The human body is an amazing thing. As long as you put your heart and mind to it, you can get to where you want to be.” For breast cancer survivor Charlene Koh, being diagnosed with cancer impacted more than just her health – she struggled with low self-esteem and lost her confidence because of the physical changes she had to undergo.
Charlene was diagnosed with stage 1 HER2-positive breast cancer in April 2019 when she was 35. She underwent a mastectomy and reconstruction surgery on her left breast, and thereafter did four rounds of chemotherapy, as well as immunotherapy.
“The recovery journey doesn’t stop when you’re cancer-free,” she notes. “With the trauma and mental challenges, it’s a long journey post-cancer.”
Mark Lin, manager of the Singapore Cancer Society’s Psychosocial Support Services, agrees. He has observed how cancer treatments such as chemotherapy can have a damaging impact on one’s self-esteem.
“Cancer patients who undergo surgeries that result in visible external physical changes, such as mastectomies, are more likely to be anxious. Symptoms such as hair loss, poorer skin condition, weight loss, and cancer-related fatigue due to treatment side effects collectively also impact a cancer survivor’s self-image and identity, especially for female cancer patients,” he explains.
For Charlene, her experience affected her sense of self. The entrepreneur had always been confident; in fact, right before she was diagnosed, she had just sold her stake at Paktor, a local dating app that she co-founded.
Charlene’s recovery process was physically painful, because the nine-hour surgery included moving her back lat muscle forward for the reconstruction of her breast. But what was more painful was the emotional trauma and the hit to her confidence. “I had to rediscover who I was as a person,” she reflects. She recalls an incident when she overheard her male friends joking around that she had done a “boob job”. “Though it was just [said] in jest, it did hit a nerve, as I didn’t ask for this ‘boob job’,” she says. The silicone implant also took time to get used to, as it felt unnatural. “The implant does look a little rounder as compared to my right breast, so when I wear certain swimsuits or bikinis, you’ll be able to tell straight away that one side is fake,” she says.
Over time, however, she grew accustomed to her new implant, and has learnt how to focus her attention on exercising and strength training. “I’ve learnt not to focus on it anymore. I live life to the fullest now, and wear whatever I want,” she shares.
For Yvonne Ang, a financial consultant and co-founder of Lianhuey, a brow embroidery and lash extensions service provider, her stage 2 breast cancer diagnosis came as a shock. She was only 30 years old then.
Initially, she underwent a lumpectomy procedure to remove the cancer tissue as the tumour was contained. A genetic test done post-surgery, however, revealed that she had a 19 per cent chance of relapse in nine years. To eliminate the risks, she decided to opt for a bilateral double mastectomy and reconstruction surgery – a procedure that’s “an extreme preventive measure”, according to her doctor.
“It wasn’t an easy decision, but I’m only in my 30s. If I survive, I still have so many years to go. I didn’t want to keep living in fear [of the cancer returning],” says Yvonne.
Despite the diagnosis, she put on a brave front as she did not want to worry loved ones. In any case, it’s not in her nature to dwell on negativity.
She recounts the discussion she had with her husband about the breast removal surgery: “I told him that the silicone [implants] would be bigger, and he was like, ‘Oh, sounds good’,” she says with a laugh.
Adjusting to the new breasts wasn’t easy, especially since it was a double mastectomy. “Physically, the challenge was to accept a set of fake breasts that don’t feel and look like my real ones,” she explains. There were also post surgery scars – both literally and figuratively.
“I did not know that I’m prone to developing keloid scars. Now, I have two long keloid scars right below my breasts,” she reveals. Mentally, there is the lingering fear that the cancer might return, despite the preventive steps taken. She says: “Even as a survivor in remission, it is still my biggest worry that I will suffer from a relapse. No matter how positive I am, I’m also very scared of dying.”
For Snehal Ponde, being diagnosed with cancer completely transformed her relationship with her body. The Indian-born certified life coach discovered she had stage four breast cancer in August 2020, five months after she gave birth to a healthy baby boy, and less than a year after she’d moved to Singapore. The metastatic cancer had spread to her lungs, liver and bones. So far, Snehal, who is still battling the disease, has had to undergo 30 cycles of different chemotherapy drugs, along with other treatments such as hormonal therapy and radiation.
“Nothing prepares you for the changes that you will go through during chemotherapy,” she shares. “I knew I would lose all my hair, but I didn’t know how I would look. The transformation was slow and gradual… and it was a huge blow to my self-esteem.”
When she lost all of her hair, including her eyelashes and eyebrows due to the chemotherapy medication, the fear of being judged for her looks kept her from leaving her house. “There was a lot going on in my head, and I just didn’t want to step out. I would barely talk to anyone or meet people. For a long time, I didn’t do things like go and play with my son in the park,” she says.
The turning point came when a close friend, who is a trained counsellor, asked if she needed help. While she was initially resistant to the idea of therapy, she eventually agreed to “just talk” with her friend. This turned out to be one of the best decisions she made, she says.
