Coming Back Like a Phoenix: One Woman’s Breast Cancer Journey

Breast cancer is the most commonly diagnosed cancer in women in Singapore. While there are certain risk factors/symptoms that may cause one to be more aware, no one can tell if, or when, breast cancer (or cancer in general) may occur. When something life impacting like breast cancer is confirmed, most people are left feeling despondent and may take some time to overcome and accept the condition. We speak with Nahoko Kodama on her breast cancer diagnosis and what has helped her greatly in her journey to “come back like a phoenix”. What kind of breast health issue did you face? I was diagnosed with triple positive stage 2 plus breast cancer. How did you discover it? I felt a lump in the right upper chest and I was feeling a little pain for a few months as well. What was your biggest revelation after you were diagnosed? There were no major surprises, as the doctors told me very calmly. It was like I knew it. What is one thing you wish you knew before you started treatment? I [wished I knew] more about the type of cancer I had, its progression, treatment options, duration of treatment and side effects. What has the journey of dealing with or managing this issue been like for you? It was a tough journey, of course, but I accepted the fact that it was important to keep the energy to carry out the chemotherapy until the end of treatment. To achieve this, I decided to continue exercising (yoga) to maintain my fitness and also to continue with ballroom dance lessons, which I had been taking for a long time. After my treatment, I was determined that I would definitely take part in a dance competition, and my dance teacher in Russia supported me with messages every two weeks. I feel that his encouragement, combined with my enthusiasm for dance, was a major factor in my overcoming the chemotherapy. Before this cropped up, what was your attitude toward breast health? There was recognition that breast cancer can be self-checked and that early detection is very important. Did this journey change that attitude? This idea has not changed. I have a check-up with a specialist every six months, as I am currently on medication. And I have become more careful with my food than before. Vegetables are basically organic; I take more protein and I regularly take Chinese herbal supplements to keep my blood healthy. What do you think women in general feel about breast health? In general, I think that almost half of women feel that breast cancer screening is necessary, but they are too busy or something and don’t get regular check-ups. Basically, I think it is also common to think that you don’t get cancer. What are your thoughts when it comes to general awareness/education in this area? Unless you or someone around you has cancer, you will not understand the difficulty and the seriousness of cancer treatment. At times, it may be avoided as a topic you don’t want to see or hear about. It is necessary to make sure that people are aware of the fact that early detection means a shorter treatment period and a smaller burden. What advice would you give women about breast health? First, make it a daily routine to check your breasts for any abnormalities by self-checking every day. Although there is an overlap, regular breast cancer screening should always be carried out. If you are found to have breast cancer, accept the facts unhesitatingly and submit yourself to treatment by trusted doctors. Decide what you want to do first when your treatment is over and your health is restored, so that you can be motivated to complete your treatment. Encourage yourself to say, “I will come back like a phoenix.” The breast is a woman’s most beautiful organ. Tell yourself that you must cherish that treasure for the rest of your life. It is never too late to start taking care of your #breasthealth. Find out how you can reduce your risk of developing breast cancer here.
