Amidst the joyous news of her second pregnancy, a shocking diagnosis of stage 4 cancer with a grim prognosis turned Jennifer’s world upside down. Armed with the courage she had, the faith she professed, and the love around her, she braved all odds and turned her despairing start into a triumphant end.
Diagnosis
The bittersweet beginning of my journey
22 Feb 2016
I was pregnant with my second child. At 5½ weeks pregnant, congratulations were underway. Family and friends rejoiced with us, and we were excited to welcome another member into our family.
Amidst the happiness, I suffered from severe morning sickness. Having gone through a difficult first pregnancy of vomiting on average 10 times a day throughout the 1st and 2nd trimester, I felt confident that I would be able to face the challenge again armed with experience.
But I was wrong. This time round I could not eat, drink, nor even swallow my saliva. The thought, smell or sight of food; even light and noise would send me running to the toilet gagging and throwing up. I was constantly dizzy and vomited on average 30 to 40 times a day. At some point I vomited so much that the skin in my throat tore, and I vomited blood. I lost 9% of my body weight within 3 weeks and was weak and emaciated. I spent every day locked up in my room in darkness waiting for time to pass. I was terribly lonely, and time seemed to stand still.
My family and friends were worried and concerned for my health and the health of my baby. It seemed like with each passing day; I was getting worse and worse. My gynaecologist diagnosed me with HG– Hyperemesis Gravidarum, the most severe form of nausea and vomiting in pregnancy, characterized by persistent nausea and vomiting associated with ketosis and weight loss (>5% of pre-pregnancy weight). This condition may cause volume depletion, electrolytes and acid-base imbalances, nutritional deficiencies, and even death. Severe hyperemesis requiring hospital admission occurs in 0.3-2% of pregnancies. Hence, I was sent to the hospital for IV fluids several times.
As my condition worsened, I searched for answers
At 14 weeks pregnant, I started having pains in my right flank. At first it was a persistent achy sort of pain, which I ignored and just wrote it off yet another woe of pregnancy. Then came stabbing pains that caused me to convulse and collapse to the floor. I was rushed to the A & E 3 times, twice to KKH and once to TMC, but they could not figure out as to why I was exhibiting such symptoms. Blood tests and urine tests showed I had ketones in my urine. It showed that I had malnutrition. But what was with that stabbing pain? No answers.
The pain became worse each day until I could barely walk, I even had trouble breathing. My husband suggested I see a urologist; he had a hunch it was kidney stones. Taking his heed, I made an appointment to see one.
The urologist did an MRI (note: MRIs or any scans should be avoided upon during pregnancy, but I went ahead to do one without contrast injected into my veins) on me and turns out it wasn’t a kidney stone like we anticipated; it was in fact a 4 by 3cm tumour pressing on my ureter. My right kidney was swollen and couldn't drain out urine due to the blockage. This was causing the stabbing pains I suffered.
I was advised to remove the tumour via surgery. That night, I could not sleep. I googled like a fanatic. I repeatedly typed in my symptoms and tried to find answers that would allay my fears but to no avail. I was hoping to find a suitable doctor that would be confident in dealing with my situation. The fear was palpable. I felt desperate. My family and I came together to pray to God for help and direction.
Process of treatment
My surgery experience
The first procedure I underwent was to place a stent into my ureter to drain out the urine from my right kidney. The doctors had to use ultrasound technology instead of x-rays to perform this surgery to protect my baby from the harm of exposure. I was advised that it had a 70% success rate. When I was wheeled out from the 2.5-hour surgery, my doctor happily informed me that the stent was successfully placed! And that I could be discharged the day after.
Unfortunately, even after placing the stent which allowed my kidney to drain out urine, I still suffered the stabbing pains. It was unbearable. I told my urologist and gynaecologist, perplexed, they discussed at length on what was the next step and they both felt it was best to remove the tumour before I entered the 3rd trimester.
Learning about the true nature of my condition
Hence, the objective of the second surgery I underwent was to remove the tumour that was resting on my ureter. The operation was to last 2.5 hours and my family and close friend waited in the ward. 2.5 hours went by, then 4, then 6 hours. By then they were very worried.
