The Very Beginning (Summary)

The Very Beginning (Summary)

This blog was started because I was diagnosed with advanced pancreatic cancer and wanted to share this journey with those who were concerned with my condition.

I am truly touched with the kind responses and the support shown by family, community of Christians, friends, colleagues, business associate and friends and colleagues of my wife. Truly want to thank God and those around me who is supporting me and there are so many to name.

If I need to put a date to it, then it all started on 15 March 2012 when I went for my regular follow-up for my hypertension and hyper-cholesterol. At that time, my fasting glucose level was elevated but not to the extent to cause major alarm.  The doctor suggested that I monitor the situation for the next 6 months, followed by 2 blood tests to determine the level of glucose in my blood.

At the same time, I started feeling bloated after meals, stomach spasm and gas.  I thought at that point of time that it might be stomach flu as the symptoms were very similar.  Saw the company GP and was prescribed some medication to take care of the spasm and winds. The condition got slightly better after one week and I “cleared” for one week after that.  However, on the 3^rd week, the stomach flu symptoms all came back. Went back to see the company doctor and got prescribed the same medication but was informed to see them again if the symptoms persist.

On 7 April, we had to send our domestic helper to SGH A&E for an old wound that started to get “infected” (actually, it wasn’t an infection but the accumulation of fluid in the wound cavity that did not close up properly). I thought since I am at SGH A&E, I might as well get myself looked at for the persistence “stomach flu”.

Skipping the specific details, I was supposed to be referred to gastroenterology but the waiting time for an appointment is extremely long and so, I was referred to colorectal specialist to have a look. That was 10 April. Referred for Gastroscopy on 2 May and results came back positive for Gastritis, Duodenitis and Helicobacter bacteria in the stomach.  Underwent what is known as triple therapy to clear the stomach of the bacterial and was thus on antibiotic for 2 weeks.

Things were so far so good at least in treating the gastritis and the helicobacter. At the end of the 2 weeks, the stomach condition started to get much better but it was also during this period around 16 May that pain started to appear on the left near the stomach and occasionally the pain extended to the back. Had a follow-up with Colorectal Clinic on 18 June and told them as much and also explained that I had lost about 5kg.  They suspect some problem but I guess they are from colorectal dept and so they ordered a colonoscopy to see if there is any issue with the colon suspecting that it might be colon cancer.  Anyway on hindsight and after knowing my present condition, was upset that the doctor did not suspect any problem with the Liver/Gall Bladder or Pancreas.

Again, around this period of time, I started drinking a lot of water because I am always thirsty and going to the toilet very often and had sugar craving. I can go through 2 ice-kachangs in a single sitting.

I work in the medical industry and a few of my colleagues are register nurses.  On one afternoon, we were having chit-chat and it was round about lunch time and related my thirst and toilet visit to my colleagues. Immediately one of them said that I should get my blood sugar tested because the symptoms are very typical of diabetes. It so happen that one other colleague who was also present is diabetic and he offered to bring his test kit to office and have my blood tested the next day and this was on 29 June and the sugar level was high.  Not wasting any time, I immediate had my appointment at TTSH changed to 2 July for the blood test (Fasting Glucose and HBA1C) and seeing the Consultant on 5 July. I am very thankfully for the Consultant’s assistance because have known her for many years, she helped to push in my appointment.

Needless to say, the test showed that I am diabetic and was thus prescribe oral diabetic medication.  I thought that was the end of it and I simply have to adjust and change my lifestyle to that of a diabetic.

Anyway, the pain that was on the left side was getting worse so much so that I get woken up at night and bow over in pain.  Again this was quite unbearable and since now that I know that I am diabetic, I thought the pain could be due to some problem with the pancreas and so requested for a CT scan and that was arranged on 6 July.  I was also prescribed a strong pain killer to help with the pain and sleep.

Saw the Consultant again on 10 July and was given the “bad” news. The long and short of it is that they found a “mass” at the pancreatic head with “invasion” of the liver and duodenum. The Consultant order a few more test to ascertain the condition of the Pancreas and made a referral to a surgeon to see what can be done about the “mass”.

Saw the Surgeon on 20 July and the Surgeon was quite straight forward and told me that it is most like Pancreatic Cancer. Well, imaging my reaction? Actually I was quite calm having expected the worse knowing what I know.  Josie was very much, she was quite devastated.  2 tests were ordered, a PET-CT Scan on 25 July and a biopsy on 27 July.

Collected the PET-CT Scan result on 26 July and surprisingly, the scan result was not remarkable.  At the same time, because Josie had a colleague who knew an Oncologist in National Cancer Centre (NCC), I was given an appointment on the 26 July itself.  The Oncologist looked my CT scan report, some of my blood test results and the PET-CT scan report.  He comment that my condition is somewhat unique as there seem to be indication of Pancreatic Cancer, the blood test and PET-CT scan report is not conclusive of it. There might still be hope that it is some form of lymphoma that is more manageable or severe from pancreatitis but this is unlikely.  The only definite way of knowing is from the biopsy result.

Saw the Surgeon on 3 Aug and was immediately given the bad news confirm that I had pancreatic cancer and more specifically Adenocarcinoma in the advanced stage. Go and google “Adenocarcinoma” and you can read up about it. Bottomline is that this form of cancer is extremely difficult to treat and life expectancy is very low once in the advance stage.

Due to the specific growth and position of the tumor, it is not operatable.  My hepatic portal vein is occluded and there seem to be invasion into the liver along the bile duct.  The bright side of it is that gall-bladder and bile duct is not occluded. It would make my life miserable literally it it had been occluded.

Next stop: Saw the TTSH Oncologist on 6 August and was prescribed the treatment but he described it a palliative.

Had 2^nd opinion at NCC and 3^rd opinion at NUH, both on 7 Aug and all concur diagnosis and with the treatment planned by TTSH Oncologist.

This is end of Chapter One.