She survived womb cancer and started a wig salon to help others with hair loss
A cyst in her ovary led Misuzu Minamigawa Tashiro to discover she had womb or endometrial cancer. She tells CNA Women how her search for a wig to cover up her chemotherapy hair loss led her home to Osaka, Japan and then back to Singapore to open UZU Wig Salon.
In partnership with Parkway Cancer Centre.
Yoga instructor Misuzu Minamigawa Tashiro never imagined that the endometriosis cyst in her ovary, which she had had since her mid-20s, would result in the removal of her womb.
According to the Mayo Clinic website, in endometriosis, the cells from the lining of the uterus grow in places they don’t belong, such as the ovaries and fallopian tubes. Cysts found in the ovaries are known as endometriomas and indicate a more severe form of endometriosis.
Back then, Tashiro’s doctor had advised her to have the cyst, which was in her right ovary, removed. But shortly before the surgery, the former IT professional found out she was pregnant with her first child, and the surgery was cancelled.
The cyst went away after she gave birth, but reappeared six to seven years after her second child was born. This time, it grew larger with every six-month follow-up.
As she was not planning to have more children, her doctor recommended removing the right ovary. Tashiro was then 43.
In the lead-up to the surgery, she experienced spotting and abnormal bleeding for six months. So in October 2018, her doctor did a hysteroscopy (a procedure to examine the inside of the uterus) and found polyps, or growths, in the lining of her womb.
She was prescribed hormonal medication but the bleeding didn’t subside.
“In fact, it worsened, which puzzled my doctor,” the 49-year-old told CNA Women.
She was then scheduled for surgery in November 2018 to remove both the uterine polyps and her right ovary. But a day before the operation, she was rushed to the emergency room with severe stomach pain.
She had gastroenteritis and severe anaemia.
The surgery was re-scheduled again, this time to Jan 10, 2019.
RECEIVING WORSE NEWS: ENDOMETRIAL CANCER
Six days after the surgery, Tashiro’s life changed forever when the pathology tests showed that the uterine polyps were malignant, while the ovary removed was unaffected.
It was endometrial, or womb, cancer.
WHAT IS ENDOMETRIAL CANCER
Endometrial cancer is also called uterine cancer, or womb cancer.
It’s where “malignant (cancerous) cells form in the tissues of the inner lining of the womb called the endometrium”, said Dr See Hui Ti, a medical oncologist at Parkway Cancer Centre (PCC).
In Singapore, endometrial cancer is the fourth most common cancer in women. It ranks as the second most common cancer for Indian women, and is the third most common cancer for Malay women.
According to the Singapore Cancer Registry Annual Report 2021, it accounted for 7.3 per cent of cancers in women from 2017 to 2021.
That means one in 40 women have a risk of getting endometrial cancer, said Dr Kanneganti Abhiram, associate consultant at the Department of Obstetrics and Gynaecology, at National University Hospital (NUH).
He added the obesity and age are major risk factors in uterine cancer. “Women of a body mass index (BMI) of 30 or more have a three times greater risk.”
The cancer affects women between 30 and 69 years, with peak incidence at 40 to 59 years, said Dr Kanneganti.
Other risk factors are late menopause (beyond 55 years old), having never given birth, infertility issues, diabetes, high blood pressure, and those who have undergone oestrogen treatment as part of hormone replacement therapy, or tamoxifen therapy for breast cancer, said PCC’s Dr See.
Women with the highest risk are those with a strong family history or have a personal history of hereditary non-polyposis colon (colorectal) cancer, known as HNPCC or Lynch Syndrome.
“I didn’t burst into tears or panic; instead, I listened to my doctor calmly. I even noticed that my doctor and nurse seemed tense when delivering the results to me,” said Tashiro.
But a follow-up call from the doctor later that day released pent-up emotions – fear, anxiety, sadness, shock and tears.
“Thoughts raced through my mind about what would happen to my family, especially since I still had young children. I worried about how to break the news to them and about my upcoming treatments,” recalled the mother of two boys, who were then eight and 14 years old.
Misuzu sought a second opinion, which brought her to Dr See Hui Ti, a medical oncologist at Parkway Cancer Centre (PCC).
“Dr See patiently explained why the treatment was necessary based on evidence-based medical findings, what side effects to expect, how to control them, and how to manage the treatment period both physically and mentally,” she said.
Tashiro then underwent several rounds of surgery, including a hysterectomy to remove her womb, followed by chemotherapy and radiation therapy, the entire process lasting about nine months.
SIGNS OF ENDOMETRIAL CANCER
According to the doctors CNA Women spoke to, symptoms that can occur pre- or post-menopause include:
- Abnormal vaginal bleeding
- Watery vaginal discharge
- Unexplained weight loss
- Difficulty in urinating
- Abdominal pain
For pre-menopausal women:
- Heavy periods
- Intermenstrual bleeding (or bleeding between periods)
- Irregular periods
And for post-menopausal women:
- New vaginal bleeding more than one year after the last menstrual flow
- Excessive, abnormal vaginal discharge
NUH’s Dr Kanneganti said that endometrial cancer is usually discovered at the early stages and confined to the inner lining of the womb.
DOES ENDOMETRIOSIS INCREASE THE RISK OF ENDOMETRIAL CANCER?
