The HEALTH : April 2020 | Page 28

28 The Health | April, 2020 | Issue | Early detection of colon cancer is important Group photo at the event (from left to right): Datin Dr Sharmila Sachithanandan as co-founder of WIGNAP, Dr Ferga Gleeson from Mayo clinic USA, Dr Elizabeth Rajan from Mayo Clinic USA, Dr Anita Balakrishnan from Cambridge University Hospitals NHS Foundation Trust, Dr Jasminder Sidhu from HKL, Dr Ida Hilmi from PPUM), and Dr April Camilla Roslani from PPUM. WIGNAP to attract more women to gastroenterology THE number of new cancer cases recorded in Malaysia over five years from 2012 to 2016 increased to 115,238 from 103,507 recorded in the period from 2007 to 2011. Senior Consultant Gastroenterologist at Subang Jaya Medical Centre (SJMC), Datin Dr Sharmila Sachithanandan lends her thoughts on the worrying increase in numbers. “Colon cancer is the number two killer cause in Malaysia; therefore, we advocate those above the age of 50, both male and female to have at least one colonoscopy in their lifetime. This is to pick out those who are at risk of colon cancer,” said Dr Sharmila. “A colonoscopy allows the gastroenterologist to examine the lining of the whole large bowel and simultaneously remove polyps that may be pre-cancerous (adenomas). According to her, some groups have proposed that the screening age for colon cancer be at 45. For patients with a family history of colorectal cancer that was diagnosed before age 60 years in one first-degree relative or at any age in two first-degree relatives, testing should begin with colonoscopy at an age 10 years younger than the youngest age at diagnosis of a first-degree relative, or age 40, to be repeated every 5 years. Dr Sharmila observes that men The success of female gastroenterologists should be highlighted “T HERE were approximately 150 invited speakers at a recent International Gastroenterology event. Of the 150, how many of them were women?” quizzed Datin Dr Sharmila Sachithanandan, co-founder of the Women in Gastroenterology Network Asia-Pacific (WIGNAP). “Never would anyone imagine the answer to be eight. Yes, just eight female gastroenterologists as faculty at a major International event. At some meetings, all the speakers would be male! It’s not as if there is a shortage of women to invite,” she said. While the rest of the world is trying to move forward, the Asia-Pacific remains still, heels dug in. European and American Gastroenterological Societies have a minimum 25-30 per cent mandate for women representation on panels and as speakers, with a similar representation on committees and co-chairs of courses. Datin Dr Sharmila Sachithanandan, Senior Consultant Gastroenterologist at Subang Jaya Medical Centre (SJMC), said, "At many gastroenterology meetings and conferences I attended, I would be one of a few females in the room. At endoscopy meetings, I would sometimes be the only female. There were occasions when I was brushed off as a nurse or secretary instead and my male colleagues would feel quite embarrassed.” In East Asian countries like Japan and Korea, the profession is very male-dominated. In fact in Japan, only 20 per cent of the doctors are female and very few of that 20 per cent are specialised in gastroenterology," explained Dr Sharmila. In Malaysia, the majority of medical school graduates are female. However, only 16 per cent of gastroenterologists are female. In Asia, prior to WIGNAP, there was no such forum for women gastroenterologists to meet, collaborate and share their professional experiences and challenges. Levelling the playing field The mother of three does not take issues faced by female gastroenterologists lightly. One way of supporting female gastroenterologists, she said, was to highlight their achievements and successes to inspire younger women. "Many of these women gastroenterologists are brilliant doctors and endoscopists, but they don't get the chance to be speakers or faculty at conferences. We try to create opportunities to obtain the right platform to showcase their skills." One of the critical issues highlighted by WIGNAP is the lack of women in the gastroenterology field. "They may feel overwhelmed and that the field is too much for them to handle, but we want to show the younger doctors that it is an exciting speciality and that more women are needed." Dr Sharmila also said the partnership of other male doctors was instrumental to women empowerment. "WIGNAP doesn't just consist of women. We have men on board because we believe that it takes a combined movement to effect change. When men take action, other men will follow suit” What's next for WIGNAP? Dr Sharmila will be in Rio de Janeiro for the first-ever World Wonder Women in Gastroenterology event. "There will be women from USA, South America, Europe, the Middle East and the Asia-Pacific, and I am looking forward to it." — The Health Dr Sharmila (middle). are more proactive when it comes to screening, unlike women. She explains that this is because some (not all) women tend to feel shy to have a scope done by a male doctor and they would look for a female gastroenterologist instead. Cultural and religious barriers also explain the lower rate of colon cancer screening amongst women. They often come to her stating how tough it is to find a female gastroenterologist. "Malaysia doesn't have a screening programme because it's not cost- effective and we do not have enough resources to cope with the workload if everyone starts to go for screening. For now, it's very much opportunistic relying on educating people to come forward," she explained. This is mostly the case in private hospitals. In the public sector, there are pockets of screening available but this is not widely available. Pancreatic cancer is another cancer which affects both males and females. Dr Sharmila feels there should be an attempt to increase the awareness of the signs and symptoms because by the time it is picked up, it is too late.