March 8, 2023
Photos by: Bryan van der Beek | Words by: Jill Alphonso
(Photo above) Ms Jill Alphonso shares a tender moment with her husband Mr Justin Noreikis before she goes under the knife. As her primary caregiver post-surgery, the couple worked together with a therapist to ensure they would be prepared emotionally and mentally for what was to come.
ello, my name is Jill. I am a breast cancer patient.
I currently have one boob. The other breast and nipple were removed in a unilateral mastectomy on January 31, 2023.
They won’t grow back the way a liver can. As I sit here typing, I hope the surgery renders me cancer-free. It will be weeks before I know for sure, as the tumour goes through an Oncotype DX test for recurrence rates, and whether the cancer will be responsive to chemotherapy.
(Above) Ms Alphonso’s pre-op preparation was underway by 7.30am as a nurse prepared the writer ahead of a surgery that took three hours.
In November 2022, I was diagnosed with oestrogen- and progesterone-positive, HER2-negative breast cancer. It was mind-numbing news.
I’d experienced no pain. I’d been relatively healthy, living life as a vegetarian and a yoga and pilates addict (albeit with a hard-partying earlier life). Still, a soft lump had been forming — much like a soft-bodied sea creature, I like to think — under my skin above my left nipple.
That 5cm sliver showed up during a random mammogram; one I’d only gone for because at a routine check up, my doctor suggested: “You’re 43. Maybe you want to have a mammogram.”
Yet I am thankful, strangely, for the diagnosis. At a profound level, it reminded me of how sweet life is. See, I don’t usually think about that. It took this seismic wave to shake me.
Since I found out, I have been the happiest I have ever been.
You read that right.
(Above) Mother and daughter hold each other, as Madam Rita Chan assures her child that everything will be all right.
Documenting My Journey
Suddenly, and like any other breast cancer patient, I was caught in a series of new and unfamiliar situations. I underwent a barrage of tests — MRIs, CT and PET scans — that would show my doctors how large the tumour was, and how deep it went. A biopsy finally confirmed that the lump (or my personal sea slug) was in fact, cancer.
As a former journalist, my instinct was to document what was happening to me. I wanted to do it firstly for myself, but also to share how critical early screening is, a possible roadmap of the journey, and how staying positive can help others facing the same situation.
Because breast cancer continues to be the leading cause of cancer among women in Singapore, this piece isn’t just for new cancer patients. It’s also for their extended networks of loved ones and family.
My hope is to empower allies, and help new cancer patients build a strong support system that will be instrumental in helping them deal with the disease. Here’s what I did to cope before my surgery.
I Gave Myself a Prescription: Be Happy
The possibility of death plagued my mind especially just after the diagnosis, when I had no idea what my treatment plan would be. As I weighed up my medical options, internally, I had a deeper, simpler, decision to make: Choose life, or death.
Everything else that I did after that would align with that choice.
So I chose life. I chose to fight for life with every shred of my being. Not only would I do what was necessary to stay alive, I would put my heart and soul into actually living.
I then prescribed myself the best medication I could think of: Happiness.
I evaluated how I was living at the time, and made a conscious decision to change my mindset about the things I was not entirely happy with. Ultimately, it was a relatively minor list of bugbears such as a grudging acceptance of working in the corporate world; niggling displeasures about incidents long past.
Casting those negative feelings aside, I started looking for the good in everything. A renewed mindset allowed me to ingest massive doses of peace and joy, and replace doubt and fear. It altered how I viewed my situation.
I developed a staunch refusal to make fear-based decisions surrounding my diagnosis and treatment plan. Instead I allowed myself time to consider all my options, seek second opinions, educate myself through reading, and ask questions of other cancer survivors.
I created an unimaginably awesome future in my mind’s eye, and reached for it. So that even if the disease ended me, I figured, I still would have triumphed — I would have truly lived.
No one is promised how long their lives will be. But everyone can choose how they want to spend it walking this earth in the here and now.
So I choose joy, every chance I get. My hope is that anyone reading can, too.
