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'How can I give up a fight? It's not my way'

makapaaa

Alfrescian (Inf)
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<TABLE border=0 cellSpacing=0 cellPadding=0 width="100%"><TBODY><TR>'How can I give up a fight? It's not my way'

</TR><!-- headline one : end --><TR>Cancer-stricken Dr William Tan shares with Health Correspondent Salma Khalik the trials of his illness and speaks about his absolute commitment to beat the disease </TR><!-- show image if available --><TR vAlign=bottom><TD width=330>
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During the interview, Dr Tan wore two masks to protect his weakened immune system, a result of his ongoing chemotherapy treatment. -- ST PHOTO: CHEW SENG KIM

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<!-- START OF : div id="storytext"--><!-- more than 4 paragraphs -->Last year, Dr William Tan gave more than 30 inspirational talks around the world, sharing the secrets of turning adversity into opportunity.
He is well suited to that role, having overcome his disability - he has been paralysed from the waist down since the age of two due to polio - to become both a medical doctor and neuroscientist, a charity fund-raiser and a wheelchair marathoner who has set many world records.
But on April 14 this year, the Fulbright scholar met a hurdle he was not prepared to tackle. He was diagnosed with chronic lymphocytic leukaemia, a cancer where the B blood cells which normally fight infections are not only damaged but also grow out of control, pushing out other blood cells.
Doctors told him that without treatment, he would not survive a year.
He was understandably devastated by the news. 'I told my doctors I chose not to get treated. Let the bone marrow run its course and say goodbye,' Dr Tan, 52, told The Sunday Times last week.
'I felt frustrated. I had invested a lot in my future. I worked very hard to build up myself, overcome my disability. Now, there's not going to be a future. I was very angry.'
Just 10 days earlier, on April 5, he had been in Paris for the Paris marathon.
Among his many marathon feats was the one achieved in 2007, when he claimed a world record by doing seven marathons in seven continents in 27 days.
That year, he also became the first wheelchair athlete to do the marathon in the Arctic. He had attempted a marathon in the Antarctica in 2005, but had to abandon it halfway because of the glacial snow and m&d. In each of these feats, he battled sub-zero temperatures as he pushed his wheelchair, fitted with special spiked wheels.
But he had yet to race in Paris and it was something he had wanted to do for a long time.
'I finally went to Paris. What a place. I'd heard so much about the Eiffel Tower, the Arc de Triomphe... I was very confident. I was ready to take Paris,' he said, his eyes lighting up at the memory.
A few days before the race, his nose had bled. He attributed it to the dry spring weather, or an allergy to the pollen in the air.
Then, as the starter's gun went off and he was fully geared up to race, his nose started to drip blood like a leaky tap. 'My wristband was getting soaked. It's hard to squeeze the nose when pushing a wheelchair,' he said with a grimace.
He was forced to pull up by the side of the road to do that. By then, the marathon runners had made up for the 10-minute head start given to wheelchair participants.
Stuck in the crowd and with his nose still bleeding, he was forced to slow down and he finished the 42.2km race in 3 hours and 22 minutes, a far cry from his best time of 1 hour and 53 minutes.
'I felt very embarrassed. I was the last wheelchair athlete to cross the line.'
Being a doctor, he self-medicated. He went to a pharmacy and bought some Vitamin K, which stopped the bleeding.
One of the first things he did upon returning to Singapore was to find out the cause of the bleeding.
That was when the bottom fell out of his world. Doctors said he had cancer.
'My first reaction was, it can't happen. I have so many things lined up.'
He had just agreed to help raise funds for an orphanage in Shanghai and for another which houses HIV-positive children in Kenya.
He had also relocated to Singapore from Australia in January last year. He had been working as a doctor in a hospital in Sydney but wanted to spend more time with his 82-year-old mother and siblings here.
He was feeling good, 'unstoppable', with so many things he still wanted to do and so many projects lined up, including practising medicine and his international speaking tours.
'I've been living life at a high speed, on the fast track. My days were really packed. I was living 19 hours a day. Sleep was not important.'
He tried to fool himself for the first few days after the initial diagnosis. Perhaps his platelet count was low because he was fighting an infection, he told himself.
'I was hoping for a miracle. There was a lot of denial,' he admitted.
The Sunday Times reported Dr Tan's blood cancer on May 10, although the type was erroneously stated as acute myelogenous leukaemia (AML).
Dr Tan wrote to the newspaper to say that he did not have AML and added that he does, however, have his 'share of chronic illnesses and pain, which was a personal matter that did not warrant any major concern and publicity'.
He wrote that letter to The Straits Times, he explained last week, because he was concerned his mother would suffer a breakdown should she read the article.
 

