In 2013, Teresa Littlewood Basoglu’s world unravelled after a stage-one breast cancer diagnosis. She didn’t know where to turn nor what to expect. The prospect of navigating Hong Kong’s complex health-care system and making countless decisions was daunting. However, support from strangers became invaluable to the then 49-year-old. A friend put her in touch with Rachael Lawrence, a breast cancer survivor. Breast cancer is the most common form of cancer that afflicts women in Hong Kong. According to the Hong Kong Cancer Registry, one in every 15 women will develop breast cancer before the age of 75. The two bonded fast. Lawrence dished out emotional support and tips on navigating the city’s health-care system. Importantly, Lawrence gave Basoglu, a British native, a sense of what lay ahead. “It was so nice to meet someone who had been through it, come out of it on the other side … and looked great,” Basoglu says. Basoglu’s treatment included radiation therapy and five years of hormone treatments. “She made me see the light at the end of the tunnel,” says Basoglu, talking about Lawrence’s invaluable support. This support left an indelible mark on Basoglu, so much so that she wanted others to benefit similarly. In April 2013, the pair launched a private Facebook group, Cancer Connect Hong Kong, targeting English-speaking women in the city affected by cancer. The group has about 50 members who meet once a month. Some attendees offload their fears and anxieties while in active treatment; others discuss their life post-cancer. They share practical tips, answering queries such as where wigs and breast prosthetics can be bought. Sometimes they dispel misinformation garnered from the internet. “If you eat a grapefruit a day, will it make the cancer go away?” (The answer is no.) As group moderator, Basoglu also matches new members with survivors of the same type of cancer so they can better support each other. She also organises Christmas gatherings and other events, as this community has grown not just as a therapeutic peer support group but also a social one. Many of the usual big cancer centres … I don’t think it’s that they don’t want to do it, but they do not have enough resources and time and training [for staff] to understand this particular group of [non-Chinese-speaking] patients Dr Janice Tsang, a specialist in medical oncology A veteran of the group is Catriona Rogers, a stage 2B breast cancer survivor from Scotland who was diagnosed in 2013. Rogers completed more than two years of treatment involving surgery, chemotherapy, targeted therapy and complementary medicine. She attends sessions of other cancer-focused NGOs alongside Cancer Connect’s meetings, as they fulfil different needs. Having struggled to find support groups for English speakers, Rogers found Cancer Connect filled that gap. “I understand we are a minority but I was still surprised [the city] didn’t have something for English speakers,” says Rogers, who has been in Hong Kong for 44 years. As a counselling psychologist by profession, Rogers knew the value of support. “Cancer is a body-mind-spirit disease and doctors here are amazing in taking care of your physical self … but on the emotional and spiritual aspects, you’re left on your own,” she says. Her family had been wonderful in her, but Rogers felt she couldn’t burden them further, so the Facebook group became an emotional outlet. “This group is really powerful because you’re all on the same journey, so they both empathise and sympathise … they can have compassion for your situation and know what you are feeling,” she says. In January 2014, while she was having chemotherapy, the group became an emotional lifeline. “I perceive myself as a strong woman, but I was on my knees and didn’t think I could continue,” she recalls. Rogers reached out to one of the members in a one-hour call in which she openly shared that ordeal. “When you connect … at some level there is love, and love heals,” she says. Rogers continues to attend sessions to give back and give hope to the newly diagnosed. “Some of the new ladies have been through a rough time, so it’s nice to have ladies like Catriona, who had been through it, to look at and say, ‘I’m going to be like her one day,’” Basoglu says. According to Dr Janice Tsang, a specialist in medical oncology and honorary clinical assistant professor at the University of Hong Kong, cancer patients go through many routines, medical reviews from doctors, and phases such as biopsies and staging of the disease, as they wrestle with a number of decisions. “Some of the unmet needs are anxiety, worry of confirmation, and when [the disease is] confirmed, they have the preoccupation that this is a death sentence,” Tsang says. Having a background in psycho-oncology and psychology, Tsang looks at not just the physical but the psychosocial sides of patients upon their first visit. If patients exhibit high anxiety, for example, she recommends them to NGOs or other organisations. Tsang encourages patients to seek support from their peers, but she concurs with Rogers that for non-locals, groups for Hong Kong’s English-speaking population are lacking. “Many of the usual big cancer centres … I don’t think it’s that they don’t want to do it, but they do not have enough resources and time and training [for staff] to understand this particular group of patients, as different cultures have special unmet needs as well,” she says. Dr Wendy Lam Wing-tak, an associate professor and division head of behavourial sciences in the school of public health at the University of Hong Kong, agrees on the importance of support and has conducted much research in this area. That includes a study she led, published in 2010, that looked at 285 Chinese breast cancer patients in the first year of diagnosis. She found that 66 per cent of participants who showed psychological resilience had good social and peer support. “These patients that tend to be very optimistic have personal capacity to go out to look for resources to help manage their challenges,” Lam says. A cause for concern, though, was the 10 to 20 per cent of participants harbouring chronic distress and a pessimistic outlook. Six years later, the researchers reassessed 186 people from that study’s sample on various psychosocial measures. The distressed group continued to show worse psychological outcomes, including poor social functioning and poor quality of life. That study was published in the journal Psycho-Oncology in 2012. “That’s why we advocate the need to pay attention to this group who tend to be pessimistic and have little social support including peer support,” she says. Pancreatic cancer survivor tries wellness therapy with positive results Peer support is vital to reducing the uncertainty of patients’ cancer journey and building their confidence. Given the limited consultation time patients have with doctors, such support plays a greater role for patients in Hong Kong, Lam says. Basoglu recently set up a cancer group for men, a surprisingly challenging endeavour. “Men in general are not as forthcoming than women when it comes to showing their feelings, so it’s been hard to get them to come along,” she says. However, with the help of a recent post on the Hong Kong Moms Facebook group, a few women nudged their male loved ones to join the first session on June 9, having sensed their wish to talk to peers. “I think it will gain popularity once we get it going,” Basoglu says. For more information email email@example.com or join Cancer Connect Hong Kong on Facebook.