SINGAPORE: Her wide-eyed smile was a giveaway. Fifty-three-year-old dentist Grisilawati Hutanamon was in high-spirits and had reason to be. She had, after all, just emerged from her latest follow-up check up with Associate Professor Tay Eng Hseon, senior consultant gynaecologist and certified gynaecological oncologist at KK Women’s and Children’s Hospital (KKH), an institution of the SingHealth group in Singapore.

However, this was a far cry from the same woman who first met Associate Professor Tay in 2004.

“When I met Wati, she was in emotional distress. She had previously been treated for ovarian cancer but a relapse had devastated her. Still, she was determined to recover,” recalled Associate Professor Tay, who is also the Chairman of the Medical Board at KKH.

Wati’s ordeal had begun in September 1999 when she consulted a doctor in Jakarta after suffering from severe back pains that restricted much of her mobility.

A kidney problem was suspected initially but subsequent tests ruled it out. So she was given painkillers and referred to a gynaecologist.

An ultrasound later revealed an unnatural mass in her ovaries that needed to be removed.

However, Wati was hesitant. An opportunity for a second opinion presented itself unexpectedly during a visit to Singapore to accompany a friend for a medical check-up. Aware that she was in grave pain, Wati’s friend suggested that she had a thorough check-up done too.

“The doctor carried out some scans and blood tests and told me I required surgery urgently. He said I had ovarian cancer and I was stunned. Though fearful, I went through with the surgery to remove my ovaries,” said Wati.

She was discharged after ten days and returned to Indonesia. Thankful that she was free from pain, Wati was eager to return to her life.

A relapse

Wati remained well until early 2004, when an unfamiliar pain emerged. It started as a pinching pain originating from her pelvic area and gradually moved up.

She promptly returned to the doctor who had operated on her and he confirmed that her cancer had returned. This time, it involved the lymph nodes in the left side of her pelvis.

He had tried to surgically remove it but later decided that it was too risky to do so because the cancerous mass was wrapping around major blood vessels.

“I was very disappointed and the pain was getting worse. With some help from relatives in Australia, I got in touch separately via email, with two oncologists there and sent copies of my medical records and scans. Since it was too far for me to get an operation done there, they recommended a Singapore doctor. Interestingly, they both cited the same doctor, Associate Professor Tay from KKH,” said Wati.

Another operation

Acknowledging the precarious nature of Watiís relapsed cancer, Associate Professor Tay said: “It’s natural that I had my apprehensions. If you try to remove it, you run the risk of puncturing and injuring the blood vessels that supply the entire left leg. That could have devastating consequences. On the other hand, if you don’t remove it, it will slowly move up and gradually overcome the patient. I explained the risks to her but still she was adamant about removing it.”

Wati said: “I felt a confidence in Associate Professor Tay that was missing with all the other doctors who treated me. His calmness, patience and openness about the risks assured and motivated me. I felt I was going to be safe in his hands.”

In April 2004, Wati underwent the operation. Despite the complex and delicate nature of the procedure to remove all the lymph glands around her blood vessels and nerves, the surgery took just over two hours. She was discharged after three days.

Following that, Wati had six sessions of chemotherapy before returning home to Jakarta.

A return to normal life

Four years onwards, Wati continues to be disease free, which is a remarkable feat for a relapsed ovarian cancer patient, according to Associate Professor Tay. Nonetheless, he still continues to monitor her because, as he cautioned, “one can never be absolutely certain with cancer”.

Even with a high patient load, Associate Professor Tay involves himself in cancer research and the training of doctors from the region.

He said: “We are benchmarked with international gynaecological cancer centres in the US, Europe and Australia. Besides, our gynaecological oncology training programme is well recognised.”

For now, Wati, together with her two grown up children, aged 20 and 22 years, and her 50-year-old dentist husband, are happy to return to a normal life. She said: “Life is a luxury to me now and I intend to use it well. Each time I’m told I am disease free, it feels that I’ve been set free.”