SINGAPORE - A regular eye check for glaucoma last year led Tampines GRC MP Baey Yam Keng to discover that he had nose cancer.
Mr Baey, who is also Senior Parliamentary Secretary for Transport, was found to have a small area of limited vision in his right eye and was later referred to a ear, nose and throat specialist.
A scope found a growth in his right nasal passage and a biopsy later showed that the tumour was cancerous.
While the 51-year-old was initially calm about the cancer diagnosis, he worried about how he would pull through and what his chances of survival were like if it were late-stage cancer.
He says: "The oncologist had explained to me the treatment plans for early-, middle- and late-stage cancer, so I was worried it would be stage two or later and had to undergo chemotherapy, which would be harsher on the body."
When he found out that he had stage one nose cancer and did not need to undergo chemotherapy, he was relieved.
Most tormenting ordeal
But he had to extract five teeth, in what he dubbed his "most tormenting ordeal", to prepare for radiation therapy.
The removal of teeth before radiation in the head and neck region is often recommended to reduce the risk of osteonecrosis of the jaws after radiation. Osteonecrosis is a condition in which there is a loss of blood flow to bone tissue, causing the bone to die.
Radiation might also cause the jaws to stiffen, which may make it difficult to brush one's teeth at the extreme ends in the mouth.
"It was a traumatic experience. I had only had one extraction done my whole life and this was five extractions at one go, so I was afraid," he says with a laugh.
He started radiation therapy in December last year and underwent five sessions a week for 6½ weeks.
While each session lasted just seven minutes and was generally painless, driving to and from the hospital every morning took a toll on him.
Friends stepped in to ferry him. "It helped a lot because I didn't need to drive, park and walk to the radiation centre and back," he says.
Mr Baey felt well enough to attend meetings after the radiation therapy. "Luckily, it was year-end, so the workload was lighter and I was able to rest more," he says.
Losing the sense of taste and about 4kg
But he struggled with the side effects of radiation, which included dryness in the mouth, ulcers and a loss of taste.
Eating was a chore. He remembers eating a bao with pork filling and it was "completely tasteless" to him. He also had to eat foods such as porridge and soup due to the dryness in his mouth. "Even then, the porridge and soup tasted like plain water to me," he says.
His wife's appetite was also affected at mealtimes when she saw him "eating dreadfully", he says.
"I tend to eat very fast, but every mouthful took a great effort and I became the slowest eater at home," adds Mr Baey.
At one point, he had to take Panadol every four hours to relieve the pain from his ulcers.
Mr Baey's wife Lim Hai Yen's appetite was also affected at mealtimes when she saw him "eating dreadfully", he says. ST PHOTO: DESMOND FOO
During the last phase of radiation, the skin on his neck darkened so much that it looked sunburnt.
By the end of February, much of his sense of taste and saliva returned and he was able to enjoy his food again.
But last month, he experienced a slight change in his taste buds again. He now has an aversion to fatty and oily food and has lost about 4kg.
At a check-up late last month, the doctor found that the tumour was no longer visible.
Mr Baey also underwent an MRI and blood test last Thursday to confirm that all the cancer cells have been killed. He will receive his results on Thursday (April 21).
As a result of the radiation therapy, he has to go for dental checks regularly. He also sees a speech therapist every three months to ensure his jaw and tongue remain flexible.
He decided to make his diagnosis public in January this year because of Edusave award ceremonies later that month. He was supposed to present awards to almost 1,000 students over a few weekends.
"I had to take things slow and absent myself from some constituency activities because I knew I wouldn't be able to stretch myself the whole day," says Mr Baey.
He also did not want people to worry or speculate what was happening to him should they notice signs such as his weight loss.
Despite his condition, he has not missed a single Meet-the-People Session. He also resumed house visits last month when he felt well enough.
His wife Lim Hai Yen, 51, says: "My only complaint of him, if any, is that he is too hardworking. So, this is a timely reminder to take things slow."
Encouragement from cancer survivors
Having support from family and friends has helped Mr Baey.
