A Word to Cancer Patients Out There
“Do not give up!” – Nah, this is too cheesy. I would say, “Be strong!!” because other cancer patients have it harder, have been poked by needles more times than you, have grown weaker than you are, and are in the later stages of cancer. During my chemotherapy sessions, I saw a mother who had to take care of her three kids while on a drip, whereas I had movies on iPad to accompany me. On another occasion, I had difficulties opening the lid of my lunch takeaway because of the flexible tube in my forearm; an elderly (waiting for the nurse to start drip on her) across me smiled and came forth to assist me. I was amazed at how carefree she took chemo sessions as the norm while I dreaded each visit. I have heard stories of cancer patients going for more than 20 chemo sessions and more prolonged than 4 hours, whereas mine is only seven sessions, 4 hours each.
Stay positive, try your best to complete all treatments, think of yourself and your loved ones. And don’t worry about cancer recurrence. However, I worried about myself at times; a little angel constantly whispered to me to make more effort this time round to show more concern and cherish every moment with my family.
Introduction
I had written 42 posts for TechSch but never had once thought of penning down my journey with Stage 2 Nasopharyngeal Cancer (Nose Cancer). Using words like ‘fight’ or ‘battle’ exaggerates my case because many cancer patients are battling ten times harder than I am and even had to go for surgery. So, why do I want to share my story now? This is because I came across a thread titled “If you got cancer will you bother to go for treatment?” in one of the local forums Eat-Drink-Man-Woman (EDMW) this evening. There are many opinions and bits of advice in the replies. Some said you don’t need to bother to go treatment if you got Stage 3 or 4 cancer. Others replied that if you are, e.g., 55 years old and above, you should skip treatment, take the money, and enjoy the remaining life. Then, one had cared for his mum with cancer and is grateful that it extended her life.
As I am cured of cancer, I am biased and disagree with forgo treatments type of replies. However, it strikes me that I should write down my own experience, not to debunk that radiotherapy and chemotherapy treatments are useless or ineffective and a waste of money but to repay by sharing my story to tell cancer patients that it is not the end of the world. You see, I was disheartened when I found out that I am a suspected case of nose cancer. I went online to research various stages of Nasopharyngeal Cancer. Most importantly, I read stories about patients recovering from same cancer as me and had carried on living with their lives and family. I have a wife and two kids, so you can imagine how such stories motivated me and lifted my spirits even just for that brief moment.
Background
I never thought cancer would find me at age 38
Well, it did, and I learned to accept that it just happened to be me. I am a typical Singaporean guy. I obtained PSLE, O level, Diploma, Bachelor and went to National Service (NS). I started working, found my love, married, and bought an HDB flat. After a few years of married life, we created a family and have two naughty kids now. In between my work life, I changed 2 – 3 jobs, but all are IT-related and are 80% desk-bounded (e.g., programmer), whereas I had to move around to do end-user support for the remaining 20%.
I am healthy and fit in general.
On a scale of (obese, lazy, extremely unhealthy lifestyle) 1 to 10 (super-fit, hard-working, exercise daily), I will rate myself a ‘6’. I went to National Service (NS), and I belong to the ‘siong’ training era where one must serve 2.5 years. My vocation was Commando Fighter, and I was PES A until I completed all my eight cycles of reservist and annual Individual Physical Proficiency Test (IPPT). My worst station is 2.4km run, and there was once I managed to pass the run on my 5th attempt, I never had to do remedial training (RT) before. I had no history of major illness and seldom fell sick. On average, I took less than six sick leave per year. I can walk long distances and jog 3km easily. I can carry my little boy or girl and walk shopping malls while they fall asleep on my shoulder.
My Lifestyle
I had consumed less than 100 cans of beer in my entire life! I only drink alcoholic drinks during Chinese New Year and Christmas but in small quantities. For example, I would share a can of beer with my dad. And no, I don’t smoke or go clubbing. I have a mixed diet, and I ate lots of meat and little vegetable, the ratio about 3:1. I will always order two meat/fish and one other non-vegetarian dish like sliced potatoes or fried egg for a plate of economic rice. Then either western food or fast food once a week. I don’t go crazy with bubble tea or Starbucks coffee, and I will have 1 – 2 cups of hot tea (teh) or coffee (kopi) after each meal which I consider as uncle’s favorite drinks at my age.
My bad habits include sleeping late, often at 2 – 3 am, one bowl of instant noodles, and 2 – 3 times of potato chips every week. I also drink half a cup of Jim Beam Cola which consists of Jim Beam (1cm depth) mixed with half a can of coke once a week. After completing my reservist, I ‘downsized’ my exercise regimen to 1 – 2 times jogging every two weeks at my current workplace, ranging from 3 – 4km.
Annual company health screening reported nothing unusual.
