Former S'pore Idol contestant on beating ovarian cancer

Singapore Idol contestant Daphne Khoo reveals how she pulled through a series of health scares, including a rare form of ovarian cancer last year.

SINGAPORE - It is harder to recognise former Singapore Idol contestant Daphne Khoo, 26, these days with her chic pixie cut.

The third runner-up in the first season of singing contest Singapore Idol in 2004 and former lead singer of indie band West Grand Boulevard had long locks that the audience came to know her by.

She snipped them off in June last year in preparation for chemotherapy.

That was also the year she had a most stressful experience battling wave after wave of debilitating illnesses.

The 26-year-old was diagnosed with a form of ovarian cancer so rare that it affects perhaps one Singaporean a year.

Yet, she does not pity herself, telling Mind Your Body: "I see the illnesses as part and parcel of life. When life knocks you down, you just roll with the punches."

The petite music student takes a light-hearted approach to her hiatus from school, joking that the cancer was a welcome break after four rigorous semesters at the Berklee College of Music in Boston in the United States.

But while she looks on the bright side, she will not easily forget how she discovered her cancer. After a morning gym session in March last year, she had an outbreak of hives from her neck to her ankles.

Her eyes swelled up "like golf balls", so her Korean roommate whisked her off to the emergency department at Brigham and Women's Hospital nearby, where she was given antihistamines intravenously for close to eight hours.

Though her symptoms were alleviated, Miss Khoo decided to consult an allergist.

When skin prick tests yielded no conclusive results, she underwent a full-body check-up, which included a Pap smear of her cervix.

10cm growth in left ovary

It was during this physical examination that a nurse raised the alarm about Miss Khoo's bloated abdomen, which Miss Khoo said she had had since she was 18.

Back then, she had asked her mother to feel her abdomen, but there did not seem to be an abnormal mass.

Unknown to them then, it was abnormal for a woman to have swelling of the abdomen without weight gain in other places.

Miss Khoo said: "We just never thought it could be cancer as I felt no pain there."

After a pelvic ultrasound scan, she was told there was a 10cm growth in her left ovary which had to be surgically removed.

She still held up well when told by a nurse over the phone that it might be cancerous, but broke down when she was asked if any of her family members were with her.

She had lived alone in the US for the last two years for her studies, and the bad news could not have come at a worse time. Her parents, both 60 years old, and 30-year-old elder sister were then on vacation.

Miss Khoo first called her younger sister, a 25-year-old marketing executive, and then called her parents.

Her retiree father cut short his golf vacation in Atlanta and was by her side three days later. Her mother, a treasury manager in her own firm, steeled herself on her flight back to Singapore from Japan.

Mrs Denise Khoo said: "I had no mood to enjoy being in business class. I just kept praying for Daphne."

Mrs Khoo had herself been diagnosed with early stage breast cancer at the age of 49 and had had surgery, chemotherapy and radiation therapy.

So it pained her to know that her daughter was faced with a similar ordeal.

Rare form of ovarian cancer

Miss Khoo had surgery on May 17 last year at Brigham and Women's Hospital while her parents and then-boyfriend waited anxiously outside the operating theatre during the four-hour procedure.

The surgeon told them he removed her left ovary and left fallopian tube, together with the tumour which was, in fact, 13cm in diameter.

A few days later, they learnt, to their relief, her cancer had not spread to other areas of the pelvis.
However, it had spread to the tissue lining her peritoneal cavity or abdomen.

Miss Khoo had a rare type of germ cell cancer, known as dysgerminoma. The Singapore Cancer Registry noted that there were nine such cases in a decade, from 1998 to 2007.

A spokesman from the Ministry of Health said there was just one case between 2008 and 2010. Of every 100 cases of ovarian cancer, only about five are cases of germ cell cancer, said Dr Tay Eng Hseon, medical director of the Thomson Women Cancer Centre.

Germ cells are cells in the ovaries or testes that go on to form eggs or sperms. Most germ cell tumours are not cancerous, though the testicular cancer suffered by disgraced cyclist Lance Armstrong was a form of germ cell cancer.

The other, more common, types of ovarian tumours are those of the epithelium (tissue covering the ovaries) and sex cords (structures that develop into ovarian follicles where immature eggs grow).

