The first encounter

The first encounter with a cancer patient can be traumatic, intimidating, and stressful for navigators. Fears often arise from not knowing the answers to questions or procedures, or how to handle the emotional and psychological problems faced by the patients or their families.

Constantly attending relevant courses, practising, and reading will assist the navigator. As more encounters occur, navigators gain confidence through their experiences. They also learn where to obtain factual information and which NGOs they can depend on.

Below are cases that I have encountered.

Case 1: The humble smiling villager

When I think about her, I tear up and feel humbled by her courage. She was in her late 60s, her husband sold  ice cream seller from a cycle cart. Her three sons were all working in KL. The first two sons worked as shop assistants in the market, and the youngest was saving money to get married the following year.

I met her before her third chemotherapy. Hearing her story of fortitude and perseverance in seeking treatment inspired me deeply. She grew vegetables, raised chickens and ducks, exchanging them with neighbours for other items. Her purchases were kept to the bare minimum; meat and fish were luxuries reserved for special occasions.

Travelling for treatment from her home to Hospital Melaka was long and tedious. She walked from home to her bus stop, a 15-minute walk. Buses came hourly, and she waited between a few minutes to an hour. The journey to the central bus station took another hour. From there, she walked again to Hospital Melaka — about 30 minutes depending on her condition.

Her determination and commitment were truly amazing. She always came alone for her appointments and wore a happy face each time. I was so moved by her outlook on life and her strength to overcome challenges in completing her cancer journey.

That same evening, I shared her story with a friend who donated RM300 for the coming Chinese New Year. On the next visit, I prepared to present her the cash. She spoke Chinese and a little Bahasa Malaysia, so I explained that it was a donation for her to buy food she had been craving for the past two years.

However, when I asked her to repeat what I said, she had misunderstood me completely. She thought I wanted her to go back to her village and donate the money to someone needy! I couldn’t fathom her simplicity. I sought help from a Chinese nurse to explain my intention. When she understood, she hugged me, thanked me, and I was speechless at her generosity.

Whenever I feel low or disappointed, I recall her. My spirits are lifted and I feel capable of meeting new challenges.

Case 2: The worried clerk from Muar

The next case was a single Chinese woman in her late 30s, working as an accounts clerk in Muar. She was the youngest in a family of two older brothers and three older sisters, all married and living in Melaka.

When I met her, she had been diagnosed with breast cancer three years earlier. A mammogram, ultrasound, and biopsy were done, and a treatment plan was drawn up — surgery, chemotherapy, and finally radiotherapy.

Each time, she refused and signed a form to state that it was her wish not to proceed. Yet she continued coming to the clinic regularly. When I met her, the surgeon asked me to convince her to undergo the mastectomy. Her biggest fear was burdening her sisters, who would have to be her caregivers. The thought of temporarily moving into her sister’s home and the extra expenses troubled her.

I saw her a few more times before she finally agreed to the mastectomy after Chinese New Year. On her last visit, the surgeon informed us that the lump had burst and she would have to start chemotherapy immediately.

A few days later, she came with her other sister, just before her scheduled chemo date. Both looked sad and full of grief. When I inquired about the other caregiver, she started crying.

She explained that her sister had lost her son in a motorcycle accident. Just a few days later, she herself fell in the bathroom and had a stroke. She could no longer walk without aid. The patient was now the caregiver for her sister.

Her chemotherapy was on Wednesday. On Thursday she was discharged and went home. On Friday, the sister called to say the patient was vomiting continuously. I told her to bring the patient to A&E immediately. She was admitted, and I asked the sister to call if she needed help.

The next morning, about 10 a.m., the sister called — the patient had passed away around 6:30 a.m. I was so shocked. I never thought death could come so suddenly.

In this case, she had sought treatment too late. The surgeons and nurses told me there were maggots in the breast and the wound was smelly. I felt lost and questioned if I had done enough. Slowly, through constant talks with the family and the professional care providers, I realized we had done our best. She had waited too long, but in the end, she came forward. That act alone helped her move out from Muar to Melaka.

She placed her money and home in a trust for her nephews and nieces. She was always worried about the work her presence would entail, but in the end, she had the chance to care for her sister.

Lessons in compassion

In time, I realized it is our duty to guide patients through their cancer journey. Which path they take must ultimately be decided by them on how and when to start treatment, or even when they want to stop.

We must listen carefully, follow their wishes, and recognize that sometimes, cancer patients have barriers or unresolved problems that need attention before they can continue treatment.

Each one has their own journey — one that teaches us compassion, patience, and humility in service.