SINGAPORE: The benefits of physical activity on cancer survival have been studied for many different types of cancers, including breast cancer.

A review of the research in more recent years reveals impressive results and suggests that breast cancer patients should take exercise more seriously.

In 22 cohort studies of over 120,000 breast cancer survivors who were followed for four to 12 years, participants who reported high lifetime recreational physical activity before they were diagnosed with breast cancer had significantly lower risk of all-cause and breast cancer related death by 20 to 30 per cent, compared to those who reported low to no lifetime recreational physical activity.

A recent article on Channel NewsAsia also highlighted the power of genes – as an experiment showed that newborn rats from mothers with high aerobic capacity were four times less likely to develop breast cancer.

What is perhaps more relevant to women already diagnosed with breast cancer is the finding that physical activity post diagnosis was associated with about 40 per cent lower risk of breast cancer mortality, and approximately 50 per cent lower risk of death at an early age.

Some doctors think exercise may have positive effects on body weight and composition and generally improve one’s mood and well-being, even though it’s not entirely clear why physical activity leads to longer lives and higher survival rates in breast cancer patients.

Others say exercise helps alleviate the side effects and symptoms of treatment, by helping the body fight inflammation and enhancing cell replacement.

WEIGHT GAIN AND CANCER RELAPSE

Exercise helps fight weight gain, a common experience breast cancer patients share.

Studies have shown that over 50 per cent of early-stage breast cancer patients experience weight gain during cancer treatment, and many patients report progressive weight gain in the months and years after diagnosis.

This may be the case because women suffering from breast cancer undergo hormonal treatment and chemotherapy. These treatments increase the proportion of adipose tissues – which stores energy and fat, and forms a protective layer around major organs.

Research shows breast cancer patients who gained significant weight after diagnosis are at higher risk of a relapse. Patients in a study who showed a rise in their body-mass index of more than 0.5 saw a 40 to 53 per cent higher chance of cancer recurrence.

In addition to weight gain, obesity has also been shown to be associated with poorer cancer outcomes. Obese women had poorer overall breast cancer survival rates, based on a review of 82 studies that included more than 200,000 breast cancer survivors.

Obese breast cancer survivors were also up to two times more likely to develop a new second cancer, including cancer on another breast, womb cancer and colorectal cancer, compared to non-obese survivors, based on another review of such studies.

Some researchers say that excess adipose tissue in obese women produce higher levels of estrogen after menopause, which leads to the progression and growth of breast cancer.

Obesity also produces more insulin and inflammatory substances in one’s body that promotes tumour growth.

HELPS WITH TREATMENT’S SIDE EFFECTS

Intentional weight loss with exercise and dietary control can also help manage breast cancer-causing hormones. A weight loss of 5 to 10 per cent over six to 12 months alone has been shown to reduce the general risks of chronic diseases.

Another positive effect of physical activity in cancer patients lies in its potential to reduce treatment-related side effects.

Many patients with hormone-sensitive, early-stage breast cancer undergo hormonal therapy for five to 10 years to reduce the risk of cancer relapse but this treatment often results in joint pains, discouraging patients from continuing with prescribed medication dosages.

In some cases, acute joint pain leads patients to discontinue treatment altogether

But in a trial of over 120 breast cancer patients, where some participants underwent 150 minutes of aerobic exercise and strength training each week, patients who exercised experienced 30 per cent less joint pain.

This suggests that women who exercise may stick with their hormonal therapy, which is badly needed to treat breast cancer.

Exercise also helps slow down cellular ageing by impeding the reduction of the length of telomeres – the caps at the end of each DNA strand that protects our chromosomes which shorten with age.

People who engage in lots of physical activity have longer telomeres than those who lead sedentary lives, with a telomere length difference of seven to nine biological years.

Of course, there are broader benefits that exercise offers detailed in well-known studies, which include improvements in the quality of life and reductions in the risks of depression or anxiety.

For women coping with breast cancer, where the occurrence of depression or anxiety can be as high as 4 in 10, this is good news.

Studies show that exercise improves the quality of life, self-esteem and response attitudes in breast cancer survivors.

In these studies, patients were asked to engage in a wide range of physical activity, including aerobic, resistance, stretching as well as yoga, tai chi and even dancing, showing that patients don’t have to be hardcore fitness junkies to enjoy exercise’s benefits.

EXERCISES GOOD FOR RECOVERY

So how much physical activity should a breast cancer patient engage in?