Dr Tay said dysgerminoma can grow rapidly, from being impalpable to a large tumour in the span of a few months.

The typical symptom, therefore, is a fast-enlarging abdominal mass associated with pain. The cancer tends to strike women between 15 and 25 years old.

Dr Tay said this cancer was highly fatal until the late 1970s, when the platinum group of chemotherapy drugs was introduced.

The disease is highly sensitive to this class of drugs, to the point that almost no one will die from it now. The exception is a small group of patients with an even rarer and highly aggressive form of germ cell cancer which is still difficult to treat, Dr Tay said.

Obstructed bowels

A few days after her surgery, Miss Khoo was racked with such pain she could hardly lay still. She was constipated and vomiting bile.

She had fallen prey to an uncommon complication of abdominal surgery. Adhesions, or internal scar tissue, forming as part of the healing process, were creating blocks in her bowels.

The obstruction prevented her intestines from functioning properly.

Back at the hospital, Miss Khoo had a tube passed through her nose, down the oesophagus, and into the stomach to remove the contents that had accumulated since the bowel obstruction.

She said: "It felt like someone was stabbing me in the throat. It took everything in me to stay calm during the insertion."

Five days later on her mother's birthday on May 29, Miss Khoo finally had the tube removed. By that time, her intestinal obstruction had somehow resolved on its own. She was able to move her bowels.

The problem recurred a week later but, fortunately, the obstruction cleared on its own. Then there was also the trauma of losing her hair, for which Miss Khoo had been mentally prepared by her mother.

Two weeks before she began chemotherapy at the Memorial Sloan-Kettering Cancer Centre in New York, she had her chest-length hair cut in an avant-garde style with a bob on one side and the other shaved bald.

She said with a grin: "I felt it was a fun way of preparing myself for hair loss. I wanted to do it in style."

She also had her eggs retrieved and frozen to preserve fertility.

Don't brush off complaints

That was the positive part. After three cycles of chemotherapy that lasted nine weeks, Miss Khoo lost 7kg to weigh 45kg, though her body mass index (a measure of body fat based on weight and height) showed that this was still normal for her 1.52m frame.

The food lover tried to stimulate her appetite by viewing pictures of food, and tried to swallow the soup her mother cooked lovingly for her but nothing helped.

She joked that the upside to chemotherapy drugs was that they helped to clear her eczema and gave her baby-smooth skin.

She has since gone back to college, where she is completing her final semester to graduate in May. She has also switched her major from songwriting to professional music.

The past year has been hard for her as she loathes being dependent on others for her needs and kept indoors mostly.

When asked what she missed most during her illness, she said it was her hearty appetite, before adding softly: "I also appreciated my mum more."

Mrs Khoo said parents should take note.

"When young girls say they feel bloated, don't brush it off as nothing. Bring them for ultrasound scans because this could save lives."

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Can Sabah Snake Grass cure cancer?

SINGAPORE - Its leaves look like shoots of wild grass and its stem appears plastic-like.

Nothing about this fruitless plant stands out. And it's not surprising if most people mistake it for something worthless.

Yet this unassuming plant - called the Sabah Snake Grass, or Clinacanthus nutans - is highly prized in Singapore.

Sabah Snake Grass - named for its initial use in treating snake bites - is worth its weight in gold because its claim to be a cure for cancer.

Despite these claims, which come amid anecdotes of its curative properties, there has not been any scientific proof that the herb has any actual effect on cancer.

One nursery owner in Pasir Ris in particular has watched with amazement as demand for the plant has slithered upwards in just four years.

Mr Alan Loh, 67, tells The New Paper on Sunday: "More than five years ago, nobody asked for it."

Only a small group of people with kidney problems bought the Sabah Snake Grass initially from Mr Loh.

He says: "At its peak two years ago, the demand grew from almost zero to about 10 customers each day asking or wanting to buy the plant from me. I often ran out of stock."

Mr Loh said the popularity of the herb can be traced back to the story of a Malaysian's miraculous recovery from Stage 4 thyroid cancer.

The man, Mr Liu Hui Lian from Perak, was told by doctors in 2008 that he had only three months to live.

Every medical treatment he tried proved futile until he found out about Sabah Snake Grass. After five months of consuming the leaves, he claims that his cancer had disappeared, he tells TNPS in a telephone interview this week.

