17 Nov 2011
By Joan Chew
Retiree Ting Chwee King did not know he had bile duct cancer as he had no symptoms. He speaks to Joan Chew
Retiree Ting Chwee King, 65, has his family physician to thank for saving his life.
For two weeks in July 2007, mealtimes for the former electronic salesman were a torture.
He would throw up whatever he ate within half an hour. Nothing could whet his appetite and he was slowly losing weight.
A visit to the polyclinic yielded an appointment with a public hospital specialist for the father of two grown-up sons – in six months’ time.
Unknown to him, he had cancer and his life hung in the balance. He needed an operation urgently.
Mr Ting counts as one of the luckiest in his life the day his family physician stopped him for a chat as he passed by her clinic.
She noticed he looked unwell and referred him to a friend at the Singapore General Hospital (SGH).
He went there promptly and diagnostic tests revealed that he was suffering from bile duct cancer.
The bile duct is a tube-like structure that transports bile made by the liver to the small intestines, where it helps to digest food, fats and cholesterol.
Associate Professor Alexander Chung, a senior consultant at the department of general surgery at SGH, said Mr Ting’s tumour was in the bile duct close to the small intestine.
Scans showed the duct was being blocked by the tumour, a possible reason for his nausea.
If the duct were to be totally blocked, the bile would not be transported to the intestines, but would accumulate in the blood, resulting in the skin and whites of the eyes becoming yellow, in a condition known as jaundice.
Fortunately, Mr Ting’s cancer was in the intermediate stage and could be operated on, said Prof Chung.
Half of all patients with intermediate stage bile duct cancer can survive past five years, but the chance drops to almost zero if the cancer is detected late.
Bile duct cancer is particularly prevalent in South-east Asia, especially in the north-eastern part of Thailand where rivers are infested with fluke worms, which can enter the human body when seafood is eaten raw. Fluke worms live in the bile duct and can cause bile duct cancer.
The cancer strikes about 3,000 new patients each year here – the same number as in the United States, which has a population 60 times that of Singapore’s.
It is most commonly found in patients in their 60s and 70s, but with no screening tests available, most cases are picked up only when jaundice occurs, said Prof Chung.
Prof Chung added that Mr Ting was lucky to have his cancer diagnosed even though he did not have jaundice yet.
Mr Ting took the news of his cancer in his stride.
He said: “I never thought of giving up because I believe that if cancer happens to you, you just have to face it. I didn’t feel that it was the end of the world.”
His eldest son, junior college teacher Aloysius Ting, 29, said the family came to terms with the news “quite fast” and it helped that Mr Ting had a positive attitude.
In August 2007, Prof Chung removed the 5.7cm tumour along with half of Mr Ting’s pancreas, a portion of his intestine and stomach, the entire bile duct and gall bladder.
Mr Ting was hospitalised for two weeks and then had chemotherapy and radiotherapy for several months to reduce the risk of the cancer recurring.
Prof Chung also monitors him for any effects he has suffered from losing part of his digestive system, such as absorption problems.
But he has a resilient patient. Mr Ting recalled with a laugh: “The only side effect I had was that I couldn’t taste anything because of chemotherapy. Everything I ate tasted bland.”
He counts his blessings as he has been cancer-free for four years now.
He is not bothered that he has lost close to 20kg and now weighs just 52kg for his 1.52m frame.
Pointing to a framed photograph of his son’s graduation in 2006, where he is sporting a beer belly, he said proudly: “Everybody says I look good now. I’ve also resumed my normal activities and visit my former colleagues at Sim Lim Square once a month to chat with them.”
joanchew@sph.com.sg
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