Thursday, September 22, 2022

Breast Care Fight: Dr Samuel Ow, Consultant, NUH Cancer Centre (NCIS)

I first met Dr Samuel on Thu 22 Sep 2022.

Dr Samuel came highly recommended from Nurse Joanna, and also from Kitty's friend who works at NUH who said I quote, "Samuel brilliant fellow, I will trust my friend/ family with him".

Even though Thursday isn't his usual consultation day, he still took the time to see me earlier and discuss with me my cancer treatment plan. 

So going in, I had a good impression of him and he did not disappoint.

Dr Samuel was approachable, patient, and took the time to explain to us about my biopsy report, breast cancer in general, genetic testing for breast cancer and how he would use chemotherapy etc. for my treatment.

He highlighted that based on my current test results and available information, it showed that I had a clinical Stage 1 breast cancer that was HER2-positive. After my surgery, the doctors would be able to come to a pathological stage after examining the tumours microscopically and that would be more accurate in determining how to proceed with therapy. 

Dr Samuel shared that if we did chemotherapy before surgery, it would need to be longer and more aggressive as he would like to anticipate that it might be a Stage 2 or 3 cancer. 

However, if I was prepared to go for surgery first, and the pathological stage still showed a Stage 1, my chemotherapy sessions would likely be shorter and less aggressive. 

I mean on hearing that, obviously I'd want to go for surgery first?? In any case, I would need to have a mastectomy because there were multiple cancerous lumps around my left breast and it's not like I can save my breasts if I went to chemotherapy first. 

The boy and I decided that I would not conserve my eggs as I didn't want to delay my treatment any further and were prepared not to have any further children. 

I'd read a bit up on HER2-positive breast cancer and it made me quite scared really. HER2 is a protein that helps breast cancer cells grow quickly. Breast cancer cells with higher than normal levels of HER2 are called HER2-positive. These cancers tend to grow and spread faster than breast cancers that are HER2-negative, but are much more likely to respond to treatment with drugs that target the HER2 protein. 

Since, it was more aggressive, Dr Samuel asked me to do a PET-CT scan to help see if the cancer has spread to other parts of my body. 

It was a very fruitful session with Dr Samuel and I liked that at the end, he told me step-by-step on what I needed to do as follow-up actions. It made me feel less "lost" in this whole process. 

Straight after that meeting, a nurse took my blood for the genetic testing and that would be sent over to a lab in the US. Results would usually take a few weeks but Dr Samuel would ask them to send results for the BCRA gene first. Payment for this genetic test is made in 2 parts to NUH for the delivery {$109}, and also directly to the lab for the processing {US$299}.

A positive test result means that you have a mutation in one of the breast cancer genes, BRCA1 or BRCA2, and therefore a much higher risk of developing breast cancer or ovarian cancer compared with someone who doesn't have the mutation. However, a positive result doesn't necessarily mean that I'm certain to develop cancer.

Knowing whether I have this gene mutation would help decide if I need/ want to have a mastectomy on my right breast too, if it currently does not show to have any cancer cells on my other scans and tests. 

Dr Samuel Ow first consultation cost: S$118

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Before mastectomy and breast reconstruction surgeries

After mastectomy and breast reconstruction surgeries

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