Mr Liu, 58, says in Malay: "This March will be the fifth year that my cancer has not returned. It's a bonus for me and there's a good chance I'm totally cured."

After Mr Liu's story was covered by several Chinese newspapers and a TV station in Malaysia, the plant's popularity soared.

A website - www.sabahsnakegrassfarm.com - by another farm owner in Seremban, Malaysia, documents Mr Liu's medical history from diagnosis to an apparent improvement shown in a medical examination taken in 2009.

To date, that site has garnered 97,000 views from 90 countries.

Malaysians make up 56 per cent of those who had visited the site while Singaporeans, the second largest group, make up 18 per cent.

Now, Mr Liu runs an eight-acre farm - about the size of eight football fields - that grows the herb. He usually gives away small samples to cancer sufferers.

He also teaches them how to replant the herb in their gardens.

Mr Liu says: "If you believe (that you can be cured after consuming the herb), half the battle is won. You're on the way to being cured like me."

Yet, some medical professionals here remain unconvinced. Medically, there's no "magic bullet" for cancer, they say.

Still, Mr Liu's story has led to a healthy demand here as well, said the general manager of Hua Hng Trading, a plant and tree wholesale centre off Sembawang Road, who gave her name as Madam Ang.

The woman, in her 50s, says: "Five years ago, I stocked 50 small pots of Sabah Snake Grass at any one time.

"Today, I stock close to 1,000 pots."

Smaller nurseries, like Mr Loh's outfit in Jalan Loyang Besar, have also hopped on the bandwagon.

At his nursery, roughly the size of two basketball courts, seven small plots are devoted to Sabah Snake Grass harvesting.

He sells three pots for $10 while its leaves can be bought for $30 per kg.

Mr Loh isn't the only one peddling the plant.

There are other herb farms and several online "agents" here selling the Sabah Snake Grass. About four other nurseries here supply the plant at wholesale quantities, says Mr Loh.

Those who consume the Sabah Snake Grass usually blend the leaves with green apple juice.

"You could also eat it raw," says Mr Loh, handing this reporter a leaf he had plucked from a potted plant.

There wasn't any nasty aftertaste.

How much to consume depends on which stage of cancer the sufferer is in, says Mr Loh.

"European tourists have visited me asking how to grow the plant in their gardens."

He claims: "One old man, a cancer sufferer, came in a wheelchair but three weeks later, after consuming the Sabah Snake Grass, he walks into my garden without any help.

"I'm not a doctor but I see that they've regained their strength and appear more comfortable."

Snake grass may bring false hope to cancer patients

What do you tell a child when her life may be cut short?

That's the question plaguing a mother whose daughter suffers from stomach cancer.

To Niki Ng, seven, and her mother, Mrs Ng from Taiping, Perak, the Sabah Snake Grass is a godsend.

Speaking to The New Paper on Sunday over the phone from Mr Liu Hui Lian's farm, Mrs Ng, 38, says in Malay: "I just want her to lead a normal life like other children. The herb represents hope for us."

Niki was diagnosed with the gastric carcinoma in September last year, and had undergone chemotherapy without success.

After consuming Sabah Snake Grass in November, Niki's 5cm polyp began to shrink, claims Mrs Ng.
Yet, such herbal treatments aren't all proven remedies, say medical professionals here.

Says Ms Joanna Liew, 28, a registered physician at Bao Zhong Tang TCM Centre: "The danger here is that what works for one person, may not work for another.

"There is also no 'magic bullet' in the treatment of cancer."

Dr Wong Seng Weng, Medical Director & Consultant Medical Oncologist at The Cancer Centre says that the US Food and Drug Administration (FDA) had previously approved a herbal treatment for advanced prostate cancer.

Unfortunately the approval was withdrawn.

This was due to serious problems with the quality control in the production of the herbal preparation including contamination with arsenic, says Dr Wong.

He adds: "No alternative therapies for cancer has been approved by FDA since."

Some of Dr Wong's patients have tried the Sabah Snake Grass. However, his findings may be hard to swallow.

He says: "All (his patients who consumed the Sabah Snake Grass) experienced worsening of their cancers. Hence my personal observation of the effects of Sabah Snake Grass has been very negative."

