A young breast cancer patient’s journey

For many, marriage marks the beginning of a life filled with shared dreams, love, and a bright future. But life threw recently married Ms June Koh* a curveball when she got a shocking cancer diagnosis. June, who was then 28 years old, was diagnosed with stage 2 breast cancer in October 2010 a mere nine months after she got married, which put the couple’s marriage vow ‘in sickness and health’ to the test.

Thankfully, the cancer was discovered early because June acted quickly to seek medical help after noticing a lump under her right armpit. This was followed by a whirlwind of consultations, scans and a biopsy.

Diagnosed with breast cancer at age 28, June felt she had to give up all her dreams, hopes and future.

(Credit: iStock.com/Jirakul Manjing)

“When the doctor said that I had breast cancer, it felt like a death sentence,” June, now 42, recalled. “I was in complete shock, so were my husband and mother. For weeks, I would wake up in the middle of the night, hoping it was all just a nightmare.”

Scans showed that the cancer had spread to her lymph nodes but the toughest blow came when June learnt that she would need a mastectomy. Devastated, June sought second and third opinions, but all the doctors agreed that a mastectomy was the best and safest treatment option.

“My husband was very understanding and sweet throughout my cancer journey, he put my health and recovery first. I was worried about how the changes to my body after the mastectomy would affect our relationship, but he was reassuring and positive,” said June.

June went ahead with the mastectomy to prevent the cancer spread and underwent breast reconstruction immediately after the surgery.

“I was afraid to wake up after the operation with a flat chest and scars. But fortunately, except for a few tubes attached to my body to drain excess fluids, I didn’t look too different!”

After surgery, June started 8 sessions of chemotherapy, 20 sessions of radiation therapy and was on oral hormonal therapy for 5 years.

“Most of the side effects such as hair loss, nausea and fatigue were temporary. However, I did experience permanent changes to my body including loss of feeling in the reconstructed breast and lymphoedema (swelling caused by accumulation of fluid that’s usually drained through the body’s lymphatic system) in my right arm due to the removal of the affected lymph nodes.”

“Cancer treatment reminded me not to take my body for granted. I now eat more healthy food and exercise almost daily,” added June.

The emotional and psychological toll, however hit her hard. June developed depression as she struggled with the fear of the cancer relapsing and felt she was living with a “ticking time bomb.”

“During treatment, my focus was to complete it and return to normal life. But once I finished treatment, I realised that things had changed. I wasn’t the same person anymore and adjusting to this new reality was a challenge,” shared June.

June and her husband sought help from a NCCS clinical psychologist for depression and caregiver burnout.

(Credit: iStock.com/Nuttawan Jayawan)

A fellow cancer survivor who knew June was struggling introduced her to the National Cancer Centre Singapore (NCCS) Breast Cancer Support Group. Through the group, June was referred to a NCCS clinical psychologist for psychotherapy sessions. Her husband attended some of the sessions with her. The support group and psychotherapy sessions were crucial in helping her overcome her depression and regain a sense of normalcy, and for her husband to manage caregiver burnout.

After a year of seeing the psychologist, June overcame depression resumed work and now feels life is back to normal. She also diligently keeps up with regular breast self-examinations and mammograms.

June has learnt to embrace her body despite the scars and is a strong advocate that individuals going through the challenges of a cancer journey need to seek professional help when needed.

“Our scars are a testament to our strength and resilience, but not be afraid to seek help if you need it. Support groups and professional counseling can make a world of difference,” advised June.

*Not her real name

The NCCS Women’s Wellness and Intimacy Clinic, established in August 2023, is run by a multidisciplinary team of physician- and psycho-sexologists.

Sexuality is often an under-recognised and under-addressed issue for cancer survivors. Many women hesitate to discuss it with their healthcare providers, as they feel embarrassed or believe it is trivial when it becomes an issue after life-saving cancer treatments. However, certain cancer treatment side effects can lead to sexual dysfunction. These can be temporary and treatable, but in some cases, may be long-term. It is crucial for patients to have timely discussions with their healthcare team so they can be referred for the support and advice they need.

A comprehensive assessment is done by a multi-disciplinary healthcare team to understand sexual issues faced by patients, as these often involve both physical and psychological factors. Cancer and its treatment can impact body image, self-esteem, and relationship dynamics, all of which must be considered in the treatment plan.

Including partners in these discussions can be beneficial, as it helps them understand the nuances of the sexual dysfunction that the partner undergoing cancer treatment may experience, and how to manage those challenges together. Many partners of cancer patients also experience distress and feel helpless, so addressing their concerns as a couple is important.

Since its inception, the Women’s Wellness and Intimacy Clinic has supported 30 patients and their partners to manage sexuality-related challenges which includes:

• Fatigue or loss of energy, which impacts daily functioning and sexual libido

• Sexual changes, such as arousal difficulties and painful intercourse

• Menopause-related symptoms (e.g., hot flushes, insomnia, mood changes, vaginal dryness) induced by chemotherapy and hormonal treatments

The Clinic sees patients of all ages and life stages. Patients can ask their oncologist for a referral to the Women’s Wellness and Intimacy Clinic or contact the NCCS Division of Psychosocial Oncology at Tel no: 6306 1777.

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