When he was preparing to undergo a hernia operation, Mr Mohammad Kader, 56, was told he also had leukaemia, discovered after a routine blood test.
Up to that point, neither he nor his wife realised anything was amiss. His first thoughts were that he had only a few months left to live.
That was 12 years ago. He is alive and well today, thanks to a new drug introduced here in 2001.
The only signs he noticed before being diagnosed with early-stage chronic myeloid leukaemia were frequent night sweats. Symptoms, usually non-specific, can include lethargy, poor appetite and abdominal distension from an enlarged spleen. The condition can go undetected for up to a year before symptoms appear.
He would have been justified in fearing the worst had he been diagnosed a few years earlier.
"Before the late 1990s, a stem cell transplant was the only effective treatment," said Dr Charles Chuah, a senior consultant haematologist at Singapore General Hospital (SGH).
The average survival for patients then was three to four years. Even with a successful transplant, only about half of patients with early-stage chronic myeloid leukaemia would still be alive after 10 years.
Leukaemia causes the body to produce large numbers of abnormal white blood cells.
In chronic myeloid leukaemia, the production of abnormal cells is triggered by the presence of a protein known as Bcr-Abl. In 1998, a drug called imatinib, or Glivec, that works by blocking the function of the Bcr-Abl protein, entered clinical trials in the US.
It was the first drug targeting the Bcr-Abl protein that was both effective and well-tolerated, Dr Chuah said. Now, with imatinib, a pill taken once a day, nine in 10 patients are alive after 10 years, he added.
According to the 2015 Singapore Cancer Registry Report, between 30 and 40 such cases are diagnosed every year, a number which has remained stable.
Mr Mohammad, who works for a courier service company, was also fortunate that his condition was detected early. Prognosis would be better and drug treatments likely to be more effective.
He is part of a badminton club that has weekly training sessions, and occasionally represents his club in friendlies in Malaysia.
"I was surprised that I could remain quite active. Many people don't suspect I have leukaemia," said Mr Mohammad.
He also shares his experiences with other cancer patients at gatherings organised by Touch Cancer Support, a subsidiary of Touch Community Services.
Today, most patients with chronic myeloid leukaemia are able to lead independent lives and return to their usual activities.
Some, however, experience mild side effects such as muscle cramps and water retention, said Dr Chuah. "Treatment with imatinib is potentially lifelong," he said. "Reassurance and support from their caregivers are vital for these patients."
Touch Community Services is organising a conference on Saturday at SGH to mark 15 years of medical development here that has seen chronic myeloid leukaemia go from being a terminal illness to a long-term but largely manageable condition today.
Medical experts will talk about the latest treatment options. Admission is free but registration is required. The registration form, as well as more details, can be found on www.touch.org.sg.
This article was first published on Aug 31, 2016.
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