Not yet 22, Azhany Mohamed believed her dry cough was due to fatigue, but a biopsy confirmed she had Stage II Hodgkin lymphoma.
Azhany had hoped she could enter the workforce and support her family financially after graduating from Temasek Polytechnic (TP) in 2017. However, her plans came to a screeching halt when she was diagnosed with Stage II Hodgkin lymphoma.
Azhany’s first symptoms
During her final year in TP, Azhany started experiencing intermittent low-grade fevers and a nagging cough, which she put down to fatigue. However, her condition worsened; she had trouble breathing at night, and could only sleep with her head elevated. Azhany also stopped eating solid foods because she experienced an unbearable tightness in her chest when swallowing.
“Due to my difficulty eating, I lost five kilos and became increasingly withdrawn to hide the fact I was unwell. I was in denial about these symptoms in the beginning, but they became too difficult to ignore; walking had become increasingly difficult for me as it led me to be easily short of breath.”
Undergoing diagnostic tests and receiving the news
In the early stages of her symptoms, Azhany visited a GP, who dismissed her persistent cough as an ordinary dry cough. When her symptoms did not respond to medication and worsened, Azhany consulted her family GP, who noticed her stomach was bloated. He advised her to admit herself to the hospital if the swelling did not go down in three days.
As the swelling did not subside, Azhany admitted herself to Khoo Tech Puat Hospital where she was placed in the Intensive Care Unit (ICU). At first she was believed to be suffering from a lung infection. A PET scan revealed a huge mass in her chest covering half her lungs and Azhany was transferred to Singapore General Hospital’s (SGH) oncology ward where she had a biopsy, a procedure where a tumour tissue sample was extracted from her lungs for examination.
“I remember how painful the biopsy was, and it later left a scar A few days later, a team of doctors confirmed I had Stage II Hodgkin lymphoma, which I didn’t think had anything to do with cancer. A simple Google search confirmed my worst fears.”
Azhany’s treatment options
According to Dr Eileen Poon, Azhany’s oncologist at the Department of Lymphoma and Sarcoma Division of Medical Oncology at the National Cancer Centre Singapore, Hodgkin lymphoma is a rare cancer of the lymphatic system and that accounts for 10% of all lymphoma cancers. Commonly seen in adolescents and young adults and fortunately highly curable, Hodgkin lymphoma is closely associated with immunosuppression and exposure to viruses, such as the Human Immunodeficiency Virus (HIV) or Epstein-Barr virus (EBV).
Dr Poon offered Azhany two chemotherapy options – BEACOPP and ABVD. She explained that although BEACOPP was more intense than ABVD, it was better suited to her condition, due to the size of the mass in her lungs. Dr Poon also recommended three months of radiotherapy after chemo.
“I opted for BEACOPP, a six-month long treatment, which involved taking intravenous and oral medications, and supplemented with self-administered booster jabs to increase my white cell blood count. I also had a surgery to freeze my eggs before I began chemotherapy to preserve my chances of conceiving in the future.”
The physical and emotional toll of cancer treatment
The first three months of chemo was bearable, Azhany said, and she even celebrated her 22nd birthday with friends at the hospital. Although she lost her hair in the second month of treatment, she still felt fine physically.
After the third month however, Azhany’s symptoms took a turn for the worse. Her hair stopped growing; she lost her appetite and vomited constantly. She even admitted herself into the hospital in the last month of treatment because she was too weak to travel for outpatient chemotherapy.
In addition to feeling physically ill, Azhany’s mental health was also severely affected. In addition to hair loss, she became self-conscious of her swollen face, another side effect of the treatment. She avoided posting photos of herself on social media and felt envious of and forgotten by her friends who had posted their holiday photos and videos on social media.
Nevertheless, while the last few months of treatment took a heavy toll on Azhany’s physical and mental health, she began regaining her strength and appetite after completing her last session of chemotherapy. She also underwent eight to 12 weeks of outpatient radiotherapy a month following chemo and after a PET scan confirmed there were no more cancer cells left in her body.
“Following radiotherapy, I returned to SGH weekly for a check-up, which gradually became monthly check-ups. The quarterly PET scans soon became bi-annual scans. Eventually, it was no longer necessary to have scans as I was finally cancer-free.”
Much-needed support and life after cancer treatment
Being diagnosed with cancer resulted in an ‘involuntary gap year’ where Azhany’s plans for working and supporting her family were put on hold. Her father, a forklift driver and mother, a homemaker, had also been concerned about the cost of treatments.
“Thankfully, NCCS offers financial assistance schemes which helped pay for my medical costs and gave me peace of mind while I was undergoing treatments.”
“As for emotional support, although my friends and family were encouraging throughout my cancer journey, they never truly understood what I was going through. This is why I am grateful for NCCS’ support activities for cancer patients. These sessions allowed cancer patients to share our experiences with each other and provided me with the encouragement I needed during recovery”.
Unfortunately normal life did not resume immediately for Azhany after remission. Although she was cancer-free, her medical history made it difficult for her to secure a job.
“I eventually got a job as a graphic designer in an organic product company after a year of relentless job-hunting. In that time, I helped out at home, supported my friends at their art shows and continued to participate in workshops at the NCCS. These activities kept me busy and taught me how to become part of society again, so I didn’t feel overwhelmed when I entered the workforce.”
Lifestyle changes, future plans, and cancer advocacy
One of the biggest changes Azhany made after cancer was improving her diet and lifestyle. She now eats less processed food, preferring home-cooked meals with high nutritional value. Additionally, she joined a gym and high-intensity interval training (HIIT) fitness classes to improve her overall health and reduce her risks of cancer recurring. Whenever she feels unusually tired, she also goes for health screenings to ensure she’s in the clear.
Today, Azhany has been in remission for three years. She tied the knot on 14 November 2021, and is looking forward to starting a family .
“I am grateful I was given the chance to freeze my eggs to improve my chances of conception when I’m ready to conceive. Although there’s a risk my children may have cancer, this will not stop me from having children because I now have the information needed to either prevent the disease in my children, or at least detect it before it becomes difficult to treat.”
Having experienced the emotional and physical toll cancer has on patients and their families, Azhany is now committed to raising awareness and supporting cancer research.
This is why she will be participating in Run For Hope 2021, Singapore’s largest running event for cancer research. Returning as a virtual run, Run For Hope will take place from 29 November to 26 December 2021.
“Cancer research has always been critical for the advancements of cancer treatment. By participating in RFH 2021, we will be pledging much-needed support for cancer research to develop new ways to prevent and treat cancer as well as facilitate enhanced care for patients and survivors across Singapore.
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