Expat Living (Singapore)

When Life Changes Staying active

- BY AMY GREENBURG

One woman bares all about her breast cancer journey and offers tips on trying to stay positive through it all.

DEBORAH ROQUES’ diagnosis came at an already low point in her life. Grieving the recent loss of her boyfriend, who passed away in a motorbike accident in Indonesia, the then 28-year-old French expat was not only depressed, but also found her body completely out of balance, thanks to a lack of sleep, loss of appetite and too much exercise. Tired and losing weight rapidly, she felt that something just wasn’t right, but she didn’t know what. It was six months before she found some sort of identifyin­g sign: a lump on her breast.

What she thought was a simple visit to her doctor during her lunchbreak turned out to be a life-changing turn of events. She was diagnosed with stage-two breast cancer that had started spreading into her lymph nodes.

“It was a shock. I had always led a healthy lifestyle, paying a lot of attention to my diet,” says Deborah. Breast cancer did not run in her family, so it was never something she was particular­ly fearful of.

It was clear that a mastectomy was the obvious route for removing the large tumour in her breast.

“I thought, ‘What’s happening to me? I’m 28 years old, I’m single, I pay attention to my body, I pay attention to how I look.’ But, I’m quite pragmatic, and wanted to get the cancer out straight away,” she says.

After reconstruc­tive surgery in Singapore, Deborah moved to France for six months to be with her family while she underwent chemothera­py treatment.

Once she returned to Singapore, Deborah opted to have her nipple removed to ensure all the cancer was gone, then built back through plastic surgery to balance out her breasts. For her, the beauty aspect was very important to feeling comfortabl­e in her own body again.

Three surgeries later, and weeks of radiation in between, she was satisfied with the shape that had been achieved, and felt more at ease with her body. Though she admits her breasts are still not perfect, she feels comfortabl­e enough with them, at least for now, but certainly isn’t ruling out additional surgeries down the line.

Since one breast no longer has any tissue, it doesn’t have any feeling, which was something to get used to.

“It’s something that’s difficult to accept when you have breasts you didn’t have for the past 28 years,” she says. “When you’re young and healthy, and you go through this kind of thing, you want to understand why this is happening to you.”

One way of dealing with the diagnosis and treatment was remaining active through it all. Even during chemo, she continued running, practicing yoga or even just walking on the days she felt extra fatigued. It was her mode of “pain management”, she says.

“I never stopped being active. I had to reduce the distance I would run during treatment, but I feel that, when you exercise, you can better manage the side effects of the treatment. I think it’s a vicious cycle; the more you exercise, the better you feel and the more comfortabl­e you are with your body.”

She adds, “I tried to take everything at my own pace. I love to be outside and, for me, exercise has been a way to take the ownership back of what I can do.”

Mental state matters

While some researcher­s argue that stress can cause cancer, or at least increase someone’s risk, others haven’t found conclusive evidence. Deborah, for one, wholeheart­edly believes that the emotional distress of losing a loved one – and not appropriat­ely dealing with her emotions properly and immediatel­y – is ultimately what led to her developmen­t of breast cancer.

“You can be careful to eat all your veggies and exercise but, if your mind isn’t well, you send the wrong message to your body. Cancer is just that: one cell that sends the wrong message to your body.”

Though she did start seeing a therapist some time after her boyfriend’s death – and admits that therapy was one of the best decisions she’s made – she feels that she didn’t seek help early enough.

“I thought I could just give it some time and keep myself busy. But, if you don’t deal with what’s happening in your mind and in your life, it will always come up at some point,” says Deborah.

And, though she admits it’s unfair to blame herself for not managing her feelings properly in a time of pain, she does feel that the experience has taught her to think differentl­y.

“I’ve learned that I need to pay more attention to what’s happening in my mind, find a way to free all my emotions, accept what is happening in my life at that point in time, and find closure with what happened.”

This shift of perspectiv­e goes for her cancer diagnosis, too. Though she admits it’s hard to remain positive on a daily basis, she seems to be doing a darn good job of it.

“Sometimes, there are things we unfortunat­ely can’t control and we have to accept that. I was very upset at the beginning. But, then I thought, ‘What is this teaching me?’ ‘What do I do next?’ ‘How does this change my life?’ You don’t have a choice but to learn from what’s there and to just deal with it. If not, you’re always looking in the past and can’t move forward,” says Deborah.

Having a strong support system has, of course, been a significan­t part of being able to get through everything. Her parents have spent time in Singapore with her, and her best friend flew in from France for her first surgery. The friends she’s made here have also played a crucial role, and have been an incredible support for her when she didn’t have family around.

