Uterine Leiomyosarcoma: Stories of Hope - A Brave Warrior

Contributed by: Dr Richard Quek

Nguyen discovered that she had a uterine fibroid when she underwent an ultrasound in Hanoi in 2016. What she thought was a noncancerous growth later turned out to be uterine leiomyosarcoma (LMS) following a hysterectomy.

“The shock of receiving the news felt like rain falling down on me,” Nguyen recalls. “I was depressed and cried all night. I had to pretend to be strong in front of my husband and children because I did not want them to break down.”

Following the devastating news, Nguyen was referred to a medical oncologist in Hanoi, who ordered a biopsy and PET-CT scan for Nguyen. Based on her results, she was told that she did not need any chemotherapy or radiation therapy, but would need regular follow-ups to monitor her condition.

“Everything seemed normal the first two years after that,” explains Nguyen. “I stopped worrying, my general health was stable, and I began social and community work to distract myself from my disease.”

  • Leiomyosarcoma (LMS) is a rare type of soft tissue sarcoma that arises from smooth muscles lining the wall of the uterus, shares Dr Richard Quek, Senior Consultant, Medical Oncology. Sarcomas are malignant tumours that arise from connective tissues that support and surround critical structures and organs in the body.
  • The signs and symptoms of LMS may vary depending on the location of the tumour. Generally, patients may present with vaginal bleeding (LMS of uterine origin), pain, weight loss, and a persistent lump or swelling (LMS of limb origin).

When prospects turn bleak

Nguyen’s prospects began to turn bleak in 2019. During one of her regular follow-up appointments that year, a chest X-ray revealed that there was a small opaque nodule in Nguyen’s lung. This persisted for three months. A subsequent lung biopsy showed that Nguyen’s uterine LMS had indeed spread to her lungs.

Numbed by shock, Nguyen was unable to process the next steps recommended by her oncologist. Fortunately, her daughter—who was based in Ho Chi Minh City—called at that moment. Upon learning about her mother’s condition, she decided that she was going to bring her mother to Singapore for treatment.

“I flew to Ho Chi Minh City to join my daughter and son-in-law,” Nguyen describes. “Prior to that, they both had already consulted with the CanHOPE office in Hanoi for information and guidance about what my treatment in Singapore was going to look like.”

When the three of them arrived in Singapore, they met with a medical oncologist, who gave them an overview of the treatment options available, and requested some blood tests and a PET-CT scan.

That same afternoon, Nguyen was confirmed to have uterine LMS with metastasis to the lung.

“I initially wanted to return to Vietnam and undergo treatment there,” shared Nguyen. “But my children placed a lot of trust in Singapore’s healthcare system, especially in the field of cancer treatment, and wanted me to undergo treatment here.

“What motivated me to stay was the thought of my second daughter back home. I did not want to miss her big milestones in life, like her wedding. And so, I decided to receive treatment in Singapore and get better for her.”

“I was not done with my treatment”

In Singapore, Nguyen’s children took her sightseeing, shopping, and dining. This helped her mentally and emotionally prepare for the start of her treatment journey in December 2019.

However, it did not prepare her for what was going to happen in 2020.

Halfway through her course of treatment in March 2020, Nguyen learnt shocking news that could derail the rest of her treatment journey: Singapore’s borders were going to close due to the COVID-19 pandemic.

“I was upset because it meant that we would be stuck in Singapore,” Nguyen recalls. “I was worried about the high cost of accommodation, and there were no flights home. Furthermore, I was not done with my treatment.”

In total, Nguyen underwent 6 cycles of chemotherapy over 18 weeks, and the plan was to consolidate with radiation therapy thereafter. But the COVID-19 pandemic was ever-worsening and borders all over the world were closing fast. Disoriented by the news and pressured by fast changing global circumstances, Nguyen had to quickly weigh her options and settle on a decision that could alter the course of her journey over the next few months.

Despite increasing worry about being stranded abroad for an indefinite period of time, and even greater worry about getting infected by an unknown virus, Nguyen decided to stay in Singapore to complete her treatment. Desperate for a way to leave the country after completing her chemotherapy, she wrote to the Embassy of Vietnam in Singapore asking for help in returning home.

Fortunately, Nguyen was able to get a seat on a rescue flight home in April 2020. However, her radiation therapy was not completed yet. Should Nguyen miss this flight, it was unclear when the next available flight would be. Alerted to Nguyen’s situation, her treatment team had to scramble, using all their wits and resources to expedite her radiation treatment in time for Nguyen to catch her flight. Thanks to their quick response, Nguyen was able to complete her treatment and return home safely.

“I burst with joy when I learnt I was finally going to return home to my beloved family,” shared Nguyen.

Rising to be a Brave Warrior

Today, Nguyen is well and still undergoes regular check-ups and scans at her hospital in Hanoi. Her results are sent to her oncologist in Singapore to review and advise the next steps.

“If my children had not decided to bring me to Singapore for treatment, I may not be here today,” Nguyen says. “My children have given me life. I feel like I have been revived for the second time. For that I’m grateful.

“I’m also grateful to Ms Hanh from the CanHOPE office in Hanoi, who gave me the guidance and support I needed so I can focus on recovery, checked in on me regularly, and helped get my test results and reports translated to Vietnamese so I could easily get up to date on my condition.

“I would also like to thank Carol Theu who always encouraged me with positive thoughts and helped me whenever I needed it, as well as the doctors and the nurses who took good care of me and gave me the support I needed during my treatment journey.

“Thanks to them, I can be a brave warrior in my fight against cancer.”

POSTED IN Covid-19, Up Close and Personal
TAGS CanHOPE, radiotherapy (radiation therapy), tumours