Who and when was the term Oncology used? What did it mean?

In 1975, I returned to Singapore to the University Department of Medicine 1, at the Singapore General Hospital. Having just received my Cambridge University research Doctorate in Medicine (M.D. Cantab.) on Cancer Immunology and the use of the prototype Blood Cell Separator, I was tasked by the then Head of University Department of Medicine, Professor Khoo Oon Teik, to continue my research on Cancer and Immunology. So in those early days, I was in charge of the first and new Division of Oncology and Immunology in the University Department of Medicine. I was also tasked by our three then doyens in Medicine, the late Professors Seah Cheng Seang, Khoo Oon Teik, and Emeritus Professor Shanmugaratnam to conduct researches on liver cancer, then the top Cancer in our country.

 

How and why was the term Oncology used?

Cancer at that time was a dreaded word, and there was no funding for it. Patients were dying from it in our wards. It was a death sentence. Was Cancer, the suitable word to use for our research on Cancer? Thinking amongst the laity then, was why waste money in cancer research, when the patients eventually died anyway from the disease. It was better to feed the poor and the hungry.

 

So I proposed to Professor Khoo Oon Teik, and Wong Poi Kong, my department head, that we should not use the term cancer but oncology. Onco (Greek) meant swelling, mass or tumor. Oncology was the science of tumor or malignancy development. So that was how Oncology was started as a division in our University Department of Medicine. We had a small team. Professor Kueh Yan Koon, just back from Vancouver, dealt with hematological malignancies, and assisted by the late Professor Ravi Suri. Later we were joined by Professor Tan Yew Oo ( back from U.S.A.), who helped to look after the solid tumors and teratomas, while I concentrated on liver cancers. We had a small Ransome Research laboratory in the attic of the old Norris Block, at the Singapore General Hospital, and with small funds from the Lee Foundation, and later from the Singapore Turf Club, we started to do some basic research on the aetiology of liver cancers. In those days, we worked on hepatitis viruses, aflatoxins, and had formed a Hepatoma Research group, with surgeons, radiologists, radiotherapists, pathologists, scientists and physicians interested or caring for cancer patients. The term Oncologist was not in use yet.

 

Before returning to Singapore, I worked at the Westminster Hospital in London, where I had been in charge of the Tumor Biology Unit, and we conducted basic research on the mechanisms of how to reject human cancers, such as melanomas, neuroblastomas and later at the Royal Marsden Hospital, on how to immunize remission patients with acute myeloid leukemia, with their own irradiated leukemia cells, to stimulate a long-lasting immunity.

 

From this infant beginnings of Oncology research in Singapore, a keen interest in studying cancers rose. How should we solve the problem of how best to treat, (given the options), of surgery, radiation therapy, endocrine therapy, and chemotherapy now available from our collective expertise in our Hepatoma Research Group?

 

In 1981, this small group of clinicians and researchers met at the lecture room on the ground floor of the College of Medicine Building, and formed the Singapore Society of Oncology (SSO). I had already at that time also formed the Asia Pacific Association for the Study of the Liver, and the Singapore Society of Immunology and Rheumatology, so the aims and objectives could be used but now it was for the study and management of cancers. We had about twenty persons, and I was elected the pro tem President and later, on approval from the Registrar of Societies, we also obtained tax exemption for Cancer Research from a donation from the Turf Club amounting to about SD$10,000. Unfortunately, the money was not used, and later we were taxed for the income.

 

In 1985, I brought back the first Haemonetics Cell Separator into our Department, to collect large volumes of Hepatitis B high-titer antigen for vaccine manufacture. In the process, we taught our staff and also the Blood Transfusion Department the use of the Cell Separator Machine. With more staff trained and machines available, we were able to take on the task of now treating cancers, more vigorously, with leukocyte and platelet-rich fractions, and plasma exchanges for myeloma and hyper viscosity patients.

 

In September that year, the World Health Organization Western Pacific Regional held its first meeting in Singapore, on Cancer Epidemiology and Control in Singapore. Using our National Cancer Registry data, as well as many experts both overseas and locally (from our SSO), and the academic institutions, a recommendation for the prevention and control of our common cancers was made to our Ministry of Health. It was the forerunner of the National Cancer Center, and the training of future oncologists .The specialty of cancer management, and the study of how tumors developed then began in a more formalized and structured manner. This was the nascent stage for the future of Oncologists.

 

It is now 32 years since those early foundation years. Oncology Research has blossomed and we are indeed blessed with so many Oncologists in the country, and a hive of activities, from education, research, collaboration to scientific meetings. Singapore is one of the leading centers in the world on basic, epidemiological, diagnostic and treatments comparable to the best institutions in the world. Oncology is today, also a recognized specialty by the Ministry of Health and the Academy of Medicine. These are momentous developments. On the 2nd October 2010, Singapore celebrated the 25th anniversary of the launch of the universal immunization of all newborns, and the young under the age of 20 years from hepatitis B with the Hepatitis B vaccine. It is the first country to introduce the vaccine into its childhood immunization program, and showed that Liver Cancer and hepatitis B carriers rates have fallen substantially, and millions of lives have been saved worldwide. This is one of Singapore's great contribution to the public health control of a formidable cancer and infectious disease, and it succeeded with some assistance from a collaborative agreement with the International Agency for Research in Cancer of the World Health Organization.

 

I take this opportunity of wishing all members of the SSO, continued success in their endeavors as your leaders in SSO chart its course through the exciting future.

 

Dr. Oon Chong Jin Gabriel

M.D. Cantab., F.R.C. P. (London), F.A.M.S, (Singapore), D.C.H. (London)

SSO Founding President, 1981-1983

 

 

Professor Oon’s book, A Cancer Vaccine that Transformed Singapore and the World (published by Straits Times Press Ltd, Singapore), was launched on the 2nd of October 2010 by the Minister of Health, Mr. Khaw Boon Wan. For more information about Professor Oon and his research, visit his website at http://gabrieloon.com.