(Above) Rallying around Ms Jill Alphonso the day of her mastectomy, her closest friends and cousin crowd her hospital room, filling it with well wishes, showing her love just by being there for her.
I Gathered My Medical Team
For anyone facing cancer, gathering a team of professionals will be the key to unlocking the mystery of “What’s Next And Necessary”. Given that treatment will be a long-term affair, I knew I needed people I’d be able to work with over a long stretch of time.
My entire medical team came together rather organically. Over two months, it came to include two breast surgeons, my insurance agent, a plastic surgeon, a radiation oncologist, a therapist, and a team of natural healing doctors.
I knew I needed to attack the cancer from all angles. I was facing a unilateral mastectomy, then reconstruction work. I opted for the mastectomy because the lump was relatively large, and my breasts, rather small. A lumpectomy, which would have been a smaller procedure to remove only the lump, may not have removed all cancer cells. A small woman like me, who also has cyst-prone breasts, would face more difficult screenings in years to come.
After all, regular screenings for years is a non-negotiable to keep the cancer under tight watch, because breast cancer can recur in the same area, or the lymph nodes, bone marrow, as well as in organs such as the brain, kidneys and lungs.
|Breast cancer is the leading cause of cancer among women in Singapore. The Singapore Cancer Registry Annual Report 2020 states that it accounted for 29.7% of cancer cases among women, ahead of colorectal (13%) and lung (7.9%). Women’s cancers also include uterus (7.2%), ovary (4.4%) and cervix (2.6%). In general, cancer cases have been rising over the years. The number of people living with cancer will continue to increase. Nonetheless, vast advancements in cancer treatments have also greatly improved survival rates for people with cancer. Improvements in screening for some common cancers have also led to earlier detection and consequently, more timely treatment for many people. Source: National Cancer Centre Singapore|
Initially, I was in the care of a single breast surgeon — he held my hand through the first steps of diagnosis, and with great compassion told my mother at my biopsy results, “No, it is not great news”. He helped me map out possible next steps, he also referred me to a plastic surgeon to speak about reconstruction.
I also leaned on my insurance agent, who led me through the practical steps of insurance claims, and gave me financial peace of mind.
But I also consulted a senior radiation oncologist with years of experience — he’d treated my father and grandfather, who both battled cancer — and at his advice met a second surgeon with a different take on my case than my first doctor. With long-term considerations in mind, I came to select her as my primary cancer surgeon.
Much more than a “cutter”, she became a carer I could lean on for love and support. We prayed together before the operation, and she and her team constantly assured me they would be with me every step of the way.
In the days leading up to the surgery and right before it, each time I pictured the process, I would envision her hands as golden beams of light, scooping the cancer out of me.
I Attended to My Mental, Emotional and Spiritual Self
I also recruited another kind of professional, one not always talked in mainstream discussions in Singapore, yet are crucial to a person’s spiritual, mental and emotional sense of wellness. They play a critical role in healing and well-being during any traumatic experience.
I believe that the “Self” — or the essence of who we are — comprises the physical form, the mind, and the soul. As a vegetarian for years, a yoga teacher and an active person with a healthy lifestyle, I wondered what I could have changed to not have had cancer.
Perhaps I’d allowed negative thoughts too much room in my life, and let my spiritual life fall to the wayside. So, a week after diagnosis, I got in touch with that healthcare centre in Malaysia, located in a hilly town near Malacca.
My aunt-in-law, also a breast cancer patient, had found peace and solace there, and relied on their natural healing therapies to keep her cancer in remission for nearly 20 years.
Aenon Healthcare’s medically trained professionals pointed out that healing the body is only one aspect of the path to health. One also has to work on the mind, because the mind sends messages to the physical body, creating good or ill health within its cells.
I got to work cleaning up my thoughts, and explored the darkest parts of my heart. With their guidance, I rekindled a practice of prayer and meditation.
Because of their advice, I surrendered my life to a higher power and put faith in this: That the universe has a plan for us — one we cannot fully see and know. At a spiritual level, I decided to keep the faith and walk my path, one step at a time.
