I AM now 60 years old. Five years ago, I was diagnosed with bile duct cancer (peripheral cholangiocarcinoma) in the liver.
The solitary tumour measured 10x8x6 cm. It didn’t look good.
Two weeks later, I underwent a major surgery under an eminently skilful liver surgeon. About 60 per cent of my liver, containing the tumour, was removed.
The following week, the doctors in Singapore General Hospital and National Cancer Centre, Singapore, advised me to undergo chemotherapy to ‘mop’ up the remnant cancer cells, if any, in my body.
They recommended 12 rounds of Intravenous (IV) chemotherapy of Gemcitabine and Cisplatin on three weeks cycle.
Some kind friends who had undergone chemo for breast cancers shared their experience with me, saying it wasn’t as bad as many people made it out to be.
I was somewhat encouraged, but was still nervous and apprehensive when I went for my first round at National Cancer Centre, Singapore.
I was given an anti-vomit pill, half an hour before the actual chemo. This proved very effective.
The Gemcitabine drip through the vein was slightly uncomfortable but fortunately, it took only about half an hour.
Then my vein was flushed with a saline solution before we commenced the four and half hours of Cisplatin.
Throughout, they also dripped me with saline solution to ensure my kidneys were protected. They monitored to check if I passed out an equivalent amount of urine.
Immediately after the first round, I felt lethargic, and my head was heavy. My body felt a bit hot, as if having a slight fever, but the thermometer revealed normal body temperature.
I tried to rest, but found it difficult to fall asleep. When I did sleep, it was uneasy sleep.
I also suffered from constipation, which was to last for about four days, and when the stool finally came out, they were like hard pebbles. My tummy felt so bloated, churning and uncomfortable those few days.
My appetite remained all right and I didn’t vomit a single time.
However, on the third day, I started having recurrent hiccupping for two days. I also experienced a few times a ‘glassy’ vision sensation on the fourth day, lasting a few minutes each time. The tone of my muscles became very soft and my bums were real flabby! I became noticeably less strong.
By the fifth day, things became more normal, and my sleep was better. On the seventh day, I could take the one and half hour flight from my hometown, Kuching to Singapore for my second round, involving only Gemcitabine — so it was much easier. All the symptoms were less severe, and I already knew what to expect too. My oncologist advised if I could, exercise would help.
So after I arrived home in Kuching in the evening of the same day, after some food and a short rest, I tried stationary cycling in my home gym.
Normally, I would set the resistance level at 5 or 6, but I found that I could only manage to pedal at level 1.
It was hard going. After five minutes, I felt so much like giving up. However, 45 minutes later, I started to perspire!
Strangely, the moment that happened, my ‘foggy’ mind started to clear! I felt warmed up and stronger! I could even increase the resistance level of my gym bicycle to 2. I could sort of ‘smell’ the chemo drug in my sweat! I pushed myself on by imagining was literally sweating out the drug injected into me in the morning, and in so doing, would reduce the side effects.
After a total of 90 minutes of cycling, I felt worn out but strangely refreshed! The heavy internal ‘cloud’ in my head was sort of lifted.
Though I was physically drained, I felt mentally cleared.
After cooling down for half an hour, I took a warm shower, then retired to bed. Sleep came quite easy. The following morning I felt rested and much better.
I took lots of water throughout my chemo days. Learning from my first round, I took the constipation relieving medicine three days before each subsequent round. I still suffered from constipation but only for two days each time.
I also changed my diet after my surgery, starting each day with fruit and/or vegetable juice, and cooked oats, mixed with some nuts (almond, walnuts and dried pumpkin seeds). I reduced my sugar intake significantly and avoided fried or preserved food.
When I went for my third round, the blood test showed that my white blood cell count was too low. The oncologist decided to postpone the chemo by a week, and I was instead injected in the tummy with a white blood cell booster. The following week, my white blood cell count reached almost normal level, and I received both Gemcitabine and Cisplatin doses.
