Yvonne Ang was in the prime of her life in 2019 when she was hit with news no one had expected.
Then only 30 years old, Ang was happily married and working as a flight attendant — a job she loved — when she was diagnosed with Stage 2 breast cancer.
Ang had difficulty processing the information when she first got the news from her doctor. “To be very honest, my mind was blank,” she shared.
“It just felt like something or someone just hit you hard at the back of your head.”
But her next reaction surprised even herself.
Instead of being paranoid and dwelling on worst-case scenarios as she normally would, Ang immediately kicked into problem-solving mode.
To Ang, it had to do with her “gan cheong” personality.
“I like things to be done as soon as possible, same if I have a problem. So the next question I asked the doctor was, what can I do [about it]?” said Ang.
At the doctor’s suggestion, Ang readily agreed to do a lumpectomy a few days later. “I just wanted to take it out quickly and not have to keep thinking about it,” she reflected.
On the surface, Ang appeared to handle the news fairly well.
In hindsight however, she said her reaction was out of character. “I think I reacted too positively, it was something I didn’t expect [I’d do].”
But her emotions eventually kicked in when she was waiting to make payment after the initial consultation.
With her head down, the tears that she’d unconsciously held back finally fell.
“I wasn’t really sobbing but I just kept thinking, siao liao, how am I going to tell my mother?”
Ang’s husband of six years who accompanied her to the appointment appeared just as calm on the surface, reassuring Ang on the steps to take and what he can do to help. But she knew that her husband’s stoicism was merely a facade.
“He was putting up a brave front for me too. Deep down, he was super, super worried.”
Cancer came as a surprise
As someone who loved her greens, exercised regularly and didn’t smoke, Ang never thought that she’d be at risk of getting cancer. As for her family, there was only an aunt who had a brush with the disease 12 years ago and survived.
For Ang, the only indication that something was wrong was an occasional shooting pain she felt in her left breast which went on for months.
She brushed it off as a muscle ache, until one day when the pain escalated.
“It was May 2019 after a flight to India and I was just in a hotel room lying on my chest playing games,” said Ang of the twinge she felt in her left breast.
She was ready to dismiss the discomfort as “normal”, but the pain refused to go away even after two days. Ang also noticed that her breast was swollen and “rock hard”.
“I still wasn’t overly concerned, but I went to see a general practitioner (GP). I told him I felt pain in my left breast and only my left breast.” There, the GP did a breast examination, and he found a small lump behind the nipple. But he reassured her not to worry as “cancer lumps don’t usually hurt”.
To be safe, Ang was scheduled for an ultrasound. When the results came back, she was told they “didn’t look good”.
“Normally if it’s a benign lump, the edges should be smooth, but mine was uneven, like a sunny-side up egg.”
Her GP advised her to see a specialist, where a biopsy was done on the spot, followed by an MRI (magnetic resonance imaging) scan.
Within a few days, Ang got the bad news — the lump was cancerous and at Stage 2. Thankfully, scans showed that the cancer had not yet spread to other parts of her body.
“From the time I felt the pain in India to doing the biopsy and getting the results, it was about a week,” said Ang on the chain of events which quickly unfolded.
After a lumpectomy to remove the cancerous mass, she was put on four rounds of chemotherapy — once every three weeks — as an additional measure to remove any cancerous cells that may have remained undetected.
But with treatment, Ang’s greatest fear — of losing her precious hair — was realised. In fact, it was the first thing that she’d communicated to her doctors regarding chemotherapy.
“I was so afraid of doing chemo because of my hair. Because I was a stewardess, hair was everything to me. And I really wanted to go back to work because I loved my job,” said Ang who had been flying for close to 10 years by then.
Based on an assessment by her oncologist, Wong Nan Soon from OncoCare Cancer Centre, being a young cancer patient is a “double-edged sword”, as she could “recover very fast”, but the cancer could also “spread very fast”.
Said Ang: “I had a 19 percent chance of having a relapse in nine years, which is considered high.” Despite being in favour of finding alternative treatments, she eventually relented to the idea of chemo, in part due to the advice of those close to her.
“I have a good friend who’s a nurse and works with an oncologist. She’s the one who told me ‘please don’t be stupid, just go with chemo, especially when the survival rate for breast cancer is so high,” she recounted.
Ang’s hair started to fall out in clumps about one month after her first chemotherapy session.
“My hair kept getting entangled in my fingers in the shower, it was very frustrating. And when it dried, they just fell everywhere I went.”
That experience drove her to make an appointment at a hair salon to shave off all her hair the very next day.
Ang had emotional scenes of K-drama-esque proportions unfolding in her mind on the way to the hair salon. But her fears of being bald ended up unfounded.
In fact, Ang realised by the third stroke of the shaver across her scalp that being bald wasn’t so bad.
“My head is actually pretty nice and round. It was the opposite of what I thought the result might be,” said Ang, who happily took photos of her new look.
