MIMS recently spoke to Dr Wong Seng Weng, medical director and consultant medical oncologist of The Cancer Centre, Singapore Medical Group. Dr Wong discussed how oncology is a field that uniquely blends the art and science of patient care and shared insights on how he builds trust with his patients. He also touched on whether alternative medicine was effective in the treatment of cancer.

MIMS: How do you establish your relationship with your patients?

Dr Wong: There are two aspects needed in order to build a strong trusting relationship with your patient – bonding and confidence. I think doctors walk a fine line emotionally and we need to learn to strike a good balance. In order to develop that relationship, the doctor must be able to relate to his patient. If you are able to put yourself in the patient’s shoes, they will feel closer and will open up to you. In turn, you will be able to see things from their perspective, understand their situation better and offer solutions to their problems.

MIMS: How do you regain the confidence of patients who get demoralised when the prescribed course of treatment you have recommended do not work out for them?

Dr Wong: The important thing is to set the right expectations at the very beginning before embarking on any treatment journey with patients. Giving pep talks and making patients optimistic may seem like the right thing to do, but that’s not always the correct approach.

Sometimes, the correct approach is to make the patient slightly pessimistic. For instance, I have to lower the expectations of an overly optimistic patient in order to match reality better and prevent further disappointment. Conversely, I will attempt to inject more optimism to an overly pessimistic patient. If you manage patients’ expectations properly at the start, patients will have more confidence in you regardless of whether your prescribed treatments are successful or not. In life, some things are beyond our control and it is important for a patient to understand this from the start.

MIMS: It seems that your field of expertise, oncology, intertwines with aspects of psychology and psychotherapy as well. To what extent is this true?

Dr Wong: Oncology is a very interesting mesh between art and cutting-edge science, and I believe that not every doctor is cut out to be an oncologist. Science is the starting point of cancer care, but there is an art to applying that science with each patient. We are not merely treating a tumour or dealing with blood results, we are essentially treating a human being packaged with emotions. An oncologist has to manage the patient’s expectations, navigate the emotional highs and lows and be able to show empathy at the same time – that to me, is very much an art.

MIMS: The late Steve Jobs, founder of Apple Inc., opted for homeopathic treatment and refused conventional treatment when he was diagnosed with pancreatic cancer in the early stages. How do you deal with patients who have voiced out their preference to go for such treatment?

Dr Wong: For patients to make objective and informed decisions, there is a need to raise awareness on the lack of credibility of some of the information that they are relying on. Sometimes, we cannot be too rigid and force the patient to choose their preferred doctor as this may not be the best way forward. If I find that I need to manage the patient alongside someone else offering alternative medicine, I will accept it. Of course, I will have to monitor their condition at the same time as homeopathic treatment, albeit derived from natural substances, may cause side effects and affect the existing treatment.

MIMS: Do you have personal experience managing these cases?

Dr Wong: Yes, it happens all the time. An Indonesian man, diagnosed with advanced lung cancer, came to see me one day. As the cancer had become resistant to chemotherapy, I recommended the next course of treatment which was immunotherapy.

We started on a treatment cycle but even before the first phase ended, he defaulted from the course. After a short hiatus, he returned and informed me that he had consulted a bomoh, an Indonesian traditional healer. He requested for a medical evaluation to assess his current condition, and reports showed that his condition improved substantially. I remarked that the immunotherapy had begun to take effect, but he insisted that it was the bomoh who cured him!

Having said that, I think it is important for doctors to be willing to cooperate with patients to keep them alive longer. Obviously, if they are going to do things to harm themselves, such as going on a prolonged fast to starve the cancer to death, I will do my best to dissuade them. Where necessary, I have to be flexible enough to compromise for the sake of my patients. MIMS