Can-Care patient care executive Ms Wong Seow Chyi guides a patient with measuring her under-bust line, cup size and identifying her breast shape profile in an online personalised mastectomy bra fitting session.PHOTO: CAN-CARE

When Ms Lim Peck Khim found out she had stage 4 ovarian cancer in April last year, she was shattered.

She had experienced symptoms such as back pain, joint aches and frequently felt tired. She went to a polyclinic and was referred to Singapore General Hospital. She underwent a few medical tests at the National Cancer Centre Singapore (NCCS), which then confirmed the diagnosis.

"I was sad, shocked and found it difficult to accept," said the 53-year-old former clinic assistant.

She went for surgery to remove her ovaries in July last year and is currently undergoing chemotherapy.

To cope with feeling low, Ms Lim decided to join cancer support programmes after she came across a poster about them at NCCS.

Support group programmes, talks and even bra fittings for breast cancer mastectomy patients have moved online to help people deal with their medical conditions in a time of social distancing.

Support groups bring patients and caregivers with similar conditions and situations together to garner support from one another and learn how to cope better throughout the cancer journey. They are free and open to all cancer patients in Singapore.

Group activities include offering of psycho-social support and dispensing of medical and health information, on topics such as understanding cancer pain, mindfulness practice, physiotherapy, resilience in patients and self-care for caregivers.

The sessions are co-led by a volunteer patient leader and a team of healthcare professionals, such as medical social workers, nurses and medical physicians.

Since last December, Ms Lim has attended several support group sessions, where she received advice and tips from other patients on how to cope with the disease.

"I decided to join the sessions as a form of support for myself so I don't feel alone and to make some friends who have the same condition as me. I also wanted to gain knowledge on managing pain and know more about cancer generally," said Ms Lim, who is married and has four children aged between 12 and 29.

During the circuit breaker in April, NCCS temporarily suspended its support group meetings on-site before it started conducting online sessions on video-conferencing platform Zoom last month.

Ms Lim, who was worried about her health and the risk of getting an infection given her weakened immunity, said: "I tried to stay at home most of the time unless it was important for me to go out. The online support sessions are a good way to keep me engaged during the stressful Covid-19 pandemic."

So far, she has participated in two online support sessions on traditional Chinese medicine and understanding cancer pain.

Patient support manager at NCCS' Department of Psychosocial Oncology Brandon Goh said it can be a challenging time for cancer patients during the Covid-19 pandemic.

"Besides worrying about their health, some of them may feel the effects of isolation as the level of social activities has been reduced. It is important to introduce a virtual platform to help patients and caregivers who are in similar situations to stay connected, to share and give each other support, and to know that they are not alone in this journey," said Mr Goh.

He added that participants are encouraged to share their experiences and exchange coping tips with one another.

Currently, the online support group sessions run weekly and, depending on the topic, last between one hour and three hours.

Social enterprise Can-Care, which helps newly diagnosed cancer patients and cancer survivors cope with the changes they are experiencing with their body and lifestyle, have also been offering online support and educational sessions for patients and their caregivers since the circuit breaker was announced in April.

Can-Care general manager Joeanne Wong said the platform provides educational sharing while allowing patients and their caregivers to share their experiences or challenges with other members.

"This fosters a stronger sense of belonging, while at the same time patients can gain more knowledge on cancer management related topics," she said, adding that it also supports the patient's emotional well-being by reassuring them that they are not alone.

So far, it has conducted sessions on topics such as breast prostheses, taking care of the skin and scalp and lymphedema management.

The online sessions, which are free and open to all cancer patients in Singapore, are conducted by healthcare professionals and patient care executives from Can-Care.

It was conducted once in two weeks during the circuit breaker and, currently, once a month.

Apart from online support sessions, the company also provides personalised mastectomy bra-fitting sessions online for breast cancer patients. Patients pay for the mastectomy bra, which costs about $75 to $130 per piece.

Can-Care works with manufacturers to bring in healthcare products including prosthesis, post-operative bras, mastectomy bras and hair wigs to support the needs of cancer patients.

Ms Wong said: "The circuit breaker restricted many activities. We could not conduct any personalised (breast prosthesis and mastectomy bra) fitting for patients in person during that period. While our product offerings may not be essential to the common public, they are essential to certain breast cancer patients who have just had a mastectomy."

So Can-Care started to offer fittings over video calls in April. It has provided more than 100 patients with their customised bras through such consultations and has a return rate of below 7 per cent.

"This proves that virtual fitting is possible and it challenges our old-fashioned beliefs that patients need to be fitted physically," said Ms Wong.

Ms Tricia Ng, who was diagnosed with breast cancer in December last year, heard about Can-Care's services from breast care nurses at National University Hospital.

The 27-year-old healthcare worker went through an online personalised mastectomy bra fitting session last month and found the process worked well.

She initially felt daunted and overwhelmed with the idea of searching for post-mastectomy products but her experience has led her to feel "grateful for a supportive community of women who want to make a difference in the lives of those with breast cancer".

Can-Care's Ms Wong said: "Supporting the physical appearance of patients is especially important as this helps to boost their confidence and self-esteem, which has been found to improve the treatment outcome of patients."