The doctors assembled my family and friend, informing that they have only managed to remove two thirds of the tumour as the rest of it was too gummed down to the ureter, common iliac, nerves and psoas muscle. They also went on to explain that the tumour has been tested and results show that unfortunately it is cancerous. Through pathology reports - they understood that this tumour was not the origin of the cancer. It meant that cancer had spread elsewhere in my body and is at an advanced stage. They explained that I would have to be put through various medical tests to find the primary location of the cancer.
With that knowledge, my family tearfully decided to keep the news from me that night as they wept in secret. Meanwhile I was still ignorant and groggy from general anaesthesia. The next day, they all gathered around my bed and my husband told me, “They only managed to remove part of the tumour. It has been found that you have cancer, and it is very aggressive.”
I was strangely calm when I received the news. Prior to being a stay-home mother when I gave birth to my firstborn, I was serving as a Public Education Executive at Singapore Cancer Society. I became familiar with the topic of cancer; it was not taboo to me. A deep realisation beset my heart; I was convinced that I have been prepared by God for this trial in my life.
I did however think a lot about death from that point and what I should be doing in preparation for it so that it eases the transition in the event of my passing for my family. Things like writing a will, filing the children’s documents, approaching extended family members to get their assurance on their commitment to help raise my children with my husband.
I felt sad for my parents. As a young parent myself, I could finally understand how intensely they love and feel for me. I wondered a lot, how much they must be suffering seeing me in pain and knowing I have cancer. It must be heart-breaking for them.
I felt sorry for my husband and parents in law; having been married for merely 3 years into the family and being presented with this news must have been so difficult for them.
I felt the anguish of my siblings and their spouses, as they cried out to God for help. I know how passionately they love and protect me.
I felt grateful for my friends and the friendship we have shared through the years of our lives and felt sorry that I might not share in more moments with them.
Lastly, I felt great sadness for my children - Joshua, my firstborn and Jill, my unborn child. Imagining them having to fend for themselves without a mother (the person they would expect to wholeheartedly advocate and be cheerleader in their life; just broke my heart. So many nights I would cry myself to sleep with that sense of sorrow.
Finding an oncologist
By this time, I was very emotionally attached to my team of surgeons. They were so committed to my well-being and were also praying for a miracle. However, now I also had to find an oncologist to add to the team that was taking care of me. Despite being in immense pain, I had to go seek out a suitable oncologist.
After seeing a couple of oncologists, I learnt that I have a rare condition – pregnant with advanced cancer. That there was no data to help us in making decisions on my treatment plan. Even trying to tap on worldwide case studies was futile as those that were documented were not similar. At this point we had found out that we were dealing with 2 malignant tumours according to the scans - The primary tumour, in my colon and the secondary, in my peritoneum. They gravely explained that my prognosis was bad and time to live would not be long... I was given the spectrum of 3 months to 2 years.
I trembled at the reality of this information.
My doctors all respected my wanting to keep my baby although medically it was most sound to abort and seek treatment immediately. It was of great concern to me that my treatment plan would be tailored with full intent on my baby's well-being as God placed it emphatically on my heart, “do not lay a hand on this child.”
Before I could even commit to selecting an oncologist, I was admitted into hospital once again for excruciating stabbing pains in the back. Blood was taken and a 2nd MRI showed that the tumour had grown back in size just mere days after the surgery. The tumour was once again attacking my nerves/ muscles thus the pain.
It was that same day that I was introduced to a 3rd oncologist. He told me that as a doctor he had the duty to advise me to abort my baby for the best chance of survival. He teared when he saw my baby through the MRI. I could tell that he was broken. He had a lot of compassion, but he gave me the brutal information on my circumstance without mincing his words. I knew in my heart that God had selected this doctor to journey with me.
All choices that are offered to me were metaphorically a cup of poison. Choosing to remove the tumour again to buy time through radical surgery might result in losing my baby or both of us. If I chose chemotherapy in an attempt (it might not even work) to reduce or halt tumour growth, the chemo drugs could potentially kill or deform my baby. My third choice was to wait till my baby was born before embarking on treatment. However, I learnt that it was the worst option, as the cancer was so aggressive that it was now threatening to bridge my womb.
