FRE
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July/August 2012
HealthNews Inspiring and informative stories for patients
From pain to
victory Indriyanto Seno Adji (left, with family and relatives) recalls the shock of being told that he had cancer
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hroughout my life, I had seen and heard of stories of people with cancer, but never thought that I would have this illness one day. So it was a big shock when I was told I had cancer. As a lawyer practising criminal law Stories of and an academic lecturing at several national and private universities, as well as at law enforcement agencies, I saw my daily activities come abruptly to a halt. It all started in 2010, when I kept coughing for about one and a half months. On 11 November of that year, the same day I was celebrating my 53rd birthday, I suddenly felt the most excruciating pain in my left eye, on the left side of my head, and in my left shoulder and back. I also lost my voice. These pains lasted about 10 minutes, so I rushed to the Rumah Sakit Medistra Hospital, where I had my heart, nerves and eyes examined. To my relief, I was given a clean bill of health. But the pains continued, so on 22 November, I went to another hospital, Rumah Sakit Siloam
HOPE
Continued next page
IN THIS ISSUE: Nose cancer | Natural foods and TCM | 擤除鼻咽癌
MICA (P) No. 021/01/2012
Stories of Hope
Indriyanto’s PET-CT scans show the cancer in January 2011 (left, arrowed) and improvement in May 2012 (right). From cover page
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Karawaci, where I underwent a magnetic resonance imaging (MRI) scan that covered my head and abdomen. Again, I was told that all was well. A week later, I also went for an ear, nose and throat scan, which also showed nothing of concern. Unhappy with all these test results and still experiencing a lot of pain, I then went on to ask for a thoracic X-ray and CT scan. The result came out on the following day, 1 December, which quickly became the most horrifying day of my life: I was told that I had cancer. I headed home in a daze, after having dashed off a text message to my brother Wimbo. At home, I told my wife Nies, my sister Wati and my sister-in-law Gia about the bad news. Chaos and panic struck my whole family. At that time a relative, Ms Maria Soetopo, the daughter of former Bank Indonesia’s Managing Director Paul Soetopo, came to mind. Ms Soetopo had always been the caregiver in our family, especially when it came to matters of health. Although she was not a health or medical expert, she had always guided us through our medical check-ups. So, on that same day, we told her about my condition, and asked her to help us find out and decide what we could do to find the most effective treatment for the cancer. Without any delay, we made an appointment for 3 December at a hospital in Singapore. There, I began the lengthy process of thorough examinations. I had blood tests on the very same day, MRI and PET scans three days later, and a fine-needle biopsy on 7 December. We then waited anxiously for the results for a week, while I continued to experience tremendous pain. But the results, when they finally came, were disappointing: The biopsy was inconclusive, and I was told that I should undergo yet another series of tests, including a heart catheter and surgical biopsy.
I was dismayed and extremely frustrated – I just could not understand why I had to go through yet another series of tests, let alone a surgical biopsy – and could not tolerate such a lengthy procedure of cancer treatment. Feeling our pain, Ms Soetopo did not hesitate, and quickly went to find other medical experts that could help. Eventually, after seeking the opinions of several doctors, she got a contact from a family friend who got her in touch with Dr Ang Peng Tiam from Parkway Cancer Centre. After reviewing all my medical results, he immediately recommended chemotherapy for me. Meeting Dr Ang for the first time completely changed my perspective of cancer: It turned all my pessimism into optimism. I will never forget the words that he told me. Medical treatment is made up of 60 per cent of recovery from cancer, he said, with the rest coming from a patient’s optimism and his will to fight the disease. Dr Ang then went on to explain the three things that were needed to “win the war against cancer”. They were an experienced doctor with knowledge of cancer; the patient’s motivation; and the will of the all-loving, all-powerful Almighty God. 14 December 2010, marked the day of my first chemotherapy session. And, amazingly, all the pain that I was experiencing in my eye and on my shoulder and head disappeared, as if by magic. By the time I went for my second chemotherapy session, I could tell Dr Ang that the pain was gone. He replied: “All this was from the grace of God.” It has been nearly one and a half years since I was told that I had cancer. I have gone through 19 sessions of chemotherapy, 30 sessions of tomotherapy, and am now continuing treatment. I am back pursuing my passion of practising law and lecturing criminal law at the universities and law enforcement agencies. Not a day has gone without me saying: “Thank you, God.”
