Rhabdomyosarcoma...

By Frank

By today, most of my friends will know that I successfully battled cancer and won over it many years ago. But my guess is that, most of you do not know the type of cancer and the treatment I underwent through the painful 30 months since 1992.

Rhabdomyosarcoma was the name of the cancer that struck me on my left wrist. It's a cancer that normally is diagnose among young children and it was a rare case for me, a kid at the age of 12 years to be diagnosed of it. So rare that the doctors took me on a roller coaster ride in doing test, test and more test. Yes, I was "special" in a way. The below is a description of Rhabdomyosarcoma extracted from American Cancer Society and modified with some of my own words.

My left wrist where the tumour was removed...

Sarcomas are cancers that develop from connective tissues in the body, such as muscles, fat, membranes that line the joints or blood vessels. Rhabdomyosarcoma is a cancer made up of cells similar to those that normally develop into skeletal muscles of the body.

Skeletal muscles first begin to form in embryos about 7 weeks after the egg cell is fertilized by a sperm cell. At that time, rhabdomyoblasts (cells that will eventually form muscles) begin to form. It is these cells that can become malignant and develop into the cancer call Rhabdomyosarcoma. Because this is a cancer of embryonal cells, it is more common in infants and young children. Though it does occur in adults, it is very uncommon.

Although Rhabdomyosarcoma tends to grow and spread rapidly, fortunately its symptoms are quite obvious compared to those of other forms of childhood cancer. A noticeable lump or swelling, is present. Definite diagnosis relies on biopsy and evidence of tumour spread is sought with x-rays, tomograms, scans and bone marrow examination.

Traditionally, surgery has been the primary treatment followed by intensive chemotherapy and radiotherapy.

The below is my experience battling through Rhabdomyosarcoma. It may have been 20 years since, but I will try to recap as much as possible on what had happened during that time.

It happened in the first quarter of year 1992 when I first discovered myself of a swollen left wrist. Being curious, I've asked my dad about it and was immediately send over to our regular clinic to seek advice. First diagnosis by Dr. Tan was gangrene where they liquid is to be squeeze out. Next day, Dr. Tan called up. After having second thoughts, he suggested for a scan which was done over at Maria Specialist Hospital and it quickly revealed a growth in my left wrist. A surgery was needed to remove it and so I went under the knife just a couple of weeks before my first high school semester exams.

Kind of weird, but at that time I thought that it will be quite an exciting experience for me. 1, 2 and 3 and it's lights off for me. Upon waking up, feeling drowsy, I soon saw my left arm till the wrist was encased in plaster and it hurt. So much for an exciting experience. Dr. Chiew, the doctor that operated me then came for a visit and even showed the tumour that was remove from me. It was whitish in colour and no bigger than a traditional marble ball. It was to be send to Mount Elizabeth Hospital at Singapore for test.

A typical Rhabdomyosarcoma tumour. Mine was whitish and rounder though...

The test result was revealed on my first paper on my first day of semester exam. Just when the exam is going to start, my dad suddenly appeared in school and told me that I was to make a trip to Singapore National University Hospital (SNUH). Apparently the test result showed a malignant cancerous tumour. Under the watchful eye of Dr. Quah, I was to undergo many test from blood to bone marrow before the first phase of treatment which was chemotherapy.

Most unforgettable moment for me was the extraction of my bone marrow. Midway through while the needle is still embedded on my lower back, I woke up after the anaesthetic effect worn off. I was in pain and what other thing a 12 year old can do is to scream and cry. I was instantly injected with more anaesthetic and was knock out again.

Chemotherapy after just only a few days, took its toll on me. I weaken and hair started to drop off. Soon, I was a baldy and not even my eyebrows were spared. Pimples started to breakout and I was constantly throwing up. Throwing up with nothing to throw up is certainly a horrible thing to go through as I had no appetite at all. And these lasted about 6 months on a 2 weeks interval of me travelling between home at Johor Bahru to Singapore. And during treatment, I ballooned up nearing up to 80KG in weight.

Class photo during my Form 2 days in year 1993. Try to spot me at the middle row, third from the right. Yes, I'm the odd one wearing a cap cause I was bald...

Soon, second phase came and radiotherapy was next. This time under the care of Dr. Yang from Singapore General Hospital (SGH). A 1 month radiotherapy treatment was to be administer each day except the weekends, this saw me and mum travelling to and from Singapore each day. Even my left arm has weird markings on it, as it will guide where the radiation laser should be aimed at. Technically speaking, my entire left arm was burnt after 1 week's treatment. And to make matters worst, fellow schoolmates that did not understand what I was going through, laugh at my left arm which has weird markings on it.

Soon after radiotherapy treatment was over, I was back to SNUH for more chemotherapy. Stronger chemo drugs were administer and this time was the introduction of morphine to me as the pain got pretty unbearable. Besides, some of my veins began to harden and doctors had problem inserting the intravenous needle in. I remember that it sometime takes up to more than 10 tries to find the correct working vein.

Soon time passes, and the dosage strength began to change for the better. I do not need to be warded any more and can just visit the Oncologist for light dosage. However, it will still take up a whole afternoon for the process to be administer. But I held on, and soon I was on the way back to recovery. My hair grew slowly and soon, I was able to remove my cap in public.

A post mortem on what I had gone through with Dr. Quah was did and I showed positive signs. However, an annual check-up for the next 10 years will need to be done as it's the most critical time to watch out for any relapse. I survived the 10 years and this is where I am today, some 20 years after my first and hopefully last encounter with Rhabdomyosarcoma.

So now you know my history. Will you look at me the same for I am different in a way. Life goes on for sure but the weaker side of me will also represent my strength. To those battling the disease, know it that the battle can be won. It's tough but one day, surely it will be better.

This entry is dedicated to both my parents, Dr. Quah, Dr. Chiew, Dr. Yang, Dr. Tan and doctors and nurses from Singapore National University Hospital, Singapore General Hospital, Mount Elizabeth Hospital Singapore and Maria Specialist Hospital Johor Bahru. And not forgetting those who have showered care for me during my darkest hours. Finally but not least, those who have been warded together whom have battled successfully cancer together and to those have gave their life for it. It's an ongoing battle, but surely one day, YOU.ME.WE CAN BEAT CANCER together!