Leong Pei Ying is a go-getter.

In the last decade, the Singaporean has scuba-dived, run marathons, sky-dived, travelled solo, played the violin, and started a post-graduate diploma in artificial intelligence.

She has also had brain surgery five times.

Misdiagnosis

After switching from a career in banking to healthcare, Leong — then in her late 20s — started experiencing headaches. She put it down to the stresses of the new job, and so did the GPs she consulted, sending her away loaded up on painkillers.

It wasn’t stress.

In 2013, Leong was on her way home from work with a colleague when she had her first seizure and fainted.

She doesn’t quite remember it — “I was only semi-conscious at the time," she says. Fortunately, her colleague was quick to get help.

She recalls waking up as the bus was pulling into the interchange, where it was met by a team of paramedics ready to load her into an ambulance.

At the hospital, Leong says she was “subjected to a battery of tests".

"I had to undergo a magnetic resonance imaging (MRI) test, computed tomography (CT) scan, and a lumbar puncture, which was a painful procedure," she says.

By the end of the week, at age 30, she was told she had a malignant brain tumour. 

Brain tumours

In Singapore, brain tumours are “relatively rare”, says her doctor, neurosurgeon Teo Kejia from Mount Elizabeth Medical Centre.

In the 40-year period between 1968 and 2007, there were fewer than 2,000 cases reported.

There are a bunch of different types of brain tumours. One of the most common is gliomas, what Leong would eventually be diagnosed with.

Early symptoms are different for everybody. For some, it's headaches; for others, seizures; and sometimes there are no warning signs at all.

Unlike many other cancers, brain tumours are indiscriminate.

“[They] can occur in anyone, regardless of age. Brain tumours or cancers can occur in toddlers and very young children, to young adults to older people in their 60s or above,” said Teo.

It’s what caught Leong by surprise. She recalls her life before the diagnosis:

“I took good care of my diet, watched what I ate, took vitamins, got proper sleep, and [had an] active lifestyle… I was a normal 20-something… who was doing everything right, so my diagnosis really came as a shock to me.”

Under the knife

Different cancers — and different people — require different surgeries. Leong has, as of this week, had five.

The thing about brain tumours is that it’s common for them to recur after surgery.

After the first two operations, Leong resumed daily life with "no problems". Although on medication to control her seizures, she was healthy. In both instances, it was three years before her tumour reappeared in an MRI.

But after the third operation, only six months passed before her tumour returned. This time, its aggressiveness had progressed from Grade 2 to Grade 3.

Two years on from her fourth operation, Leong has gone under the knife again this week for round five.

She was put under general anaesthesia for her first two procedures. But the the next two were performed whilst she was awake.

Awake surgery, where the patient remains conscious throughout the procedure, is relatively new and allows for “more precise and effective treatments”.

Teo, who specialises in it, says patients are asked to perform simple tasks during the surgery to “preserve brain function”.

During Leong’s operation, she was handed an iPad where she was tasked with "identify[ing] a series of items shown to me as pictures on the iPad" and naming each, in both English and Cantonese, within two seconds.

Next, her motor skills were tested. She recalls: "I was instructed to perform hand movements by bending my arm, while simultaneously using my fingers to count from one to ten" and repeating it.

Bouncing back

The road to recovery after brain surgery can be long, but Leong’s a fighter.

Coming out of the operating theatre, patients enter a world of rehabilitation, monitoring, and rest.

Luckily for Leong, she bounced back pretty quickly. Within two weeks of being discharged from hospital after her first surgery, she was jogging — much to the surprise of her surgeon.

After her third surgery — the first one where she was awake — she resumed solo travelling within a few months, visiting Japan, Switzerland, Finland, and Russia.

She said:

“My doctor was astonished that I would even consider travelling alone, given my circumstances, but I did not let his concerns stop me from living my best life.”

Leong had her fifth surgery earlier this week, from which she is "recovering well".

Fortunately, she also has a great team rallying behind her.

The now-40-year-old didn’t tell her elderly mother about her diagnosis, only that “there was something in [her] brain”.

But whether it’s loved ones arranging for a birthday cake to be sent her hospital bed during the pandemic, osteopath friends helping with rehabilitation free of charge, or those simply offering Leong a shoulder to lean on, she has a “strong support system”.

On the other hand, though, she has also faced discrimination in the workplace.

Whilst working in healthcare, Leong was once told by her boss to “consider [her]self lucky to be employed". The boss said no other company would hire her since she was ill and often took prolonged hospitalisation leave.

She doesn’t work there anymore and is currently taking a career break.

What's next

Leong will be on anti-epileptic medication for the rest of her life, and there may be more surgeries ahead, but she’s "determined" not to let that dampen her plans for the future:

“I do not see myself as a sick person, and I keep telling myself that I will be okay and that I can do anything."

Her dream travel destination? Easter Island off the coast of Chile.

But first, Leong Pei Ying just wants to finish her post-graduate diploma. She said:

“I am determined to beat the odds and live freely according to my terms, instead of allowing this disease to rule my life”.

Top photos courtesy of Leong Pei Ying