Serving You
W
hat should you eat when you have cancer? This is one of the enduring puzzles for caregivers and patients alike. As part of CanHOPE’s continuous efforts to educate cancer patients and their caregivers, a session focusing on Nutrition in Cancer Care and Traditional Chinese Medicine was held at Parkway Cancer Centre (PCC) on 8 February. The three-hour session provided an in-depth exchange of information and ideas between food experts and cancer patients to better cope with the disease. It was chaired by PCC’s Senior Dietitian Fahma Sunarja and had three main messages: Food in its most natural form serves an effective way for the optimal regeneration of cells in the body, as the system efficiently absorbs the necessary nutrients, vitamins and minerals that are vital for the overall well-being of patients. Patients should abstain from processed foods and allow the body system to fully utilise the natural sources of nourishment. Patients should consume a variety of fruits and vegetables. Unlike multi-vitamin tablets, the natural colour pigments found in these au-naturel ingredients offer the authentic alpha and betacarotene agents responsible for dispelling freeradicals and viruses found in the human body. Ms Sunarja took time to stress the importance of knowing what is really inside our food. “Bear in mind that fishballs contain only a quarter of fish meat. Therefore, eating fishballs alone or any other proteinprocessed meat will not provide sufficient intake of nutrients for the body’s requirements,” she said. For instance, consuming unprocessed fish meat ensures the body’s efficient conversion of high protein, where these compounds are essential for building body immune system and in enhancing tissue recovery. Due to the starch-based composition of fishballs, such functions are inevitably compromised if processed fish meat is consumed instead. Ms Sunarja stressed that patients who eat more healthily would be in a better state of mind and body to fight cancer while undergoing cancer treatments. Including Traditional Chinese Medicine (TCM) as part of a dietary programme can also aid in their recovery. Physician Tang Yue of Eu Yan Sang Premier TCM Centre shared with the audience on the appropriate use of TCM to alleviate discomfort as experienced by patients after cycles of chemotherapy. For instance, Wolfberries have Qi or energyinfusing agents that aid in the strengthening of the patient’s liver and kidney, thus enabling the body to maintain a good flow of blood and everlasting youthfulness. Likewise, Chinese Caterpillar Fungus or commonly known as Cordyceps, have the ability to ‘cleanse’ one’s lung and kidney, ensuring the revitalisation of these organs, leading patients to better their chances of recovery. However, Dr Tang warned, patients should first seek the advice of their oncologist. She added that some Chinese herbs should not be consumed while patients undergo chemotherapy treatments. “Herbs such as Commelina Difussa and Creeping Lobelia leaves and flower seeds are known to cause adverse effects on patients if consumed during the period of cancer treatments, thus, it is crucial for patients to inquire professional help before introducing such programme as their recovery plan.”
Natural foods and TCM
Physician Tang Yue of Eu Yan Sang Premier TCM Centre (top) and PCC’s Senior Dietitian Fahma Sunarja (left) talk about nutrition for cancer patients.
“This session is important... because we may not know what exactly is good for us. There may be a plethora of information on the Internet but we don’t know if we can trust these sources entirely.”
Madam Tracy Tan, 36, diagnosed with Stage IV breast cancer
Kisah Penuh Harapan
Semangat untuk mendorongku me Kenangan Indriyanto Seno Adji saat ia divonis mengidap kanker
S
aya sudah sering melihat dan mendengar cerita tentang para penderita kanker, tapi samasekali tidak pernah menyangka bahwa suatu saat saya akan menjadi salah satu dari mereka. Saat vonis kanker ditentukan, saya sama sekali tidak siap. Sebagai seorang pengacara hukum pidana dan dosen pengajar di beberapa universitas negeri, swasta, dan lembaga-lembaga penegak hukum, saya langsung membayangkan bahwa vonis kanker ini akan menghentikan seluruh kegiatan saya. Semua dimulai pada awal 2010, saat saya terus menerus batuk selama satu setengah bulan. Tanggal 11 November di tahun yang sama, bertepatan dengan ulang tahun saya yang ke-53, saya merasakan sakit yang amat sangat pada mata kiri, kepala sebelah kiri, juga pada bahu dan punggung sebelah