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An Early Diagnosis of Cancer Leads to a Higher Chance of Treatment Success

In our new series, Best Advice from Women, for Women, Ms Jayde Simpson, an expatriate from the United Kingdom shares with us on finding out about her breast cancer diagnosis, coupled with the discovery of a high-risk gene. What kind of breast health issue did you face? I was diagnosed with Stage 2 Breast Cancer, which was ER+ PR- and HER2. How did you discover it? I felt a lump whilst on vacation that didn’t go away. Upon my return I scheduled an appointment with a breast specialist who performed an ultrasound. Within the week I had a mammogram, MRI and a PET scan which confirmed the suspicion. However, it wasn’t until a biopsy was conducted that it was confirmed as breast cancer. What was your biggest revelation after you were diagnosed? I did a gene test and discovered that I have a gene that makes my risk of breast cancer higher than the general population, although only a small number of cancers are hereditary.  Lifestyle and other factors influence an individual’s risk profile. What is one thing you wish you knew before you started treatment? Understanding the type of breast cancer (ER/PR/HER2 positive or negative) can lead to different recommendations on the type of treatment you should get.  I was upset when I had to get chemotherapy, believing what I had seen in the movies about the side effects from it.  However, I sailed through this.  A friend had recommended doing something nice around chemo and for me what stood out during my treatment was celebrating the end of each chemo with a lunch with a friend. My chemo duration had plenty of nice lunches and different friends supporting me throughout. What has the journey of dealing with or managing this issue been like for you? The absolute worst part was receiving the diagnosis as I did not truly believe this would happen to me and that all the tests would show this was a false alarm.  The biopsy I received confirmed this was not the case.  After that I did everything that I could to take a holistic integrative approach. I had a great breast surgeon and oncologist who partnered to give me the best medical treatment and tailored my treatment specific to me, e.g. my oncologist added a chemo that is shown to have more effect for people with the gene that I had, while my breast surgeon helped to add regular ultrasounds so we could measure the impact the chemo was having on reducing the tumour. This helped alleviate any anxiety on whether the treatment was working or not.  I focused on ensuring that I did everything at home that I could to help – diet, exercise and I worked with a naturopath to identify supplements that would help me through the treatment. After the chemo I had a double mastectomy with immediate reconstruction and whilst this was a challenging decision, I did everything I could to minimise any future risk.  I believe all of these things helped me to achieve a ‘pathological complete response’. The cancer diagnosis gave me the discipline I needed to prioritise me and ensure that I focused on a diet and exercise regime to best support my treatment. Despite the numerous rounds of chemo, I never once felt ill and felt stronger and fitter throughout.  I had the odd tired day and some other limited symptoms. However, the treatment was nowhere near as bad as I expected. Before this cropped up, what was your attitude toward breast health? Sadly, I had a close friend who passed away from Breast Cancer and so I was very much aware of the need to do regular self-exams.  The earlier you identify an issue, the more likely you have the chance of successfully dealing with it.  I was aware of how my breasts would change during my regular cycle and so managed to self-identify the lump early enough to have a very successful outcome. Did this journey change that attitude? It only strengthened it.  I am more in tune and aware of my body and if anything doesn’t feel right.  I take care to watch stress levels and not overreact and am focused on ensuring that I have balance in my life with adequate sleep, exercise, supplements and focusing on what I eat (80% of the time). What do you think women in general feel about breast health? Whilst I was aware of the importance, I think I still thought of myself as being invincible and that something would not happen to me.  I think women in general put other family members first and neglect to prioritise themselves.  These two things together can mean that they neglect breast health.  I also think sometimes people can feel embarrassed about seeking help or not wanting to expose themselves, or think “it’s probably nothing, I don’t want to bother anyone”. What are your thoughts when it comes to general awareness/education in this area? I hear of friends who tell me they don’t really know how to do a self-exam, or they skipped the last mammogram because they had to do something else and forgot to reschedule.  I think they are missing the 2 most important factors here:  1. prevention is always better than cure (focusing on healthy lifestyle can reduce your risk) 2. the earlier you catch these things, the better your outcome.  Whilst it’s rare, the tumour I had was not present on a mammogram but could be seen on the ultrasound, MRI and PET scan.  My advice would be to listen to your body and if something doesn’t feel right, advocate for yourself and seek a referral to a breast specialist who can help allay any fears or help ensure you get treatment early. What advice would you give women about breast health? The risk is too high so early identification will give you more chance of success.  Previously I did not prioritise myself, making excuses that I needed to attend to work, husband, children and that I had limited time.  I now consider that prioritising my health means I will be around longer to enjoy time with my family.  Ensuring I take steps to monitor my health and raising any concerns to my doctor means I’m around longer to enjoy my family.  The earlier you detect something the more chance of success you have.  Everyone I met throughout my journey was empathetic, caring, listened to me and addressed any concerns; the only downside is not acting early.
