Marianne Tan, a 33-year-old counselor-in-training, and dedicated spin instructor, shares her cancer journey with Pang Xin Yuan, affectionately known as Rat—a 28-year-old civil servant and equally passionate spin instructor.
For over 2 years, their friendship has been shaped not only by their shared passion for fitness but also by their parallel journeys as cancer survivors.
In a candid conversation, Marianne and Rat reflect on the diagnosis that changed their lives, the challenges of treatment, the relationships with their doctors and support systems that kept them going, and the life lessons they’ve carried forward in their shared fight against Hodgkin’s lymphoma.
The diagnosis: From routine checkups to life-altering news
For Marianne, the news came out of nowhere.
"I was diagnosed with Hodgkin’s lymphoma, stage two, during a routine health checkup sponsored by work in 2018,” she recalls. “There were no signs—no warnings. I thought it was just a normal Tuesday until the results came back. The next day, I was admitted to the hospital, and a week later, I started chemotherapy."
Rat’s discovery was more visible but equally unexpected, coming at a time when the world was grappling with the COVID-19 pandemic in 2021.
"It was a swelling on my neck," she explains. "Back then, everyone was talking about the side effects of COVID-19 vaccinations, which I had taken, so I assumed the swelling was one of them, and ignored it. It wasn’t until a masseuse told me it felt ‘too hard’ that I decided to see a doctor. A few scans and a biopsy later, I heard the words: Hodgkin’s lymphoma, stage two."
Hodgkin’s lymphoma is a type of blood cancer that starts in the lymphatic system, a part of the immune system. Lymphomas, as a broader category that includes both Hodgkin’s and non-Hodgkin’s lymphoma, are among the most common cancers in Singapore.
Within days, both women found themselves navigating a flurry of tests, surgeries, and treatment plans to confront the cancers head-on.
Battling cancer treatment together… and finding strength in fitness post-recovery
Upon their doctors’ recommendations, Marianne and Rat underwent 8 doses of chemotherapy, over a span of 4 months, followed by a month of radiotherapy.
Early on, their doctors also recommended egg freezing as the treatments could potentially affect their fertility. Both Marianne and Rat opted not to proceed, citing the costs and their priorities at the time.
"I was 25," Rat explains. "It didn’t seem urgent, so I decided to focus on starting treatment right away."
For Marianne, a significant challenge was her fear of needles. She chose to have a port-a-cath implanted, a device that made the frequent blood draws and medication infusions less painful.
"I was really scared of needles," she admits with a laugh. “So having that option really helped.”
Fitness, particularly indoor cycling—commonly known as ‘spinning’—which was central to both their lives, also became a bittersweet challenge.
Rat, who had been a spin instructor for 3 months before her diagnosis, struggled with being advised to stop strenuous exercise.
"Spinning was my identity," she says. " Losing that was hard as I was advised to not to do strenuous exercise during treatment… which included doing spin.”
“Sometimes, even during treatment, I’d sneak into class, sit in the saddle, and just move my body,” she adds with a laugh.
Marianne remembers seeing Rat during a spin class. "You were bald but still had the energy to be there. I thought, ‘This girl is crazy!’ But it was inspiring."
For Marianne, the loss of certain activities, like hiking and scuba diving, was a harder pill to swallow.
“When I realised that I couldn’t climb mountains or scuba dive anymore because of lung scarring (a side effect) from the chemotherapy drugs… that was harder for me to accept than losing my hair."
Despite the physical limitations, however, both women shifted their focus on the positives, and learned to adapt and slowly reclaim their passions post-treatment.
"Even though I can’t travel to places with high altitude, I’ve taken to snorkeling and smaller hikes," Marianne says. "And now I can spin again… The body’s ability to recover is incredible."
Credit: Marianne Tan
For Rat, she gradually rebuilt her stamina over time, and is thankful to have regained a state of fitness that feels close to normal.
"Now, I feel like I’ve nearly returned to my pre-sickness fitness," she shares with a smile.
Credit: Pang Xin Yuan
The doctors, friends, and communities that made a difference
Both women credit their recovery in part to their affable and experienced doctors, and the extended medical teams at Mount Elizabeth Hospitals and Gleneagles Hospital.
Marianne’s journey began with an unexpected finding during a routine health check-up. Her cancer markers showed no abnormalities, but a chest X-ray revealed a large mass, prompting her doctor to refer her to heart specialist and cardiothoracic surgeon Dr Su Jang Wen.
From there, a multidisciplinary team came together, including medical oncologist Dr Daniel Chan, lung specialist and respiratory physician Dr John Law, and radiation oncologist Dr Lee Kuo Ann to guide her through her recovery.
She describes her doctors as not only in good in what they do, but also "humorous, reassuring, and incredibly human."
"My oncologist, for example, would text me about random things, not just cancer," she says. "It made me feel like I was more than just a patient."
Another incident stands out in her memory:
"Once, I ended up with a high fever in the middle of the night… because of an infection. I was alone, shivering, and panicked. I texted Dr Chan, and he immediately told me what to do and arranged for my hospital admission. Knowing he was just a text message away was a huge comfort."
For Rat, her doctors included ENT specialist Dr Christopher Goh, medical oncologist Dr Kevin Tay, and radiation oncologist Dr Lee Kuo Ann.
Initially, Rat’s relationship with her doctors was more formal. She recalls clamming up during her diagnosis, overwhelmed by the sudden shift from being perfectly healthy to facing cancer, but over time, she began opening up to them.
"Once, during chemotherapy, my doctor recommended a book to me about life after treatment," she recalls. “The book reminded me that cancer wasn’t a death sentence, and this encouragement really stuck with me.”
Support for both women extended beyond their medical teams; Marianne found strength in her close-knit circle of friends, colleagues, and even strangers who had walked similar paths.
"Dr Chan, my oncologist, connected me with another cancer survivor, who shared with me tips for managing side effects of chemotherapy, among other things. Her overall encouragement helped me so much, and it was very comforting to know I wasn’t alone."
Rat, on the other hand, initially found it difficult to open up, grappling with self-doubt and a sense of responsibility for her illness.
"I didn’t tell anyone at first," she admits. "But eventually, people started noticing—especially when my hair was gone. Strangers who had been through cancer themselves recognised the signs and reached out. Slowly, I began to find comfort in talking.”
Embracing life after cancer with hope and laughter
For both women, cancer was an opportunity to pause and reevaluate their lives.
"I used to live on autopilot," Marianne reflects. "Now, I try to live intentionally, appreciating even the small things, like being able to go for a walk."
Credit: Marianne Tan
Rat found herself reassessing her career and lifestyle: "I pivoted to working with youth in the public sector, something closer to my heart. I also started eating healthier and listening to my body more."
Their journeys also inspired them to help others. Marianne, who benefited from a support network, now offers the same to others.
Credit: Pang Xin Yuan
"People message me saying they’ve been diagnosed,” she shares. “It’s a privilege to be someone they can talk to."
Rat nods in agreement. "Marianne was that person for me.”
When asked about their hopes for the future, both women share a common wish: good health and no relapses.
"I just want to live a good, sustainable life," Rat says. "And maybe, one day, start a family."
Marianne adds, "Cancer taught me to appreciate life’s little things, like being able to poop properly after treatment!" They laugh, finding humour even in the toughest memories.