kiri saya. Suara saya pun ikut hilang. Sakit itu saya rasakan sekitar 10 menit lamanya. Saya langsung memeriksakan jantung, syaraf dan mata saya di Rumah Sakit Medistra. Ternyata hasil pemeriksaan menyatakan saya dalam kondisi kesehatan yang baik. Saya sempat lega dan tenang mendengarnya. Namun rasa sakit itu tidak kunjung hilang. Lalu pada tanggal 22 November saya memeriksakan diri untuk mencari second-opinion ke rumah sakit Siloam Karawaci. Disana saya menjalani pemindaian magnetic resonance imaging (MRI) pada daerah kepala dan dada. Sekali lagi, saya dinyatakan baik-baik saja. Seminggu berikutnya, pemeriksaan berlanjut pada daerah telinga, hidung dan tenggorokan. Hasilnya juga tidak menunjukkan adanya hal yang mencurigakan. Aneh. Padahal kenyataannya saya masih terus merasakan sakit. Tidak puas dengan penjelasan ini, saya bersikeras meminta pemeriksaan X-ray di bagian dada dan juga CT scan. Saya mendapatkan hasilnya pada hari berikutnya, tanggal 1 Desember. Hari itu menjadi hari yang paling mengerikan dalam hidup saya: saya divonis menderita kanker. Saya sempat mengabarkan berita ini via sms pada saudara laki-laki saya,Wimbo. Segera sesudahnya dalam keadaan linglung saya pulang ke rumah, untuk mengabarkan berita buruk ini pada istri saya, Nies, saudara perempuan saya, Wati dan ipar saya, Gia. Berita ini jelas menghempaskan seluruh keluarga kami. Pada saat itu, saya teringat saudara saya yang lain, Mbak Maria Soetopo, anak dari mantan Direktur Eksekutif Bank Indonesia Paul Soetopo. Sejak dulu, dalam keluarga kami, Mbak Maria selalu merupakan saudara yang penuh perhatian, khususnya dalam hal kesehatan. Walaupun ia bukan seorang dokter atau ahli kesehatan, ia selalu membimbing anggota keluarga kami menjalani check-up kesehatan. Pada hari yang sama, saya langsung menghubungi Mbak Maria dan mengabarkan kondisi kesehatan saya.
Saya berharap Mbak Maria dapat membantu dan mendampingi untuk menentukan langkah yang paling tepat untuk mengobati kanker saya. Tanpa menunggu lebih lama, kami membuat janji konsultasi untuk tanggal 3 Desember di sebuah rumah sakit di Singapura. Disana saya menjalani proses pemeriksaan yang panjang dan menyeluruh. Pada hari yang sama saya menjalani pemeriksaan darah, dilanjutkan dengan MRI dan PET scan 3 hari sesudahnya, dan juga fine needle biopsy pada tanggal 7 Desember.
Kisah Penuh Harapan
sembuh engalahkan kanker “Saya tidak akan melupakan apa yang ia katakan, ‘Proses medis hanya akan membantu mengatasi kanker sebanyak 60%, yang tidak kalah menentukan adalah optimisme pasien dan keinginannya untuk berjuang melawan kanker.’ Ini mengubah rasa pesimis saya menjadi rasa optimis.”
Atas: Indriyanto (kiri) dengan istrinya, anakanak perempuannya, menantunya, cucucucunya, juga Maria dan anak laki-lakinya di Disneyland, Hong Kong. Kiri: Indriyanto, setelah menguji kandidat Doktor Amir Syamsuddin, kini Menteri Hukum dan Hak Asasi Manusia. Kami menunggu hasilnya dengan cemas selama satu minggu, sementara saya terus merasakan sakit yang amat sangat. Ketika akhirnya kami mendapatkan hasil pemeriksaan, kami merasa kecewa. Proses biopsi ternyata tidak cukup untuk memberikan hasil yang pasti, dan saya diminta untuk menjalani kembali berbagai macam pemeriksaan, termasuk heart catheter dan surgical biopsy. Saya merasa sangat frustasi, tidak dapat saya mengerti mengapa saya harus menjalani kembali berbagai pemeriksaan, apalagi termasuk harus
menjalani surgical biopsy. Saya tidak dapat menerima, kenapa saya harus mengikuti prosedur pemeriksaan kanker yang sedemikian panjang. Dengan empati yang besar terhadap kondisi saya, Maria tidak berputus asa. Ia segera mencari dokter lain yang dapat menolong saya. Akhirnya, setelah menerima pendapat dari beberapa dokter, seorang teman keluarga memperkenalkan kami dengan Dr Ang Peng Tiam dari Parkway Cancer Centre. Setelah membaca riwayat kesehatan dan hasilhasil pemeriksaan saya terdahulu, Dr Ang segera merekomendasikan saya untuk mendapatkan perawatan kemoterapi. Sewaktu saya bertemu dengan Dr Ang untuk pertama kalinya, ia langsung mengubah pandangan saya tentang kanker: Rasa pesimis saya berubah menjadi rasa optimis. Saya tidak akan melupakan apa yang ia katakan, “Proses medis membantu mengatasi kanker sebanyak 60%, yang tidak kalah menentukan adalah optimisme pasien dan keinginannya untuk berjuang melawan kanker.” Dr Ang kemudian menerangkan tentang 3 hal yang sangat dibutuhkan untuk “menang melawan kanker.” Ketiga hal tersebut adalah dokter yang berpengalaman menangani kanker dengan efektif; semangat pasien