SINGAPORE - To mark World National Cancer Survivors Day on the first Sunday in June - or June 5 this year - The Straits Times speaks to two people who were diagnosed with cancer in their 20s - and beat it. 

The National Cancer Centre Singapore (NCCS) last Saturday held its annual event, CanSurvive, to honour cancer survivors and encourage them to stay resilient in their fight against cancer. 

Themed Revived Lives, Renewed Resilience, the virtual event included a motivational talk and experts sharing tips on nutrition for cancer patients and survivors. There was also a screening of cancer patients who told their stories. 

Survived cancer, now pregnant 

In December 2014, just after Ms Pratibha Rai got married, she started having a lingering, guttural cough. She also endured persistent sharp pains and an ache in her chest and the back of her shoulders for weeks. 

She was also not able to sleep at night and would wake up drenched in sweat. She lost 7kg in 1½ months. 

After two months, the primary school teacher consulted a family doctor about her symptoms, but was told that these were probably due to the stress of planning her recent marriage and major life changes. 

It was only when she started to have severe breathlessness a month later that she became more concerned. 

"I felt like my heart was about to explode when I climbed an overhead bridge," says Ms Rai, who is now 34. 

It got to a point where she could sleep at night only if seated at a 90-degree angle. 

A full-body check-up, which included a chest X-ray, showed a huge mass covering her lungs, heart, major arteries and windpipe. 

Further tests showed she had diffuse B-cell non-Hodgkin's lymphoma, a cancer of the lymphatic system. It affects the B-lymphocytes that produce antibodies which help the body fight infections. 

Ms Pratibha Rai and her husband Jeremy Pillai shaved their heads together during her cancer treatment in February 2015. PHOTO: COURTESY OF PRATIBHA RAI

Ms Rai, who was in shock when she heard the diagnosis, says: "I knew something was wrong with me, but a 17.8cm tumour that was cancerous was the last thing on my mind." 

She stopped working for almost a year after her diagnosis and was on hospitalisation leave while she underwent chemotherapy and spent time on recovery. 

Apart from side effects such as headaches, nausea, fainting spells and lethargy, she also had painful mouth ulcers. 

On some days, the pain was too unbearable to even move her head and sleep, let alone eat, swallow or talk, she adds. 

"Those were the days that I would have to dig deep and force myself to practise gratitude and be thankful that I was at least still living and breathing," says Ms Rai. 

Though she and her husband always wanted a family, she could not receive fertility preservation before her cancer treatment as she was in a critical state at diagnosis and could not delay treatment by even a day. 

The couple also decided that they would explore options in starting a family later. 

Ms Pratibha Rai and her husband Jeremy Pillai decided that they would explore options in starting a family later. PHOTO: COURTESY OF PRATIBHA RAI

Ms Rai says: "If it wasn't through fertility treatment, we were most certainly going to adopt in the future. If our child could not be born in my womb, he or she would be born in our hearts instead." 

Fortunately, she has been considered to be in remission since July 2015, when check-ups showed no sign of the disease. 

Due to her cancer history, diminished ovarian reserve and the small size of her ovaries, she was an ideal candidate for in-vitro fertilisation (IVF). Ms Rai is now eight months pregnant with a girl. 

Through it all, her husband was her rock, she says. 

"He stopped work for about four months, just so he could be by my side and care for me." 

'Life gets sweeter after beating cancer' 

A biopsy confirmed that Mr Darren Tan had stage 4 nasopharyngeal cancer, also known as nose cancer. PHOTO: COURTESY OF DARREN TAN

Two years ago, Mr Darren Tan noticed a painless lump on the right side of his neck and went to a polyclinic. He was referred to an ear, nose and throat specialist and a biopsy confirmed he had stage 4 nasopharyngeal cancer, also known as nose cancer. 

At that stage, the cancer had grown into lymph nodes in his neck and the shoulder and collarbone region. 

The diagnosis came as a shock to Mr Tan, now 31, a non-smoker who exercised regularly. 

"My immediate thought was whether the diagnosis would affect my work, rather than how much time I have left. Knowing that I would still be able to pursue what I aspire to do was my main motivation to go through the treatment and to recover from cancer," says Mr Tan, who is married and works in the aviation industry. 

He also did not want to be a burden to his wife. 

"I wanted to live my life as per normal and did not want my wife to quit her job just to care for me. I want to be able to live normally despite having to go through the side effects of the treatment," says Mr Tan, whose wife is also in the aviation sector. 

Mr Darren Tan said that he wanted to live life as per normal and did not want his wife to quit her job just to care for him. PHOTO: COURTESY OF DARREN TAN

Mr Tan underwent chemotherapy and radiation therapy, but suffered severe side effects from the radiation therapy. He had burn marks on his neck and lost his sense of taste.

"I could not taste spicy food. Meat didn't taste like meat and rice tasted uncooked. But I always forced myself to eat, although I was unable to taste anything," says Mr Tan, who is now based in Australasia for work, while his wife is in Singapore. 

On days when he did not have an appetite, he had to rely on supplements. 

After his treatment in March last year, he was determined to live normally again. He resumed exercise progressively to regain his fitness. 

Mr Darren Tan during his first chemotherapy session. PHOTO: COURTESY OF DARREN TAN

Before starting cancer treatment, he underwent fertility preservation as he feared infertility as a result of chemotherapy. 

"Going through cancer treatment is important. Yet, at the same time, I did not want to lose the opportunity to have children in the future," says Mr Tan, who is in remission. His wife underwent IVF in April this year and is awaiting a frozen embryo transfer in August or September. 

His advice to other young adults fighting cancer is to embrace a positive outlook and to persevere through treatment. 

"Life gets sweeter after beating cancer and knowing you have emerged victorious in this battle. I believe you will be able to overcome any challenges ahead in life." 

Support for young cancer patients

The NCCS sees 450 to 550 new cases in adolescents and young adults aged 16 to 45 each year. 

Between 2016 and last year, it saw more than 6,000 new and existing patients in that age range. 

Dr Eileen Poon, a consultant in NCCS' division of medical oncology, says the number of cancer cases in adolescents and young adults is expected to rise worldwide. 

"This is due to reasons including better and earlier diagnostic rates, better supportive care and available treatments, and higher exposure to harmful toxins such as alcohol and smoking," she says. 

Patients previously diagnosed with childhood cancers are also living longer to get secondary cancers, adds Dr Poon. 

Each age range within the adolescent and young adult group is associated with its own trends, she notes. 

For those between age 16 and 29, the more common cancers are lymphomas, germ cell tumours and sarcomas. Between age 29 and 45, breast cancers, sarcomas, head and neck cancers and lymphomas are more common. 

Having cancer support groups is important as these have been shown to help patients feel more hopeful and cope with anxiety and depression along with their condition. 

The NCCS adolescent and young adult oncology support group consists of more than 20 active members who meet for activities every two to three months. 

Activities and workshops held prior to the Covid-19 pandemic included calligraphy classes and ballet under the stars. The group also holds regular educational talks on topics such as fertility preservation and treatment-related complications. 

At the Singapore Cancer Society, support groups are open to all ages. 

Mr Mark Lin, a manager at the society's psycho-social services department, says the groups have a total of 58 members aged 40 and below. 

Among them, there are six active members who are below 30 years old, with the youngest aged 21. Five of them are with the Bishana Ladies Group and one is from SemiColons. 

The Bishana support group was formed for female survivors and women who have been diagnosed with any type of cancer, while the SemiColons support group helps colorectal cancer patients.