first person the patient with advanced cancer meets, and “we have long been responsible for providing solutions and performing surgeries for patients, but what we often lack is effective communication with patients”.

She said that about 80 per cent of advanced cancer patients have palliative care needs, including chronic pain, depression, anxiety and other social concerns, but these needs are often unmet.

While removing tumours can prolong life, Wong said the surgery can diminish the patient’s mobility and independence.

Citing the example of a patient she named Tan, Wong said she performed an emergency operation where she had to attach a stoma bag outside his body to save his life.

“But the bag was bothering him, so we did a stoma reversal and to close the existing colostomy,” she said.

While Tan died earlier in 2026 after five years of treatment, Wong noted: “Here we listened to the patient and tailored the surgery according to what he wanted and what’s most important to him despite it compromising his chemotherapy.”

All cancer patients deserve access to palliative care when they need it and “not as an afterthought or an add-on at the end of life”, said Shirlynn Ho, who heads the Division of Supportive and Palliative Care at NCCS.

“Rather than only taking referrals from specialists, we actually collaborate with the different teams within the cancer centre – with the medical oncology team, with our surgical teams – and within our campus, with the non-cancer specialist team like the those in cardiology and intensive care as well.

“ (Oncordance) helps us put our heads together, have conversations with patients and know what they prefer, before coming to a better and more thoughtful position of treatment,” Ho said.

Wong added: “In an Asian culture, we do not really talk about our goals or fears until something major happens. So (by) having these conversations before or even after surgery and continually repeating it, we will be able to understand what is important to the patients.”

Programme director at Lien Foundation Luo Ren called it “a fundamental redesign of the delivery of surgical care that places equal emphasis on treatment and the person”.

“(This empowers) surgeons to develop deeper, more meaningful patient relationships and to ask patients what they want from the operation. Both sides gain clarity, so that the operation, and everything that follows, is concordant with what the patient actually wants,” she said.

Retiree Gerald William Pereira, 63, told reporters he appreciated the fact that he had had conversations with Wong.

After he was diagnosed with an aggressive cancer in his groin in April 2025, Wong recommended chemotherapy to shrink the tumour, followed by surgery to remove it.

Wong told him that the tumour had wrapped around a major vein, and removing it carried a risk of potentially losing his left leg. However, without surgery, the tumour would grow aggressively, giving him six months to a year to live.

“The conversations were valuable as they gave me time to get my personal affairs in order – my will, nominating beneficiaries to my CPF. I was able to reflect on what mattered most and plan ahead for my brother and sister-in-law,” he said.

“I was able to clearly make up my mind to proceed with the recommended treatment of chemotherapy (before the surgery).”

癌症患者 Gerald William Pereira（右二）与（从左至右）临床副教授 Shirlynn Ho、副心理学家 Perlie Ng 和助理教授 Jolene Wong 合影。

《海峡时报》摄影：KELVIN CHNG

发布于 2026 年 9 月 3 日 下午 7:05

更新于2026年9月3日晚上7:05

新加坡国家癌症中心的外科医生现在将基本姑息治疗融入治疗早期，自 2025 年 8 月以来，已有 226 名晚期癌症患者受益，并计划帮助另外 1000 名患者。

Oncordance 计划改善外科医生和患者之间的沟通，解决疼痛、焦虑和社会问题，同时根据患者的偏好定制手术。

这种方法有助于建立更好的医患关系，并让患者做出明智的决定，退休人员杰拉尔德·威廉·佩雷拉 (Gerald William Pereira) 就是一个很好的例子，他非常重视早期关于治疗风险和个人计划的讨论。

新加坡——根据新加坡国家癌症中心 (NCCS) 的一项计划，约 1000 名晚期癌症患者将在接受常规外科手术治疗的同时，尽早获得针对其症状的姑息治疗。

这项名为 Oncordance 的姑息治疗项目自 2025 年 8 月推出以来，已使 226 名晚期癌症患者受益。其中近 80% 的患者在手术前接受了姑息治疗评估。

Oncordance于9月3日正式发布。

在连氏基金会 100 万美元的投资下，该项目预计将在两年内惠及 1000 名晚期癌症患者。

晚期癌症手术和姑息治疗过去属于不同的领域。前者旨在切除肿瘤或延长生命，但风险极高；后者则侧重于在无法治愈的情况下减轻疼痛、改善日常生活舒适度。

如今，外科医生被鼓励将两者结合起来，而 Oncordance 正是在帮助他们实现这一目标。

癌症是新加坡的主要死因之一，占死亡总数的四分之一以上。

每年新增癌症病例超过 18,000 例，大多数晚期癌症患者需要手术治疗癌症或其并发症。

癌症外科医生黄若琳表示，外科医生是晚期癌症患者遇到的第一个人，“我们长期以来一直负责为患者提供解决方案和进行手术，但我们常常缺乏的是与患者进行有效的沟通”。

她说，约 80% 的晚期癌症患者有姑息治疗需求，包括慢性疼痛、抑郁、焦虑和其他社会问题，但这些需求往往得不到满足。

黄医生表示，虽然切除肿瘤可以延长生命，但手术会降低患者的行动能力和独立性。

黄医生以一位名叫谭的病人为例，说她曾为他进行紧急手术，不得不将造口袋固定在体外以挽救他的生命。

“但是造口袋让他感到不舒服，所以我们做了造口回纳术，并关闭了现有的结肠造口，”她说。

尽管谭在接受五年治疗后于 2026 年初去世，但黄医生指出：“在这里，我们听取了病人的意见，并根据他的意愿和对他来说最重要的事情来量身定制手术方案，尽管这会影响他的化疗。”

新加坡国立癌症中心支持和姑息治疗部门负责人 Shirlynn Ho 表示，所有癌症患者都应该在需要时获得姑息治疗，“而不是在生命末期才考虑或附加治疗”。

“我们不仅接受专科医生的转诊，实际上还与癌症中心内的不同团队合作——与肿瘤内科团队、外科团队——以及我们院区内的非癌症专科团队（如心脏病科和重症监护科的团队）合作。

“（Oncordance）帮助我们集思广益，与患者沟通，了解他们的偏好，从而制定出更好、更周全的治疗方案，”Ho说道。

黄医生补充道：“在亚洲文化中，我们通常只有在发生重大事件时才会谈论自己的目标或恐惧。因此，通过在手术前甚至手术后进行这些对话，并不断重复，我们就能了解对患者而言什么才是最重要的。”

连氏基金会项目主任罗仁称之为“对外科医疗服务提供方式的根本性重新设计，它同等重视治疗和人”。

“（这让）外科医生能够与患者建立更深入、更有意义的关系，并询问患者对手术的期望。双方都能更清楚地了解情况，从而使手术以及后续的一切都能与患者的实际意愿相符，”她说道。

63岁的退休人士杰拉尔德·威廉·佩雷拉告诉记者，他很感激能与黄先生进行对话。

2025 年 4 月，黄医生被诊断出腹股沟患有侵袭性癌症。黄医生建议先进行化疗以缩小肿瘤，然后再进行手术切除。

黄医生告诉他，肿瘤已经包裹住一条主要静脉，切除肿瘤可能会导致他失去左腿。但是，如果不进行手术，肿瘤会迅速生长，他可能只有六个月到一年的寿命。

他说：“这些谈话很有价值，让我有时间处理个人事务——立遗嘱、指定公积金受益人。我得以思考什么才是最重要的，并为我的弟弟和弟媳提前做好打算。”

“我当时已经下定决心接受医生推荐的化疗治疗（在手术之前）。”