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She is a rare breed of leader who advocates for early breast cancer detection as much as she works on finding a cure for the disease.
Meet Dr Li Jingmei, Group Leader of the Laboratory of Women’s Health & Genetics at A*STAR’s Genome Institute of Singapore (GIS), under a national initiative that seeks to use genomic sciences to improve public health.
The 40-year-old geneticist says: “One in three cancers diagnosed among women is breast cancer. However, there is more we can do to prevent and detect breast cancers early when the tumours are small and most treatable.”
“Slowly, people are starting to realise that much hype has been focused on looking for a cure, and too little attention being spent on preventing or early detection of the disease and understanding what causes cancer in the first place. In my projects, I look into the book of life itself, scrutinising the DNA that defines us, for genetic differences that determine who is likely to get breast cancer, and who is not.
Outside work but in alignment with her research, Jingmei is an advocate for women’s health, particularly in breast cancer awareness. One of Singapore Kindness Movement’s Voices of Loving Kindness, or VoLKs, she is passionate about science, communication, and education, and hopes to push the boundaries of science to benefit society and make a difference to the global community.
Over the course of the past decade, Jingmei has been trying to identify common genetic variants, or single nucleotide polymorphisms (SNPs, pronounced as ‘snips’) in breast cancer cases. These can act as biological markers, helping scientists locate genes that are associated with a disease.
One of her other projects is to find out how support structures can be more involved in encouraging women to attend breast cancer screening.
“Women should feel safe and reassured to check themselves regularly,” she tells The Pride.
One of the women who Jingmei wants to help is 48-year-old Rumi Yati Razali, who went through a breast cancer diagnosis and several relapses before having her fifth child, a “miracle baby” whom she never expected would come.
In 2014, Rumi was diagnosed with Stage 2 breast cancer. A divorcee with four children (two girls and two boys), she went through a single mastectomy — eventually removing both breasts after relapses — because “I didn’t think I’d need to breastfeed another child again”, she tells The Pride.
It was a tough time.
She never forgets how supportive her children were when she was diagnosed. Her four children — the youngest, Hakimi, was just 12 then — worked together with his older siblings, Naziera, 18, Irfan, 16, and Nadia, 14, to make their home safe and clean.
“They kept it squeaky clean so that I could recover better during my chemo treatments.”
But it still took a toll. Hakimi was especially disheartened by his mother’s illness. During a parent-teacher meeting, his teacher asked Rumi if everything was okay at home because he often seemed sad at school. Worried, she asked his friends and they told her that Hakimi confided in them about how sad he was about her illness.
“He was sad to see me in pain and didn’t want to think about whether I could die from cancer. He was heartbroken but he never showed it to me.”
“In front of me, he was always a brave and happy boy.”
Jingmei says that many adults believe children are too young to understand grief but each child is unique. Talking about it honestly and answering their questions truthfully could benefit them more when children sense something is amiss.
She explains: “It is critical to be as forthcoming as possible about what is happening so that trust is not lost.”
In 2014, while she was still undergoing treatment, Rumi met her second husband, Megat Azman.
She confesses that it wasn’t easy for her, since she felt like “less of a woman, without breasts”. She even tried to convince him to leave her and find someone else instead but he refused.
“He told me he wanted to spend the rest of his life with me and take care of me.”
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With the blessings of her children, Rumi and Megat got married in July 2015.
At the start of 2017, Rumi was constantly nauseous and vomiting often. At first, she thought it was just the side effects of her ongoing radiotherapy and chemotherapy sessions.
The symptoms were so prolonged that her concerned doctors scheduled her for an MRI.
But a week before the MRI, she felt a kick in her tummy. Her mothering instinct kicked in and she went to see a gynaecologist instead, who gave her the good news — she was 26 weeks pregnant! She had never suspected it because due to her treatment, she rarely had periods to begin with.
Puteri (Princess in Malay) was born in July 2017.
Rumi says: “It felt so odd to be a mother again in my 40s. Nurses gave Puteri to me to breastfeed and all I could say was, ‘I don’t have any, anymore’.”
How cancer changes a family
Puteri is an inquisitive five-year-old now. She’s the baby of the family, doted on by her adult siblings, some of whom, like Naziera, have moved out to start families of their own. Once, Puteri asked her mother about all the scars on her body from her surgeries.
Rumi says quietly: “I wasn’t ready to tell her about it, but promised her I’d tell her when I get older.”
There were many questions Rumi still has about breast cancer too.
Is there a cure for breast cancer?
Scientists don’t speak in absolutes.
“Honestly speaking, it is unrealistic to expect that there is absolutely no chance of cancer relapsing,” says Jingmei.
She explains that the majority of patients who get treatment for breast cancer will find success and the chance of recurrence could decrease over time. Nevertheless, each individual and each tumour is biologically unique, every case is different from the other.
Jingmei says: “Hence, to say a blanket cure for breast cancer will be available soon is hard to substantiate. The best strategy is still to monitor closely and do frequent follow-ups with your doctor.”
Are there other ways to identify breast cancer?
Mammograms are regarded as a reliable screening tool for breast cancer but it can be an uncomfortable or even painful experience.
While some tolerate the pain, it can be a deterrent for others to go for screenings.
Rumi says: “I have friends who struggle doing the screening, especially those with smaller breasts.”
While there aren’t alternatives for mammograms, there are still other imaging methods such as breast ultrasounds, which can be less effective at detecting early signs of cancer and MRIs, which can be more expensive.
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That’s why Jingmei wants to change the attitude that women have towards mammograms. Instead of focusing on making it a choice between taking an uncomfortable test or not detecting early signs of cancer, she wants to treat it as a holistic health package instead.
In other words, make it a lifestyle habit, instead of a medical procedure.
Imagine, if mammograms were to be packaged with other lifestyle procedures such as facials, massages, manicures or pedicures, says Jingmei, they may feel less clinical and more inviting.
Women might be more inclined to go for such sessions.
That could make breast cancer screening can be more #instaMAMMOGRAMmable, she says.
How often should you check yourself for breast cancer?
Both Jingmei and Rumi advise all women above the age of 40 to go for regular breast cancer screenings.
You should also check for lumps while showering — there are many handy guides to monthly breast self examinations.
If you suspect something amiss, visit a doctor for further check ups.
And it’s not something just for women, says Jingmei. Spreading awareness about early detection is an important overall part for women’s empowerment and clinical health.
She says: “Spreading breast cancer awareness is not a task that one person can do. We need as many voices as possible! Men, women, young, and old!”