"My wife would accompany me for follow-up appointments at the hospital. Having your loved ones with you in most parts of the journey is very important. I feel I'm not alone," he says.
Strangers, including cancer survivors, have approached him in public and sent him messages of encouragement on social media to share advice on how to cope, making him feel part of a community.
Initially, Ms Lim says she did not know how to console her husband as he seemed very strong.
"He told me not to fret about him and that he saw this as a challenge life had given him to tackle and make him stronger," says Ms Lim, artistic director of theatre company The ETCeteras.
His daughters cried when told about his cancer
She was the only person who knew about his cancer for a month before they told their two daughters, aged 22 and 17, and son, 18.
Says Mr Baey: "We waited for my son to complete his A-level exams and my wife to finish her surgery (for Cushing's syndrome) before breaking the news to my family just a few days before my radiation therapy."
His daughters cried, but were comforted to know that his cancer was in the early stage and there was a high chance of full recovery.
Mr Baey, an avid jogger, also had to cut down on his runs. He tried getting back onto the track last month, but had to stop a few times as he felt breathless quickly.
Cancer has made him reflect on the meaning of life.
Says Mr Baey: "As a cancer patient, I have to go through a lifetime of regular checks and the anxiety of waiting for the results in case the cancer comes back. It made me rethink about what is important in life - a healthy body, the ability to spend time with family and a quality life that matters."
He hopes people will pay attention to their bodies and not have the mindset that it is better not to know if something is wrong.
"Good health is for us to own, maintain and enjoy not just for ourselves, but for our loved ones too," he says.
Symptoms of nose cancer
Nasopharyngeal cancer, or nose cancer, which occurs in the cells lining the area behind the nose and just above the back of the throat, is one of the most common cancers among men in Singapore.
According to the 2019 Singapore Cancer Registry Annual Report, it is one of the top three most common cancers in men aged 30 to 49, and the eighth most common cause of cancer death in males, with 474 cases from 2015 to 2019.
Associate Professor Melvin Chua, head and senior consultant at the Department of Head, Neck and Thoracic at National Cancer Centre Singapore's Division of Radiation Oncology, says the centre has about 150 to 200 new nose cancer cases a year.
He says the particular cancer affects mostly Southern Han Chinese, namely those from the Teochew, Hokkien, Cantonese and Hainanese dialect groups. "In this population, the risk of contracting nose cancer is primarily attributed to genetic risk factors linked to the Southern Han Chinese race and exposure to a common virus infection known as the Epstein-Barr virus infection at a young age."
Mr Baey Yam Keng and his wife Lim Hai Yen cycling along Braddell Road on March 20, 2022. PHOTO: COURTESY OF BAEY YAM KENG
Link between consumption of salted fish and risk of nose cancer
Apart from ethnicity, other factors such as smoking and certain dietary habits, such as the consumption of salted fish and vegetables, have been previously found to be associated with a higher risk of developing nose cancer.
Prof Chua notes that salted and preserved foods are high in nitrosamines, a carcinogenic compound linked to nose cancer.
Early-stage nose cancer tends to be asymptomatic and is often discovered by chance, he says.
Nose cancer is often discovered late as it displays few symptoms in its earlier stages. About 70 per cent of newly diagnosed patients present with stage three or four cancer, notes Prof Chua.
Common symptoms include a painless neck lump, nose discharge or bleeding, nasal blockage that does not go away, impaired hearing or ringing in the ears and unusual face pain or numbness.
Radiotherapy, also known as radiation therapy, is the main treatment for patients with nose cancer, and usually spans between six and 6½ weeks. Patients with stage one and two cancer are treated with radiotherapy.
The cure rates are higher for patients with stage one and two cancer compared with stage three and four cancer.
"Nonetheless, unlike other cancers, even when patients have stage three and four cancer, they stand a good chance of cure, with intensive chemotherapy and radiotherapy," notes Prof Chua.
There is no way to prevent cancer currently, he says, apart from screening, which may help in the detection of early-stage disease.