His only symptom was heel pain. It turned out to be stage 4 lung cancer

• A bout of heel pain turned out to be stage 4 lung cancer for a man in his 40s
• The former Cantopop band musician quit heavy smoking when he became a father
• However, that was likely too late
• After chemotherapy and immunotherapy, the cancer is considered to be in remission
• Treatment was costly and he said getting adequate insurance coverage is important for anyone

SINGAPORE — Music teacher Simon Loy woke up with heel pain one morning in 2018.

He thought it was a relapse of sports-related pain that he used to experience after clocking long-distance races.

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When the pain worsened over the weeks, his left calf started to swell. Walking became excruciatingly painful for the former avid runner.

What he did not know, was that cancer cells had been growing and spreading in his body.

The leg swelling turned out to be a blood clot in his left leg. Subsequent investigations revealed a 5cm tumour in the lungs. Cancer was also found in his neck.

“Up until then, I had no major issues with my health and had never been hospitalised,” he said. “I had no respiratory symptoms either. If it hadn’t been for the heel pain, I would never have known I had stage 4 lung cancer.”

Now 47 years old, he is the father of three children aged 17, 20 and 21.

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Lung cancer usually shows up as a persistent cough, where the person coughs up blood and has chest pains that worsen with deep breathing and coughing, shortness of breath and voice hoarseness.

However, it is estimated that up to one in five people with cancer — not just lung cancer — may develop blood clots.

Dr Kevin Tay, a senior consultant medical oncologist at OncoCare Cancer Centre who is treating Mr Loy, said that these blood clots most commonly occur in the veins of the legs and lungs.

The risk is greater in patients with advanced cancer.

Dr Tay said: “Cancer cells are capable of activating the clotting pathways and other pro-thrombotic (coagulation) properties of host cells, making the blood ‘stickier’ and hence easier to form clots. Furthermore, abnormal growth and enlargement of the cancer mass may press on major blood vessels in the body, and therefore impede (blood) flow, resulting in development of blood clots.”

Patients with advanced cancer may also be more fatigued and less mobile, which also puts them at higher risk of developing blood clots due to poor blood circulation, he added.

HE JUST WANTED TO DIE FAST

When Mr Loy first learnt he had lung cancer, all he wanted to do was to give up and die without a fight.

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Having witnessed how his late mother battled cancer three times in a span of 15 years, he felt fearful and hopeless.

His mother, who worked as a cleaner, had breast cancer twice and stomach cancer. She died from complications following surgery to treat stomach cancer.

He recalled the immense physical and financial toll the cancer treatments took on her and the family.

Reading up about his condition online further heightened his sense of impending doom. He even made financial plans so that his wife and their children, aged around 14, 18 and 19 at the time, could cope when he was no longer around.

“I was devastated after finding out (online) that the survival rate was merely 5 per cent while the remaining lifespan of a stage-4 patient was not more than 200 days. It was a scary and emotional time for me,” Mr Loy said.

“I told the doctor, if I was going to have only 200 days to live, why bother treating me? Just give me painkillers so I can enjoy my remaining days. Just let me be.”

More than 200 days have passed since Mr Loy’s diagnosis in June 2018.

“Dr Tay dispelled my prior misconceptions on survival rate, explaining that the statistics I had found online also included patients who either refused or had no access to treatment,” he said.

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