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Wendy was on a long-haul trip to the US and New Zealand with her family for the holidays when she developed a cough. What she thought was an upper respiratory infection she got from her toddler, ended up being a rare disease: Hodgkin lymphoma.

A month after developing a cough during the holidays with her family in 2019, Wendy went to see a GP who diagnosed it as an upper respiratory infection.

Wendy was given antibiotics, but after developing a fever a week later, she underwent a chest X-ray which later revealed that there was an anterior mediastinal mass on a part of her lung and trachea. A biopsy and several scans later, it was determined that she had Stage 2A Hodgkin Lymphoma.

• Hodgkin Lymphoma is a rarer subtype of Lymphoma in adults compared to non-Hodgkin Lymphoma, explains Dr Dawn Mya, Senior Consultant, Haematology.
• The disease typically presents with lymph node swelling, most commonly in the neck and chest. It usually progresses from a single lymph node to nearby lymph nodes in a contiguous pattern. These enlarged lymph nodes are not painful but pain can sometimes occur especially with alcohol. Advanced stages will present with unexplained fever, weight loss and night sweats.
• The selection of treatment is based on the presenting stage and disease risk factors. Disease-related risk factors allow the discrimination of patients with favourable outcomes from unfavourable outcomes in patients with Hodgkin Lymphoma. Patients with early stage Hodgkin Lymphoma commonly attain a long-term complete remission with treatment. Treatment options include a few cycles of combination chemotherapy and/or radiotherapy. Second line treatment options for refractory/relapsed disease include salvage combination chemotherapy, autologous stem cell transplant, targeted chemotherapy and immunotherapy and immune checkpoint inhibitors.

Receiving a cancer diagnosis abroad

Wendy was based in Singapore when she received her diagnosis. “I don’t think it would matter where I lived in the world,” Wendy shares. “Receiving the news that you have cancer is devastating and shocking as I thought I was at my healthiest.”

However, despite the devastating news, she found it a blessing to undergo treatment in Singapore, particularly during the COVID-19 circuit breaker period, which saw city-wide lockdowns except for essential services and emergencies.

“I was grateful that I could take the MRT to the hospital and not worry about ‘germs’ as there was hardly anyone around and mandates such as mask-wearing and social distancing were strictly enforced. It was opposite to how the US was handling COVID-19,” Wendy explained.

She added that the personalised care she received in the country made an emotionally overwhelming experience more bearable and positive for her.

Staying positive and realistic

Despite a positive mindset, lingering concerns remained. “I knew that I was strong, but the lingering questions of why this was happening and how this would affect my future as a parent to a young child kept plaguing me,” shared Wendy.

She credited her vast support system around the world for cheering her on; her helper for helping her make her home feel ‘back to normal’ amid the countless treatment sessions, appointments and physical and mental fatigue she underwent over a year; and her husband, Steven, and daughter, Stella, for being her pillars of strength.

“We should never forget the caregivers as they need emotional support as well,” shares Wendy. “The love that was sent my way truly got me through the treatments and into remission.”

Besides the support of her loved ones, Wendy also joined Lymphoma support groups. “Unless your family or friends have/had cancer, they will not truly understand what you are going through. It’s important to be realistic,” Wendy points out.

Feeling fearless

Wendy achieved remission on World Lymphoma Awareness Day in September 2020. Since then, her approach to life is to be fearless.

“Even though I have low bone density and neck arthritis, I feel healthy and strong. After I finished my treatment, I decided to handle my fear of drowning so I hired a private swim coach and learned how to swim. After the first lesson, my coach was surprised as to how confident I was as he expected me to ‘freak out’ after submerging my head under water. My response was, “I just went to battle with cancer and won so I am feeling fearless right now”.

“As a cancer survivor, there are still the long-term thoughts of uncertainty that continue to haunt me; the thoughts of relapse, recurrence, further organ damage, and secondary cancers linger. But I know I can only control what I can control, which is my diet, exercise and my mind, so I eat healthy, stay fit, and stay positive.”