The Big C has been unusually cruel to Mr Richard Lim and his family.
Last November, his 74-year-old father died from intestinal cancer.
Last week, his 44-year-old brother succumbed to liposarcoma, a cancer of the fat cells.
The graphic designer, 39, the youngest of four brothers, has not been spared.
He was diagnosed with dermatofibrosarcoma - a type of skin cancer - in 2008.
As he went through surgery to remove a growth in March, he struggled to care for his dying father and brother.
Mr Lim's mother, who is in her 60s, has been devastated by the loss.
He said: "She cried, 'Why are we so unlucky? Why must all three of you be affected by cancer at the same time?' I tried to comfort her but she was inconsolable."
Mr Lim, who earns $2,500 a month, told The New Paper that paying for costly cancer treatments and operations for the family has been challenging.
Originally from Batu Pahat, Johor, the Singapore permanent resident is now receiving financial assistance from a nonprofit organisation, Ray of Hope Initiative. They found out about his plight in May from their contacts.
Its manager, Ms Sharmin Foo, told TNP it is helping to raise funds for Mr Lim and hopes to give him $2,000 per month for two months.
More people in Singapore are being struck by cancer, The Straits Times reported last month.
According to the latest figures from the National Registry of Diseases, an average of 36 people are diagnosed with cancer every day, and the number of cases has jumped by about 17 per cent since 2010.
The disease is the top cause of death here, with one in three dying from it now.
Mr Richard Lim's personal battle with cancer started seven years ago, when he noticed a small, painless pimple-like lump near the second toe of his left foot.
The bachelor, who first came to Singapore to work in 2000 and became a PR nine years later, said: "My family members advised me to see a doctor only when it grew to about 1cm long a few months later."
Mr Lim went to the Pantai Hospital in Batu Pahat to have it removed, where the surgery cost about RM6,000 (S$2100).
To his shock, a biopsy revealed that he had stage 1 dermatofibrosarcoma.
After the diagnosis, Mr Lim, who lives in a rented flat in Woodlands and works at Paya Lebar, decided get treated at Singapore's National Cancer Centre (NCC).
While the cancer was still in remission, he found out that his once-healthy father was diagnosed with stage four intestinal cancer in March last year.
Mr Lim said: "My father used to play badminton regularly but he stopped after he started getting easily tired in December 2013. He was also losing a lot of weight. "
After finding blood in his urine, the elderly man had surgery to remove the tumours from his intestines and it cost the family about RM40,000.
The older Mr Lim seemed to be getting better at first, but things took a turn for the worse last October, when he became bedridden.
Said Mr Lim : "His condition deteriorated by the day until finally, he couldn't even eat and became really skinny."
He made a three-hour trip by bus to Batu Pahat every week to help his family with his father's care.
Around the same time, he found out that the cancerous growth which was earlier removed from his foot had returned at the same spot.
And he received another blow when one of his elder brothers was also diagnosed with cancer.
Mr Lim Kao Siang, a bachelor who worked as a computer repair man, noticed blood in his urine and was diagnosed with stage 3 liposarcoma after a check-up.
He used to earn several hundred ringgit a month and was still recuperating at the Johor Specialist Hospital when their father died last November.
Already saddened, he became more distraught when he found that he had to miss his father's funeral as he was still too weak to be discharged.
He had gone through a 12-hour operation in Malaysia to remove the tumours at a cost of RM90,000.
With the tragic events surrounding his family, Mr Richard Lim decided to have surgery in Singapore to remove the growth on his foot in March.
His cancer had already progressed to stage 2.
Thanks to Medisave, he paid only around $300 for this operation.
The surgery left him in pain and he had to hobble around on crutches for two weeks.
He said: "It was too painful to walk and I couldn't put any weight on my swollen foot. Because of this, I decided to take two months' no-pay leave to fully recover."
At this time, his brother felt some discomfort around his back and abdomen. Scans revealed that his tumours were back.