“A woman can have both conditions existing separately,” said Dr Wang Junjie, head and senior consultant at the Department of Gynaecology Oncology, at KK Women’s and Children’s Hospital.
Endometriosis may increase the risk of other cancers, such as ovarian cancer, said PCC’s Dr See. “[Endometriosis] can cause severe inflammation of the areas where the abnormal womb lining is; long-term inflammation can cause cancer.”
She added that it would be wise for women with endometriosis to receive routine screening like pelvic examinations and ultrasounds to rule out cancer.
KEEPING BUSY DURING CANCER TREATMENT
To prevent herself from worrying too much, Tashiro, who was now working part-time, took up new hobbies, such as pottery and ikebana flower arrangement. She also visited museums, practised yoga, meditated and went for walks.
During the intervals between her chemotherapy and radiation treatments, she travelled – and travelled even more after completing all her treatments.
This was thanks to Dr See’s counsel. “She recommended using this time to challenge myself to do something new and distract myself from treatment or cancer-related thoughts. And it’s because of Dr See’s advice that I think I was able to spend my treatment period more meaningfully.”
Due to surgical complications, the nerves in her right leg were damaged and for more than six months, Tashiro couldn’t jog or run. She decided to attend yoga lessons to regain strength and heal her injured leg.
“After each session, I felt a sense of peace within myself and noticed improvements in both my physical body and mental clarity. Overall, I felt happier,” she said.
That led her to become a certified yoga therapist. She now conducts private self-care sessions that include yoga, meditation and pranayama (a yogic breathing technique).
ENDOMETRIAL CANCER: SCREENING AND TREATMENT
There is currently no globally accepted means of screening for endometrial cancer in low-risk women, although NUH’s Dr Kanneganti said obvious symptoms like abnormal vaginal bleeding or heavy periods need immediate medical attention.
Regular visits to your gynaecologist can help as symptoms can be quickly addressed. Screening tests done in-clinic include physical examination, ultrasound of the pelvic organs and an endometrial biopsy, where tissue from the uterus lining is removed for testing, said Dr Kanneganti.
Even a pap smear used to screen for cervical cancer, “can sometimes find some early endometrial cancers”, said Dr See.
For women in the high-risk group, such as those having Lynch Syndrome or endometrial hyperplasia (where the lining of the uterus becomes too thick, resulting in heavy or abnormal bleeding), Dr Kanneganti advised doing frequent, regular endometrial biopsies.
TREATMENT FOR ENDOMETRIAL CANCER
“The mainstay treatment of womb cancer is surgery,” said KKH’s Dr Wang. This involves removing the womb and ovaries, as well as the lymph nodes in the pelvis.
Your doctor might also include radiation or chemotherapy to lower the risk of cancer recurrence.
The good news: “As most women present at the earliest stage (Stage 1) of endometrial cancer, women at this stage have more than a nine in 10 chance of survival at five years, for whom the majority would have a lifelong cure,” said NUH’s Dr Kanneganti.
At Stages 2, 3 and 4, the five-year survival rate for endometrial cancer is about 75 per cent, 50 per cent and 15 per cent, respectively, he added.
For younger patients who wish to have children, Dr Kanneganti said if the cancer is detected early, hormonal treatment may be used. However, removing the womb would still be recommended once they have completed their family.
Women with Lynch Syndrome may also consider a “risk removal of the womb” after they have completed their family. “It removes the womb while it is normal to prevent cancer,” Dr See added.
HELPING OTHERS FEEL AND LOOK GOOD
Tashiro said she never felt alone during her road to recovery. Her family and friends checked in frequently, took her out for meals, accompanied her on walks and even looked after her sons when things got tough.
Though reserved by nature, Tashiro took part in activities offered by Parkway Cancer Centre. “Connecting with support groups and utilising the support system was invaluable for me during that time.”
Last year, the Singapore permanent resident started a wig business, UZU Wig Salon, which offers medical-grade wigs. These are made using real human hair and are specially created for those who suffer from hair loss due to alopecia or cancer.
“When my hair began to fall out, I had to find a medical wig quickly, but I didn’t feel comfortable going shopping while dealing with my hair loss.
“It was uncomfortable having to explain why I was looking for a wig, and the store staff didn’t show much sympathy and focused on hard selling. The options were limited too.”
Tashiro then decided to take her search to Japan. She would shop online and have the wigs sent to her parents’ place in Osaka. Her mother would then ship them to Singapore.
“I had to conduct extensive research and read numerous reviews. I ordered a couple of wigs from different shops and finally found my favourite one,” she said.
In 2023, Tashiro met with the CEO of the wig store when she visited her parents in Osaka, and clinched the rights to be the distributor for the wigs in Singapore.
MOVING FORWARD AFTER ENDOMETRIAL CANCER
There are days when Tashiro forgets that she is a cancer survivor. “I can say now that the cancer diagnosis is not all bad; rather, it has given me an opportunity to reassess my life.
“Getting sick made me realise what is truly important. My perspective on existence and my values have shifted significantly – I noticed what really matters to me and learnt to love myself, live more comfortably and simply, to stay away from stress, negativity and not push myself too hard, while also being grateful.”
To those going through their own cancer journey, she said: “Don’t worry too much; focus on yourself and concentrate on your healing journey and be stress-free. You are not alone.”
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