The American Cancer Society recommends that cancer survivors between the ages of 18 and 65 do 150 minutes a week of moderate-intensity exercise. These could include brisk walking, cycling, or even water aerobics, general gardening, ballroom or line dancing.

Alternatively, just 75 minutes of vigorous exercise each week through activities like uphill hiking, jogging, running, swimming fast or swimming laps, fast biking or fast dancing could do the trick.

Researchers also recommend for each session to last at least 10 minutes, for activities to be spread throughout the week, and for breast cancer survivors to also do some form of muscle strength training at least two days each week.

Even older cancer survivors, especially those 65 and above, are encouraged to follow these guidelines within limits permitted by their medical condition and physical fitness level.

While exercising more than this amount is encouraged, what’s most important is for breast cancer survivors to get some form of physical activity, rather than to aim to fulfill the recommended level of exercises and feel deflated or discouraged if they’re not able to.

After all, some activity is better than none.

This is important because despite the obvious benefits that exercise can bring to breast cancer patients, only 20 to 30 per cent are likely to be physically active after they recover from cancer treatment, and even fewer of them are active during cancer treatment.

Breast cancer patients who have been less physically active should not be afraid to take the first step to exercise.

As a range of physical activities has been shown to have positive effects, most should be able to find an activity they can enjoy while reaping health benefits.

Associate Professor Lee Soo Chin is head of the Department of Haematology-Oncology at the National University Cancer Institute of Singapore.

ROCKHAMPTON, Australia: Against a never-ending canvas of vast plains and blue skies, Singapore’s land and air fighters showed what it takes to operate as a team.

This is Exercise Wallaby, the largest Singapore Armed Forces (SAF) overseas training exercise, conducted in an area four times the size of Singapore.

Since its humble beginnings in 1990, when it lasted for only three weeks, the exercise has grown to involve almost 4,000 SAF personnel participating across three months.

Exercise director Brigadier General (BG) Mark Tan called it a “unique opportunity that we don’t have anywhere else in the world”, as plans are afoot to expand training areas in Shoalwater Bay and accommodate even more troops for a longer duration.

“The space here allows us to train both with helicopters and ships in a very large and complex exercise, which allows us to advance our capabilities and train our soldiers in a realistic and tough environment,” BG Tan said.

“As the SAF has progressed over the years, fighting jointly is something that’s very important to our capabilities.”

Indeed, the army and Republic of Singapore Armed Forces put on a joint show of force on Sunday (Oct 8), as they demonstrated one method of large-scale troop transportation.

The deployment, which involves up to eight helicopters flying in formation, can transport a maximum of 300 troops at one go, exercise air director Senior Lieutenant Colonel (SLTC) Sherman Ong said.

Like a parade of elephants, the helicopters move with the more vulnerable targets protected in the middle. “The AHs (Apache Attack Helicopter) are there to escort the large-force package and ensure that the route is screened and the determinate area is clear,” SLTC Ong added.

While the Apaches provide the firepower, the Chinook and Super Puma helicopters form the bulk of the convoy. They are capable of carrying not only large troops, but also different types of vehicles slung under their bellies.

“We carry vehicles from a pick-up zone to a landing site, and we try to positon them further into enemy terrain,” SLTC Ong said.

This form of transportation also serves to resupply combat troops, one serviceman involved in the underslung operations said, as his voice strained to compete against the whirring rotors. The cargo ranges from oil drums to food and ammunition.

“One of the challenges is the fact we’re going to have many aircraft airborne at the same time, so planning and deciding who goes first and who goes next is important,” said Major Vivek Nair, one of the team leads for the media heli-borne demonstrations.

“The bigger challenge is that all these have to tie in with what the army wants. The mission lead has to (ensure) the number of troops and the loads are delivered in a timely manner for them to carry on with their mission.”

I boarded a Chinook to witness first-hand how the rigging of the cargo is done, but found myself rigged to the ground instead. The giant spinning blades generated a downforce and kicked up mini plumes of sand and dust.

A pair of soldiers, known as the lookout team, are sent to the underbelly to hook the cargo up and conduct the “five-second hover check”. The most dangerous part of the entire operation, this ensures the load is secure as it is lifted off the ground.

Inside the Chinook, I breathed in more sand when a large hatch on the floor was opened to observe the cargo beneath. At the landing site, the load is released after it hits the ground and there is no more tension on the rigging. Then the troops are deployed.

For the soldiers, this is not a joyride. They run out of the Chinook, surround the helicopter and prone in the sand. They only get up once the chopper leaves them.