I broke down and cried out for mercy and to have pity on me and my baby. I asked Him to tell me what to do and I will do it. I asked him for clarity, as amidst all the well-meaning advice, what was most important is what He wants me to do.
Who shall I send?
In my dilemma, God had sent a messenger, a prayer warrior in my church whom I did not know personally, to give His instruction and reassurance. When I was told abortion was the medically sound advice, a lady came to visit me in the hospital to give me a message from God. Her first message was a command from the Lord.
Have I not commanded you? Be strong and courageous. Do not be afraid, for the Lord your God will be with you wherever you go. Joshua 1:9
Her second message was a revelation. God told her to tell me that my baby would be like a Rock Flower. That baby will thrive despite the harsh conditions that she would be put through.
The day after I decided to go through chemotherapy, God sent another stranger to encourage and reassure me. A God-fearing sister in Christ who was accompanied by her sister visited me in the hospital. She told me that she was diagnosed with stage 1 ovarian cancer whilst pregnant 8 years ago, and that she underwent chemotherapy. She showed me a picture of her beautiful son who is now a healthy and energetic 8-year-old. It took my breath away how meticulous God was in leading me step by step through his providence. Having been reminded that God had my back, I set to trust and obey and just face each day with faith and hope leaning on His instruction and Word.
An arduous process
When there’s pain, time goes by slowly…
Every day I would sit or lie on the bed, shuffling to try and get comfortable. I was heavily dosed with pain medication which at best took the edge off my many pains. I had pregnancy pain, urinal pain and tumour pains. Sometimes it was hard to focus on what I was thinking or saying because of the constant pain.
I would visit the toilet many times a day. I had constant nausea, vomiting and diarrhoea. Each day I was glad to be alive but at times discouraged at the horror of the suffering. I wanted to sleep the pain away, yet I was anxious to spend each waking moment with my son and family. It was a time where I experienced many mixed emotions. Everyday taught me patience and perseverance.
It was at times like this when I fed on God’s word with great hunger and felt His comfort reign through my suffering. It is only through His authoritative Word that I found the strength to breathe and endure the many medical procedures performed on my weakened body. One of my pastors sent me two messages from God, the first was:
Show me Lord, my life’s end and the number of my days; let me know how fleeting my life is. You have made my days a mere handbreadth; the span of my years is as nothing before you. Everyone is but a breath, even those who seem secure. Psalm 39:4-5
It was a sobering message, and I could relate with the Psalmist as he laments; death was crouching at my door. The second message however, surprised me! Could God be hinting that I would possibly live long enough to tell my tale?
I waited patiently for the Lord; he turned to me and heard my cry. He lifted me out of the slimy pit, out of the mud and mire; he set my feet on a rock and gave me a firm place to stand. He put a new song in my mouth, a hymn of praise to our God. Many will see and fear the Lord and put their trust in Him. Psalm 40:1-3
Upon receiving His word, I kept it safely in my heart and prayed to Him for faith in His word. God then sent an encourager – a nurse. She told me that she is an Indian National who came to Singapore to work as a nurse. Over here in Singapore, she heard the gospel and accepted Christ and attended a church. Back home, her father was a head priest of the Hindu temple in the village and upon learning about her conversion, the entire village ostracised her and her family. She was downcast and at that point she was then also diagnosed with stage 3 Ovarian Cancer! Her scans showed a huge tumour in her abdomen. She had no family support as she was here in Singapore alone and because of strained relations people back in India did not offer their support. Fortunately, her church members rallied around her and kept praying for her.
Before mapping out a treatment strategy of surgery and chemotherapy, the doctor had to put her through another scan. The scan this time showed that the tumour completely disappeared before they could even start treatment or offer surgery! It was the most puzzling thing and could only be acknowledged as a miracle by doctors. She told me with a smile,
“Don’t worry; even if Satan wants to hurt you, he needs permission from God! So now after what God has done for me, I just sing His praises and share! You know, after this incident, my family back home started to put their trust in Christ and many of the villages in my hometown too! Even my own father left his life as a Hindu priest to follow Jesus. About 70 people in my village in India are now Christians.”
