SINGAPORE – Madam Quek Lee Ken first noticed a painless lump under her left armpit in 2019. It would sometimes cause her arm to swell, but because it was painless, the 74-year-old dismissed it and did not tell anyone about it.
In 2022, when the swelling became more persistent, her daughter Margaret Ng took her to a general practitioner and found out about the lump.
Madam Quek was then referred to Singapore General Hospital, where a series of tests in April that year showed that she had advanced-stage triple-negative breast cancer, an aggressive form of the disease.
By then, the cancer in her left breast had spread to the lymph nodes in her underarm and neck.
“I lost all hope. I was prepared to die, so I gave my valuables to my two children and my daughter-in-law,” says Madam Quek, who spoke to The Straits Times in Mandarin, with her daughter interpreting.
Ms Ng, 47, was filled with guilt and anger.
“I felt that if I had watched her a bit more closely, we could have checked out the swelling in her arm earlier, as it could have been one of the early symptoms,” she says. She took no-pay leave from her job as a senior manager in the transport industry to take care of her mother.
Madam Quek, a retiree who ran a hawker stall selling fried carrot cake and chwee kueh in Ang Mo Kio for 41 years, started on a combination of chemotherapy and immunotherapy at National Cancer Centre Singapore (NCCS). Her husband still owns the stall and has hired assistants to run the business.
Ms Ng accompanied her mother to all her treatment sessions and doctor visits.
But two months later in June 2022, Ms Ng’s life was turned upside down when she found out she had the same cancer.
Knowing that breast cancer is hereditary, she decided to do a self-examination one day, and she felt a lump at the top of her left breast. She thought it could not be cancer because the results from a routine mammogram just eight months earlier had come back negative.
She hesitated for two weeks before going to a private clinic, where scans showed she had a 2.7cm cancerous tumour.
She, too, had triple-negative breast cancer. But unlike Madam Quek, Ms Ng had caught the cancer at an early stage.
Both of them have the BRCA1 gene mutation, which significantly increases one’s risk of developing cancer, especially breast and ovarian cancers in women.
Ms Ng was recommended to a doctor at OncoCare Cancer Centre at Mount Elizabeth Novena Hospital, where she began chemotherapy and immunotherapy.
“My first thought was – how am I going to tell my mother. I also feared what the next steps were, whether I would be treated successfully and if I could live to see my son grow up,” says Ms Ng, who is married to a 49-year-old secondary school teacher and has a 15-year-old son.
Madam Quek, who also has a 48-year-old son, took her daughter’s diagnosis harder than her own.
She became depressed and could not sleep at night, ruminating on why this had happen to them.
“It felt more painful to know that I had passed this to my daughter. I had thoughts of suicide when she was diagnosed. I prayed for God to save us both and if only one of us could be saved, let it be Margaret,” says Madam Quek.
Ms Ng soon came to terms with her own diagnosis and was also determined to be there for her mother.
Dr Peter Ang, an oncologist at OncoCare Cancer Centre who treated Ms Ng, says having two family members on cancer treatment at the same time is not common.
He says: “When we discussed treatment, Margaret was familiar with the names of the drugs and potential side effects of treatment. Walking the treatment journey together creates a special bond for mother and daughter. When families are able to share good and tough times together, it speaks of the strength of the relationship.”
To ensure she could continue to accompany her mother for all her treatments, Ms Ng scheduled her therapy sessions on Fridays, so it would not clash with her mother’s on Thursdays.
She would then rest over the weekend and spend the following week at her mother’s home as her main caregiver.
Ms Ng’s husband would ferry her between her mother’s house in Hougang and their home in Katong.
Despite her fatigue, Madam Quek cooked meals such as steamed fish and fish porridge for Ms Ng when they were at home.
Ms Ng says: “Our immunity was very low, so we stayed at home and watched comedies, travelogues and cooking shows. It took our minds off things.”
She would also lift her mother’s spirits by getting her favourite food delivered, such as dim sum and minced meat noodles.
When Madam Quek was more energetic, her family accompanied her for short walks and gradually increased the distance when she became stronger.
Ms Ng also took responsibility for her mother’s medicine regimen, making sure she took her medication on time.
Madam Quek says: “I wanted to get well so I could help Margaret and be there for her during her journey as well. I wanted to do my part as a mother.”
Though Ms Ng was generally steely, she became upset when she lost all her hair while undergoing chemotherapy. To gain a sense of normalcy, she bought two wigs – a bob cut for $500 and a longer one for $1,000. She has used only one, and plans to donate the other.
Madam Quek, on the other hand, developed only some bald patches and was hardly fazed by it.
But when their hair started growing again, they marvelled in excitement.
Ms Ng and Madam Quek underwent a double mastectomy in 2023 after they completed chemotherapy and immunotherapy.
Madam Quek also had 26 lymph nodes removed from her left underarm, as she had a lump in the area. She then did 21 sessions of radiotherapy to target the cancer that had spread to her neck, and is now on targeted oral therapy to prevent the cancer from recurring.
Both mother and daughter are cancer-free now.
Madam Quek goes for follow-up appointments every two months now, while Ms Ng, who underwent breast construction, goes for checks every three to six months.
Their respective medical bills amounted to a six-figure sum each and were fully covered by insurance.
Ms Ng returned to her job full-time in October, working three days in the office and two days from home.
Looking back, she says: “It was a tough time for my dad as well, but he stayed strong. He would go to shops nearby to get my mum’s favourite food, such as Nonya kueh, and also help her with the cooking.”
Relatives and friends also constantly checked in to see how they were doing.
Ms Ng says her husband was also a strong pillar of support for her.
“Having someone who is logical and positive to talk to and who will be your cheerleader during your recovery helps.”