Don't Waste Your Life

ON CHRISTMAS Day last year, a 19-year-old girl suffering from Stage IV tongue cancer moved many readers to tears by declaring to this paper: I will not go quietly into the night.

The exact words of Joan Chan were: 'I'm not going to let cancer have its way so easily. If I'm going down, I'm not leaving without a fight.'

Her one wish was to beat the debilitating condition and then attend university. A place at the National University of Singapore's architecture faculty was waiting, but study plans were derailed when cancer struck in 2004.

Today, the health of this spunky, doe-eyed former Raffles Girls' School (RGS) and Raffles Junior College (RJC) student has taken a turn for the worse.

The cancer, which has spread throughout her neck and face, has taken a life of its own. It has affected her spinal cord, and even holding her head up has become a challenge.

Friends, who keep vigil at her bedside in her four-room flat in Yishun, say the doctor has given Joan just 'a few weeks to three months more' to live.

In her last entry in her blog on March 22, the 20-year-old says plainly that options for treatment are 'limited'. She adds, with the lucidity of one whose fate is beyond control: 'I just want to say my dear friends, I am prepared for the worst.'

But the story of Joan Chan has also brought out the best in people.

After LifeStyle ran her story - together with that of two other young cancer sufferers - nearly 100 readers wrote in to ask if they could help in one way or another.

Some wanted to recommend alternative treatments; others simply wanted to tell her that things - bleak as they seemed - would work themselves out. One reader sent us a copy of a Buddhist scripture that she hoped would help Joan tide through trying times.

Then last month, when her alma mater RGS learnt that her condition had worsened, students, teachers and old girls of the school quietly rallied to raise funds for her.

The target was $36,000, but in a matter of weeks, $130,000 was amassed to help her parents - her father is a taxi-driver and her mother a former childcare teacher - meet hospital bills and other medical expenses.

Current students of the school who had never known Joan offered money from their own pockets and sold T-shirts to raise funds.

With help from Joan's friends, they set up a PowerPoint presentation to share her story in the hope of inspiring their peers to donate.

The fund-raising effort was carried out without fuss, fanfare or any request for media publicity. LifeStyle only learnt of it when we were doing this story.

Says RGS principal Deborah Tan: 'I told the girls 'once a Rafflesian, always a Rafflesian'. I saw Joan as one of our flock and that motivated us to do something.'

Cancer shocker

IN JUNE 2004, Joan, then in her second year in RJC, discovered an ulcer on her tongue. As her examinations were then nearing, she thought little of it until a hard lump the size of a marble appeared on her neck.

She was referred to a specialist in January last year, who told her that the ulcer was a cancerous tumour. The cancer was in Stage IV, one stage away from terminal cancer.

The news came as a shock to the active student, who was a member of the National Cadet Corps (NCC) in RGS and captain of her softball team in RJC.

Dr Ang Peng Tiam, a consultant medical oncologist in the private sector, says tongue cancer is fairly rare.

According to the Singapore Cancer Registry, there were 214 cases of tongue cancer here from 1998 to 2002. It is not among the top 10 cancers here.

Dr Ang says it occurs in people who often experience forms of irritation on their tongue.

Smokers or people with ill-fitting dentures, for instance, may be at risk. But tongue cancer also develops among those with no risk factors, adds Dr Ang.

'Very often, these turn out to be young female patients.' In such cases, the cancer often becomes 'very aggressive'.

What starts out as a chronic ulcer on the tongue may spread to other parts of the body like the lungs.

Once this happens, there is 'no chance of a cure', he says, but medication can control the disease.

Joan's case came to light when LifeStyle contacted the Singapore Cancer Society last year in search of young people who had overcome hardships and was given her name.

Because of her speech difficulties, she shared her story via e-mail, conscientiously answering every question we posed.

She also sent pictures of her room at home, where one wall had been adorned with a rainbow mural lovingly painted by her friends.

Three months after our story came out, we received an e-mail from Joan on March 15.

She told us that she was no longer responding to chemotherapy and the one hope left was a new cancer drug called Iressa.

Though we learnt subsequently that it later proved to have little effect on her, she had to take the pills - which cost $110.35 each - twice daily.

The cost of treatment came up to a huge burden of over $6,000 a month.

Her mother had quit her job to care for her and her father did not earn enough to cover expenses for both her and her 24-year-old brother.

'My family is now faced with a serious financial problem,' she wrote. 'I was just wondering if you know of any organisations that I can ask for sponsorship?'

We called the Old Rafflesians Association, which suggested that Joan's friends put together a fund-raising proposal.

Rallying around

BUT help was already on the way from old friends and her former school. In early March, RGS principal Mrs Tan got an e-mail from one of Joan's former classmates, NUS arts student Tan Li Ling.

Li Ling, who attended the same Secondary 1 and 2 classes as Joan, had read of her friend's plight in LifeStyle. The two had lost touch when Li Ling went to Anderson Junior College and Joan RJC.

She felt compelled to do something.

The first step was to contact some of Joan's former NCC platoon mates and, together, they sent an impassioned e-mail to Mrs Tan, asking if she could help in any way.

'We knew the school would help in some way, just how much we didn't know,' Li Ling says.

As it turned out, there was no cause for worry.

