World's Top Class Breast Cancer Treatment in Korea: Interview with Dr. Paik Nam-Sun, Breast Cancer Surgeon

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Monday, October 10th, 2016
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Dr. Paik Nam-sun, Director of the Ewha Womans University Cancer Center for Women

Ewha Womens University Medical Center’s C-SMART platform was conceived of by Dr. Paik, Nam-Sun when he became the director of that hospital’s all-women cancer treatment center – the only such hospital in Korea. A great deal of meanings is embedded into this platform, where patients experience Convenience and Comfort and the Competence of the staff. The remaining portion of the acronym focuses on key areas: Scientific and Speedy diagnosis and treatment; encouragement of Medical tourism; recognition of Alumni a resource; Research; Trust and good use of Technology.

In an era of fiercely competitive hospitals, it is easy to dismiss this as gimmicky PR. Yet, the C-SMART platform reflects Dr. Paik’s earnest desire to provide comfort and ease of process for his patients in what is likely the most difficult period of their lives. Indeed, the platform is treated more like a mantra by the director and serves as guiding principles for the staff of the cancer treatment center. Nowhere is this more evident than when Dr. Paik speaks about the care, respect, and consideration given to his Muslim patients – women, whose sickness offers them a degree of latitude, but whose daily routines are for the most part guided by strict cultural and religious principles.

Communication is key to being a good doctor, he says. Although he stresses the importance of learning different languages to facilitate this, his patients must undoubtedly pick up on his superb bedside manner and non-verbal skills. Often referred to as “the singing doctor,” the doctor’s easy smiles and general affability engender a sense of approachability and trust, and surely communicate the feeling of individualized, personal treatment.

Although the cancer treatment center is visited annually by thousands of women from China, Russia, and the Middle East, the doctor is keen to expand the center’s patient list with the addition of more Korean-Americans. This makes sense of course, as Korean medical skills now are on par with – or surpass – American medical skills, for 1/10th of the price tag. Below, Dr. Paik addresses this and other areas of interest.

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Julia Yoo, Reporter of Korea IT Times (left) and Dr. Paik Nam-sun, Director of the Ewha Womans University Cancer Center for Women (right)

Q: In what areas do you think EWMC surpasses other hospitals in Korea and abroad?

A: In some areas, Korean medical skill surpasses that of the Americans, Europeans, or Japanese – especially in the fields of gastric and breast cancers. Ewha Womens University is 130 years old, and the hospital is 129 years old. As a university hospital, we are very experienced. Also, at other hospitals, patients keep their street clothes on during their consultation and, perhaps, take some x-rays. Here, the protocol is for the women to change into hospital gowns. They are then given a physical examination. These things are extremely important. We have a highly developed and structured process, and ultimately this gives women peace of mind. They have confidence in us. More importantly, as the only cancer center for women in Korea, we have been able to specifically focus on women’s issues. For breast cancer, our results speak for themselves.

The 5-year survival rate is about 91% and the 10-year survival rate is about 84%. Globally, those are top results in the field of breast cancer treatment. So in terms of treating the disease, we are unsurpassed. But, almost as important is what we have been able to do for the women’s quality of life. Using my special technique for breast cancer treatment, I was the first doctor in Asia to successfully to perform breast-conserving surgery, so that the breast is saved while recurrence or survival rates remain almost the same. In terms of the cosmetic effect, it’s superior to the alternative – mastectomy for example. This surgery is highly developed at this hospital and I’m proud to have developed it.

Removing and replacing

Process (1~6) of oncoplastic breast-conserving surgery

Q: A patient in the hospital in the fast track system can be diagnosed and in surgery within one day. You use something called cryosection, which can be done in a few hours, as opposed to up to a week at other hospitals. How accurate is it?

A: The accuracy is almost 100%. It’s excellent. But let me mention again that we always first check the patient in a physical examination. We also order a mammography and sonography for the patient. If something looks suspicious we also check with MRI and we do tests on breast specific imaging. And, yes, within the first visit, we do a frozen biopsy. It takes just 2 or 3 hours to get the pathological results, so that is also our hospital’s advantage.

Q: Is it expensive?

A: The cost is about 1/10 of American prices. And our medical skills are the same or even better. So it’s quite a bargain. And many foreigners appreciate this. People from the Middle East, Europe, Russia come here, as do people from Kazakhstan, Uzbekistan, Mongolia and China. They recognize the advantages of coming here.

Q: Surely the smart hospital platform is more than simply providing friendly service. Because you have patients from all over the world, how are cultural differences or specific social mores accounted for in your Smart Hospital platform?

A: We try to make our foreign patients as comfortable as possible. For example, Muslim women don’t like to expose themselves in any way to men not their kin, much less doctors from other countries. They do want a woman doctor. But in these situations they make exceptions. They all come to see me. I do my best to take into consideration their sensibilities and culture. Also, in order to make them feel comforted and respected, they are given a prayer room, a TV with Arabic channels, and halal food [“Permissible” food developed by Islamic scholars based on Islamic tradition and Islamic verses]. They seem to appreciate this because many of my patients come to this hospital through word of mouth.

ewha womans university cancer center for women

Q: Depending on the mass in the breast, the removal amount is different, so is there silicone involved? Are you enhancing the breast during the reconstruction?

A: If there the defect is small, we remove the tumor and replace it with some biologically inert material; in case of advanced cancer, we administer chemotherapy before surgery – so called neoadjuvant chemotherapy. Then we save the breast or sometimes totally remove it and insert a silicone or saline bag. If the cancer is too advanced, saline or silicone bags can’t be used. In those situations, tissue from the lower abdomen is transplanted to the breast.

Q: You were a gastric cancer specialist. What led you to the breast cancer field?

A. At that time, conferences in the U.S. mainly focused on lung or breast cancers, while Koreans were mostly getting gastric (or stomach) cancer. I saw a link between the economic status of a country and the rates of lung and breast cancers. By observing developed countries, we can know our own future in terms of disease patterns.

Q: You are frequently invited by foreign governments to demonstrate surgical procedures, and you and your team have volunteered your medical services abroad. What are your main goals when you make these trips?

A: I go abroad about 5 to 7 times a year. I always try to be active. I think Korea and this hospital should be active. I’ve been told that every time I go on one of these service trips, it’s a form of medical diplomacy.

Russian patient shakes hands with Dr. Paik after surgery

Russian patient shakes hands with Dr. Paik after surgery

Q: You have spoken about encouraging Korean-Americans to come to Korea for treatment. Have the enticements been enough to win them over?

A: In Korea, detecting early cancer with medical insurance is about 200,000 won; in America it costs about $7000. But a lot of Korean-Americans who’ve lived in the U.S. for 30, 40 years don’t know how advanced we’ve become, especially in the field of medicine. It’s important to let them know because one illness in the United States could wipe out their bank account.

Q: What do you see as being the greatest challenges?

A: Communication is important to me – to teach other doctors and to communicate with my patients. Translators are necessary of course, but doctors should make the effort, too.

Q: You clearly have a global scope. What motivates you?

A: Ultimately to be a good doctor … to be a competent doctor to my patients and give them comfort.

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