Similarly, the Health Sciences Authority (HSA) says that it is "not aware of any scientific evidence that substantiates the medical use of Sabah Snake Grass in the treatment of cancer."

Like Dr Wong, HSA reminds cancer patients to exercise caution.

Says Dr Wong: "Patients with an incurable disease may be in a state of emotional desperation and can be very vulnerable to people peddling false hope."

What's important in the treatment of cancers is its early detection, says Ms Liew, 28.

"I have heard of many horror stories of people delaying cancer treatment," she says.

She adds that the longer the patient waits in making a treatment decision, the lower the chances of success.

Snake gall bladder

The gall bladder of a snake, believed to help cleanse blood and detoxify the body, can be found in traditional Chinese medical halls here.

"It is not popular with locals, but mainland Chinese, especially those from Fujian and Xiamen, seem to like it," says a Thye Shan Medical Hall spokesman.

It is also known to alleviate rheumatism, she adds.

Snake gall bladder is mostly imported from countries such as Indonesia, Thailand, and India, and is typically consumed after soaked in wine.

The teardrop-shaped ingredient, which is sold in a dried form at medical halls, can also be sliced and cooked before being eaten.

It costs a hefty $200 to $400 per 100g, depending on the grade, says the spokesman.

Snake fruit

Also known as salak, this fruit has reddish-brown, prickly skin that resembles that of a snake.

The skin breaks away to reveal lobes of white, juicy flesh, which tastes like a combination of honey and pineapple.

The fruit grows in Indonesia, Brunei, and Malaysia. Finely sliced, it makes a great ingredient in salads, and packs a big dose of vitamin C.

Teen who battled brain cancer never complained

SHE never once complained, said Mr Tan Bien Kiat of his 18-year-old daughter, Isabelle, who died after 10 months of battling brain cancer.

A lively student from St Joseph's Institution International School, she pursued sports like soccer and netball and was also the lead singer of a rock band called Tofu Fighters.

Recounting the series of events leading up to her death on Sunday, Mr Tan, who is in his mid-50s, told my paper: "It was a very difficult fight for the last 10 months and she was very courageous."

He was speaking at his family's Pasir Panjang bungalow yesterday, where Isabelle's wake was held.

Mr Tan is an executive director of an investment company, reported Chinese evening newspaper Lianhe Wanbao.

Isabelle was in the pink of health - except for a persistent headache she had at least once every two months since 2004.

MRI scans in 2008 revealed a white oval patch in her brain, but doctors she consulted were not overly worried as the abnormality showed no telltale signs of being a malignant tumour.

Her headaches increased in both intensity and frequency last year, to a point when she would experience discomfort almost every day.

One evening in May last year, a severe headache caused Isabelle to be overcome by a wave of nausea. She was home at the time.

Her parents later found her passed out on the bathroom floor and took her to Singapore General Hospital (SGH).

Tumour grew by 30 per cent
There, doctors confirmed that the growth in her brain was a tumour. It had grown by 30 per cent since it was discovered. An operation was performed to remove most of the tumour, followed by radiotherapy sessions and medication.

Last September, her family took her to Burzynski Clinic, a cancer centre in Houston, Texas, in the United States, to seek further treatment.

Isabelle returned to Singapore in January and was admitted to the intensive-care unit at SGH, where she remained until her death. She has five siblings - four sisters and a brother - who are aged between 15 and 26.

Her last hours were spent with her housewife- mother, Mrs Agnes Tulio Tan, 53, who played the guitar and sang hymns to her.

Mrs Tan told my paper that her daughter was unable to speak in her final moments but she was "incredibly awake".

She said: "She never complained or questioned why she had to go through this, despite the terrible pain she felt on a daily basis."

Doctors that my paper spoke to said that Isabelle's tumour, which began in the brain, is very rare, as such tumours are usually spread from other parts of the body.

Dr Wong Seng Weng, medical director of Singapore Medical Group's The Cancer Centre, said there are 100 new cases of "true brain tumour", where the tumour starts forming in the brain itself, every year.

"With other forms of cancer, such as breast cancer, you can sacrifice most of the affected tissue. Generous surgery on the brain can cause the patient to become a vegetable," said Dr Wong.

Isabelle will be cremated at Mandai Crematorium tomorrow, following a funeral mass at the Church of St Ignatius in King's Road.