The Worst Birthday Present A Woman Can Receive

The most unpleasant gift a woman can receive on her birthday is a lump in her breast.

Yet a lump was exactly what Ruth found as she stood in front of the bathroom mirror, in a state of complete disbelief. It was late July 2018. In a few days, she would turn 59. Mentally, she’d been hoping to feel 29 years young again. But in that life-changing moment, Ruth suddenly started feeling her age. 


The first person she shared the news with was Sam (59), her husband of thirty three years. If shock were the first emotion that threatened to spring up inside Sam, it would be swiftly and violently suppressed by his Singaporean pragmatism.  

“I had to think like, okay, what to do about it already?” he recounts nearly two years later. “We had to get it checked immediately. Shock is (he pauses) …shock just isn’t a productive emotion.”  

The next day, he called around for recommendations to the top doctors in Singapore. He started weighing the pros and cons of public versus private hospitals, making appointments and getting the family’s finances in order. Because, to him, until his wife’s lump became a diagnosis, there was still one glimmer of hope. Every option was still on the table. 

Unfortunately, Sam’s pragmatism also meant keeping his wife’s news from their daughters, Andrea and Alyssa. At the very least, he reasoned, until their mother’s diagnosis can be confirmed by a doctor. 

That was still the plan as they sat in the living room one evening next to their eldest daughter Andrea, pretending to watch television. Andrea (27), had just returned home from the Netherlands, ready to re-enter the job market to begin her second career as a trained physiotherapist. When she overheard her parents casually mentioning a doctor’s appointment, she sensed that something was amiss. 

“I had to really press them to find out what it was about,” she recalls. “until they reluctantly revealed it to me. First, I was shocked. Then I felt dismayed and upset that they thought I couldn’t handle the news.”

It wasn’t until much later that they finally decided to inform their youngest daughter Alyssa (24).

“I was a bit hurt that I didn’t find out sooner,” says Alyssa, which sounded like an understatement. “It’s just like [my parents] to make a decision on their own, sort everything out, then tell us about it. I guess they didn’t want us to worry.”

Days later came Ruth’s official diagnosis: breast cancer stage 3A. The doctor prescribed an aggressive treatment: six rounds of chemotherapy over six months, followed by three weeks of radiotherapy and finally, a lumpectomy to surgically remove the tumor.  

By the time all four members of the family were informed, there was no longer any trace of shock—only a blank sense of resignation. 

“We had all anticipated it leading up to the diagnosis,” explains Andrea. “But I also felt a little cold. It was big news.” 

As the family became consumed by their private thoughts and fears, one question repeated itself over and over again:

What’s next? What’s next? What’s next?

The Loneliness and Isolation of Cancer

Chemotherapy is a dose of toxic chemicals that’s injected straight into the vein. While designed to kill fast-growing cells, it makes no distinction between normal and cancerous ones. Ruth wondered if her body would be able to withstand this treatment. After all, she was quite advanced in years. Could she muster enough reserves to outlast this foreign thing inside her?

Yet no matter how much information she sought about breast cancer, Ruth could never shake off the feeling of uncertainty and dread. Her knowledge always felt peripheral, as she found herself constantly grappling with the reality of what it all actually meant. 

No matter how hard she looked, there was just no such thing as a comforting cancer statistic.

As Ruth’s treatment progressed, other details emerged. Ones that were almost painfully mundane. Her daughters saw cancer in their mother’s long walk from the bedroom to the bathroom. It was the reason a chair was left in the bath, because she couldn’t stand for long enough to take a simple shower. To make matters worse, the family had to watch as each successive round of chemotherapy not only wore down her body, but also her optimistic spirit, sending her into bouts of depression. 

During the day, the burden of caring for Ruth fell on the eldest Andrea, who decided to postpone her job search—this in spite of insinuations about her unemployment from outsiders. For months, her life revolved around her mother, Google and the pharmacy. 

“I became a bit neurotic about managing mom,” Andrea explains. “I was always trying to find workarounds. How to encourage her to eat and drink while she had painful sores in her mouth. How to be patient and keep things positive whenever she got emotional.” 

For the younger Alyssa, who works as an Account Executive, there was a feeling of guilt. The sisters had always been close. Yet Alyssa’s experience in accounts had taught her that having too many cooks was a recipe for conflict. So when she returned home after work in the evenings, she did her best to follow her sister’s instructions. 

Despite all of the support, the loneliness and isolation of the mother remained. 

“No matter how close your family is, or how much care they show, this burden is yours to carry,” says Ruth. “No one else can carry it for you.”

Remission Isn’t the End of the Story 

Remission is a word that has a false ring of finality to it. It sounds like survival. Like success. And in a certain sense, that’s true. 

Two years after her diagnosis, Ruth has returned to work. The adjustment hasn’t always been easy. ‘Chemo brain’ or ‘chemo fog’ as it’s known among cancer survivors describes the cognitive impairment following months of chemotherapy.  Upon her return, she came to the frustrating realisation that she’d forgotten some of the skills she’d mastered a long time ago.

In other ways, ‘remission’ is still a work-in-progress. Her treatment and surgery had cost her upwards of S$150,000, which was largely covered by two insurance policies she’d taken out decades ago when she first started work. But there were also unexpected post-treatment expenses. To prevent a recurrence, she would need to take hormone suppressant pills every day for the next five years—medicine that will cost her family an average of S$440 per month. Then there’s the cost of regular doctor visits (S$120 per visit) and scans (S$4,000-5,000) every 3-4 months. 

All of this will likely be the new normal for the rest of her life.

A Mother’s Gift to Her Daughters

Beyond family finances, Ruth’s second chance at life has made her introspective.

“It’s not so much about money,” she says. “But more about the intangible things like quality relationships. Quality time in relationships. Recently, I’ve been doing a lot of thinking. What am I going to do with the rest of my life? How do I spend it in a meaningful manner?”

She’s lost so much precious time already. And still, so many things about the future remain uncertain. For starters, will she ever make it to Machu Picchu or see the Northern Lights? Will she be around to see her daughters get married? Or the birth of her grandchildren?


But there are also so many things she’s grateful for. Her illness has allowed her to see the innate goodness in people in the form of calls, messages, and get-well packages. Her relationship with her family has grown closer and stronger. Maybe, if viewed in a different, more refracted light, this experience really has been a gift.

Though surviving breast cancer has been a painful ordeal, it’s also served as an early warning for her daughters. Every day, she sees parts of herself in them: in their optimism, care, and peace-loving spirit. And perhaps, an enduring faith that nature isn’t always destiny, that this unpleasant gift she received won’t be passed down to her children.     

Her hopes for Andrea and Alyssa are simple: that they’ll pay greater attention to their diet, health and perform regular self-examinations. To not stress or overwork themselves over the small things. To find happiness and contentment in their relationships. 

For a mother to be able to pass on this gift, there’s no price she wouldn’t pay.

Don’t let money be a source of stress following a cancer diagnosis. Plan ahead with MSIG’s CancerCare Plus. Because supporting each other and strengthening family bonds is the most important thing you can do.

Have you or a loved one ever had to overcome challenges from a cancer diagnosis? Tell us your story at

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