I always make an effort to sign up for my company’s annual health screening. I will also upgrade the basic screening package to the next tier to include more tests. For the past ten years, all the lab reports never detected anything terrible. The recent report (the year I was diagnosed with cancer) concluded that I was slightly obese at 71kg weight and 1.71m height.
Timeline
Early Nov 2019 – Symptoms: Nose bleed, lump on the neck, and ear block
I felt a small painless lump on the lower right of my neck one day, the size smaller than a 1-cent coin, and I got frequent right ear blocks as if the sound was muffled during those days. I hesitated to see a doctor and went on with my daily routine thinking that it might be some insect bite or go away in time. It bothered me for almost two weeks until one day when I was eating tom yam flavor instant noodle at the dining table, and halfway through; I felt some liquid flow out of my nose. It was blood! Alright, so I thought maybe the noodle was too spicy. But within a week, I got a nose bled again when I was doing work in front of my desktop. Within a week, this two nose bleeds occurrences, coupled with the lump on my neck, made me feel that something was not quite right and prompted me to see a doctor the next day.
Mid-Nov 2019 – Diagnosis: Doctor says, “You got to prepare yourself….”
It was late evening, around 5 pm on a weekday when I visited my family doctor. I went in told him about my nose bleed and the neck lump. He did not check my nose, and I can’t recall if he even felt the bump on my neck or because it could be visible to the naked eye. He was calm and told me, yeah, you got to prepare yourself for what I’m going to say, but before I could, he already let out the second sentence, you may have nose cancer (Nasopharyngeal Cancer). He explained that there are two paths that I can take for treatments. Visit Polyclinics and get deferment letters or head straight and check me into the A&E. He mentioned the longer waiting time for Polyclinics and recommended that I go the A&E route if I wanted fast.
At this point, I felt more confused than worried, perhaps because ‘cancer’ is still new to me, and I left the clinic. I was walking back home when my mobile rang. It was the clinic asking me to return. I went back, and the receptionist asked me to wait while the doctor wrote me a letter to pass to the next doctor I would see. Back home, I told my wife what the doctor said and that I would go to A&E by myself after dinner. I guess she wasn’t too worried, and it was dinner as usual for the whole family.
15 Nov 2019 – Checked myself into SGH A&E
I took a cab down to A&E by myself because my wife had to look after the kids. It was almost 8 pm when I arrived at A&E. I took a queue number and was called up for ‘basic’ registration at about 10 pm. Then, I waited again to do my blood test, and after my blood sample was taken, it was like another 3 – 4 hours wait before the blood test results came out. The general doctor called me in and told me that my blood did not show any signs of cancer makers. I thought for a moment, alright, this is good news; maybe the entire episode is a false alarm.
I waited again to see an Ear, Nose & Throat (ENT) specialist for a general diagnosis. She used a vacuum-type medical machine to suck wax from my right ear. It only helped a little bit. She further explained that my ear is fine, no wax or anything, and the lump on the neck causes the irritation because I don’t know what liquid cannot discharge out normally. The ENT specialist then made a phone call to a senior doctor down to A&E to see me, which by this time, I guess my cancer was more or less positive. He collected my nose swab (biopsy) by inserting a lubricated tube down into both nostrils to scrap the tissues. At the same time, photos were taken. He told me that I needed to wait 1 – 2 weeks for the lab results to confirm if I really got nose cancer. And by the time I reached back home, it was already 5+ in the morning.
ENT specialist explained there is no medicine for my ear discomfort. Unconvinced, before my Taiwan trip, I went to see another family doctor and told him all my symptoms and the hearing irritation that I wished him to help me with. I also informed him that I am suspected of having nose cancer pending results. He didn’t seem alarmed and never offered any cancer-related pieces of advice. He just prescribed some ‘tablet’ medicine for me to eat, but it did not help. While I still have not alerted my parents up to this point, I did share with my wife whatever the doctors told me. And I told myself, I did whatever I could; I sought A&E, which is the fastest path after my GP advice on the same day. I did all tests during my A&E visit and had to wait for lab results before knowing what the doctors could plan for me.
19 – 24 Nov 2019 – Taiwan Holidays
I was still very upbeat about the Taiwan trip with my family. We talked about the trip for a couple of weeks now and finally purchased air tickets on 16 Oct, before discovering my nose bleeds and neck lump. After my A&E visit and before the Taiwan trip, I was more focused on the trip itinerary than my health, probably because I didn’t know what lay ahead for me while waiting for the lab results.
It wasn’t a delightful trip because my right ear was muffled most of the time, which irritated me plenty. The feeling is equivalent to ear blocked at high altitudes. For most of the days, I had like 50% hearing loss on my right ear, and I found myself talking louder than usual because of it. One day, I received 2 – 3 calls from an unknown Singapore (+65) phone number, which I ignored. It was about 8+ pm local time when I finally decided to pick it up while I was strolling alone (family resting in the hotel) in one of the street night markets. The caller was the senior doctor who did the nose swab for me during the A&E visit.
