She fought cancer but gave up when it got 'unbearable'. Now this 27-year-old is trying again
Claire Liew, who has Hodgkin’s lymphoma, is not the only young cancer patient to stop treatment.
15 Sep 2024 06:00AM (Updated: 15 Sep 2024 06:51AM)
SINGAPORE: Claire Liew knew right away when she noticed the small lump on her neck in October last year.
She had been diagnosed with Stage 2 Hodgkin’s lymphoma, a type of cancer that affects the body’s germ-fighting immune system, back in December 2018. She was just 21 years old then.
And for nearly two years after, she fought tooth and nail to destroy the tumours in her body.
But when the physical and mental toll of multiple treatment regimens became too much, Ms Liew made the difficult decision to stop.
She then tried to live life as normally as possible; though she knew the cancer was still lurking in the shadows.
At the end of 2023, when she realised the lump in her neck had grown, she decided to seek medical attention.
A biopsy confirmed it: The cancer was back.
LIFE AT A STANDSTILL
It started with a persistent cough that lasted for more than a month, followed by night sweats, random fevers and small, painless lumps on her neck.The subsequent diagnosis of Hodgkin’s lymphoma came as a rude shock to Ms Liew, who had no family history and was healthy and active.
But she was determined to stay positive.
A first-year undergraduate in business management with communications at the Singapore Institute of Management at the time, she decided to defer her studies for a year to focus on treatment - and recovering quickly.
Ms Liew went through chemotherapy, which led to her losing hair as a side effect. That didn't deter her - instead, she experimented with different hairstyles through a collection of over 30 wigs.
“I just kept on telling myself that I will get out of this, because I knew that this will definitely pass … and that I’m stronger than I think,” she said.
But after completing 12 rounds of chemotherapy, scans in mid-2019 showed that a tumour was still in her chest.
In October that year, she received three more rounds of chemotherapy, followed by a stem cell transplant that further compromised her immune system.
It put her in hospital isolation for a month, and that's when "things became more unbearable".
Ms Liew developed an aversion to the "hospital smell", and couldn't sleep well because she was waking up every hour to vomit.
“It was just very, very bad … I would cry and beg to go home," she recalled. "I was already 22 years old, so I felt very (embarrassed) to do this."
She also longed for some normalcy and to regain her freedom.
“That was the worst … basically, not being able to do what other people could do at that age,” she said. “For my life to come to a standstill was just something that I didn't know how to react to.”
When further scans showed that the tumour remained in her chest, she decided she couldn't go through it all again.
Ms Liew discussed with her parents and eventually halted all her treatment.
“They saw how bad things were ... so I think to them, they also realised that (going through) a lot of this harsh treatment doesn't mean that it would work 100 per cent," she said.
She went back to school to complete her degree and graduated in 2021. She started working as a financial consultant last year.
Ms Liew, who had deferred her studies for a year to focus on her cancer treatment, graduated from the Singapore Institute of Management in 2021. (Photo: Claire Liew)
WHEN THE YOUNG STOP TREATMENT
The National Cancer Centre Singapore (NCCS) has seen an increase in the number of young patients like Ms Liew defaulting on treatment or follow-ups in the last six years, according to Dr Eileen Poon, a senior consultant in NCCS’ division of medical oncology.She estimated that this group makes up about 30 to 40 per cent of NCCS' patients aged between 15 and 39, which is an "alarming" number.
“Cancer, in general, is supposed to be a disease of the older folks," she said.
For it to strike earlier and afflict younger people could mean that "quite a sizable" portion of these patients would have a more aggressive and more serious form of the disease, Dr Poon added.
“For (younger patients) to stop treatment, it can actually be a lot more devastating and … have a lot more adverse outcomes. It’s not advised.”
According to Dr Poon, logistical and financial challenges were among the top reasons for why younger patients defaulted treatments or follow-ups.
Multiple, frequent clinic visits can "take a toll", while some of them could also be in denial or suffering depression over their diagnosis.
Then there are others who halt treatment because they "think they can use other methods of natural healing to get better”, said Dr Poon.
The Singapore Cancer Registry's latest annual report, which presented trends from 1968 to 2022, showed that men and women aged no older than 29 have historically made up less than 8 per cent of all cancer diagnoses.
NCCS treated over 6,000 adolescents and young adult cancer patients from 2018 to 2021, with 80 to 85 per cent expected to have long-term survival.
It sees about 500 new patients aged between 16 and 45 each year.
While they make up a smaller proportion of cases, younger patients face a distinct set of issues such as fertility preservation and the ability to return to work, said Dr Poon.
To help them navigate these, NCCS officially set up a clinical service last year offering holistic care specifically for adolescents and young adults.
It doesn't interfere with actual treatment but takes care of everything else, said Dr Poon, who started the service and is currently leading it.
“(This includes looking at) all the psychosocial distresses and identifying what is causing them to potentially not be compliant to treatment, or what is causing them distresses and then from there, we work out a plan to try and help them get through treatment.”
KEEPING UP THE FIGHT
Shortly after the biopsy confirmed that her cancer had recurred, Ms Liew started treatment again.This time, however, she was prescribed a different type of intravenous immunotherapy which to her relief, didn't cause any side effects.
To date, she is still undergoing immunotherapy with NCCS. Latest scans showed that the tumours in her neck and chest have shrunk significantly.
“Everything is normal, I don't feel anything in particular and I haven't been falling sick,” she told CNA. “The lump (in my neck) has gone too so that’s good.”
She doesn't regret her previous decision to stop treatment.
“For myself, it was really about me listening to my own body,” she said.
“I felt that, at that point in time, if I was going to pursue more and more treatment, it would not do my body any good ... I wanted to wait out for a treatment that I felt was worth to take again.”
Ms Liew wants her story to give hope to other cancer patients - and their caregivers - that the challenges and struggles will eventually pass.
“There are 'down' times but there are also definitely times where things will get better," she said. "You just really have to hold on to the hope and the support from your loved ones."
"I will just keep on thinking that I’m strong … and I take it that this journey is giving me a deeper understanding of life.”