Whoa. She was demonstrating to me how pure and powerful faith could be! I was filled with hope and the Holy Spirit filled my heart with great joy. Nurses, family and friends were bewildered but delighted at my positive disposition. Most of them not knowing it was not a positivity of my own, but that it was God’s joy was my strength! (Nehemiah 8:10)
Great support is half the battle won!
Chemotherapy was physically taxing. The side effects like nausea, vomiting, diarrhoea, mouth sores, neuropathy, etc. wore on my body. Emotionally, it was also tough at times.
But I had lots of support! My husband, parents, parents in law, siblings, sibling in-laws were rock solid in their care and support. They were my caregivers and cheerleaders. They did not give up on me. They prayed and cried and prayed more and soon crying turned to laughter. God really lifted our spirits with His hope and infused us with good cheer. My family members looked after my son, Joshua who is 2½ when I was in hospital and incapacitated. They brought him to the hospital so I could touch him and sing to him and just feast my eyes on him. Friends gave practical help, brought food, and talked and joked with me and those chuckles gave me strength.
My pastors and church friends gave me and my family great encouragement through prayer, practical help and care. Strangers from all over Singapore and other countries were moved to pray for me and Jill, it was incredibly touching. My family and friends prayed over me every day, we talked about everything, reminiscing about times past. I laughed a lot. Yes! You can still guffaw when you have cancer!
The birth of Rock Flower!
Soon, time managed to creep till I was 32 weeks pregnant. One day, I was running a fever and had to have blood transfusions, and my gynaecologist prepared for delivery. I delivered my baby through caesarean as my doctors wanted me to be awake to witness her birth. The surgical staff and nursing staff prayed over me, what a tremendous surrender in faith!
It was a momentous half hour where I was so excited to see my baby. When the nurses placed her on me, I was undone. She was so beautiful and perfect. She was to me, a living, breathing promise and testimony of God’s faithfulness to me and my loved ones. The medical team were tearing and cheering. For my husband and me, it was a holy moment that we will always remember.
Baby Rock Flower was taken to the NICU (Neonatal Intensive Care) to fight for her life. At 32 weeks, she was born 2 months premature and had to be assisted by machines to breathe, eat and stabilize her body temperature. She was so small and fragile, but we could see she was feisty. She had been through a lot in my womb, through Hyperemesis Gravidarum, through numerous and continuous pain medication and even chemotherapy. God was with her. It was evident. I could feel His protection and presence with her tiny being. There at NICU, under the loving care of the nurses and doctors, God strengthened her body.
Death at the door
7 Sept, just 2 weeks after giving birth to Jill, I went for another cycle of chemotherapy. My doc admitted me in hospital to monitor me closely and I stayed in my ward for 2 nights alone without company. Past midnight on Friday into Saturday morning I felt a radiating pain in my stomach. It made me splutter and gasp, but I could somewhat tolerate the pain. I did, however, inform the nurses who contacted my oncologist. He rushed back to the hospital to check on me, felt my stomach and somehow looked worried. My stomach was tender, and I was to go through a CT scan immediately.
The CT scan confirmed my doctor's hunch that my colon had perforated (broke)! That my tumour had somewhat ruptured. I was to have emergency surgery as soon as possible! My colon surgeon flew back to Singapore to scrub in.
As I have read up previously on perforations especially with people in my condition with advanced cancer, it truly can be a very grim scenario. People die from perforations within hours. It was rather chaotic as I was rushed to the operating theatre. It was like what I had seen in the movies. I was crying bitterly, thinking, this could be the very last time I would see my loved ones.
At this point, a bunch of prayer warriors arrived. They happened to visit me at the hospital. Upon seeing me being wheeled to have emergency surgery, they immediately laid hands and prayed aloud over me.
Whilst I was in surgery, my Senior Pastor and prayer warriors led my family in prayers and sang praises to the Lord. No one knew if I would come out of that surgery alive. Yet somehow my Pastor chose this verse to minister to my family, which in retrospect was prophetic.