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Hear From A Breast Cancer Survivor: Listen To Your Body

Learn how a breast cancer survivor stayed positive and survived her first health scare with courage, determination, and an effective treatment plan When Lay Peng felt a lump on her right breast in mid-2019, she brushed it off, thinking that it was due to hormonal changes and would soon go away. However, she became worried when the lump remained after six months. After completing an ultrasound scan and mammogram at her next annual health screening, she was advised to seek medical attention. “I was concerned about the lump but I did not think it was breast cancer,” Lay Peng related. “I have no family history of cancer and I also have been healthy all along.” Lay Peng came to know of her breast cancer diagnosis through a biopsy and consultations with a Breast Surgeon. When the news of her breast cancer broke, her mind immediately went blank. “I was worried for my family – my daughters, my husband and my elderly folk,” Lay Peng recalled. “I came to realise the fragility of life.” Understanding breast cancer and undergoing treatment Breast cancer is a type of cancer arising from the milk glands of the breast, described Dr Tan Yah Yuen, Breast Surgeon at Solis Breast Care & Surgery Centre. There are a wide variety of symptoms for breast cancer, she explained, with the most common symptom being a painless breast lump. However, some patients manifest no signs nor symptoms at all. Hence, in the very early stages of breast cancer, findings can only be discovered via mammography. Ultrasound scans are also useful in complementing these screenings, while 3D mammography is recommended for a more thorough examination of dense breast tissues. Dr Wong Chiung Ing, Senior Consultant, Medical Oncologist at Parkway Cancer Centre, observed that the chance of cure is more than 95% for early-stage breast cancers that are confined in the breast. However, breast cancer is generally not curable if there is spread to other organs such as the liver, lungs, bones, or brain. Nonetheless, treatment options such as chemotherapy, radiation therapy, hormonal therapy, targeted therapy, and immunotherapy are available to improve survival rates and the quality of life. “In determining the treatment regimen for each patient, we perform tests on cancer cells before tailoring the type of treatment,” Dr Wong said, adding that the patient’s general health and condition would also be taken into consideration. The treatment of breast cancer thus involves a multi-disciplinary team of doctors and specialists which includes surgeons, medical oncologists, radiation oncologists, and pathologists. Strong support is also needed from nurses and other health professionals such as physiotherapists, dieticians, and psychologists. “With so many treatment options available, it is therefore very important for us to come together as a team to derive the most effective treatment plan for patients,” Dr Wong shared. In Lay Peng’s case, her doctors had advised for her to receive neoadjuvant chemotherapy, or chemotherapy before surgery, as initial treatment for her cancer. The primary objective of neoadjuvant chemotherapy is to downstage the tumour which may allow less extensive surgery on the breast/axilla, and to reduce the risk of distant recurrence. Despite her initial concerns, Lay Peng mustered the courage and determination to undergo treatment and get well. “I only have one life,” she reflected. “Instead of asking why, I accepted reality and embarked on the recovery journey. While there were tough moments along the way, I think the focus on getting well is important for you to get going.” Feeling well and cancer-free Lay Peng and her doctors’ efforts paid off post-surgery in September 2020. The treatment had resulted in a complete pathological response at surgery, meaning that no cancer cells were detected from tissue samples after surgery. Besides surviving breast cancer, Lay Peng was also able to conserve her breast, and did not require mastectomy. While treatment was manageable on the whole, Lay Peng revealed challenging moments such as hair loss, loss of appetite, nausea, and diarrhoea. Nonetheless, she remained grateful for the time and space to recover, as well as for the strong support from her doctors and nurses in Allied Health, as well as her family, friends and colleagues. It is never too late to seek medical help, Dr Tan assured, though there is a lower risk of relapse if breast cancer is detected earlier. Today, just slightly more than 50% of women in Singapore undergo regular breast cancer screening. Yearly screenings are recommended for women who are 40 years of age and older, or earlier for women with a family history of breast or ovarian cancers. For postmenopausal women, screenings should be done at one- or two-yearly intervals, depending on their individual risk factors. Most importantly, women should not put off their breast cancer screenings and should remain alert to bodily changes. “Listen to your body and trust your instincts,” Lay Peng encouraged. “If you sense something wrong, it is best to get it verified.” Article contributed and reviewed by Dr Tan Yah Yuen, Senior Consultant and Breast Surgeon at Solis Breast Care & Surgery and jointly produced with Parkway Cancer Centre
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