untuk sembuh; dan pertolongan dari Tuhan yang Maha Pengasih. Rangkaian perawatan kemoterapi saya dimulai pada tanggal 14 Desember 2010. Seperti sebuah keajaiban, semua rasa sakit yang selama ini saya rasakan pada mata, bahu dan punggung saya seperti hilang tak berbekas. Menjelang proses kemoterapi yang kedua, saya mengatakan pada Dr Ang bahwa rasa sakit saya sudah hilang. Ia menjawab, “Semua ini adalah berkat karunia Tuhan.” Setahun setengah sudah berlalu sejak pertama kali saya divonis kanker. Saya sudah menjalani 19 kali kemoterapi, 30 kali tomoterapi, dan masih terus melakukan rawat-jalan. Kini saya kembali beraktivitas sebagai pengacara dan pengajar hukum pidana di universitas dan lembaga penegak hukum. Tiada hari saya lalui tanpa bersyukur kepadaNya, “Terima kasih Tuhan.”
Fighting Cancer
significantly higher risk of developing nose cancer than those without a close relative with NPC.
How is NPC diagnosed?
Common but
curable What is Nasopharyngeal cancer?
Nasopharyngeal cancer is the seventh most common cancer among men in Singapore
Nasopharyngeal cancer (NPC) or nose cancer occurs when cancer cells develop from the tissues in the nasopharynx, the area behind the nose and above the back of the throat. According to statistics from the Singapore Cancer Registry of cases between 2003 and 2007, it is the seventh most common cancer among men in Singapore and 12th among women, accounting for 4.6 per cent of cancer deaths among men and 1.7 per cent of cancer deaths among women. NPC is also the most common cancer in the head and neck region. Others in the head and neck area include cancer of the larynx (voice box), pharynx, oral cavity cancers (including cancer of the tongue), and salivary gland cancer.
What are the symptoms of NPC? While there is no screening available for nose cancer, the symptoms are often discernible. These include nosebleeds or obstruction of the nose, ringing in the ears and partial deafness as well as frequent headaches. Other symptoms include lymph node swelling or an apparent mass in the neck, which may be painless, sore throat and coughing. A tumour blocking the Eustachian tube, which connects the ear to the nose, may also cause tinnitus or “airplane ear syndrome” – pain in the ear due to air pressure, a syndrome commonly experienced by airplane passengers.
Who is at risk and what causes this cancer? Research conducted by the Singapore Cancer Registry shows that the disease is more common among Chinese men, with the Cantonese especially suffering the highest incidence of nose cancer. It is less common among Malays and even rarer among Indians. While the exact causes of the cancer are unknown, links have been drawn to a high-salt diet and excessive consumption of salted fish from an early age. There is also a strong familial trend, with first-degree relatives of NPC patients having a
When nose cancer is suspected, a nasoendoscopy is carried out in which a long, narrow, flexible, lighted tube is inserted through the nose to look into the nasopharynx for abnormal growths. Tissue samples are taken during the nasoendoscopy to be used in a biopsy. A neck node biopsy may also be done if they are found to be enlarged.
How is NPC treated and what are the chances of a cure? NPC is one of the most curable head and neck cancers. Radiotherapy alone is the treatment of choice for early stage NPC. For locally advanced NPC, which usually include patients with high tumour stages (a large tumour or a tumour invading the adjacent bones or causing cranial nerve deficit) or high nodal stages (large nodes, bilateral neck nodes or nodes that extend to the base of the neck), chemotherapy is given with radiation to improve the treatment outcome. Up to 70 per cent of patients with locally advanced NPC can still be cured. Because of the proximity to surrounding critical organs, accurate delivery of radiation to the tumour is important to maximize treatment results and to minimize side effects. Mount Elizabeth Hospital Singapore is the first hospital in Southeast Asia to introduce Image guided radiotherapy (IGRT) in the treatment of NPC in 2006. Using the TomoTherapy HI-ART System, the integrated CT scanner allows daily tumour target verification prior to treatment. This reduces the risk of missing the target, resulting in better local tumour control with reduced side effects, especially dry mouth. At present, trials incorporating upfront chemotherapy before radiation, as well as new targeted agents are being conducted to further improve the cure rate of NPC.
