Too old to get better? Never!
Age was no barrier: Meditation and family support helped this 70-year-old pull through
Cancer patient Madam Tin Aung from Myanmar is 70 and a living testimony that elderly cancer patients can beat their disease. A jewellery business owner from Mandalay, Madam Tin Aung first discovered lumps in her breast and armpit while bathing. She alerted her family members and was referred to doctors in the capital, Yangon.
Last July, she flew to Singapore to consult Dr Khoo Kei Siong, Senior Consultant, Medical Oncology, at Parkway Cancer Centre, after receiving recommendations from three doctors.
The old lady, a spinster, could not understand English, so strong family support during her treatment was very important. She contacted relatives in Myanmar and the US and asked them to take time off to be with her, sponsoring their flights and accommodation in Singapore. She also flew in her nephew, a doctor based in Jamaica, for her initial consultations.
According to Dr Khoo, Madam Tin Aung first went to him with a large breast tumour. A biopsy on the same day confirmed she had an aggressive form of breast cancer.
Family friend Nini (far left) visited Madam Tin Aung to give a little encouragement during her treatment.
The locally advanced breast cancer, upon examination, was found to be an “inflammatory breast cancer” measuring about 6 cm. The overlying skin was red and tender, and the lymph node in the armpit was enlarged. He treated her with chemotherapy. Dr Hoe Ah Leong, a breast surgeon, operated on her in January this year, after which Dr Lee Kim Shang took charge of her radiotherapy.
According to Dr Khoo, Madam Tin Aung’s treatment was a challenging problem on several counts.
Firstly, Madam Tin Aung’s tumour was too large to be operated and had to be shrunk considerably before she could undergo surgery. Secondly, the tumour was not sensitive to hormonal therapy and would require fairly high doses of chemotherapy to downsize it adequately.
Madam Tin Aung also had a history of hypertension, diabetes, asthma and coronary artery disease for which an angioplasty was done some three years ago. Her old age and medical problems increased the risk of potentially serious complications from chemotherapy.
Her family understood the odds and the risks, and along with Madam Tin Aung, they were prepared to do whatever it took for the best chance of cure.
On treatment, the tumour did not respond well in the early stages and she had the usual side effects of chemotherapy, losing all her hair and a lot of weight, and suffering fever and bouts of the cold. Madam Tin Aung also cried many times, out of helplessness, when she did not have anyone by her side to translate for her.
The treatment programme was modified after two months and the response was remarkable. She also found a family friend in Singapore who could provide translation and moral support.
By the end of November, the tumour was no longer palpable clinically. Madam Tin Aung got ready for surgery.
In January, she was operated on and only a small residual tumour was found in the breast. She then underwent radiotherapy to the chest wall and recovered well.
Her formula for coping with pain is meditation. A Buddhist who regularly helps out in temples in Myanmar, Madam Tin Aung sets regular timings during the day to meditate, willing away the pain she felt from having tubes inserted in her body for eight months.
Said Dr Khoo: “Treating elderly cancer patients is always a challenge. This is especially so for those with a potential curable cancers. On the one hand, one should always try to give optimal treatment for the best outcome. On the other hand, one has to be careful with adverse effects of treatment. Striking the right balance is the key to a favorable outcome.
“Madam Tin Aung’s case is a good illustration of such challenges. The take home message is that elderly patients and patients with other medical problems may also receive optimal treatment for cancer, including chemotherapy.”