“When the doctor says you have cancer, you have to learn a new vocabulary; I had to understand a process in English that I never even had to understand in French,” says Deborah. “My friends went with me to doctors’ appointmen­ts and made sure I was understand­ing everything that was happening.”

Life after treatment

It took a bit of time for Deborah to adapt to her “new normal.”

“A lot of people think that when you’re in remission you can go back to your old life. But that’s not the case. You face a lot of stress and fears of the cancer coming back,” she says. “You have to manage the long-term side effects of the disease.”

While she could talk about what she’d been through with her friends and family, she found it was more helpful to talk to fellow survivors. Through the Singapore Cancer Society, she met other young people facing cancer, and found comfort in sharing her story with others.

“When you don’t have your family nearby, it’s a challenge. It’s important to talk to people going through the same kind of situation,” she says. “Having people you can talk to makes you feel that you can do it and you’re not alone.”

Taking some time to focus on herself and re-evaluate what’s important in her life was also key.

“For me, being an expat in Singapore meant always saying ‘yes’ to everything. It sometimes meant spending too much time and energy on things that possibly wouldn’t last,” says Deborah. “I’m no longer scared to say ‘no’ and I don’t try to please everyone. I try to focus on what matters most to me, and the people who matter most to me. Don’t hesitate to say ‘no’ if you need to spend time on your own at home – for yourself, to focus on your wellbeing.”

She has made certain lifestyle changes, too. In addition to eating organic, eliminatin­g all refined sugars and working more ginger, turmeric and supplement­s into her daily diet, Deborah credits Traditiona­l Chinese Medicine, including acupunctur­e, as a beneficial boost for mind and body.

The idea of mindfulnes­s has also been significan­t. She tries to live more in the moment, appreciati­ng everything around her.

“People always look for more. I don’t want more; I’m happy with what I have. If you’re always looking for more, you are always living in the future, not the moment. I think that’s the most important lesson for me. We all need to learn how to enjoy the daily things.”

She adds, “Of course, it’s tough to remember this on a daily basis because, slowly, the pace of life becomes fast again and you feel better, so the cancer feels a bit more far away; it’s not that you forget, but you put it a bit on the side-lines. You have less side effects from treatment, so you start to live your life in a different way.”

On staying positive

Though she was diagnosed with a relapse – stage four breast cancer that has spread to her liver – this past January, after four years of remission and no warning signs, Deborah remains hopeful and continues to take things one day at a time.

“Breast cancer today is not breast cancer five years ago. Stage four doesn’t mean it’s the end of your life anymore. At least, not today.”

Luckily, her targeted therapy (an oral medication that works similarly to chemothera­py) has worked effectivel­y from day one, leaving her with only one tumour left to fight, down from 11. In addition, she gets ultrasound­s every three months and monthly hormone therapy injections.

“The first time, I told myself if it happens a second time I’m not sure I will have the energy to go through treatment again. But, when it happens a second time, you say, ‘Okay, I want to live, let’s go through it second time,’” she says. “I still have a lot of things I want to do in my life and a lot of places I want to visit.”

Of course, every day is a challenge, no matter how positive she can be.

“The most difficult part is accepting the side effects cancer can have on your life. My memory is not the same anymore, and I have less energy than before, even though I’m still active. I know I’m physically strong enough to manage treatment; it’s the emotional aspects and impacts on my life that are the hardest part.”

Having people you can talk to makes you feel that you can do it and you’re not alone

That being said, she says, “The less importance and tragedy you give to cancer, the better you’ll recover and the more you’ll feel comfortabl­e with your daily life again.”

Where she’s at now

Now, happy with a long-term boyfriend, Deborah continues to cherish each moment, and put one foot in front of the other. And, though she can’t have children of her own due to her hormone therapy, she is thrilled to have gained a family through her boyfriend’s children.

“It’s my story and it’s a beautiful story. I may not be able to have my own kids, but I have two beautiful stepdaught­ers,” says Deborah.

Continuing to take on projects (for example, looking into buying a house in France to rent with her boyfriend) is what’s driving her nowadays. Learning new things, taking on new challenges at work, keeping her mind busy and focusing on the now is what it’s all about.

“I’m trying to make some plans again. But I try to not think too much about what will happen in a few years from now.”

She adds, “Cancer is a part of my life now, forever. But, I try to dedicate only one percent of my day to the negative side of cancer and make the most of the other 99 percent.”

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