On the decline The good news on nose cancer is that the incidence of the disease is declining with the annual age-standardised rate falling significantly from 18.7 per 100,000 in 19881992, to 12.5 per 100,000 in 2003-2007. This may be partly attributed to a younger generation with wider food choices and lower intake of salted fish and preserved vegetables.
对抗癌症
擤除鼻咽癌 什么是鼻咽癌? 当位于鼻子后方、喉咙后面的鼻咽组织出现癌细胞 时,就会产生鼻咽癌或鼻腔癌。根据新加坡癌症注 册处的统计,在2003年至2007年间,鼻咽癌是本地 男性最有可能患上的第七种癌症。在女性最有可 能患上的癌症中,鼻咽癌则名列第12。在所有死于 癌症的男性中,百分之4.6%死于鼻咽癌;在女性癌 症死者中,鼻咽癌患者的比例则占1.7%。 鼻咽癌也是最普遍的头颈癌。鼻咽癌也是最普 遍的头颈癌。其他头颈癌症还包括喉癌(声带)、 咽癌、口腔癌(包括舌癌)和唾液腺癌。
鼻咽癌的症状有哪些? 到目前为止,鼻咽癌仍无法依赖诊断仪器进行诊 断。虽然如此,鼻咽癌的症状通常相当明显,包括 流鼻血、或鼻腔阻塞、耳鸣、部分失聪,以及经常
头痛。其他症状还包括淋巴结肿大或颈部出现瘤块 (该瘤块可能不会引起疼痛)、喉咙痛及咳嗽。 当肿瘤阻碍到衔接耳朵和鼻子的耳咽管时,也可 能造成耳鸣症状 – 一种类似飞机乘客在机舱内因 机舱内气压变化引发耳朵疼痛的现象。
什么因素会提高患鼻咽癌的风险? 一项由新加坡癌症注册处进行的研究显示,这类癌 症在华族男性中,尤其是广东藉人士中,较为普遍。 马来人则较少患上鼻咽癌,印度人就更少了。 虽然鼻咽癌的确切导因还不明朗,一般相信,高 盐饮食习惯以及从小吃大量的咸鱼都可能提高患鼻 咽癌的可能性。 此外,鼻咽癌的患病趋势也明显显示,鼻咽癌患 者的近亲患上同类癌症的几率比那些没有近亲患鼻 咽癌的人高出很多。
鼻咽癌或鼻 腔癌是新加 坡男性最普 遍患上的第 七类癌症
鼻咽癌如何诊断? 如果医生怀疑您患有鼻咽癌,他可能会要求您接受 鼻内窥镜检查 - 通过鼻孔插入细长的灯管,检查 鼻咽内是否发现不寻常增生物。在进行鼻内窥镜检 查时,医生也可能採取组织样本进行检查。 如果颈结看似肿大,医生也可能为病人进行颈淋 巴结组织切片检查。
鼻咽癌要如何治疗,治愈的机会又有 多高? 鼻咽癌是治愈率最高的头颈癌之一。如果病人的鼻 咽癌仍属早期,他们一般只需要接受放射治疗。 即使病情已经进入晚期(肿瘤体积已经非常大或 已经侵入附近的骨头部位,或医造成脑神经出现缺 陷)或癌细胞已经扩散到多个主要鼻咽附近淋巴结 受影响(大淋巴结、颈双侧淋巴结或延伸到颈底部 的淋巴结),化疗综合放疗的疗程仍能对病情起帮 助。那些癌细胞还没扩散的晚期病人当中,有高达 70%仍可被治愈。 由于鼻咽癌靠近附近的其他器官,准确的放疗对 防止其他副作用非常重要。伊丽莎白医院在2006年 引进影像导航放射治疗技术,是首家利用这项技 术来治疗鼻咽癌的东南亚医院。利用这台名为影像 導引螺旋刀HI-ART系统结合综合断层扫描仪,病 人每天接受治疗前都可先再次确定肿瘤标靶的位 置。这减低了错过目标的风险,让病人在面对较少 副作用,尤其是嘴干,的情况下更有效地控制肿瘤 的恶化情况。 目前,医学界正在进行各种临床试验,包括在为 病人进行放疗前先接受化疗,以及利用新标靶药物, 以便进一步提高鼻咽癌的治愈率。
下跌趋势 好消息是,鼻咽癌的年龄标化患病率有常年下跌的趋势,从 1988至1992年的每10万人中18.7人减少到2003年至2007年的每 10万人中12.5人。 这当中的部分原因可能是现代人有更多的食物选择, 因此所吃的咸鱼咸菜少了。 Picture ©iStockphoto.com/Health_News
The Doctor Is In
Waking up from coma F A doctor learns a lesson about never giving up on patients
or more than two weeks, my patient has gotten my name wrong, but her mistake still delights me each day. Each morning, for two weeks, I’ve been asking Lucinda: “What’s my name?” After a brief pause, she would reply: “Adrian!” I would feign being distraught and hurt, and jokingly remind her that I am “Doctor Ang Peng Tiam, the world’s best oncologist” while Dr Adrian Tan was her neurologist. This scene has been replayed so many mornings that the nurses have suggested that to save myself from the embarrassment, I call myself Adrian Ang. Considering that Lucinda was in a coma when she was first admitted to Mount Elizabeth Hospital, I consider it remarkable that she can speak, let alone respond coherently to my questions. It brings me much joy to see her gradually improve with treatment. I met Lucinda’s family in my clinic first, without the patient. She had been admitted to another hospital for increasing weakness, gradual loss of memory and change in mental state. Investigations subsequently confirmed that she had an extensive tumour infiltrating into frontal lobe of the brain. The outlook was deemed to be poor as it was unlikely that the neurosurgeons would be able to remove the tumour