“It’s the absence of hope that makes cancer patients lose all sense of life.”
At 32, Andrew has only about four to six months to live, should his current treatments fail. He has Aggressive Non-Hodgkin’s Lymphoma, and it isn’t the first time medical treatments have failed on him. He had already gone through 10 rounds of what is supposed to be the most effective, available chemotherapy for his case, only for the cancer cells to return with a vengeance.
Within the span of less than a year, he has gone from optimistic and hopeful to terminally ill.
When I first met Andrew about 9 years ago, he was an assistant producer at the place I interned at. In short, just an ordinary, healthy person who is few years my senior. Yet, when I met him at a cafe near his home earlier last week, he had to walk with the help of a cane. What used to be the physique of a sportsman is now this frail person with a slight hunchback, pallid face, and a bare head, save for a soft fuzz of hair that has started to regrow.
He was first diagnosed with stage 1 Aggressive Non-Hodgkin’s Lymphoma, a type of cancer that affects certain types of immune system cells, last June. The tumour has since grown to a point where he is unable to ‘survive’ without the use of morphine. The tumour growth near his lungs presses on his rib cage every time he takes a breath, causing him immense pain.
Back then, it was only by pure coincidence that the doctor stumbled upon the tumor.
Stage 1 Only, No Biggie
It was only when Andrew checked himself into A&E for a high fever one night when they found out.
He had gone to the hospital as a precautionary measure, as he had a history with Pneumothorax (collapsed lung). Fearing complications that could have arose from the major surgery he did for Pneumothorax prior, the doctors ran some x-ray tests on him. The tests returned with signs of a tumour growth at the upper part of his chest.
Further biopsy tests identified it as stage 1 Lymphoma.
“Back then, the doctors were super confident—it wasn’t a complicated case. 90 percent of people who had this [cancer] at this stage have been cured.”
With that assurance and his strong belief in the medical system, he proceeded with the recommended treatments—chemotherapy—confident that it was nothing to worry about.
“I had great trust in our medical treatments. Like eh, stage one [only], what is this man! You know, I thought this will just be something like a few months ‘holiday’ where I go for treatments, then I’ll be out soon enough.”
Nobody would have expected that he was that 10 percent.
Instead of shrinking, the tumour grew from 8cm to 13.5cm. By this time, the cancer cells had began to spread to his other organs—the worst sign of any cancer. The 10 rounds of chemotherapy, which comprised of R-EPOCH therapy, and another stronger, RICE therapy, had failed.
As he went on to explain how chemotherapy works on cancer patients, Andrew added that it is something he would never wish upon anybody.
“It lives up to its reputation as a very uncomfortable process.”
The side effects of chemotherapy varies for each person. For Andrew, the sessions completely sucked the life out of him and made it impossible to palate anything. “I would eat and then ‘Merlion’ everything out.”
Besides the nausea, lethargy, and hair loss, there was also a general uneasiness in his body which he could only describe as “an oily feeling,” and “it’s like your body is rejecting [what’s being done to it]”
Coming To Terms With The Truth
When he saw the PET scan and heard the doctor’s remarks, his first thoughts were: “So how long more do I have left?”
“I don’t want to be in a situation where I haven’t said my goodbyes and I haven’t done my final things before I pass away.”
Any cancer patient would have mentally prepared themselves for the worst, but knowing that the worst that they could expect came true is another thing altogether. The news gutted Andrew and his family.
A Christian, he had on many occasions questioned why God allowed this to happen to him. He questioned why it had to be him. Why it had to be cancer.
Acceptance only came later, and it came from the pain that he had to go through.
“There was one night I really thought I was really going to die.”
He recounted to me about the night a bad coughing fit left him curled up into a ball on his bed. Besides the physical pain he felt at his ribs and the stars he was seeing from it, it also broke his heart to see his mother crying by his bedside.
“My mum said that she wished she could take the pain from me. She said that she wished she could be the one who had cancer instead of me. For me, for a child to see your mother crying for you so helplessly, it was so painful.”
In our generation, a lot of us spend long hours at work or with our friends. It was no different for Andrew. Looking back at the times he had placed work and friends above time with his family, his biggest regret is not having spent enough time with his mother.
“Ultimately, during the most difficult time of my life it was my mum who sat at the side of my bed. She cannot do anything but sit there and cry, but it’s this kind of relationship that [reminds me that this is something] we should never compromise.”
When You’re In The Face Of Death
Andrew’s everyday life now revolves around rest. His therapies leave him with little energy for anything else. Besides the 16 or 17 hours of sleep he needs a day, he spends his time on simple pleasures like reading, catching up with friends, or fulfilling his wanderlust through travel shows on Netflix.
Since the traditional treatment of chemotherapy has failed, he has gone on to alternative therapies, which works slower and have a lower success rate. And because his is an aggressive cancer, it is now a race against time—for the alternative therapy to save him before the cancer takes his life.
However, the prognosis, or ‘time till death’ is not something that the doctors can determine as he is on a relatively new treatment. If it does not work, he will only have up to six months to live.
“The truth for cancer patients is that we cling on to every bit of hope if possible because otherwise, there’s really nothing else to cling on to anymore.”
Hope. It is the one thing that keeps Andrew alive despite being in the face of death. Besides, cancer is unlike the common cough and flu, where you know recovery is only a matter of time with the help of medications.
Reflecting on his journey, he tells me about how the worst part is when the doctor looks at him with a look of defeat—when they look like they have no idea what else to do.
“It’s the absence of hope that makes cancer patients lose all sense of life.
The fear of death is what makes people struggle with coming to terms with being terminally ill, he explained, and stressed the importance of seeing death as a happy closure. The change in mindset and the understanding that death is one end to the pain and suffering is what helped him accept death.
Last Words: Prioritise Happiness & Hold On To Hope
As someone who used to be extremely health conscious, Andrew joked about how he regrets not living life previously. “I used to actively clamp down on a lot of things believing that I have my health under my control. I should have just eaten whatever I want!”
Lymphoma, however, is one of those mysterious diseases that do not discriminate. He just happened to one who has it.
“I think we should live our life as happy as possible. Make a commitment to live as happy as possible. Happiness is now. Happiness is eating dinner with friends and family instead of doing paperwork at 9pm thinking that your boss and company will appreciate.”
For those who are also terminally ill, “Never stop fighting. Fighting on is a big part of fighting cancer.”
Many patients get very depressed and scared as they fear the ultimate result of cancer: death. However, one needs to believe that there is light at the end of the tunnel and believe that the pain will end.
“You need to believe that it will not be darkness when you close your eyes for the last time. [For me,] that is the hope I need to cling on to because otherwise I will fall into depression.”
Even loved ones will not be able to help in this journey, for it is a very personal battle when it comes to accepting death.
“We need to cling on to something larger and stronger than ourselves,” Andrew emphasised.
“The moment we give up hope, the battle is lost.”