A brush with cancer seems to leave a long shadow behind its survivors and their families.

The trauma of the season is a dark memory, and the threat of having to relive the ordeal is ever a silent stalker. In combination, it’s a dreadful mix.

But that would be the story of Brenda Tan’s life. She nearly lost her son, Nicklas Chang, to neuroblastoma, a nerve cell cancer that is the leading cause of cancer death in children under five. Thirteen years on, he is cancer-free.

But that, too, would be the story of Marianne Lam’s life. Her younger son, Joel Lim, continues to battle leukemia even after 14 years of chemotherapy and radiotherapy, a bone marrow transplant and five rounds of immunotherapy.

If not for the full assurance of Job 19:25: “I know that my Redeemer lives, and at the last He will stand upon the earth”, there would be a dearth of courage for these two mothers in the face of their uncertain tomorrows.

A perpetual state of panic is no longer the norm for Brenda. Since coming to Christ, “I don’t live in fear, although I still have my fears”, she affirms. 

Shock waves

Nicklas was a boy of five in 2006 when Brenda sought medical advice for a lump she had noticed in his abdomen. A paediatrician prescribed laxatives for what he diagnosed as constipation and scolded her for being concerned that her son – born so heavy he was nicknamed “the Michelin man” – was losing weight.

Once nicknamed “Michelin man”, Nicklas began losing weight and became increasingly lethargic. Photo courtesy of Brenda Tan.

She came away chastened and more than $100 poorer. A busy and successful corporate trainer at the time, she felt “stupid”, she says, thinking to herself: “Of course it must be ‘hard stools’.”

Doubt nagged her, however, and she decided to consult her family GP. In the most considerate way imaginable, he calmly recommended an abdominal x-ray via the Accident and Emergency (A&E) route, for he had straightaway recognised that something was very wrong.

“He told me, ‘I believe you and I think that if you want peace of mind, you should bring him for an x-ray. I will write you a chit. But all of you should go home and shower first, have dinner.’

“That was exactly what he said. He didn’t raise the alarm. Actually our whole family went, because after dinner what, nothing to do … ”

That night of September 19, 2006, Brenda and her husband, Keith Chang, spent agonising hours in a KK Hospital (KKH) waiting room, drawing a frantic blank as doctors streamed in and out, repeating the same refrain: “Wait.”

Eventually, at 5am the next morning, Dr Chui Chan Hon, a specialist in paediatric surgical oncology, came to see them. He diagnosed the 15cm tumour sitting on Nicklas’ left adrenal gland as “neuroblastoma” and pegged his chance of survival at 10%.

“I broke down,” Brenda says. Keith was silent. So was Nicklas.

The boy ended up staying in the hospital for three weeks. Chemotherapy and radiation were carried out in earnest to shrink the tumour, and Brenda dropped everything to remain by his bedside.

If he was bewildered by all that was happening to him, Nicklas did not show it. “He just took it,” shares Brenda, who’s been a homemaker since. “I told everyone if he is not that strong I don’t know what I would have done.

Nicklas held his own while undergoing treatment, never complaining, hardly even speaking. Photo courtesy of Brenda Tan.

“The whole time in the hospital, from the minute my son was admitted, he didn’t talk. He didn’t really even eat. He was just silent.

“I explained to him everything in very simple terms. I told him what he had and what is the next procedure that he would have to do.

“He would just look at me. He could understand; he would nod. He would tell me simple things – like, he wants to eat, he doesn’t want to eat; he didn’t verbalise anything else.

“I was like a wreck. I kept questioning (the doctors), ‘Why do you have to give him so much antibiotics? He’s just having a fever’ – without knowing that was part and parcel of the chemo treatment.”

For six months, she couldn’t stop crying. The burden of responsibility resting on her shoulders felt overwhelming. She couldn’t bring herself to talk to anybody about her fears – not even to her husband, an engineer whose job required him to travel often.

“I had to hold the fort. It is so hard to make a decision for your child, because there’s no ‘best’. There isn’t a best solution because when they give you an option, it’s a lose-lose situation. There is so much down-side and side effect.

“When his hair started dropping, I actually picked it up and kept it in a Ziploc bag.”

Steady stream of blessings

At the time, the Changs were pre-believers. While consoled that God’s unseen footprints (Psalm 77:19) were paving the way for her even before she knew Him, Brenda, now 48, struggles with the difficult memory of those desperate times. She admits she can only talk about it “with God’s grace”.

After their family GP, Dr Chui was the next godsend. He was the leading local specialist in neuroblastoma. It was he who made the first accurate diagnosis, as well as the effort to explain the situation to her and Keith, now 50, in layman terms.

“This doctor – thank God … I know now why I was in KKH – it was because of this surgeon.”

Chinese New Year of 2007 was a watershed for the change it marked in their family life. After intensive treatment, Nicklas’ tumour had reduced to 10cm and surgery to remove it was performed.