Mr Lim arranged for his brother to be treated at NCC, where he had one round of chemotherapy in April, which cost around $2,000.
He was feeling better after the treatment and was looking forward to a second round when he received devastating news a month later.
A doctor informed the family that Mr Lim Kao Siang's kidneys were failing due to the chemotherapy.
Said Mr Richard Lim: "My brother then asked me to help him look for a nursing home in JB and he moved to Pusat Jagaan Penyayang (Loving Nursing Centre in Malay) in May.
"Due to the pain, he had to be put on morphine. His stay there cost us around RM6,000 a month.
"He was sick and very thin the last time I saw him alive. Due to the cancer, his stomach had bloated up like a pregnant woman's. It was a difficult decision to send him to the home but none of us could care for him full-time."
Last Monday evening, Mr Lim Kao Siang died in the nursing home.
Mr Richard Lim had been closest to him out of all his brothers.
"I am very sad that Kao Siang is gone. But I know he's out of pain now."
Mr Lim adds that his eldest brother is not close to the family, while his other older brother, who is married, helps to care for their mother in Batu Pahat.
Mr Lim, who returned to work early last month, is still under observation.
He does not need chemotherapy as his cancer was still at an early stage when the growth was removed.
But he has a $10,000 debt after paying for all the medical treatments.
He said: "I am glad that I'm now getting help from Ray of Hope. I feel much better now and I know I have to remain strong for my family."
She cried, 'Why are we so unlucky? Why must all three of you be affected by cancer at the same time?' I tried to comfort her but she was inconsolable.
About Ray of Hope
Ray of Hope is a nonprofit organisation founded in November 2012. It connects donors with people who need tiding over due to a sudden crisis.
Hedge fund manager Danny Yong, 43, founded it after reading news in 2010 about an Indian national whose hands were badly slashed in an attack in Kallang.
Mr Yong wanted to donate money to the victim, who could not pay his children's school fees, but could not figure out how to reach him.
About two years later, he roped in a colleague, Mr Keith Tan, and founded the organisation.
Its manager, Ms Sharmin Foo, told The New Paper that it tries to help as many people as possible.
Commenting on Mr Richard Lim's case, she said: "I admire his strength as he is shouldering many responsibilities even though he, too, has cancer.
"He doesn't let his medical condition stop him from helping his loved ones."
To date, the Ray of Hope Initiative has handled 11 cases and helped raise more than $59,000.
Brothers have rare forms of cancer: Oncologist
Mr Richard Lim and his brother were diagnosed with rare forms of cancer - sarcomas that affect 1 per cent of all malignancies.
The medical director of The Cancer Centre, Dr Wong Seng Weng, said sarcomas are cancers of the soft tissue and can grow in various parts of the body.
The consultant specialist in medical oncology added that it is not known what triggers sarcomas.
The National Cancer Centre (NCC) website said that no risk factors have been identified for most patients.
Many patients first consult a doctor because of a lump or mass on the trunk, leg or arm. The lump may or may not be painful.
But many sarcoma patients discover their cancers at the late stage as the condition is rare and cannot be screened, said Dr Wong.
Furthermore, the prognosis for sarcomas is usually not very good unless they are treated at an early stage.
He added: "They are hard to treat and are fairly resistant to chemotherapy and radiotherapy."
The brothers' late father had intestinal cancer. Dr Ong said there are several types of cancer that affect the intestines.
Colorectal cancer is the second most common cancer among Malaysians and the most common cancer in Singapore affecting both men and women.
Dr Wong said: "It is very treatable when detected early and those above 50 years should go for regular screening to detect any abnormalities."
The NCC said the most important factors causing colorectal cancer are dietary and hereditary causes. Cigarette smoking has also recently been confirmed as a contributing factor in 20 per cent of cases.
Dr Wong said: "It has been found that people who have a high red meat intake have higher risks while those who eat more vegetables and fish have lower risks."
This article was first published on July 6, 2015.
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