Rather than the trauma Ang envisioned, it ended up being “a very pleasant experience” for her.
“The hair thing never bothered me anymore, because it also helped with the side effects of chemo,” said Ang, who suffered from hot flushes. “So [with no hair] I just have to take a piece of tissue and wipe my scalp.”
She didn’t even bother wearing the wigs she bought due to the suffocating heat. Instead, she turned to caps and beanies until fine hairs on her head began growing out again.
Fighting strong for her loved ones
Ang’s positive outlook and brave front she puts on can be attributed to her loved ones.
The youngest of three siblings shared that her eldest brother broke down when he found out about her diagnosis.
He cried in front of their mother — something he’d never done before.
“Because of this, I cannot give up on myself, you see. They are the only reason why I’m so strong and they keep me fighting.”
Even her close friends rallied around her when she shaved her head, and accompanied her to chemotherapy sessions just to “sit and chat”.
As her husband also works as cabin crew, he is not always around to accompany her for appointments or be with her at home.
Whenever he is away, Ang’s mum would come by to stay and “cook on demand” for her. Her friends would also take turns to help her with the household chores or just to accompany her and her mum.
This outpouring of love and affection from those around her pushes Ang to fight the good fight:
“I didn’t want to disappoint them. They had so much hope and so much love for me, I didn’t want to upset them and I wanted to do my part.”
Ang is especially conscious about staying strong for her husband.
“If he was the one that’s ill and if he were to complain or lose hope, I don’t think I’ll feel good or be at ease when I’m at work. So I didn’t want to do that to him,” she explained.
One thing which Ang reiterates to fellow cancer patients on their own journey is that “the patient is not the only one that’s suffering, it’s the caregiver as well, and it’s a very tough job”.
Her determination to do her best in beating the cancer meant choosing to go for a double mastectomy with reconstructive surgery — an “extreme preventive measure”, according to Ang’s doctor.
This was despite the fact that Ang did not possess any pathogenic variants of the BRCA1 or BRCA2 gene.
Ang gave the go-ahead to proceed. She shared that at that point, she was willing “to do anything” to lower the risk of the cancer returning.
It may seem like a tall order for most, but even with the impending reality of losing both her natural breasts, Ang was hell-bent on enjoying the process as much as possible.
Ang shared that she had fun at the breast surgeon’s office, playing with the “chicken fillets” (implants). She laughed: “I asked the doctor, since I’m doing this, can I ‘upsize’ or not?”
‘Living on borrowed time’
After months of chemotherapy and recovery from her mastectomy, Ang was given the all clear by the end of 2019 and is now considered cancer-free. But she still has to make a visit to her oncologist every two months and is on life-long medication to control her oestrogen levels.
Despite her strength and tenacity, there’s definitely still a deep-seated fear that the cancer would return.
“I always show people how positive I am, but deep down I definitely have this fear of a relapse or that things will get worse. But it’s something we cannot control, I just have to do my best. No matter how strong I am, I’m very scared [of dying].”
It doesn’t help that Ang has come across stories of people who suffered relapses despite putting up a strong fight. Relapses are also much harder to recover from.
To further reduce the likelihood of that happening, Ang has modified her diet to exclude processed foods and foods that are high in oestrogen as much as possible. But she doesn’t believe in making extreme changes to her lifestyle or diet, as her goal is to reclaim as much of her old life as possible.
‘The only way to look is up’
If there is one takeaway that Ang has gleaned from this entire journey, it is the change in her perspective.
“People wonder why those who are sick are always so positive? It’s because you’re already at the bottom. If I don’t look up, I don’t know which direction I should go.”
Her journey with cancer has also made her realise that “life and death is more important than any small, petty arguments”. In fact, Ang says that has learnt to appreciate life more and not let setbacks get her down.
On her doctor’s advice, Ang was forced to stop flying in 2020 as “a regular lifestyle is better for me now”.
It was a difficult decision for Ang, but with the onset of the Covid-19 pandemic, it was a decision that turned out for the best.
In a turn of events, Ang has also found her calling — in the beauty business.
Ang, who does eyelash extensions, launched a beauty salon last year together with a friend, and the shop offers an initiative that’s close to her heart — free eyebrow embroidery for newly-diagnosed cancer patients before their first chemotherapy session.
“I had my eyebrow embroidery done before my chemo and it helped a lot. With the brows there, I didn’t look sick even when all my hair dropped,” shared Ang, who also became a financial advisor this year.
Her path has also made her realise how important having a supportive network is, and she consciously pays it forward, be it in her business or personal life.
Ever since she was first diagnosed, she has openly shared her cancer journey on social media. This attracted followers who asked for help regarding what to expect, or how they can help their family members who are diagnosed with breast cancer.
Ang has one tip to share.
“If you’ve someone around you who is going through [the cancer journey], all the little words of encouragement really help,” said Ang, who described being immensely touched by messages of support she received, even from people in her life whom she’d not met for close to 10 years.
