“Medical services in Namibia are developing towards a higher level, and what we are going to see in Namibia is the introduction of super specialist clinics that are organ specific. We are doing this for breast and thyroid.” Renowned surgeon Professor Justus Apffelstaedt is an Oncologic Surgeon, the head of the Breast Clinic at Tygerberg Academic Hospital, an Associate Professor at the University of Stellenbosch in South Africa, and has just opened a breast, thyroid and parathyroid health practice in Windhoek.
“If you look for example, the survival of breast cancer in our clinic is better than world indicators stage by stage.”
When the Professor noticed that a third of his patients at his Cape Town practice, were from Namibia, he decided to bring his services here. “The aim is to replicate the set up that we have in Cape Town where we run a super specialist practice, practicing according to leading indicators of quality in health on the global scale. If you look for example, the survival of breast cancer in our clinic is better than world indicators stage by stage.” Says Professor Apffelstaedt, who adds explaining the indicators, “If you look for example in screening for breast cancer, we pick up cancers so early that we exceed quality parameters in the Australian breast cancer screening program which is the worldwide best screening program. If we look at parathyroid surgery, we are achieving a ninety eight per cent, correct localisation and operation procedures.”
“I like to practice medicine academically. And that means to do what’s right for the patient in the patient’s totality.”
From his practice, which is operating out of the Paramount Healthcare Centre in Windhoek, the Professor notes, “I think the times where you just practice medicine without proving that you are having the right quality, these times are slowly coming to an end. I like to practice medicine academically. And that means to do what’s right for the patient in the patient’s totality.”
“We can integrate oncologic treatments to decrease the invasiveness of surgical treatment, which in turn will improve functionality of the patient afterwards.”
“We are becoming much more integrated. For example, in the management of breast cancer, we are seeing our patients in so called combined clinics, where people with the appropriate skills are present and deliver their inputs. For me in breast health it has been most interesting to see that in a combined clinic the most important exchange does not come between the oncologic surgeon and the plastic surgeon but between the radiation oncologist and the plastic surgery. That is something that is very interesting and that’s what many people don’t know about. What we are seeing is that the reconstructive part and the minimising invasiveness and minimising toxicity at all levels of management of cancer problems, has come to the fore. We can integrate oncologic treatments to decrease the invasiveness of surgical treatment, which in turn will improve functionality of the patient afterwards. We adapt our reconstructive options for example, as to whether radiation is needed or not. So it has become much more integrated and much more patient centric and centred on the patient’s functional, emotional and social rehabilitation.”
Discussing the potential warning signs the Professor notes, “In my special field of interest, lumps in the breast should not be neglected. Furthermore imaging that doesn’t show the lesion does not mean that there’s not something there because mammography and ultrasound have got their faults, negative rates.” To which the professor adds that if correctly performed this negative rate should only be at around five percent.
“The act of going to an imaging centre that practices high quality of mammography will actually decrease your risk of dying of breast cancer by at least half.”
When talking reliability of mammograms, the Professor says, “We have shown in our own set up in Cape Town that if you go for regular mammography, your mortality from best cancer is going to be halved.” He adds that this is even just in the act, and thus ultimately the earlier detection, “The act of going to an imaging centre that practices high quality of mammography will actually decrease your risk of dying of breast cancer by at least half.”
When asked how often a woman should be going for regular mammography testing, the Professor explains, “For the younger, that means the woman below fourty years of age, the screening, in my opinion, should be relatively narrow, that means once annually. Once you are postmenopausal the density of the breast decreases and mammography and ultrasound become much easier and then screening can be stretched up to two years.”
“If other people are telling you ‘listen there is that mass, this lump in your neck’, have it examined.”
Talking warning signs for the Professors second area of expertise, the thyroid gland, Apffelstaedt explains, “There are two types of problems with the thyroid. Functional problems, which will be picked up by the general practitioner like for examples if the thyroid becomes sluggish and tired and your skin becomes dry and your nails and your hair becomes brittle, this is hypothyroidism. Hyperthyroidism is also something that should interest the general practitioner, where you have palpitations, you have got anxiety, you are sweating, you lose weight. This is the general stuff that patients would visit their general practitioner for. If you talking about anatomical problems in the thyroid gland, and this is my major field of interest in the thyroid gland, the possibility of cancer arises obviously. If other people are telling you ‘listen there is that mass, this lump in your neck’, have it examined. When you are in front of the mirror in the morning and you see on the one side of the neck something is thickened or is sticking out, have it seen to.”
Discussing recovery in these cases, the Professors notes “Most of the thyroid cancers luckily, are what we call differentiated thyroid cancers. This means that they grow rather slowly and the long-term survival, up to thirty-five years, is excellent if treated properly. So you should not neglect that because if you leave even a slow growing thyroid cancer that grows over years and sometimes even decades they have the potential to dedifferentiate and become rather aggressive.”
With an approach to treating breast and thyroid cancer patients in a manner that is supportive and encompasses both physical and psychological reconstruction, the Professor will be offering in-practice consults in Windhoek, for two days of every month, while he grows his super specialist practise here.
For more information about Professor Apffelstaedt, find his website here
To find when Professor Apffelstaedt will be in Windhoek contact Annecke Mansfeld on +264 (0)61 287 1188 or send an email to email@example.com
Written by Kirsty Watermeyer