The hope of recovery that this represented gave Brenda the tenacity to fight off the extraneous. Paring down his life to only that which he needed for survival, she refused visitors – even her own mother, who brought reunion dinner food to the hospital.

Paranoia honed her self-devised regime of cleaning to perfection: Everything Nicklas came into contact with was frenziedly wiped down.

Despite her best efforts, the bone marrow transplant he underwent in June 2007 was fraught with complications.

The agony was almost too much to bear, when a Hickman line for medication had to be put into Nicklas’ chest. Photo courtesy of Brenda Tan.

“I nearly lost him,” she asserts candidly. “He couldn’t complete any of his treatments because his body was breaking down.

“I don’t know how to explain to you how I felt. You just look at your child and he is thin as a stick and almost motionless.”

To the left and right of his hospital bed were multiple stands holding up bags of medicine being dripped into him. His digestive system had failed and his lungs were starting to get scarred. All too soon, he began to have difficulty breathing.

“I think that was the worst. A surgeon actually had to come into the room, with all the scans inside the room, and they operated on him inside there, not even in the (operating) theatre.

“Water started to seep out from his intestines. Nothing could go in.

“That was when I started praying. I didn’t know what else to do. I don’t know what I was praying but I was definitely praying.”

Nicklas pulled through, even though he didn’t finish the treatment protocol.

The gift of prayer

Unbeknownst to her, the idea of God was quietly taking root in Brenda’s mind. Her daughter, Valerie, now 20, was a student at Paya Lebar Methodist Girls’ School and had requested that their family start going to church.

Valerie, in her love for her brother, requested that the Chang family start going to church. Photo courtesy of Brenda Tan.

Also, by divine appointment, circumstances were such that the Changs made the decision to transfer Nicklas to the National University Hospital (NUH). During his stays there under his new oncologist, Dr Aung Le Le, there were often visits from volunteer well-wishers who came to the Viva University Children’s Cancer Centre to cheer the kids up.

One of these groups happened to include neighbours from Brenda’s block, a Christian family who said they were from Bethesda (Bedok-Tampines) Church (BBTC). They were with another family from BBTC, “just to bring the love of Christ”, she remembers.

“Even though we were neighbours, they didn’t know we were going through this. They asked us to go to church. They prayed for us.

“I welcomed prayers. I was not an atheist,” she says, while qualifying that she and her husband, by nature, were and are still “very logical people”.

Separately, another neighbour – also a BBTC regular – noticed Brenda taking Nicklas for a walk around their Bedok condo one morning and asked after the boy.

“He saw that quite obviously Nicklas didn’t look like a normal child – he had lost his hair, he looked pale. He asked, so I just told him, and broke down again. Being a guy, I guess he didn’t know what to do, seeing a woman cry, so he asked me to go to church.

“These were the seeds planted, but at that time I didn’t know. I was just sad, bitter, confused, in denial.”

Brenda’s former boss, too, rendered encouragement, even though she never went back to work. The Catholic American rallied many of her own friends in the US to pray for the family. “She texted me and said, ‘We are praying for you.’

“Everybody was praying for us. We were very, very touched. 

“There was comfort but yet there was a lot of uncertainty, because I guess I didn’t personally know the Lord? You know, how can people be so nice? That’s the thing that you ask yourself. But they are nice.

“After my son fell sick, many people prayed. People that you don’t know, why would they pray for you? It’s just this good feeling.”

Grace unending

Carried on the wings of such grace, the family eventually walked in to BBTC in November 2007 “by ourselves”.

“The minute they started the worship, I cried buckets,” Brenda laughs. “I cried and cried, non-stop, until it’s so embarrassing.”

Through their trials, the Chang family made BBTC their home church and began walking with the Lord. Photo courtesy of Brenda Tan.

The man next to her asked: “Are you new?” and invited her to respond to the altar call.

“‘Altar call? What is that?’ He explained. I didn’t know what it was about. We were alone, we were embarrassed. I didn’t know what we had got ourselves into, but we all went (forward) that first Sunday.

“We didn’t pray to receive Christ. But the person that prayed for us at that time was so personal. When my son relapsed, he remembered us.”

By way of the loose connections previously established, the Changs were put in touch with the cell group their neighbours belonged to. When Nicklas had a relapse in January 2008 and the family stopped going to church, “they reached out in a very, very distant way”, she says, “but that was good enough for me at that time.”

Meanwhile, as Nicklas was fighting for his life in NUH, Brenda was getting to know someone named Marianne Lam, whose son had been battling leukemia since 2005. The beginnings of a spiritual friendship was wrought. Marianne would prove to live out unrelenting faith.

Brenda describes: “We’re all going through different journeys, we have different stories and things, but when you start meeting people, it just registers – who are the Christians.