The flight back to Kuching from Singapore was easier for me than after the first round. I wore a breathing mask to reduce the chance of infection while in the plane. My hair was half gone, but I was still quite far from being bald. I still had not worn any of the two caps I had bought at the start of my chemo.
I continued to gym-cycle daily for 90 minutes — sometimes twice a day. I also worked almost full time. That helped tire me out so that I could get restful sleep.
Subsequent rounds
My oncologist was really kind to allow me to transfer my remaining nine chemo rounds to a private hospital in Kuching under his remote guidance. When receiving the ‘long’ (five to six hours) chemo doses of Gemcitabine and Cisplatin, I would try meditation or just prayed, and would fall asleep during part of the process. I also practised 20 minutes meditation before going to sleep at night, and did deep diaphragm breathing exercises upon waking up in the morning.
My oncologist was a real angel. In my earlier rounds, whenever I felt uneasy over something (piles in my rectum, throbbing in my left ear, numb feet, dry mouth, tired eyelids, heavy head), all I needed was to text or email him, and he never failed to promptly give short but clear advice, which was comforting. Having such an oncologist made a huge difference.
After the fourth round, I knew better what to expect each day after the chemo, and this knowledge reduced my anxiety. I still experienced the mild side effects but fortunately did not feel nauseated at all. My caregivers ensured my food was very clean and hygienic. I stayed clear of any persons suffering from any infections like flu or colds.
I was fortunate not to suffer from any infection throughout my chemo days, as any illness could become serious due to my low immunity as a result of the chemo drugs.
I maintained a healthy lifestyle — sleeping well, eating moderately with lots of fluids and fruits. I exercised regularly, cycling in my home gym doing gardening, playing ping-pong and even golf. I also continued working.
The remaining rounds were almost a breeze. I ‘looked forward’ to each round, because it meant I was nearer being ‘free’.
Every time I received the chemo drugs, I ‘welcomed’ them in my mind, imagining the flowing throughout my body, to be killing any stray cancer cells.
I liked imagining them as little soldiers combing through my body, mopping up any errant cells. Then, in the evening while exercising, I would picture them as being sweated out after doing their cleaning job. I persuaded myself that after the drugs had been sweated out, I should no longer feel their side effects, and indeed, I didn’t, at least, not much!
However, I did experience peripheral neuropathy — constant tingling sensation in both feet. I understood from my oncologist, it was something
like the sheaths of the nerve endings at my feet were damaged by the chemo, resulting in my nerves receiving unfiltered stray signals from the surrounding cells, resulting in inaccurate messages from the feet to the brain.
I sort of felt both hot and cold tingling sensations in my feet all the time. This feeling was most pronounced around four to five months after the completion of my chemotherapy. After my oncologist assured this was quite harmless and would improve over time, I becameless bothered. Some nights, I wore compression socks to sleep to reduce the funny sensation.
The present
It’s now two years five months since my surgery. I’ve undergone four follow-up checks with PET and CT scans. Praise the Lord, so far, the results are all clear. I’m not sure if the cancer will recur but with each passing day of wellness, I become more optimistic.
(The doctors use a benchmark of five years of non-recurrence as cure.)
The tingling sensation in my feet is much reduced now. My hair has completely grown back (indeed, I actually feel I’ve slightly more hair than before). Apart from the tingling feet sensation, I suffer no other side effects now. I feel completely normal, well, happy and lead a busy life.
Two and half years ago, I felt like I had been issued a death sentence. Not any more now. After my personal ordeal and with the enhanced knowledge of cancers, I realise and take comfort that great advances in treating cancers have been made in the last 30 years. With a strong faith in God, wise doctors, and a positive spirit, we may perhaps regard cancer as a chronic, if not a curable illness.
Lastly, let’s all pray to the Almighty for help and guidance. In God may we trust and find comfort.