There can be few more harrowing events than counselling a man who wants to take his own life. Knowing what you say or do has consequences that are literally a matter of life and death.
Clarence Heng, aged 62, recently had this experience, talking to someone who became suicidal after being diagnosed with prostate cancer.
What did Clarence say? What did he do?
We will never know the answers to these questions as the shared emotions between the counsellor and the counselled must remain personal and private. But what we do know is the troubled man has now regained his desire to live, and is facing prostate cancer with a much more positive outlook.
What is as remarkable as the result is that Clarence is himself in a battle with prostate cancer. Clarence is a Walnut Warrior and a volunteer with the Singapore Cancer Society. The Walnut Warriors are part of a prostate cancer support group, providing psychosocial support and encouragement to fellow patients. The group helps men in their battle against the disease by enhancing their well-being through therapeutic and enrichment programmes.
The Walnut Warriors get their name from the description of a healthy male prostate which is about the size of a walnut. The prostate is located just below the bladder and in front of the rectum and it plays an important role in the male reproductive function, making a fluid that helps keep the sperm alive and healthy.
Clarence first became aware that something may be wrong in 2013 during a routine medical check-up for the multi-national company he worked for. He had a blood test which showed his prostate-specific antigen (PSA) reading was 3 ng/mL. PSA is a substance in the blood that is made by the prostate gland, and prostate cancer can cause PSA levels to rise. While the reading was on the high side, it was still within the normal range of between zero and four, so he took no further action.
Then in 2015, his PSA level rose to 10 ng/mL. Hence, he went to Singapore General Hospital to have a more thorough examination. After a biopsy, the results came back positive for prostate cancer. While the news was a shock, he took hope in the fact it showed no signs of spreading.
The next step for Clarence was an operation in 2016 using an advanced surgical technique called the Da Vinci Robotic Prostatectomy – or pinhole surgery assisted by robotics. It is a procedure where small surgical instruments are inserted through the abdomen, allowing the surgeon to remove the cancer by manipulating the instruments while watching a screen.
Clarence recovered well after the operation, suffered minimal discomfort and was active again after six months. He even managed to walk a daily distance of 3.5 km and scaled mountains with altitudes at 4,500 m. His PSA level has since dropped to 0.003 ng/mL and he routinely gets it checked every year.
Clarence’s life has changed after his experience with cancer. He follows the diet recommended to him by the hospital, doesn’t smoke and only occasionally enjoys a glass of red wine. Red meat is out in favour of chicken and fish.
He gains fulfillment through his volunteer work and his involvement with the Walnut Warriors. To help others, Clarence openly discusses his own experiences with both newly diagnosed patients and their families. And if that were not enough, he also gives public talks to increase the awareness and understanding of prostate cancer.
He is proof that men diagnosed with prostate cancer do not have to face it alone. Doctors, nurses and the Walnut Warriors are all there to lend a hand and an encouraging word.
Leading up to his diagnosis of prostate cancer, Clarence had no symptoms. If not for his regular medical check-up, the cancer may not have been detected until it was much more advanced.
Little wonder that Clarence, when talking to other men, encourages them to visit a doctor so that detection can happen early, leading to early treatment and recovery.