makapaaa

Alfrescian (Inf)
Asset
But when he read some of the negative comments about The Straits Times on the Internet - accusing the paper of getting its facts completely wrong - following the publication of his letter, he decided to give an interview to clarify matters, while also taking the opportunity to talk about a project to raise money for The Straits Times School Pocket Money Fund.
But as his test results came in, there was no more denying it. His B cell count was in the 500,000s, instead of the normal 4,000 to 11,000 range.
Then one morning, when he was brushing his teeth, he found himself spitting out lumps of blood. Reality slowly seeped in. He became frightened. As a doctor, he has seen patients go through this.
'I am not afraid of death. But I don't like having to go through all that suffering and pain. It was also difficult to accept that, from a physician, I was now becoming a patient.'
He knew about the inevitable hair loss and the periods of nausea and extreme fatigue that go with chemotherapy.
The treatment aims to knock out all the cancerous cells in his body but it is non-discriminatory and would knock out the good infection-fighting cells as well, leaving him very susceptible to infections.
Doctors said he would need at least six to nine months of treatment. From experience, he knew that not everyone who goes through the treatment survives. Some die part way through, not from the cancer, but from infections caught while the body is weak.
But within days of the diagnosis, he knew his initial rejection of treatment was not the right thing to do because there would be no quality of life in his remaining months. 'I won't be able to do any sports. I would bleed.'
But treatment alone would not be enough. He also needed a bone marrow transplant. Outside of family members, there was less than a one in 20,000 chance of getting a good match.
Five of his six siblings came forward. He did not tell his eldest sister, the one who gave up her own schooling to carry him to school every day, because she was battling late-stage breast cancer. She has since found out about his cancer.
Fortunately, there was a match with one of his sisters. She is 54 years old, frail and nervous about the procedure, but more than willing to do what she can to help.
But he was still not fully committed to going for treatment and negotiated with his doctors: could he start on a small dose as a trial? They agreed.
He did not want his mother to know about his cancer, so the family came up with a story that he needed to travel a lot, and thus got her to move out of his home to live with his younger brother instead.
A week after he was diagnosed, he started his first chemotherapy cycle on a fraction of the needed dose. His bad cells plummeted from 540,000 to 77,000.
It was still not normal but the results were very promising.
Best of all, he suffered no side effects. He made up his mind then that he would fight the cancer all the way. He has gone around the world telling others how to turn adversity into opportunity. Now he had to walk the talk.
'I told myself, it's perfectly okay to have cancer. Others do too. I will be a stronger person, a better doctor, because I have crossed the bridge. When I help my patients, I can tell them I've been there before.'
But things did not go smoothly. A fortnight after the trial dose, his doctors said he needed to go on a full dose. That was when he nearly died from an adverse reaction.
His blood pressure crashed from 120 to 70. He was so cold he was in rigor, shivering badly despite the blankets piled on him.
'It was colder than the Antarctica,' he said, recalling those 20 minutes of hell.
He remembered thinking then: 'I should have died in the Antarctica or at the North Pole. I would have died a hero, and not because of an adverse reaction.'
When his shivering stopped, the doctors said he should continue with the cycle and he agreed.
'When I took the decisive step to go for treatment, there was no going back.'
As he had always done in the past, once a decision was made, he was fully committed. He decided to do everything possible to help his body fight the cancer by being a 'very compliant' patient.
Despite his nausea - even the thought of his favourite foods would make him want to throw up - he forced himself to eat and drink.
He also avoided crowded places because of his low immunity. When we met, he had on two masks - an N95 mask over a surgical mask.
And when the hair on his eyebrows fell out, he used an eyebrow pencil to fill in the missing parts.
As an athlete, the most painful and difficult aspect of his illness was accepting the changes in his body: his triceps and deltoids were melting away while his waistline expanded. He told himself: 'It's not just surviving, but thriving. I must do as much as I normally would without the cancer.'
He started working out, though at a lighter pace than before. He worked out with 5kg dumb-bells instead of the usual 15kg, even when in hospital for treatment. He does 5km instead of the usual 20km on his racing wheelchair each day.
He has also decided to go ahead with his promise to help The Straits Times School Pocket Money Fund raise money in September for a project he calls Cycle Of Hope.
The name of the project has special meaning for him. It spells hope for not only daily pocket money for the children but also success in beating his cancer.
By September, he would have finished six cycles of chemotherapy. He needs a minimum of six, perhaps even eight cycles, before he is ready for the life-giving bone marrow transplant from his sister.
One can feel his confidence even behind the double masks.
He has taken on the challenge that is now before him, and as always, will give it his best shot and not give up, no matter how bad things might get.
'How can I give up a fight? It's not my way of life,' he said, his eyes crinkling in a smile.
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