In this demonstration, the cargo being transported is a Light Strike Vehicle (LSV). First Sergeant Joel Wong, a platoon sergeant in the Light Strike Platoon, said the LSV is used to travel faster and cover longer distances because it is “light and mobile”.

“The terrain here allows us to push our vehicles to the limit, especially because the space back in Singapore doesn’t allow us to execute the whole bigger plan,” he added.

The LSV can go up to speeds of 90kmh off road, though the speed limit in the training area is slower than that.

Still, an LSV driver asked during a familiarisation ride if I wanted to get wet. After politely declining for fear of my equipment, he proceeded to give a thrilling ride anyway.

The LSV made light work of boulders and even small tree logs, and ploughed through water obstacles as though they weren’t there. Steep incline? No problem. I was on a bumpy version of a four-wheeled rollercoaster.

It does not come as a surprise then that some full-time national servicemen (NSF) like 3rd Sergeant Ryan Tan extend their service just to participate in Exercise Wallaby. It is a chance to try new things.

The 24-year-old air force technician, who services the Apache helicopters, missed out on loading the Hellfire missile on the chopper during his first Wallaby stint last year. He extended his service by a month to try it this year.

“Last year, very few NSFs were given the privilege to actually handle it, so it was something special for me this year,” he added. 

SINGAPORE: A new hawker centre that aims to offer a “holistic approach” to the hawker trade has opened in Jurong West.

Located at Jurong West Street 61, the new 500-seat hawker centre is managed by Hawker Management – a subsidiary of food centre operator Koufu – on a not-for-profit basis, and aims to offer healthy, affordable food as well as measures to help budding hawker entrepreneurs, Hawker Management announced in its media release on Sunday (Oct 8).

For example, each of its 34 cooked food stalls – which sell dishes ranging from traditional hawker fare to contemporary fusion food – offers two regular-sized dishes at S$2.80 each. 

Additionally, the hawker centre and market has 14 market slab stalls selling fresh produce and groceries.

HELPING ASPIRING HAWKERS

As part of its Happy Hawkerpreneur programme, Hawker Management said it has also set aside six cooked food stalls at the hawker centre to groom “passionate aspiring hawkers” and help sustain the local hawker trade.

“The programme aims to encourage these hawkers to pursue their culinary dreams, while supporting them with subsidies to lower their initial capital costs and guidance in running a hawker business,” said Hawker Management.

For instance, Jackson Tan, 24, is one of the many who stand to benefit from the programme. He decided to switch careers and become a hawker, according to Hawker Management’s press release, and fuses vegetarian food with Western and Korean cuisines to provide the public with more vegetarian options.

“While there is growing interest in keeping the hawker culture going, we recognise the need to offer practical support for hawkers as they evolve with the changing needs today, while preserving traditional skills and flavours,” said Hawker Management’s chief executive officer David Yang.

“By working together with the community to impart, share and support an environment for the hawker trade to adapt and flourish, we hope to do our part to ensure that hawker centres remain a place we hold dear, for generations to come.”

TRAY RETURN ROBOTS, CASHLESS PAYMENT

In order to encourage the faster clearing of tables, the hawker centre has an RFID tray return system as well as three SMART Tray Return robots to help diners who may not be able to carry their trays to the tray return area, said Hawker Management.

In line with other national efforts to enhance productivity, said Hawker Management, eight cashless payment options will also be provided, including PayWave, Apple Pay and EZ-Link payment. 

It will also host community activities such as flea markets, festive fairs and music performances.

“The social initiatives that will be rolled out also makes this hawker centre a natural gathering place for residents to bond and enjoy their meals together,” said Member of Parliament for West Coast GRC Patrick Tay, who was present at the official opening of the hawker centre.

ROCKHAMPTON, Australia: The death of 3rd Sergeant (3SG) Gavin Chan during an annual training exercise in Australia has left a mark on his fellow National Service comrades, senior commanders said.

“When somebody so close to you and (who) spent so many years with you was killed in an accident, naturally the soldiers in the unit were very affected,” exercise director Mark Tan told reporters in a dusty clearing at the Shoalwater Bay Training Area in Queensland, Australia on Sunday (Oct 8).

“(This is) especially for those who were within the same Bionix vehicle and those in his platoon.”

Military Expert (ME) 6 Luke Goh, commander of the forward support group that provides medical assistance during the training exercise, said 3SG Chan’s death made an “impact” on his fellow National Service colleagues.

To that end, Brigadier General (BG) Tan added that “special arrangements” were made so that platoon mates could send off 3SG Chan’s body and attend his funeral back in Singapore last month.