He told me that my lab results are out and I need to go back for a review. I explained to him that I am now in Taiwan for a holiday hence can only do so after I return. I asked him how was the results, and he told me to come back for a review then say. Sensing that he doesn’t want to disclose the outcome, I ask him again if it is good or bad news. He replied, not good, but not that bad…. still requesting that I return first and continue enjoying my holidays. After putting down the call, I continued to walk in the night market, although in my heart, I know the meaning of ‘not good,’ which means there is some truth to nose cancer. Again, returning to the hotel room, I shared the phone conversation with my wife.
25 Nov – 16 Dec 2019 – Consultations happened one after another at an accelerated speed
Back in Singapore, the senior doctor at SGH disclosed that the outcome of my test result is positive (Stage 2 Nasopharyngeal Cancer) but not too worried as it is potentially curable. He asked me questions like, do I drink alcohol or eat salty meat? No, I only drink beers on occasions like Chinese New Year and Christmas, and I don’t eat salty meat. Do I smoke? No, I said. Do I ever smoke before? No, never before, I said. He was kind of dumbfounded. Then he explained to me that nose cancer is common among Singaporeans and is not age-related. He arranged for me to see a radiotherapy doctor in the radiation oncology department in National Cancer Centre (NCC) and booked a dental review with National Dental Centre (NCC). He also arranged a hearing test for me to check the irregular hearing of my right ear, and results concluded that my right hearing is indeed affected to some extent when comparing the audible graph to my left ear.
1st Week Dec 2019 – Dental review and Tooth extraction
I had to clear my dental review before I could go for radiotherapy. This is because radiotherapy, in my case, will be targeted at my neck and nose areas which affect the mouth, including saliva glands, etc. For example, the mouth will be dry, and the gum will be weak during and after radiotherapy. If one ever had done tooth surgery during this period, it will result in a slow recovery. In short, the gum is not going to recuperate as fast as it should. I have got an ‘extra’ tooth at the beginning of my right bottom row of teeth. A few years ago, a dentist advised me that this tooth got to go as it is useless, not helping me chew food, and could cause potential problems in the future. I held back because I already had gum surgery and a root canal with him, and I needed a break. But this time around, there is no running away. I had to do the tooth extraction. In all, I paid 4 – 5 visits to different dentists at NDC for initial review, extraction, removal of stitches, and the last one for final review.
2nd week Dec 2019 – Pre-book Radiotherapy and Chemotherapy sessions in National Cancer Centre (NCC)
My radiotherapy doctor scoped the back of my nose and took some pictures. As I wouldn’t say I liked this procedure, I told her that the senior doctor over at ENT had done this already, but she replied that they don’t share the information. She then explained that I have to attend 33 radiotherapy sessions, and I questioned her why 33 times? She explained that medical studies had shown that 33 is the optimum number of times a person receives radiotherapy for killing the cancer cells while having minimum side effects to the body. On top of that, she told me that my neck lump was small but still sizeable. Hence, she also advised me to go for chemotherapy, which will have a more effective treatment outcome when combined with radiotherapy. Next, she arranged for me to meet my chemotherapy doctor, who is also from NCC.
My chemotherapy doctor told me that I would need to attend one chemotherapy session every week when the radiotherapy starts, all the way to the last week (inclusive) when radiotherapy ends. She pressed her calculator, and it returned 6.x times of chemotherapy, so she arranged for me to complete seven chemotherapy sessions as part of my cancer treatment. The drug that she is proposed for my case is Cisplatin, and she mentioned this is a lighter variant of the chemotherapy drugs that will still have but no drastic side effects.
Thinking Back
For many months, before discovering a nose bleed and neck lump, I had always thought that my life was unbelievably smooth sailing with no major illness and no physical injuries. I never sustained any severe injuries in my entire 38 years of life, had never broken any parts of my body before, and survived 2.5 years of my NS with superficial cuts. Deep down, with a clean bill of health, I am a little worried that misfortune will strike me when I get older, e.g., 60 years and above, as I don’t believe a human life can be perfectly fine without illness until the end of it. Premonition? Well, sort of. A couple of things I felt I had to be thankful for:
- My family doctor diagnosed accurately about the suspected Nasopharyngeal Cancer. Not only that, he gave clear pieces of advice that prompted me to rush myself to A&E on the same day of his diagnosis and not just chuck it away, e.g., only attend to it at the end of my Taiwan trip.
- I have no regrets about picking SGH as my treatment facility. The appointments after my Taiwan trip are well-coordinated and stacked tightly against one another from various departments (ENT, NCC, and NDC), ensuring I could start my 1st radiotherapy session within two weeks of my return.
- I had reviewed and bought insurance coverage for critical illness (CI) in 2018; hence all my expenses from SGH and NCC are covered except dental bills from National Dental Centre.
Up till now, I had only updated my wife and not my parents nor my brother.
On 17 Dec 2019, my cancer treatment journey began…. (Part 2)
