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Doctors offer hope to never-smoker mother after Stage 4 lung cancer treatment fails

  • Huang Yiyan, mother of a 12-year-old son, receives funds from Hong Kong Adventist Hospital Foundation for an effective new drug
  • Patient’s dark days of depression and worst symptoms have gone and she is happy to spend the time she has left with her family
In Partnership WithHong Kong Adventist Hospital Foundation

It was only about a year ago when never-smoker Huang Yiyan was racked with pain after being diagnosed with lung cancer.

The 48-year-old Hongkonger’s family were devastated to hear the news and learn that her treatment was failing to improve her condition.

“I talked about ending my life every day, saying, ‘There’s no hope for me and I don't want to live anymore’, Huang, the mother of a 12-year-old son, says.

Huang Yiyan’s family say she initially seemed untroubled after hearing of her diagnosis, but her mental state took a nosedive once her symptoms worsened. Photo: Akif Hakan Celebi

Early last year, she noticed the lymph nodes in her neck were swollen and she began experiencing shortness of breath. But her doctor told that nothing abnormal had been seen.

However, by March her condition had deteriorated to the point where she was finding it difficult to swallow and experiencing chest pains.

A chest X-ray revealed an unusual white-grey mass, which led to her being referred to a specialist at the Queen Elizabeth Hospital, in Kowloon. On March 18, further tests showed she was suffering from Stage 4 lung cancer which featured a special T790M gene mutation.

I talked about ending my life every day, saying, ‘There’s no hope for me and I don't want to live anymore’
Huang Yiyan, Hong Kong cancer patient

According to Hong Kong Anti-Cancer Society, 10-15 per cent of lung cancer patients have never smoked and the majority of these cases happen to women.

Her younger sister, Huang Yeshu, says: “The whole family were very distressed and saddened when we heard she had lung cancer. We never thought someone in our family would get sick with such an illness.

“All of her siblings living in Shenzhen cried at the news. From what we knew, her condition was likely to be quite serious.

“We started to worry about the cost of her treatment because these kinds of illnesses can be really expensive to treat. We didn’t know what to do.”

The next day Yeshu and another of her sisters in Shenzhen travelled to Hong Kong to check on Huang. “We wanted to give our big sister some company for a week, and to see how she was feeling and what she thought about her condition,” Yeshu says.

Huang Yiyan (left), who has never smoked, but developed lung cancer because of a gene mutation, discusses her condition with clinical oncologist Dr Au Siu-kie at Hong Kong Adventist Hospital – Stubbs Road. Photo: Akif Hakan Celebi

“For the first week, she seemed untroubled and her emotions appeared quite stable. She was the one comforting us, saying to us, ‘It’s alright, don’t worry’.”

Yet within a couple of weeks Huang’s condition had deteriorated further – and all her composure had vanished.

A doctor suggested that she start to take a third-generation targeted drug that would cost HK$50,000 (US$6,400) a month, but unable to afford the huge cost, Huang chose to use a first-generation targeted drug available from public hospitals.

Sadly, the treatment proved ineffective and she began experiencing pain in many different parts of her body, and suffered from coughing, shortness of breath, rashes on her skin and insomnia.

“At first, I thought I could take it,” says Huang, who had stopped working at a home for the elderly because of her illness. “But gradually, I realised I couldn’t cope with the fact that my symptoms kept getting more serious.”

Social worker Ellie Fu (above left with Huang Yiyan) referred the patient to Hong Kong Adventist Hospital Foundation, and Dr Au Siu-kie (right with Huang), a clinical oncologist at Hong Kong Adventist Hospital – Stubbs Road, picked up her case. Photo: Akif Hakan Celebi

She also started to worry about her family and how her son, in particular, was coping with the knowledge that she was seriously ill. The more she started to think about her condition, the gloomier she became.

“At my lowest point, I couldn’t stop thinking about my illness – it was a vicious cycle and I became really depressed,” Huang says. “I didn’t want to do anything, or go anywhere. All I wanted to do was to sleep.”