“I could see the strength and hope in Marianne. It helped me to move forward. That, in itself, was a great support and help.

“She brought her Christian friends who were very sweet. When you chat with them; you’ll be wondering where their peace comes from.”

Two roads converge

Marianne’s son, Joel Lim, fell ill easily when he was in Primary 1 and his dangerously low immunity was put down to leukemia.

There have since been many near-death experiences, each one harrowing but duplicitous – “thanks be to God”, she says. “It is the Lord who preserves Joel’s life. His power to heal never ceases to humble and amaze us.” 

Joel has weathered many near-death experiences – too many to count. Photo courtesy of Marianne Lam.

Prayer all too regularly being their only recourse, Marianne, 54, and her husband, Jeremy Lim, 53, a manager in a global IT company, draw their sustenance from God’s grace and – ironically – Joel’s own deep faith.

The young man’s wry humour belies the simplicity of his belief in God (John 6:29). Time and again, it has undergirded his medical, physical and academic struggles. 

Each day to him is holy to the Lord. He does not grieve and is present evidence that the joy of the Lord is strength (Nehemiah 8:10). “God, please heal me” is his fervent prayer.

Prolonged treatment for cancer has compromised Joel’s mobility, but he remains determined to persevere through his trials. Photo courtesy of Marianne Lam.

Even when he had a bone marrow transplant and was away from school during the year he should have been in Primary 5, he set his sights firmly on taking his PSLE with the cohort after him, in October 2011, despite the challenges that his low immunity presented.

He had to be given tuition at home by volunteers, had to take his papers from a hospital bed, but he passed the exam.

His ‘N’ and ‘O’ level exams were taken in a similar manner, as a student at Anglo-Chinese School (Barker Road). He contracted shingles in 2015, but took his ‘N’ level exams nonetheless.

The next year, on the eve of his first ‘O’ level paper, he developed chicken pox and had to be rushed to the NUH A&E department. He sat for all his papers in an isolation room, with multiple intravenous (IV) lines attached to his body and a smile on his face.

Through it all, he had the favour of a supportive school principal and teachers, as well as the company of loyal friends, who – like David’s mighty men (2 Samuel 23:8-12) – would go out of their way to help him make it through each day.

They carried his school bag. They gave him piggy-back rides whenever his class needed to get somewhere quickly, and even fulfilled his long-held wish to complete the annual school Cross-Country event by pushing him in a wheelchair from the starting point to finish line.

God was clearly watching over him – as well as his mother – for Marianne had stumbled upon a godsend herself and was growing deeper in faith with Brenda.

Joel kept a smile on his face even as he sat for his ‘O’ level exams from a hospital bed in an isolation room. Photo courtesy of Marianne Lam.

In 2015, Joel completed his school’s Cross Country when his classmates pushed him in a wheelchair through the course. Photo courtesy of Marianne Lam.

Friends for life

“It didn’t take long for us to click,” Marianne recalls of their first meeting about a decade ago. The experience of being in the crucible of a mother’s suffering meant they instinctively understood each other’s hearts.

Beyond the nail-biting suspense of waiting for test results after each procedure, there were the shared day-to-day experiences: “The sight of the IV drips hooked onto your child’s frail and weak body, the needle that poked their tiny hand to find a good vein to set a plug for medication or draw blood … It’s worse when it fails and they have to find another good vein to repeat the same. 

“Your world can turn upside-down, not once but again and again, when treatment doesn’t go as planned,” the homemaker describes. “It’s another infection, another relapse, another this and another that …

“Inevitably in the hospital, you brace yourself to see all sorts of miseries and heart-wrenching situations that can arise.

“There were many times we were left with no words to share our pains with anyone, nor could we take comfort easily from anyone.

Sometimes, multiple stands are needed to hold up the variety of medicines needed. Photo courtesy of Marianne Lam.

“Times like these, only those who walk the same path will understand and they are a shoulder for you to really cry on.

“Praying and encouraging each other to keep our faith is so crucial and utterly needed.”

The tables turned pleasantly last year when it was the “younger” Christian Brenda who ministered to Marianne by buying a birthday cake for Joel when he was ill and had to stay home on his 20th birthday. 

Marianne is deeply appreciative. “She is busy and yet she will still find time to carry out this very beautiful act of kindness for us.

When Joel turned 21 in January 2019, it was cause for celebration indeed, especially for his parents, Jeremy and Marianne, and older brother (not pictured), Gabriel. Photo courtesy of Marianne Lam.

“To be a God-centered caregiver, you certainly need another God-centered caregiver to spur you on. Though we may have our church to support us – cell group, BSF (Bible Study Fellowship) – nothing compares to having another sister who is walking the same path.

“Brenda’s loving messages were often sent into my desperate moments, to lift me up and to remind me, I am never alone. God is watching, God is with us, God is in complete control.”