entirely. Lucinda’s condition continued to deteriorate and she eventually lapsed into a coma. With little to lose, the neurosurgeons decided to operate on her to establish a firm diagnosis. Her brother told me at the time: “She was just operated yesterday and the surgeon said that it was good news! He said that this was probably a lymphoma of the brain and that she had a 90 per cent chance of cure.” Sceptical, yet hopeful, the whole family descended upon my consultation room to seek a second opinion. Indeed, lymphoma of the brain is a highly treatable condition. 90 per cent cure is a rather exaggerated prognosis, but the statement was probably intended to convey a message of hope rather than aimed at being accurate. In most cancers of the brain, complete surgical removal of the tumour is an important factor in determining eventual outcome. Generally, the better the clearance, the higher the chance of curing the cancer. In lymphoma of the brain, the main purpose of
the surgery is to get enough tissue for the pathologist to make an accurate diagnosis. There is no real need to remove the entire tumour as the primary treatment of the cancer is through chemotherapy. These tumours are very chemo-responsive and with aggressive treatment, the median survival is about five years. Up to a quarter of the patients are eventually cured of the disease. When Lucinda was admitted, she was unresponsive except when we pinched her painfully. There were purposeless and involuntary movements of her arms. With each week of treatment, we have been able to observe slow but steady recovery. From a coma state, she has recovered adequately to answer simple questions. Initially fed via a tube through her nose down to her stomach, she is now able to eat a soft diet. The question of the extent to which she will recover remains unknown. I remember caring for a young man in his early twenties with germ cell tumour of the brain. He had been in a coma for more than a month. Adrian and I predicted that he would only have a five per cent chance of ever waking up. To my amazement, he did! During a morning round, he suddenly woke up and shocked me with: “Good morning, doctor. Can I borrow a phone to call my girlfriend?” I laughed so hard that there were tears in my eyes. He recovered enough to be able to be discharged from hospital and to walk with the aid of a walking frame. Sadly, that young man eventually succumbed to his cancer. The lesson that I have learnt is never to give up on patients with brain tumours that are responsive to chemotherapy. Regardless of how “brain-damaged” they may appear to be, there is always a chance that they may recover meaningful function and quality of life. So far, Lucinda has completed four weeks of chemotherapy. Although there remains a long arduous road ahead, I remain optimistically hopeful that she would continue to improve. The other day, she called me “Adrian” again, and I sighed and said: “I am Dr Ang…” “…Peng Tiam!” she completed. Yes! I punched the air. My joy will be complete when she beats the cancer. Dr Ang Peng Tiam