Life seemed good for Ms Jen Wang, 33, who was pregnant with her second child, and had just moved into her new HDB flat with her family.
However, a few months later, she found out she had stage 4 cancer – rare for a pregnant woman, not just in Singapore but other countries, too.
Just like that, at 17 weeks pregnant, Jen found herself battling colon cancer, worried for her and her baby’s life, and thinking about her son and husband’s future without her.
She was in a dilemma about making a decision about her course of treatment. Her oncologist did not mince his words when he spoke to her. “You have three options. Each choice is a cup of poison and you have to choose one,” he told her.
She could go for “radical surgery” to take out the tumour, but mother and baby could both die. The second option was to undergo chemotherapy, but there was a chance the cancer may not respond to it. The drugs would also be toxic to the body, and there was the risk of losing the baby. The final option was to do nothing but this meant the cancer would grow aggressively and compete for space with the baby.
Should a pregnant woman who is diagnosed with cancer begin treatment before the child is born? Some studies show most chemotherapy drugs can pass to the baby via the placenta.
Her concerned family members even urged her to go for an abortion, so that she could focus on fighting for her own life.
“I decided to start chemotherapy immediately and went ahead without thinking too much,” said Jen, whose son is now two years old.
Her husband, Jeremy Goh, also considered abortion because of the limited treatment options for a pregnant patient, but ultimately decided to support Jen’s decision. “I prepared myself mentally to care for the children should anything happen to her, and even if the baby is born with disabilities.”
By then, Jen was 21 weeks into the pregnancy. The cancer had spread to an area near her right kidney and was pressing on the common iliac artery – a large artery that also supplies blood to her womb.
According to doctors, people suffering from stage 4 colon cancer have a median timeframe of two years to live. And for Jen, the prognosis was worse because she was pregnant.
Jen started her first round of chemotherapy when she was 21 weeks pregnant. Every two weeks, she would go through another three-day cycle of chemotherapy. Besides suffering from severe nausea and fatigue, she was in so much pain sometimes that she forgot to breathe, and she hyperventilated. After the fourth cycle of chemotherapy, when she was 27 weeks pregnant, the doctor decided to stop treatment and wait. Five weeks later, her haemoglobin levels dipped and she became feverish. That week, a caesarean section was done to get the baby out.
“She was perfect. She had so much hair, more than her brother, despite me having gone through chemotherapy and losing my hair. I asked if the baby was okay and they said she was okay, and everyone was laughing,” Jen shared.
The baby girl, called Jill, was sent to the intensive care unit and Jen resumed chemotherapy two weeks after the delivery. She also started on immunotherapy, a new form of treatment that was undergoing clinical trials at the time.
But before long, there were more problems. Two weeks later, Jen’s colon ruptured and doctors told her family members to rush down to the medical centre – patients have died from having a ruptured colon.
But the emergency surgery was a turning point. “The operation was a miracle. Doctors not only managed to take out about 50cm of my colon, but they also removed parts of the tumour around the kidneys,” Jen said.
Last month, she underwent a scan and there was no evidence of the cancer. The recurrence rate for cancer is about 70 per cent.
For now, Jen and her family are celebrating. The baby is four months old now, and healthy.
Jen said she hopes to fight on for her children. “Facing mortality has showed me how to live. I used to be paiseh (shy), but now, I will not wait to tell my loved ones how I feel about them.” She added that she hopes to continue working or volunteering with the Singapore Cancer Society, where she was formerly an executive. “I want to share my story with others, about how my struggles have helped to strengthen my faith.”
By Janice Tai, The Straits Times, January 2018
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