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After sarcoma 'miracle', NUH doctor wants to help others and find a cure

SINGAPORE – Dr Grace Moshi, 57, used to be, in her own words, a “perfectionist” and “hardcore” medical scientist who trusted nothing but published data. But surviving a rare cancer changed her outlook on life and the way she practises medicine.

Dr Grace Moshi wants to increase survival rates and find a cure for sarcoma.

Dr Grace Moshi wants to increase survival rates and find a cure for sarcoma.

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SINGAPORE – Dr Grace Moshi, 57, used to be, in her own words, a “perfectionist” and “hardcore” medical scientist who trusted nothing but published data. But surviving a rare cancer changed her outlook on life and the way she practises medicine.

Diagnosed with an aggressive form of sarcoma in 2008, Dr Moshi, who was born in Tanzania  and working in Africa then, was given six months to two years to live.

Sarcoma is a general term describing a group of malignant cancers that arise from connective tissue cells such as the bone, cartilage, muscle, nerves, deep skin tissues and fat cells. It can arise anywhere in the body, such as in the breast, ovary, lung and stomach.

Sarcoma accounts for about 2 per cent of adult cancer diagnoses in Singapore, according to the Ministry of Health (MOH).

“Before my experience with cancer, if something wasn’t published data, I didn’t believe it. If my patients wanted to try certain treatments, like traditional Chinese medicine, I would say ‘no, no, no. It hasn’t been tested’. But I survived against all odds. I’m more chill now,” said Dr Moshi, a haematologist or specialist in blood conditions, in an exclusive interview with TODAY.

The director and founder of the Sarah-Grace Sarcoma Organisation Singapore as well as the Sarah-Grace Sarcoma Foundation, Australia, Dr Moshi is also a senior consultant at the department of laboratory medicine at the National University Hospital (NUH).

Dr Moshi’s symptoms had been vague at first: A “fullness” in her left ankle which various doctors had dismissed as harmless. She eventually requested for surgery to remove the lump, as she noticed it had grown after accidentally twisting her ankle.

“I asked my doctor to do an operation. He told me it was likely just a little bit of fat, a lipoma, which is benign. Because he didn’t think it was dangerous, he cut right through the lump and after that, it started growing rapidly,” she said.

Dr Moshi, whose three children were in their teenage years at the time of her diagnosis, had her ankle “shelled out” to remove the rapidly growing cancer. She required extensive transplants from her thigh to ankle and underwent radiotherapy.

Not one to dwell on death, the terminal prognosis spurred Dr Moshi to round up a group of friends, many of them from the medical community, to establish a foundation that looked into research for newer, better therapies for sarcoma. She had hoped for them to continue the research after her death.

“At the time, all I wanted was a bit more time to see my kids through school, to see them graduate. I also offered up my organs for research, should I die, so they can be used for sarcoma research. We set up everything, kickstarted research and then, I didn’t die. I got to the five-year (cancer-free) mark, and now – touch wood – I’ve gotten to the 10th year,” she said.

Until now, Dr Moshi isn’t certain how she had survived the cancer but guessed that good treatment – 10 of her colleagues had been present during her surgery – might have played a role.

“Statistically, the oncologist who gave me the prognosis was correct. The cancer was growing very rapidly after it was cut through. They talked about my case (as) the miracle survivor. A few other people who underwent treatment at the same time, none of them survived, unfortunately. I’m truly grateful to have survived,” she said.

FROM DOCTOR TO PATIENT

Her experience switching sides – from doctor to patient – and spending two years in a wheelchair following the extensive surgery and radiotherapy allowed her to see things in a different light.

“I struggled very much with the fact that I was on the other side of the patient’s bed. From a medical practitioner, I became the ‘Sarcoma in Room 2501’, which I had overheard the nurses calling me. That was terrible,” she said with a laugh.

The standard way that doctors communicated with patients also troubled her.

“As a clinician, you are always so used to leaning over the patient lying on the bed. I wanted to discuss things with my doctor on an even plane, not when I’m lying in bed and feeling helpless. Before I became a patient myself, I had not realised that patients might sometimes feel that too. It’s the subtleties you wouldn’t know until you have faced it yourself,” said Dr Moshi, who has since changed her way of communicating with patients.

When asked if she was a “good patient”, Dr Moshi said she did not always adhere to her doctor’s orders.

For instance, she was prescribed morphine and painkillers to help her cope with the pain but was so worried about becoming addicted that she flushed them down the toilet bowl.

“I shouldn’t have endured so much pain but I wanted to be in control,” she said.

Since then, Dr Moshi has given much of her time, without remuneration, to establish a global movement to raise sarcoma awareness and support patients in their journey.

For instance, the Sarah-Grace Sarcoma Organisation Singapore, which received charity status earlier this year, is looking to provide financial support to help five to 10 children with sarcoma access novel immunotherapy each year. And in Australia, the foundation has active campaigns in schools to raise awareness of the disease.

“I see life as a gift now. The gratitude of having survived (the cancer) has somewhat turned this into a calling. It’s my way of giving back,” she said.

HOPE FOR A CURE

Dr Moshi also has big dreams of finding a cure for the disease, which currently has a high mortality rate.

She said sarcoma research has not attracted as much funding and interest as other more common cancers due to its complexity. There are currently over 50 subtypes of sarcomas.

Research funded by her foundation has already made headway after identifying how the cancer metastasises.

The non-profit organisation established a PhD award programme, through which it is conducting research at the John Curtin School of Medical Research at the Australian National University. It is also currently funding grants for the support of sarcoma research at NUH and the KK Women’s and Children’s Hospital.

“We don’t completely understand the mechanisms (for its spread) but our research in Australia has found that sarcoma tends to metastasise to the lungs and developed molecules to block this metastasis to improve survival rates,” she said.

The molecules are currently being trialed in Australia and, soon, in Singapore.

Citing the strides made in treatments for the human immunodeficiency virus due to solid research funding, Dr Moshi said: “Studies have shown that the more funding you give to research for a disease, the better the outcome.

“Sarcoma is the deadliest form of cancer… yet it receives the least amount of study and is poorly understood due to lack of high-level research. Through our efforts, we hope to increase survival rates and make sarcoma a curable disease.”

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