To address her uneasiness about venturing out of her home, her counsellor encouraged her to look inwards. Was the unfounded fear of being judged coming from strangers, or from herself?
“I realised that it’s my voice casting judgement [on myself ], and that I had to counter that,” says Snehal.
“I slowly started stepping out, and then I got more comfortable with [being outside].”
Both Yvonne and Charlene empathise with Snehal – losing their hair dealt a blow to their confidence as well.
>“I was fearful of chemotherapy not because of the aches and pains, but because [it meant] losing my hair,” says Charlene. “At that point in time, my hair was very significant to me. I had really long and luscious locks.”
ooking back, she notes that she “placed too much emphasis on [her] hair”. “After the start of the treatments, my focus shifted to my own well-being and my mental health during chemotherapy.” Yvonne had a similar experience. “Truthfully, when I was first diagnosed, all I cared about was my hair,” she recalls. When her hair started falling out in clumps due to chemotherapy, she decided to get her head shaved at a hair salon. With each stroke f the shaver across her scalp, her fear of being bald diminished.
“I realised I had a really pretty head that’s nice and round,” she says, giggling at the memory. She adds that having her eyebrows embroidered before her first chemotherapy treatment helped boost her self-confidence, even when she lost her eyebrow hair. This spurred her to launch an eyebrow embroidery initiative for cancer patients at her own salon.
“Losing your hair, eyelashes and eyebrows can be very demoralising… which is why my [business] partner and I thought of giving back by offering free eyebrow embroidery to newly diagnosed cancer patients (a month before their first chemotherapy),” she says of the programme. “Through this small initiative of ours, we hope we can help these patients find the strength and confidence to battle cancer.”
All three women emphasise the importance of having a support system – whether it is among family and friends, or within a community.
“My biggest motivators were my family and friends. I have a very strong support team that was by my side during my surgery, chemotherapy sessions and doctor’s visits. The love they gave me was the strength I had to fight cancer,” says Yvonne.
Snehal agrees – her source of strength also comes from her loved ones. “My family is pillar of strength, and my husband has been my biggest anchor and cheerleader through it all,” she shares.
At the start of her diagnosis, there were a lot of fears running through her mind, including whether her husband would leave her. With his patience and understanding, she has quietly rebuilt her confidence in their relationship.
“Yes, of course intimacy will suffer, as your focus is placed on other issues,” she says candidly. “But we learnt to appreciate and value each other so much more because we realised that we were a great team. And there’s no one else I’d want next to me through this. “It’s not that I don’t have my dark days, but I have my own Energizer Bunny (my son) to ensure that I don’t stay low for long!”
For Charlene, she found a small tribe of breast cancer survivors – she affectionately calls them her “boob sisters” – to rely on when things get tough. “No one around me was really going through breast cancer at my age, so it was hard at the start. I met these other women, and we formed an unbreakable bond and journeyed together,” she explains. They share their worries with each other, she says, including the struggle of jumping back into the dating game.
“When I started talking to single men on dating apps [post surgery], most of [the men] asked if I was ever going to grow my hair long again – which, to me, is a huge turn-off,” she reveals.
Charlene refuses to let such opinions daunt her. “When I do meet someone now, I’m quite upfront with them that I have had breast cancer. If that guy is meant for you, he will love you for everything that you are. And if he doesn’t, then don’t force it, because that’s not for you, and you will never be happy,” she says.
Recalling how lost they felt at the start of their journeys, both Yvonne and Charlene have also made the effort to share their stories on social media platforms. “I decided to share my story on Instagram as I wanted to break the myth or taboo that getting cancer was a death sentence, because it clearly isn’t,” Charlene shares.
Yvonne agrees: “I realised that many breast cancer patients are like me – they have no clue about what to expect while going through treatments,” she explains. “I am very grateful that my humble story became an inspiration to some breast cancer patients.”
Meanwhile, Snehal is helping others find strength as a professional life and career coach. She shares: “Through my counselling journey with my therapist, I also realised my strong need to give back and to help others. Coaching provided me the opportunity to work with people through their challenges.”
As Snehal sums it up: “Cancer made me a new person. I think I had far more insecurities in my life before cancer. I love who I am now, and I’ve learnt that my future is of my choosing.”
Triple-negative breast cancer (TNBC) is an aggressive cancer that does not have any of the three proteins commonly found on breast cancer cells – oestrogen, progesterone and the HER2 receptors. TNBC is difficult to treat and more likely to affect younger women, especially those aged 40 and below. Arm yourself with these brief TNBC facts and common symptoms, as explained by Dr Michelle Dee, the medical affairs lead for Singapore and Malaysia in multinational pharmaceutical company MSD, as early detection is crucial in improving survival rates.
- Makes up 10-15 per cent of breast cancer diagnoses
- Tends to affect women under 40 years old
- Is highly prone to spreading and relapse
KNOW THE SIGNS
- A lump in the breast
- Breast pain or redness
- Nipple discharge or a nipple turned inward
- Changes in the breast skin