Near the beginning of 2022, I discovered an ulcer on my tongue. One of those things you don’t think very much about—a little painful and irritating, that’s all. I saw a GP when it didn’t go away after a few weeks and he gave me ulcer medication. When that failed to work, I visited my dentist. I had my own theory as to why I had a recurring ulcer—one of my teeth must have gone out of place and it was now scratching my tongue, leading to an abrasion. It was on my second visit to the dentist, after he had already filed my tooth down, that he told me quite seriously to see an oral surgeon.
I got a biopsy done immediately. The diagnosis came a week later: tongue cancer. Tongue cancer isn’t a common cancer. I understand there is a specific demographic that tends to get it—men over 45 who smoke. I don’t fall into that category. But there’s no point in agonising over ‘why’ when it comes to cancer. Behind every case, there could be multiple factors, not just one cause.
My diagnosis filled me with regret. Why had I wasted months in between noticing the ulcer and finally getting it checked out? I had delayed proper medical attention because I was travelling, working and life had gotten in the way. It had never crossed my mind that it could be something serious.
When it comes to cancer, the approach to treatment is unique to each patient, depending on the stage of the disease. My ulcer appeared small, so the plan was to surgically remove it and radiate the surrounding areas in the event of any spread. Then, I’d be done.
After receiving the pathology report from my surgery, I sought a second opinion to verify that this treatment plan was the right one. My second set of doctors took no pleasure in telling me this, but they recommended a second surgery to make sure the margins were clear.
Anyone familiar with the cancer journey would understand that if a tumour is operable, doctors want to make sure that the margins are as clear as possible. You don’t just remove the tumour, you remove the portion around it as a buffer, so as to reduce the chance of cancer cells spreading.
Of course, it was hard receiving such news—knowing that after all the progress I had made after my first surgery, I had to go back into the operating theatre for a second one.
Yet, it was a no brainer for me. Sitting there in the clinic, I told them to do what they needed to to give me the best chance of surviving this. It was a clarifying moment. My job was to live, not to act.
“I’m living from scan to scan, so I don’t plan too far ahead of time”
More than half my tongue has now been surgically removed. It’s very obvious when I speak. I’m in speech therapy, and it is slowly improving over time. But I’m an actor—I can’t help but have high expectations of myself when it comes to clarity and articulation.
Three weeks after my second surgery, I was shopping in a Lululemon store. You know how they ask for your name so they can write it on the door of the changing room? I had to repeat my name five times before I could be understood. I thought, ‘Oh my god. If I can’t even say my name, what am I going to do?’
Still, it’s a small price to pay for being well. Even though there is a part of me that mourns and grieves for my voice, I’m learning to accept that there is a limit to how perfect my speech will be, since physiologically, my tongue has completely changed. Being able to accept that, to me, is part of the emotional recovery from the trauma of the illness.
I try not to let it bother me. In fact, I try to talk to as many people as I can. Rather than isolate myself due to embarrassment or fear, I feel it’s important for me to be social, to attend events or weddings, to meet friends and industry folk, so that everyone can get used to my new voice—and so that I can get used to it too.
I have no expectations of going back to work in front of a camera or on stage. It is something I am slowly letting go of. If it happens, that’d be great. But I have been performing for over 30 years now. My husband had said something to me very early on in this journey, when I was wondering if I could ever act again. He said: “We have so many other mountains to climb. Why do we feel the need to keep going back to this one mountain?”
His words made me question what I was clinging to and why. For those of us who are artists or creatives, our work is a huge part of our identity. It might be time for me to figure out—who am I outside my work? Am I willing to evolve? Am I willing to let go?
A month after my second surgery, I started six weeks of radiation. I also had adjuvant chemotherapy, which was explained to me as a way of enhancing the radiation treatment by targeting any cancerous cells that may have randomly moved to other parts of the body.
Radiation was five days a week, and the actual radiation process lasted only 10 minutes. You don’t feel any pain. Similarly, the weekly chemotherapy I underwent was intravenous, so the drugs went straight into my body and I didn’t feel anything.
The side effects always come after. In my case, my mouth slowly filled up with painful sores and ulcers. By the third week of radiation, it was becoming too difficult to eat solid food or even soup, so I went on a pure Ensure milk diet for the six weeks that followed.
As the treatment progressed and the side effects worsened, building a sense of daily routine became a vital way of maintaining calm and optimism. I meditated, I journalled, I jigsaw-ed, I read a lot of books. To avoid losing too much weight, I put myself on a strict schedule of drinking five to six packets of fortified milk a day. I would go for short walks to get fresh air and exercise. I said yes to having visitors twice or thrice a week because it made me happy to see my family and friends. I said yes when friends wanted to drive me to hospital or send me ice cream because I knew it was the only way they knew how to help, and I knew they so badly wanted to.
I joked with my directors, Ivan Heng and Ong Keng Sen, that my treatment journey was like being in a terrible theatre production where you hated the script and couldn’t get along with your castmates. The show had to go on anyway, so what do you do? Put on your rehearsal clothes, suck it up and turn up every day. You’ll get to the end eventually, why not find some joy along the way?
I am now roughly five months out of treatment. My scans have been clear. Cancer patients are most vulnerable in the first two years of cancer care, so the doctors monitor us closely for any relapses or recurrences. Who’s to say what might happen? The verdict is still out.
I am privileged to have had most of my medical expenses taken care of by MediSave and insurance. That’s something I will advocate to no end about, especially for people who are freelance or gig workers. If there’s one thing you should be spending some money on, it’s making sure you are well protected because that has allowed me the freedom to seek treatment, to rest, to not be stressed out about rushing back to work.
The timing of this illness is most ironic as I was awarded a knighthood by the French government literally weeks before I got my diagnosis. [Editor’s note: In 2022, Koh was awarded the title of Chevalier des Arts et des Lettres (Knight of the Order of Arts and Letters) for significant contributions to the arts and literature.] I know there are many who are eager for me to get back on my feet—to get back on stage or to do some form of creative work. Perhaps we see work as a way of being productive, of not wasting talent and potential.
But I’ve spent so many years working. I work in theatre and television, where the hours are long. Since my sons were born, I have always felt like I didn’t have enough time with them. I have missed birthday dinners and important family occasions because I was away at a theatre show or on a touring production.
Now, I feel like I’m making up for lost time. I’m home when the kids come back from school. I have time to drive them to places they need to go. We sit down for dinner together and talk about how their days went. This time to be present with my family is a real luxury. Even if it is under these circumstances, it is a gift.
I’m in a liminal space now where death doesn’t feel as far as it once did. I’m living from scan to scan, so I don’t plan too far ahead of time. These first few years after cancer are delicate.
It’s become important for me to live my days well—and mindfully—irrespective of the outcome. I don’t skip breakfast anymore. I do yoga, or a workout, or go on a hike in the morning. There is no fixed routine. Sometimes I spend my afternoons meeting up with friends. Sometimes I stay home, reading, doing a jigsaw or just pottering about. And I still find a lot of joy in going to the theatre.
Photography Sayher Heffernan
Styling Desmond Lim
Fashion assistants Guo Lile and Cecilia Qi
Hair and make-up Zhou Aiyi/Makeup Entourage
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