It was then that Huang turned to social worker Ellie Fu for help and emotional support.

“When she first came to see me she looked very serious and really depressed,” Fu says. “It was then she told me she had final-stage cancer.”

Fu referred Huang’s case to Hong Kong Adventist Hospital Foundation, in Stubbs Road, Wan Chai, last June.

After assessing her situation, the Foundation, which gives funding for timely medical treatment to the sick and underprivileged children in Hong Kong, mainland China and Asia, quickly approved an application to provide funding for her medication.

In general, the prognosis for Stage 4 lung cancer is very bad. Without targeted therapy, most patients die within three years; only 2 to 3 per cent have a five-year survival rate
Dr Au Siu-kie, clinical oncologist, Hong Kong Adventist Hospital

It means she can take osimertinib, a new-generation, targeted drug for treating patients with lung cancers that have a specific mutation, which costs about HK$50,000 a month.

The Foundation previously had used its Cancer Fund to help financially disadvantaged cancer patients only with funding for things such as screening or radiological examinations.

Huang was the first person to receive the Foundation’s financial support to pay the cost of her medication.

Dr Au Siu-kie, a clinical oncologist at Hong Kong Adventist Hospital – Stubbs Road, says most Stage 4 lung cancer patients die within three years without targeted therapy. Photo: Akif Hakan Celebi

“In general, the prognosis for Stage 4 lung cancer is very bad,” says Dr Au Siu-kie, a clinical oncologist at the Hong Kong Adventist Hospital – Stubbs Road, with almost three decades of experience.

“Without targeted therapy, most patients will die within two to three years; only 2 to 3 per cent of patients have a five-year survival rate.”

Without the Foundation’s help, it is very likely that Huang would have been offered chemotherapy at a public hospital after the failure of the first-generation targeted drugs.

However, there is only about a 20 per cent response rate to the chemotherapy and any improvement lasts only a few months, Dr Au says.

“Hope is something we want to give, rather than aiming at a cure,” he says. “We hope that Huang can live happy days and make the best use of her life, despite her illness.

“We wish to emphasise to people the message that you should always be happy with your life, irrespective of what you may be suffering now or in the future.”

I want to use every moment I have left to be with [my son and family] … to do what I can, for as long as I can, to just learn to be thankful for this chance and try to help others
Huang Yiyan

Dr Au says the reason for the high number of cases of lung cancer among never-smokers in Hong Kong is still unknown, and lots of different research is now going on.

After taking the medication for about a month, Huang’s condition has improved noticeably.

Huang Yiyan’s condition had changed her outlook on life and she often reminds her family and friends about the importance of taking care of one’s health. Photo: Akif Hakan Celebi

Most of her former symptoms and their side effects have gone and, after enduring all the tough times, she has been able to return to living a normal life.

“I can now do the grocery shopping by myself, and the cooking, and taking care of my family,” Huang says, with a big grin on her face.

“I take part in a lot of activities, such as going on walks, and doing yoga and tai chi classes.”

Her friends and family, including her son, have all noticed a significant change in her.

“We’ve seen an improvement in the condition of her illness and, most importantly, in her emotions,” Yeishu says. “She has become a lot more cheerful and positive.”

Despite her own condition, Huang also finds the time to ask other people about their own health. “She often calls us to remind us to take better care of ourselves and to tell us about what we need to pay attention to,” Yeshu says.

With her condition now under control, Huang Yiyan plans to dedicate the time she has left to be with family and try to help others. Photo: Akif Hakan Celebi

Although no one can predict how long Huang will survive, she remains hopeful about continuing to do the things that she enjoys in the days to come.

“I’m recovering now, thanks to my family and friends, and the doctors and nurses at Hong Kong Adventist Hospital and the generous donors,” Huang says.

“I want to use every moment I have left to be with [my son and family] … to do what I can, for as long as I can, to just learn to be thankful for this chance and try to help others.”

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