When Mr Kee Nguk Hoon came to see Dr Tay Miah Hiang, senior consultant medical oncologist of OncoCare Cancer Centre, he was emaciated, frightened and with a terrible cough. It was in 2016 when Mr Kee was suffering from stage 4 kidney cancer which had metastasized to his lungs.
He had every reason to worry: from whatever angle you looked, the odds seemed to be against him. First, there were only two kinds of drugs available then for his condition. Second, he had the most aggressive type of kidney cancer and, if not treated immediately, the cancer cells could spread fast to his other organs. Third, and most important of all, he was afraid not to live to see his daughter graduate.
Prior to his diagnosis, Mr Kee was a health-conscious man, with his routine during his free time involving jogging and cycling. It, thus, came as a surprise to him and his family to know that what he initially thought of as a bad cough and a fever had turned out to be advanced cancer.
When he went to see Dr Tay for the first time, his diseased kidney had already been surgically removed but his condition was not improving.
Given the urgency to place cancer under control, Dr Tay knew he was racing against time. The doctor’s first order was to place Mr Kee under a targeted therapy medication approved for kidney cancer.
Controlling the disease
Dr Tay explained that when dealing with cancer of any kind, knowing if the cancer is in an early or advanced stage and establishing the grade of the disease is crucial to building an effective treatment plan.
The grade of cancer tells you how aggressive the cancer is, whereas the stage of cancer tells you where cancer has spread to, indicating the potential for cure. Stages 1, 2 and 3 are localised cancer but of different sizes and are still curable, he said. But when it comes to Stage 4 cancer, controlling the disease is the number one priority as it has already spread beyond the confines of the affected organ.
For kidney cancer, the 11th most common type of cancer in Singapore as per the Icon Cancer Centre, the tumours can disrupt part of or all of the organ’s functions.
Kidney cancer is unfortunately chemo-resistant and radiation-therapy-resistant. Thus, Dr Tay treated Mr Kee’s kidney cancer using an oral targeted therapy drug.
Targeted therapy drugs aim to stop cancer growth by targeting cancer’s specific genes, proteins or the tissue environment, according to cancer.net. Through the years, targeted therapy medications for kidney cancer have significantly evolved and improved, providing patients with better outcomes with minimum side effects. But during Mr Kee’s diagnosis, only the first-generation targeted therapy— under which were two kinds of drugs— was available.
Dr Tay initially administered one of the two but had to be stopped after the patient developed liver dysfunction. The oncologist then switched to the second one, which delivered the desired results.
“We were able to adjust the dose and the frequency to control the disease… we managed to balance to get the best benefit of complete remission of the disease with minimal side effects,” he said.
Road to recovery
Fast forward to 2022, Mr Kee is turning 59. He is now a healthy man free from cancer for the past 3 years.
For him, his recovery was the result of a host of factors. Apart from his body’s fantastic response to the treatment, he took charge of his health as well. For one, he did not shy away from opening up about his illness and asking for his friends’ help and support. He also did not hesitate to seek a second or third opinion to explore varied options.
His advice to cancer patients: “You have to talk to your doctor, tell him your symptoms… one thing for sure, don’t ever give up. Try whatever means that are available to you. Just go for it.”
He also credited his remission to his mental toughness further strengthened by his desire to see his daughter finish her studies.
Mr Kee’s daughter is now working, and he, too, is back to work. The experience has completely transformed his lifestyle habits and priorities. Whilst before he was a workaholic, now he makes sure to devote more time to what matters most in his life: his family.