Seizing opportunities, fighting to live: How young cancer patients deal with challenges and treatment
SINGAPORE: For the past three years, life has been a juggling act for Shaun Lim.
Like most of his peers, the 24-year-old psychology undergraduate spends his time studying for examinations, as well as rushing to meet deadlines for assignments and schools projects.
He is also battling cancer.
Mr Lim was diagnosed with stage three sarcoma cancer in July 2019. It is a rare and aggressive form of cancer that affects bone and soft tissues. He was 22 years old then and had just started university.
Being young and active, Mr Lim struggled to process the news and was in denial about his diagnosis.
“At that point in time, I was playing basketball quite regularly and I was also going to the gym quite regularly as well,” he told CNA. “So it was one of the last things, in my mind, that could happen to me.”
The reality of the situation only hit him a month later, when he started his treatment.
“I was warded for chemotherapy and that was when it finally sank in that I had cancer and that I had to go through treatment to get rid of it,” he said.
Things took a turn for the worse in December 2019, when he had to undergo major surgery to remove a tumour in his abdomen. It forced him to take a year-long leave of absence from university.
Mr Lim was among the patients highlighted by the National Cancer Centre of Singapore (NCCS) as it marks National Cancer Survivors Day on Sunday (Jun 6).
It is a "celebration of life" that is marked annually around the world.
"Participants unite in such a symbolic event to show the world that life after a cancer diagnosis can still be meaningful, active and productive," said NCCS on its website.
WHEN THE YOUNG GET CANCER
According to an annual report published by the Singapore Cancer Registry, which presented trends from 1968 to 2018, those under 39 years old historically make up less than 10 per cent of all cancer diagnoses per year.
NCCS said it sees between 450 and 550 new adolescent and young adult cancer cases each year.
While they are a relatively small group, medical experts CNA spoke to said such patients face a distinct set of issues because of their age group.
Fertility preservation, as well as the ability to return to work, are common concerns among young cancer patients, said Dr Teh Yi Lin, the director of NCCS’ Cancer Education and Information Services.
“For young patients, especially those who have yet to get married, or are newly married and who do not have children, fertility may be one of the things that are on their mind,” said Dr Teh, who is also an associate consultant at NCCS’ medical oncology division.
“This is something that we do have to discuss with each individual patient before they embark on treatment because various treatments can cause sub-fertility, and while our younger patients tend to recover fairly well, not all of them would be able to conceive in the future."
Returning to normalcy or trying to restart careers after treatment could also be challenging.
“Patients might feel like they are always feeling fatigued and that this might impact their day to day work, or day to day lives,” Dr Teh said.
She noted that in some cases, patients who had an amputation as part of their treatment would also have to get used to using a prosthesis and find a job that accommodates their needs.
FIGHTING TO LIVE
Despite the odds stacked against them, young patients often demonstrate a “strong” determination and will to fight and live, according to medical experts CNA spoke to.
Dr Wong Seng Weng, a medical director and consultant medical oncologist at The Cancer Centre, said he sees between two and five young adult patients each year.
Most of them choose not to compromise on their treatment, often opting for aggressive therapy, he said.
“They have a lot to live for and they have many years ahead of them,” he said.
“So if you give them strong chemotherapy, they take it because they are able to handle side effects fairly well and also because they are young and their organ functions are very strong.”
It is a similar observation for Dr Teh who said that none of the young patients she has encountered so far has rejected treatment.
That is despite knowing how tough it can be, she added.
Recalling a patient she lost last year, Dr Teh said the man in his 30s, who had been diagnosed with stage four cancer, continued treatment even though the outlook was not promising.
“He had quite a bit of side effects related to treatment but all the while, he told me that he wanted to live on for his child, so that he could see his child grow up,” Dr Teh said.
“When the cancer got too aggressive, he was still fighting on, he was still trying to go to work so that he could still save whatever of the savings for his spouse as well as his child," she added.
“It was definitely a heartbreaking journey, especially towards the end, but seeing his determination … I think that was very inspiring.”
FINDING MEANING IN HELPING OTHERS
For young people like Mr Lim, the cancer and treatment also affected his social life.
“At the start, I couldn’t go out and spend time with my friends and I couldn't play at the basketball court or go out for meals with friends … so for a good period of time, I felt a bit more isolated,” he said.
Even after he returned to school, it was not without challenges.
“There were some moments where it was quite tiring because of the side effects of chemotherapy but, I still had to continue studying for my quizzes or contribute to my group projects, study for finals,” he said.
“Actually looking back, I have no idea how I did it, somehow I managed to pull through.”
Mr Lim is not out of the woods yet. He is due for a scan early this month that will determine whether the treatment has been successful.
In the meantime, he is planning for his future and is leaning towards a career path in psycho-oncology, a field that looks at the psychosocial aspects of cancer.
The hope is to be able to help others like him deal with cancer, he said.
“With everything that has happened, it made me think, as well as explore, the prospect of psychology,” he said. “I want to try to give back to society, as well as help current and future patients, by putting what I study into something meaningful.”
As he waits for his third year at university to begin in August, Mr Lim is volunteering at NCCS, where he helps to plan outreach programmes for young cancer patients.
“It’s definitely fulfilling … and it's not a chance or an opportunity that I want to waste,” he said.
“After going through everything, I’ve realised that life is pretty unpredictable and short so … if there’s something that I want to do, I shouldn’t waste time thinking about unnecessary stuff and just go in and do it.”