“I think that was an important form of closure for them to come together and show support for 3rd Sergeant Gavin, who was very much a treasured commander of the unit,” he said.

3SG Chan was found unconscious on Sep 15 after a Bionix infantry vehicle that he was guiding out of difficult terrain landed on its side, the Ministry of Defence said.

A medic tried to resucitate 3SG Chan before he was evacuated via helicopter to Rockhampton Hospital, where he died.

ME6 Goh said the forward support group, whose wide-ranging responsibilities include logistics and maintenance support, was activated when the incident happened.

“It was certainly important to get the casualty out to the nearest medical facility,” ME6 Goh said, adding that resources involved included a helicopter and a 24-hour standby ambulance operator.

Ambulance operator Wesley Kok, 20, was on duty when the incident happened.

“I prepped my vehicle and was ready to go any time,” he said. “So when I got the call, everything was loaded up and we moved off to the airfield to bring the medical officer to the helicopter to bring him to the site of the accident.”

Private Kok said he took about five minutes to get from the camp to the airfield, where a helicopter was waiting to transport the medic to the scene. As it was an emergency, he was given authorisation to go beyond the speed limit for the 2km journey.

The full-time National Serviceman said his parents rang him up “the day it went on the news”.

“I told them I was involved in the activation, but I’m safe and nothing else happened,” he said.

“I feel like it’s very unfortunate for it to happen,” he added. “I did my best to rush as fast as possible, but I think the safety measures will be revised to keep up.”

The mood grew sombre as soldiers sat side by side and recounted the incident. One army engineer regular, 31, said he was devastated for 3SG Chan’s family, especially because he had been planning on studying at university and “making the family proud”.

TRAINING RESUMED TO “INSTIL CONFIDENCE” IN SOLDIERS

But ME6 Goh said the battalion “recovered well and recovered quickly”.

Following the incident, said BG Tan, a safety pause was initiated to evaluate “what had happened and whether our safety measures were sufficient”.

“Having established that, as well as the readiness and the morale of the soldiers on the ground, we were convinced that there were sufficient measures in place,” added the chief guards officer.

“We have resumed training to instill confidence in the soldiers that the training they are undergoing is still safe.”

Nevertheless, BG Tan said investigations into the cause of the incident are ongoing. “As of now, we have not made any changes to our safety regulations.”

However, he stressed that safety measures are in place at “every level of the exercise design”, from the planning stage back home to execution in Australia, where soldiers can train in conditions that are harsh and realistic.

“We have multiple levels of safety coverage to ensure that soldiers are watched both by their commanders as well as by the conducting headquarters,” he said.

ME6 Goh added: “Of course, we endeavour to learn as much as we can because every life lost is one too many.” 
 

SINGAPORE: Jazz crooner Joanna Dong has a chance to make history as the first Singaporean singer to win the Sing! China talent show.

After three grueling elimination rounds, she has made it to the final of the popular singing competition by Zhejiang Television.

Last October, Nathan Hartono was a trailblazer for Singapore singers when he came in second in the show. Will Dong likewise make it into the final two – or do even better?

She is up against four other contenders in the finals, broadcast live from the Beijing ‘Bird’s Nest’ National Stadium on Sunday (Oct 8) night. They are the last five standing from four teams of performers, led by celebrity coaches Jay Chou, Liu Huan, Na Ying and Eason Chan.

Dong is from Taiwanese Mandopop superstar Chou’s team. Hong Kong star Eason Chan’s team won an earlier battle between the teams and is fielding two singers – Xiao Kaiye, 26, and Ye Xiaoyue, 26, both from Guangdong.

Tibetan Zhaxipingcuo, 30, is the winning singer from Chinese pop pioneer Liu Huan’s team, while Doris Guo Qin from Hunan represents Na Ying’s team. Guo is the youngest contestant at 17.

Each of them will sing a duet with their coaches and perform a solo. The two singers who get the most votes from the audience will then duke it out in a final round.

While preparing for the final, coach Chou invited her to his concert in Taiwan and even called her up on stage for a spontaneous duet.

Dong, who is a musical theatre veteran, has impressed with jazzy show tunes in the run up to the final. For the show’s blind audition, she pepped up Luo Da You’s Love Song 1990 with a touch of jazz and a mouth trumpet performance.

She went retro in the round-robin battles between the teams with Grace Chang’s I Want You to Be My Baby.

In the next round against her own team members, Dong sang True Love Song in a duet with Taiwanese star Harlem Yu and for her solo, a mash-up of Journey’s Open Arms and Chinese classic Lover’s Tears.