Cara Chew, 32, from Singapore, was diagnosed with Diffused Large B-Cell Lymphoma. She shares her brush with cancer, chemo therapy and its after effects, and also how she learnt to overcome the trauma with Taichi, physical exercise and a positive mind.
Cara, please tell us a bit about your condition
In December 2015, I was diagnosed with Diffused Large B-Cell Lymphoma (DLBCL) at one spot located at my lower left jaw at Stage 1. Diffuse large B-cell lymphoma (DLBCL) is the most common type of high-grade (fast-growing) non-Hodgkin lymphoma.
What were the early symptoms?
I had a really bad cold which led to my loss of voice, which has never happened to me before, after which I realised a swollen lump hardening just below my lower jaw. When I went to see the doctor, he said that usually lymph nodes may swell when the body is undergoing some sort of an infection (i.e. my bad cold) so I was asked to wait for a while.
After my cold went away, the hard lump persisted and even grew a little bit. This is when I went to the A&E (Accident & Emergency department) and the doctor urged me to get a biopsy done. A week later, I got the biopsy done and a few days later I received news that I should get a surgery to remove the lump for a full diagnosis report.
Is there a history of lymphoma in your family?
Strangely enough, 2 months after my sister was diagnosed with the same type of lymphoma (DLBCL), except hers was in the chest (Primary Mediastinal Large B-Cell Lymphoma), I also started falling sick and was similarly diagnosed with the same problem
What is your present condition?
I am currently officially 10 months in remission and feeling really healthy and well. Exercise and going back to studies helped stimulate my mind and body in a big way..
Please describe your experience of managing Lymphoma.
I’ve encountered cancer before as a caregiver, taking care of my sister when she was diagnosed with a brain tumor, and then surviving it. When I was diagnosed with lymphoma, my father had just undergone a heart bypass and my sister was at the same time diagnosed with lymphoma in the same week. Managing my own lymphoma chemotherapy journey was probably easier than having to give care to one or multiple family members going through cancer/surgery treatment.
My chemotherapy treatment consisted of 6 cycles of R-CHOP medication, 1 day in the hospital to get the IV drips, and the other 5 days of oral medication plus white blood cell injections. I went to my doctor and chemotherapy appointments myself and stayed home when I was fatigued from the low white blood cell counts.
While my sister was getting her R-EPOCH chemotherapy at the hospital, I had the strength to visit her at the hospital at least once every cycle, and she also managed her chemotherapy independently.
The key for us was to rest when we were tired.
Currently, I am not on any medication post chemotherapy.
Were there any side-effects of the medication?
These were strong medicines to kill the cancer cells and inevitably they would kill the healthy cells as well in the body. This is when the body can get really fatigued. As an energetic person, I was extremely fatigued and could not get out of bed in the first week of the cycle, especially when the white blood cell counts were low. A normal walk up a slight gradient hill would tire me out halfway sometimes.
Other side-effects I experienced were chemo brain, neuropathy in the fingertips, and hyperpigmentation which got me really tanned towards the end of the chemotherapy. I had phlebitis from the 1st chemo cycle as my veins were tiny. Occasional nausea, severe acid reflux, loss of muscle were a few of the other symptoms I experienced.
I had induced menopause (I was injected Zoladex every month during my chemotherapy) by shutting down my ovaries to protect them during this period of time. I suffered from menopausal symptoms such as hot flashes and hormonal changes. When I stopped those injections, it took a couple of months for my hormones to regulate back to pre-menopausal state
What were some of the challenges you faced and what is your advice to patients who face similar challenges?
The biggest challenge I faced was to deal with fatigue as a typically energetic person. I’ve always been the person who is on the go and not having the same kind of energy to do what I want made me feel inadequate and guilty for not doing those things. It took me a couple of cycles of chemotherapy to accept the fact that I needed to rest and not do as much as I wanted to.
My advice would be: Just rest because your body needs it. All the other physical changes can be managed with certain medication and natural foods.
Have you learnt anything in managing in your condition that you wish you knew before?
Not really. I have seen through brain cancer treatment and recovery, and both my sister and I were in the same boat when we both were undergoing chemotherapy together.
I think that expecting the unexpected and believing that it will pass helps a lot.
What kind of specialists do you consult and how often?
I see my oncologist once every few months for a blood test and a consult. That’s about it.
What resources are available to you in your city to help you manage the condition?
The internet and researching online really helps me a lot in getting information about my situation and how to deal with it. I would go to the library sometimes to read up on some books for natural food cures.
Have you had to make some changes to your lifestyle because of your condition?
I was going to the gym regularly before lymphoma and working really hard. I have quit my job after chemotherapy to take a sabbatical from work to take it easy from work stress.
I just finished a course on web development learning how to programme both front-end and back-end development to add onto my 10-years of marketing experience, which ended up being harder than I thought. But learning something new, especially something so practical and focussed, truly helped with my chemo brain.
I have also taken up Taichi right after my chemotherapy to build back my muscles and energy and it has produced extraordinary results in my recovery.
Tell us more about Taichi as a complementary therapy?
Taichi is my choice of complementary therapy as I have read some articles from the Harvard Medical journals on the health benefits of Taichi. After doing Taichi for 11 months, my leg muscles have grown back their strength and I no longer involuntarily trip on myself. I can even climb higher flights of stairs without feeling breathless as compared to some of my non-active friends. The hardening of veins in my left arm from the first chemotherapy cycle has significantly reduced. When I just ended chemotherapy, both my palms were of a greyish colour. Now, they are back to being pink.
Has it been difficult emotionally to cope with your condition?
I felt most emotional when I was experiencing menopausal symptoms and hormonal imbalances. Otherwise, I knew that it was something that would pass with the chemotherapy treatment and a positive attitude.
How has your family supported you? How did your friends treat you ? Were you isolated?
I get most of my support from friends who were always offering to drive me to places and cook food for me which was really nice. I created an instagram account (@smilesandcocktails) to document my daily chemotherapy journey and there I found many like-experienced friends from all over the world that made the journey more positive and bearable.
Did you see a counsellor for support?
When I was a caregiver to my sister during her brain cancer treatment, I had to see a counsellor to deal with not having a life, not taking care of myself, not having help, and learning how to not be burnt out.
As a patient and slightly more familiar with the process, with friends and a community of cancer patients going through the same experiences and cancer survivors providing encouragement, I didn't need a counsellor.
What was the hardest part of the treatment ? What kept you going? How has this changed your life perspectives and ambitions..
Fatigue and not being able to do the things that I wanted to do was the hardest part of the treatment for me. What kept me going was my social media account where I could connect with like-experienced friends and knowing that I could make a difference online if not in person.
This experience has not changed my life perspective much but only amplified the desire to help more people going through the same thing.