Praise the Lord, my soul; all my inmost being, praise his holy name. Praise the Lord, my soul and forget not all his benefits – who forgives all your sins and heals all your diseases, who redeems your life from the pit and crowns you with love and compassion, who satisfies your desires with good things so that your youth is renewed like the eagle’s. Psalm 103:1-5
Back in the operating theatre, the surgeons went in to try to save my life from the spillage within. The agenda was not to attempt on my other tumours.
But God had other plans.
The doctors proceeded to resect approximately 50cm of my colon and apparently the spillage was minor as part of my small intestines conveniently blocked the perforation! After which, my surgeon had a thought to just look at my other tumour in my peritoneum. He went on to surgically peel off the tumour from the nerves, and it peeled right off. The rest of the tumour he had to get other expertise as they were attached to my artery and ureter.
My colon surgery then called on my vascular surgeon who happened to be in the next OT doing a procedure! What were the odds since this was an emergency operation! My vascular surgeon came on to attempt at removal (that was previously encrusting my common iliac, psoas muscle and ureter), and he managed to peel the tumour off my blood vessels! They then called in the urologist and in seeing that the cancer had already eaten up most of my ureter and bridge onto my kidney, he felt it best for the organs infected with cancer to be removed. After obtaining permission from my family, he proceeded to remove my right kidney.
After 7 hours of surgery...they managed to resect all my visible tumours and I was wheeled out at 4am on 11 Sept.
My family was jubilant! The doctors were so happy with the outcome! From a no hope situation...to a good resection of all my visible tumours! It was only by God's grace has it been so! Remember! I was deemed inoperable and not a good candidate for a resection because of how gummed down the tumours were the last time I was opened which was not too long ago, so how could this be?
My family huddled together and immediately began to thank God for His goodness and were filled with awe and reverence at His dramatic rescue.
In conclusion
Today – In the Year 2022
In His time, through His way, God had brought everything to pass. He used many people to touch my life. He sent messengers, he sent doctors who went over and beyond the call of duty to look after me, His church – the body of Christ stood by me and lifted me up in unceasing prayer and petition. He gave me my parents, siblings, parents in law and siblings in law to love and uphold me in tears and prayer. He gave me a strong and wise husband to lean on and cry to. He gave me children, both my firstborn and unborn who gave me the fight to live. He gave me His commands and His Word that anchored and instructed me through the pit of pain and suffering. Through physical suffering and anguish, I hid in the shelter of His wings. I knew His everlasting love and compassion first hand. He never left me; He never forsakes His child.
Fast forward to the year 2022, and baby Rock Flower who my husband and I named Jill Evangeline has turned 6 years old. I have been in remission since 2018 and am blessed to be a mother to 2 lovely children. Physically, I am still building up my body, which was weakened by cancer, surgeries and treatment, but I am free from stabbing pains and living joyously with a shorter-than-most colon and 1 kidney!
Through this, I have developed a sensitivity and compassion for those who are going through illness and God given me a ministry to reach out to those who are going through battles of physical ailments, to deliver to them the gospel of salvation. I have resolved to live out the verse that the Lord encouraged me through my pastor while I was in the valley of suffering:
I waited patiently for the Lord; he turned to me and heard my cry. He lifted me out of the slimy pit, out of the mud and mire; he set my feet on a rock and gave me a firm place to stand. He put a new song in my mouth, a hymn of praise to our God. Many will see and fear the Lord and put their trust in Him. Psalm 40:1-3
I turn 40 this year. Since the day I believed and was born into God’s family, I have walked with the Lord for thirty-four years and counting, and His mercies are still new every morning. Great is Thy Faithfulness LORD unto me even when I was unfaithful and disobedient many a time. I cannot help but sing hymns of praise to my God and testify of His great faithfulness!
I pray that you, my reader, will always hope in the God of the Bible. Always choose to hope in the Him. For He is before all things, and in Him all things hold together (Colossian 1:17). In all circumstances and trouble, always chose to hang on to His Word.
“I have told you all this so that you may have peace in me. Here on earth you will have many trials and sorrows. But take heart, because I have overcome the world." John 16.33
One day I will face physical death, as we all will as the physical body is transient. Yet it is well with my soul. Because I know Jesus as my Lord and Saviour, and trust in His promise to me that in Him I shall have eternal life.
