Name of Patient: Lim Cheng Koon

Age: 60+

Diagnosed: Stage 4 - NPC

Date Confirmed NPC: 18 July 2016

Treatment Period: 02 Aug 2016 to 16 Sept 2016

Treatment Pattern: 33 Sessions of RT c/w 7 Cycles of CT

History & Radiotherapy Treatment

I recall my first encounter with NPC or nose cancer. It was sometime in July 2015 when I discovered a small lump on my right neck just behind my right ear. Initially I did not pay much attention to it. It was not until September 2015 when I was admitted to Changi General Hospital (CGH) due to the sudden loss of strength in my entire right arm and I was unable to lift up my whole arm.

During the hospitalization, I alerted the doctor to the lump behind my neck. The doctor concluded, after he has conducted a non-systematic check, that it was just a small muscle and had no relation to the movement of my arm.

However, in June 2016, I noticed that the lump had grown bigger. Feeling uncomfortable, I went to see a General Practitioner and was given antibiotics for 2 weeks. Thereafter, he referred me to the ENT Specialist in CGH where I was confirmed to have contracted NPC on 13th July 2016. I was then referred to the National Cancer Centre, Singapore (NCCS) for treatment.

I still can recall the turmoil in my mind after I was told I had contracted NPC. I had even contemplated ending my own life. I was also suffering from a serious nose block that often left me feeling breathless. On my request for medication to clear the blockage, the radiation doctor told me it was caused by the tumor and there was nothing he could do about it. This added to my misery.

Fortunately, my good friends and colleagues came alongside to encourage and console me. My children advised me to look for volunteer groups to seek their advice and learn from their experience. From the internet search, I found the NCCS NPC Support Group and contacted their programme leader, Teo Thiam Chye (TC as he is known), who is also a 13th year NPC survivor.

From the experience sharing by TC, I came to understand that I was not alone in my cancer journey where 465 survivors from the Support Group have successfully undergone their treatment and returned to living as normal a life as possible. This had given me further encouragement to face my treatment.

My treatment at NCCS began on 2nd August 2016 with 7 cycle​​s​ of chemotherapy (chemo) and 33 sessions of radiotherapy (RT). The sharing by TC on “Managing the 4 major side effects of Radiotherapy” played a big role in helping me through the treatment with minimal pain and discomfort, (​​​)

From my treatment journey, I would like to share some of my own personal experiences in the hope that it may also help the next person:

  1. A week before RT treatment, I drank concentrated Manuka Honey UMF 10+ as least 3 times a day. I also try to drink as much water as I can.
  2. After the 5th RT, when my mouth and throat felt very dry and eating became uncomfortable, I continued to drink lots of fluids especially ice water. Chinese cooling drink such as “Ling Yang”, “Yi Mi Jui” and fresh coconut juice helped to cool my body from the RT exposure.
  3. After every RT session, I take a cool shower immediately when I reach home. For 15 minutes I direct the shower to my forehead, side and back of the neck and head area which was exposed to radiation. The cool water helped to reduce the heat from the radiation of the day.
  4. Even though my saliva had thickened and the taste changed, I continued to eat as best as I can in order not to lose more weight.
  5. The use of the Nystatin Suspension prescribed by the doctor had helped me tremendously in managing the mouth fungus. I gargle my mouth after every meal, every morning and before sleep, especially targeted at the area with fungus. After gargling, I swallowed the solution slowly into the throat to further prevent throat infection. I have also requested from the doctor antibiotic tablets for fungus prevention.
  6. Apart from the Chinese cooling drinks, every morning I will take 2 “Daneuron” tablets which contain Vitamin B7 & B12 together with one tablet of “Vitamin C”. It worked well until I reached 30 RT without any ulcers in mouth and throat.
  7. Apart from my own discovery I followed TC’s instruction strictly in managing oral hygiene and keep my mouth clean after every meal. I have also consumed 2 bottles of Manuka Honey UMF +10 during the entire course of treatment. Indeed, it was effective in keeping the ulcers away.
  8. The aloe vera gel applied at least 4 to 5 times a days and immediately after the RT worked well until I completed my 30 RT without any tears on the skin of my neck. The signs of tears appeared after the 31st session but it was still manageable.

Painful Throat

A day after I have completed my 30 RT, I felt my entire throat beginning to feel more and more painful. After a physical examination, the RT doctor re-affirmed that I did not have any ulcers and t​hat the cause of the pain was due to the radiation burns to the throat, which he claimed all patients will face at the end of the treatment.

Although the Doctor had prescribed to me stronger Morphine Patch sticker it did not suppressed the pain fully. It is difficult to describe the pain in words. All I felt was that it was the most painful episode that I have ever encountered in my life. But I told myself that I have to bear with it. A price I had to pay for getting rid of the cancer from the body.

Chemotherapy - 2 Major But Bearable Side Effects:

In my first three cycles of chemo, I did not feel much side effects to my body. I began to feel the side effects from the 4 cycle and it became more serious through to the 5th & 6th cycle.

Here are the 2 major side effects which I encountered:

  1. Nausea & Bloated Stomach
  2. From the 3rd to 5th day after the chemo, my stomach started to feel very uneasy. Nausea effects took place and I began to feel like vomiting. The stomach kept bloating especially at night. The anti-nausea/vomit tablets issued by the doctor helped somewhat to contain the problem.

  3. Constipation
  4. I went 2 to 3 days without any morning bowel movement. Another side effect from chemo. Constipation tablets as well as liquid medication to soften the stool will help. If constipation persists for more than 2 days, request for the insert medication. It will work well.


I understand that every person is different and each may face and experience different side effects from exposure to chemo and RT. What I have shared is my own treatment experience in the hope that it will help the next person better manage his/her own journey.

Contributed By: Lim Cheng Koon
Date: 12 Sept 2016

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​​Ref: P16​