Working mum, 32, moves forward after rare cancer diagnosis

Property developer and working mum, Fanny Cheng got through a rare cancer diagnosis and treatment by concentrating on the positive and looking forward. (Credit: Ms Fanny Cheng)

Her entire life, Fanny Cheng has taken pride in beating the odds and forging her own future.

At the tender age of eight, her father passed away, and family circumstances led her to start working at a fast-food restaurant when she was just 14 years old. Since then, she has never stopped working. She even chose to study part-time at a private university so that she could work full-time, pay for her studies and support herself.

But when Fanny was diagnosed with a rare cancer at 32 years old, just four months after the birth of her second son, she was devastated.

Tears that would not stop

In December 2016, Fanny was the assistant general manager at a property development firm and had just returned to work after maternity leave. She loved her job and was good at it, keeping things running smoothly and ensuring staff morale stayed high. At home, her two young sons aged three years old and four months old kept her busy.

When she started experiencing constant tearing in her eyes, sharp eye pain and double vision, she went to the Singapore National Eye Centre for a check. She was sent for a CT scan, which showed a mass on her left eye close to the brain. When her ophthalmologist told her it was likely to be cancer, Fanny refused to believe him.

"Cancer? Impossible! I told him to give me antibiotics instead as I was sure I had an infection, and it would clear up."

However, further test results came back to confirm the devastating diagnosis. Fanny had lacrimal gland cancer, also known as tear duct cancer.

An impossible decision

Fanny was referred for further care to the National Cancer Centre Singapore (NCCS). Lacrimal gland cancer, a rare and aggressive disease, is often treated with surgery, radiotherapy and sometimes chemotherapy.

Her medical team recommended surgery to remove the tumour and her left eye to control the cancer and replace it with a prosthetic glass eye. The idea of losing an eye was very upsetting to Fanny.

"I didn't want my kids to grow up with a one-eyed mum! Children can be cruel sometimes and I didn’t want my kids to be bullied at school. I just wanted to be normal," confessed Fanny.

Fanny reluctantly prepared for surgery. But during her consultation with the surgical team, which included a neurosurgeon, plastic surgeon and surgical oncologist, they explained that after further review they would not be able to use a glass eye and would need to seal her left eye permanently instead. Since Fanny's ophthalmologist had opined that her left eye was doing well despite the cancer, she decided to ask for another option.

Radiotherapy for a rare cancer

Fanny was then referred to Clinical Assistant Professor Kiattisa Sommat, Senior Consultant, Department of Head and Neck and Thoracic Oncology, Division of Radiation Oncology, NCCS. Clin Asst Prof Sommat suggested proton therapy, as protons target cancer cells, while potentially causing less damage to nearby healthy tissues or structures. This made it a good option to treat the sensitive area where the tumour was located, next to Fanny's eye and brain.

In 2016, before proton therapy was available in Singapore, Fanny’s treating radiation oncologist came up with a plan to treat the lacrimal gland cancer using conventional radiotherapy.

In 2016, proton therapy was not yet available in Singapore, and patients who needed the treatment had to go overseas. This was expensive, with total costs ranging from S$100,000 to S$300,000, and Fanny would have needed to live abroad for up to six months during treatment.

It was not an option Fanny could afford, and she could not leave her young children for so long. Clin Asst Prof Sommat and the NCCS team had to look at other treatment options.

"Thankfully, proton beam therapy is now available for patients who need it at NCCS, but at that time when Fanny came to us in 2016, it was not. We wanted to do the best for her in terms of survival and quality of life, so we came up with a plan to treat Fanny using conventional radiotherapy. Although proton therapy is an excellent treatment option, we were still able to deliver very high-quality treatment using advanced conventional radiotherapy techniques," said Clin Asst Prof Sommat.

Fanny was treated by Clin Asst Prof Kiattisa Sommat, Senior Consultant, Division of Radiation Oncology, NCCS who wanted to do the best for her in terms of survival and quality of life.

Balancing treatment with motherhood

Fanny underwent 33 radiotherapy sessions over two months. From Monday to Friday, she would come to NCCS for an hour for each treatment session. She took time off work, but tried to maintain a normal routine, taking her sons to daycare before treatment and resting afterwards. Though she felt tired, she would push herself to keep to the family routine of going on weekend outings.

During the treatment she had three MRI scans to monitor her progress, and the final one showed that her tumour had disappeared completely. Fanny's left eye had sunk in slightly and her left eyebrow fell out and did not grow back. Much to her relief, she retained her eye, and her vision returned to normal after the treatment.

Cancer was just a "serious flu"

During cancer treatment, Fanny kept up with her children's activities and continued to exercise. (Credit: Ms Fanny Cheng)

Throughout her journey, Fanny refused to let the disease get the better of her. She chose to treat it like a "serious flu" that she had to overcome rather than a life-altering catastrophe. She also believed that she had been given this challenge because she was strong enough to handle it.

From the beginning, she attended medical appointments alone, as she did not want her family to feel worried.  She also made sure to stay busy, keeping up with her children's activities, checking in on work and continuing to exercise.

“Maybe because of what I've been through earlier in life, when I got cancer, I just thought, ‘bo pien’ (no choice), I have to keep moving forward," said Fanny. "My sons were also at the front of my mind and I knew that I had to persevere and be there for them.”     

Making changes after treatment

Fanny is now the boss of her own company and is able to better balance work and life. (Credit: Ms Fanny Cheng)

Fanny was declared cancer-free 72 months after being diagnosed. Only then did she stop to reflect on what she had been through. She realised that it was too hectic, and it was time to step away from the company she had been with for 15 years.

"It was time to reassess, reorganise my thoughts and priorities and decide what I really wanted to do with my life," shared Fanny.

After taking some time to recuperate, Fanny started her own property development company and also worked as a consultant for firms entering the property market. Though it's still hard work, she is able to manage her own time and work on her own terms.

"Running everything myself comes with pressure, but it has also given me greater control of my time. I’m able to balance work and life far better now than when I was working in a large corporate environment," said Fanny. 

Normal mum, normal life

Today, Fanny's sons are 10 and 13 and have no recollection of the time when their mother was sick with cancer.

"My goal was achieved – my kids have a normal mum, and I get to lead a normal life!"

Fanny’s advice to others who are going through difficult times is: "Don't dwell on the negative. Instead, concentrate on the positive and keep looking forward."