Becoming a member of the Breast Cancer Foundation (BCF) also meant she could help and support others who are on the same journey.
“I always tell cancer patients that this is a speed bump in your life and it’s meant to slow you down. But after that, you can pick up your speed. So please focus on your treatment, do whatever you need to regain your life and then you can just move on.”
Given that her cancer diagnosis was a bolt out of the blue, what Ang’s journey has also taught her is the importance of doing regular self examinations for early detection. One should also not wait to find out if there are any unusual pain in your breasts.
“Don’t wait until the lump grows, just go and check it out. If it’s something bad at least we know and can get rid of it now,” said Ang.
“For me, I think I already caught it very early and I’m thankful. But I wish I had visited
the doctor when I first felt the shooting pain, it could have been detected even earlier.”
A preliminary check can also be done with your bare hands; the Breast Cancer Foundation (BCF) provides a step-by-step video and guide on how to do self-examinations. Clinics also offer check-ups where you can also add on a breast ultrasound, making it very affordable, Ang shared.
Support from Breast Cancer Foundation
Ang is one of BCF’s “befrienders”, a programme where breast cancer survivors are trained in basic counselling skills and provide emotional support for women diagnosed with breast cancer as well as their families.
Besides this programme and resources to aid in the early detection of breast cancer, BCF provides support to breast cancer patients in other ways.
For those undergoing mastectomies due to breast cancer, BCF provides subsidies for prosthetics and bras for women with lower incomes. There’s also a free wig loan programme available to members.
This Pink October Month, BCF has just opened Singapore’s very first Breast Cancer Centre, located at Sin Ming Court. The integrated facility houses a social space, kitchen as well as fitness studio, and holds programmes that foster a strong supportive network for members of the community. The centre also welcomes members of the public who wish to find out more about breast cancer.
Said BCF’s president, Staphnie Tang: “Probably one of the most frightening sentences any patient can hear from their doctor is, ‘You have breast cancer’.
“The discovery changes everything — daily routines, family roles, future plans.”
Tang added that throughout the ordeal, having the support of family and friends is critical in helping patients regain a sense of normalcy, maintain emotional stability, and improve their chances of ensuring a positive clinical outcome.
“No one should do this alone. Breast Cancer Foundation is here to walk this journey, to provide a safe environment to share experiences and learn from others who are facing similar obstacles,” said Tang.
Cancer myth: Breast cancer doesn’t happen to young, healthy women
Ang’s oncologist told Mothership that the cancer which Ang was diagnosed with — hormone receptor positive, human epidermal growth factor receptor 2 (Her2)
negative — is a common subtype of breast cancer which accounts for 70 per cent of all breast cancers.
Her2 is a protein which drives cancer cell growth.
“Her2-negative cancers which are also hormone receptor positive are generally less aggressive and are reliant on circulating oestrogen in the blood for survival,” said Wong. “Hence, they can be controlled with anti-hormonal drugs.”
In contrast, Her2-negative cancers which are also hormone receptor negative are called triple negative breast cancers and are aggressive.
Her2-positive breast cancers on the other hand, tend to be more aggressive and have a worse prognosis if untreated, said Wong.
According to Wong, the incidence of breast cancer in Singapore has risen steadily since the 1970s, with about 2,200 new cases diagnosed each year.
About half of patients diagnosed with breast cancer are aged below 50, said Wong, adding that it’s a common myth that breast cancer doesn’t happen to young, healthy women.
The risk of developing breast cancer in women increases sharply from the age of 30, before peaking when they are in their 60s, Wong added.
Given that the relative survival rate for breast cancer patients is about 100 per cent for Stage 1 cases, 90 per cent for Stage 2, 70 per cent for Stage 3 and 20 per cent for Stage 4, the importance of screening for breast cancer cannot be overstated.
According to the oncologist, most doctors and guidelines “agree that it is useful for women to learn breast self-awareness and to seek medical attention promptly if they notice abnormalities in the breasts”.
However, self-examinations should not be a substitute for mammograms, especially
if they are in the age group (age 40 and up) to begin regular breast cancer screenings, said Wong.
For some women with high risk of developing breast cancers, such as individuals who are carriers of the BRCA1 and BRCA2 breast cancer genes, then performing regular self-checks from the age of 18 would be recommended.
This Breast Cancer Awareness Month, BCF hopes to encourage more women to do their monthly Breast Self-Examinations and go for regular mammograms. The support of men is important in this fight too — a little encouragement and timely reminders can go a long way.
Ultimately, early detection saves lives and saves breasts.
Support BCF in encouraging and empowering more women to detect breast cancer early. BCF provides 100% subsidy for the 1st mammogram screening for women over 50 years old and holding an orange or blue CHAS card. Donate to the 'Every Pink Ribbon Makes A Difference' campaign here.
This sponsored article is brought to you by Pfizer in collaboration with Breast Cancer Foundation.
Top photo courtesy of Yvonne Ang, @supercolerolls