Led by the principal and teachers, the school's Student Leader Network - comprising about 40 prefects, class chairmen, house captains and heads of co-curricular activities (CCA) - rose to the occasion.

They targeted $36,000 to support Joan's treatment for six months and were floored by the eventual amount raised. 'We never expected to raise $130,000... the spontaneity of the effort was remarkable,' says Mrs Tan.

The amount, collected in just a month, makes the charity drive the largest ever organised for a single student, she adds.

Head prefect Nadiah Hashim Arrifin, 16, helped to rally the 1,800-strong student population behind Joan, a senior whom none of the girls had gone to school with.

Still, Nadiah says, 'we felt a certain affinity to her as she was a former RGS girl... That got our emotions riled up'.

A PowerPoint presentation, with photographs charting Joan's life in RGS and RJC to her frail condition now, was shown to the students during their respective hall assemblies. Each cohort was then given letters of appeal to take home to their parents.

Donations started pouring in. 'Some parents even called to ask if they could help by looking after Joan's Mum by taking her out,' says RGS teacher Lim Soh Khim.

Everyone got involved, with individual classes devising novel ways to raise funds.

Nadiah's Secondary 4 class, for instance, gathered all the loose change they had after recess time to be put into a kitty.

CCAs like the school band sold concert programme booklets to the public during their performances, says band major Loh Yun Yiing, 16.

Even non-teaching staff chipped in, selling muah chee and guava fruit during recess time.

But most touching was how some students stepped forward to initiate their own mini fund-raising projects.

At the ORA Walk-a-Jogathon and Rafflesian Family Day, an annual carnival event organised by RGS, Raffles Institution and RJC on April 8, a group of Secondary 3 girls designed special Rafflesian T-shirts to be sold for $10 each.

Says Mrs Tan of her students' initiative: 'The day after they approached us, they already had the T-shirt designs and pricing plans.'

Word spread via the Internet, with dozens of student blogs helping to publicise efforts. As a result, all 500 T-shirts at their booth were sold out.

Other RGS-run booths also pledged a portion of their profits to the Joan Chan fund.

With the target well surpassed, fund-raising activities stopped on April 17.

But the care hasn't. Almost every week, Mrs Tan, teachers and student leaders visit Joan's flat to cheer her up.

They deliver dozens of colourful posters and hand-written notes, all lovingly made by students to remind her that hope is still in sight, even when the frightening reality of her condition may seem otherwise.

Asked about Joan's grim prognosis, Mrs Tan says poignantly: 'I really feel for her and her Mum. She has so much zest, such a strong personality... I visited her yesterday and I can see the goodness in her.'

Close call

A HORRIBLE scare took place over the Easter holiday last week.

Recounting what happened, long-time friend and former NCC platoon mate Thong Peiqin, 20, says Joan was rushed to the hospital after complaining that she could not breathe.

'The doctor said she was going to go either on Saturday or Sunday.'

Joan's battle-weary mother gathered her friends and asked them to 'get a funeral photo and dress prepared'.

Peiqin, an NUS arts student, remembers going 'around the whole island to pick out a nice dress for her'.

They picked a flowery sundress for her final journey that, thankfully, was not yet to be.

Peiqin says, a heaviness to her voice: 'It was so surreal. I couldn't believe I was doing that for my friend.'

Because of her current condition, Joan's parents and her brother declined to be interviewed.

But last Friday, one of her friends, Cherylene Aw, 20, passed LifeStyle this message from Joan: 'I am touched by all the fund-raising efforts that have been carried out and am happy that so much money could be raised in such a short period of time.'

When Joan got news from the school that $130,000 had been raised, she flashed a 'V' for victory sign and said 'Yay, I've done something good today', recalls teacher Ms Lim.

She also told her friend Peiqin: 'If I have to stay on to suffer for a few more weeks to do this, I would.'

For now, it's the little things that count. Like spending time with friends and family. Or getting to celebrate her 20th birthday earlier this month.

Her friends visit every day, even rostering times to make sure she always has company.

Mood swings are inevitable, but 'she throws tantrums only in front of us and not in front of visitors', says Peiqin.

When depression hits, her friends are by her side encouraging her to 'let her frustrations out'.

The apparent finality of the situation does not escape her. Much of her time is spent 'lying in bed and waiting', says Peiqin.

Living legacy

THE next few weeks of her life may be fraught with uncertainty, but one thing is for sure: Her legacy will live on.

While some of the $130,000 raised will go towards paying off outstanding medical bills - the final amount is still not known - Joan has said that she wants the rest of the money to go to a fund set up in her name.

Though details have not been ironed out yet, the fund will help other young people suffering from critical illnesses, says Mrs Tan. A panel will be set up to decide how best to organise this.

In her interview with LifeStyle last December, Joan, a Catholic, said she would not die soon as God had plans for her.

'That day is not near yet because I believe He wants me to help other cancer patients with my experience, especially the young ones like children with cancer.'

With the fund, her vision has become a reality.

And she will not succumb without a fight.

'I will not give up till the very end and I hope I will be remembered in your hearts as a fighter always,' she says in her last blog entry.

That sundress may be ironed. But for now, Joan's not ready to put it on yet.

sandral@sph.com.sg

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