She was always feeling breathless and had excruciating back pain. A rare, incurable blood cancer was the cause

It started with a feeling of breathlessness in December 2021 while Patricia Wong was climbing two flights of stairs at work. The then 44-year-old engineer, who had been exercising weekly, was puzzled. Thinking that her physical fitness had declined, she tried going for long walks.

This did not ease her breathlessness. In fact, three months later, she began to experience back pain as well.

Wong consulted a general practitioner who prescribed muscle relaxants and gave her a referral letter to visit a government hospital two weeks later.

Her back pain progressed significantly during those two weeks.

“Sitting up was okay. But I couldn’t lie down at all. I could not sleep every night and perspired a lot. I tried sleeping on my side, raising my feet on the pillow, sleeping in a praying position [kneeling prostrate] – it did not work,” she told CNA Women.

Out of desperation, Wong began sleeping on the sofa at night. “On sleepless nights, I walked to the kitchen and looked out of the window, wishing for good sleep,” she recalled.

Wong’s mother, whom she lives with, was heartbroken to see her daughter suffering, and managed to persuade her to try sleeping in bed again.

However, one afternoon, the pain was so bad that Wong found herself unable to get out of bed to go to the toilet. “I tried to roll over and get off in a kneeling prostrate position and then I could not hang on anymore and just urinated. I wet my shorts and there was a pool of urine on the floor,” she said.

During her appointment at the hospital in February 2022, Wong’s X-ray showed lower lumbar degeneration, the wearing down of the discs in the lower back which act as cushions between the vertebrae.

About three weeks after, she saw an orthopaedic doctor, who scheduled an MRI (magnetic resonance imaging) scan for a fortnight later. But Wong was unable to wait for that appointment. “I was in so much pain, it was unbearable,” she said.

Her sister managed to arrange for her to see an orthopaedic doctor the next day, at a private hospital. He sent her for an MRI that same day, which revealed compression fractures in her top and bottom vertebrae, even though she had not suffered any falls or injuries.

A week later, the doctor ordered a blood test, which confirmed that Wong had multiple myeloma. She was immediately admitted to hospital. 

BATTLING A RARE BLOOD CANCER

“Multiple myeloma is a blood cancer that affects a type of white blood cell called plasma cells, which are found in the bone marrow,” said Dr Melissa Ooi Gaik Ming, senior consultant at the Division of Haematology, National University Cancer Institute, Singapore (NCIS), whom CNA Women spoke with.

“In a healthy person, the role of plasma cells is to produce antibodies against infectious agents such as viruses and bacteria. Myeloma occurs when normal plasma cells become cancerous or malignant, and multiply uncontrollably.

“Multiple myeloma causes plasma cells to accumulate in the bone marrow, weakening and damaging the bone. This can result in bone pain and fracture, and can also lead to increased levels of calcium in the blood,” Dr Ooi added.

Though rare, the blood cancer is slightly more common in seniors 65 years and above, in males and those with family history. Wong does not fall into the high-risk group.

“[Plasma cells may also] overcrowd the bone marrow, outnumbering normal blood cells and limiting the production of healthy blood cells.

“Decreased blood cell numbers can cause anaemia, excessive bleeding and a decrease in the ability to fight infection. As a result of the anaemia, shortness of breath and tiredness are common symptoms,” Dr Ooi said.

Because Wong was severely anaemic at the time of her hospital admission, she received four bags of blood transfusions daily for a week as soon as she was admitted. She also began chemotherapy for multiple myeloma.

At the same time, and by chance, other diagnostic tests revealed that Wong also had Stage 2 colon cancer. Hence, she had to undergo surgery to remove part of her colon. She did not have to undergo chemotherapy for colon cancer but sees her doctor for a yearly colon review.

Although her treatment for multiple myeloma was going well, Wong decided to stop treatment at the private hospital after two weeks because of mounting costs. In April that year, she was admitted to a restructured hospital and underwent stem cell transplant for multiple myeloma.

“Generally, stem cell transplant uses a high-dose chemotherapy to destroy all the cells in the bone marrow, before re-infusing healthy stem cells that allow the bone marrow to start producing healthy blood and immune cells,” said Dr Ooi.

She continued with chemotherapy, though she experienced some allergic reactions to the drugs and developing bad rashes. Once, there was even blood in her urine, and she had to be admitted to the hospital.

Wong, who is currently being treated at the Singapore General Hospital, said that after several adjustments to her medicine, her body reacted well to the treatment. From daily chemotherapy sessions, she progressed to weekly sessions.

Now on her 22nd chemotherapy cycle over a period of more than two years, Wong is currently on monthly chemotherapy maintenance.

LIVING WITH AN INCURABLE DISEASE

Now 47, Wong knows she will have to live with multiple myeloma for life.

Last year, after a year of no-pay leave, she returned to her company on a part-time basis, working three days a week. Wong is a process manufacturing engineer, supporting the production of healthcare instruments used in the semiconductor industry.

“I was worried about paying the bills, and didn’t want to burden my mum and sister,” she said.

“My company has been supportive. My manager worked out a schedule for me so that I can continue to go for treatment while working. And my colleagues have been very understanding. They don’t let me take any strenuous jobs,” she said.

This support has been invaluable to her, said Wong. And she hopes to raise awareness, such as by doing this interview with CNA Women, so that other patients like her can receive adequate support. She is also part of a multiple myeloma support group that can be reached at myelomasg [at] gmail.com (.)

“Because multiple myeloma is so rare, few people have heard of it,” she said. 

Even though Wong’s condition has stabilised, there are hard days. “Some days, when it’s quiet, I wonder when I will pass away,” she admitted.

“But I’m taking it one step at a time. I try to take walks and look at my surroundings.”

An avid cook, she finds fulfilment in the kitchen.

“When I was hospitalised, I was so sick of hospital food. In my mind, I thought about all the food I wanted to cook,” she said.

Since discharge, Wong has been whipping up delicious meals for her family with fresh ingredients from the wet market. She loves to cook soups, saba [king mackerel], udon and even homemade chicken nuggets.

“I like it when I say, ‘Let’s eat’, and my family assembles and finishes all the food,” she laughed. “The cancer has brought my family even closer than before.”