(Above) One last kiss for luck. Husband and wife dated in the early 2000s, and got married in 2012. Mr Justin Noreikis (Right) was instrumental in giving Ms Alphonso the love and care she needed in the run-up to surgery; attending doctors’ appointments with her and asking pertinent questions. Often, a cancer patient simultaneously has to mentally absorb information and process emotions, so having an ally is a stabilising force.
Before surgery, I saw a therapist twice. She helped me with relaxation techniques for surgery prep. Prior to the op, I used breathing exercises to calm my mind and body, and visualised myself in my happy place — the ocean.
Because of that, I entered my surgery with a feeling of love, light and calm, knowing that I had done all I could to set up my caregiver and I for success. When I awoke after the procedure, I felt as though I’d spent a day in turquoise waters, carried on the waves, floating under a gentle sun.
Importantly, she counselled me and my husband — my primary carer in my recovery — so we could more effectively manage our stress and fears.
She put a lens on the communication between my husband and I, helping us “take out some trash” that had gathered over the years, as it does in any relationship. She was my referee and translator, getting us both to be aware and present to the love that we have for each other.
Therapy is ongoing. But the result is that, when I look at my husband, I see the love that shines in his eyes rather than the “things that need to be fixed” between us. I can attend to myself knowing issues that crop up can be talked through, guided by a trained professional. While it is up to us to do the work to resolve issues, the responsibility of keeping tabs on the health of our relationship no longer feels like it is solely ‘on me’. That is a huge weight off my mind as I move through treatment.
I Leaned Hard on My Family and Friends
My family is my first base of support. My husband and mother were with me at many of my doctors’ appointments. They helped absorb information, and even asked questions I couldn’t have thought of while I was still processing the news.
To them I say, thank you. You have been everything.
My extended family of wonderful aunts, uncles, cousins and various relatives consistently asked “What can we do for you”, and assured me that I was going to be just fine. They reached out to their friends with breast cancer experiences, gathering tips to help me. My cousin, who runs a vegan dips and patties company, churned out meal prep items to help me as I cleaned up my diet as I transitioned to a vegan, whole foods, gluten-free diet void of refined sugar.
(Above) Waving a see-you-later to friends and family as she is wheeled into the operating theatre at Gleneagles Hospital. An Oncotype DX test will be done on the tumour to measure recurrence rates, and ascertain whether the cancer will be responsive to chemotherapy. Ms Alphonso will have to wait for the results to determine her next steps.
To them, I say, thank you. You have been everything.
Then there is my “ride or die” group — girlfriends who’ve had my back since we were in our teens. These are the people I called on for specific things — a random pick-me-up phone call. A cry when I didn’t want to worry my family. A meet-up to talk things through, or just hang out and go for a walk. To them I say, thank you. You have been everything.
As a breast cancer patient, I needed to tell my workmates about my diagnosis so we could figure out workloads.
They gave an extra dimension of support. Their words of encouragement, love and testimonies appeared as texts and in cards and letters. They spoke of things I did not realise were so apparent to others — of my strength that they could see, of my spirit, zest for life and of my positivity. Their words bolstered my courage. Because this was how I seemed to them, I did my best to live up to what they saw. It was an infinite, positive loop that had a direct impact on my psyche.
To them I say, thank you. That was everything.
If you are a breast cancer patient, a support structure is what you’ll need so do not deny yourself the help. Not everyone will be as open as I was, and conversely, some people will immediately share their journey on social media (which I did not do at the time).
Do what is best for you. Just ask for the help you need. Those who answer the call are your tribe. They will not desert you in your time of need.
- Part 2 of Jill’s Journey: Jill Alphonso Shoots Down Breast Cancer Misconceptions
|The resources Ms Jill Alphonso used when she was newly diagnosed:|
Singaporeans and PRs above the age of 50 get subsidies for mammograms and screenings. As breast cancer is on the rise in those even younger than that, getting screened is key to early treatment. Visit the Breast Cancer Foundation or the Singapore Cancer Society for advice and more. A good place to start: Private practitioners, such as Solis Breast Care And Surgery Centre where the author received treatment, for information on mammograms, screening options, and advice.