If you or someone you love has just been told "it's cancer", you are probably holding more questions than answers right now. That is completely normal. This guide walks you through the first few weeks after a cancer diagnosis in Singapore, one step at a time.

You don't need to read it all at once. Bookmark it, come back to the section you need, and share it with the people walking beside you. Every cancer and every person is different, so treat this as a map to help you ask better questions, not a replacement for your medical team's advice.

The first few days: give yourself room to breathe

A diagnosis can bring shock, fear, numbness, anger or even a strange calm. There is no right way to feel. Many people say the waiting, between tests and between appointments, is one of the hardest parts.

A few things that can help in these early days:

• There is usually time to plan. For most cancers, taking a few days to understand your diagnosis and plan does not change the outcome. Ask your doctor how soon treatment needs to start, so you know how much time you have to think.

• Bring someone with you. A family member or friend can take notes, ask questions you forget, and help you remember what was said. Many doctors are happy for you to record the conversation if you ask first.

• Be careful with late-night searching. Online survival figures are often outdated and describe large groups, not you. Write your questions down and bring them to your care team instead.

• Decide who to tell, and when. You don't owe anyone an announcement. Some people tell a small circle first and ask one trusted person to share updates with everyone else, which saves retelling the story again and again.

• Look after the basics. Eat when you can, rest when you can, and let people help with meals, lifts and errands. Saying yes to help is not a weakness.

If the feelings become overwhelming, you are not alone. Hospital medical social workers and psychologists support patients and families every day, and you can ask your care team for a referral at any point.

Understanding your diagnosis

Knowing exactly what kind of cancer you have helps you take part in decisions about your treatment. You don't need to become an expert, but a few terms will come up again and again.

• Pathology (biopsy) report: describes the cancer cells under the microscope, including the cancer type, grade (how abnormal the cells look) and sometimes markers such as hormone receptors or genetic changes that guide treatment.

• Staging: describes how large the cancer is and whether it has spread. Many cancers use the TNM system (Tumour, Nodes, Metastasis), summarised as stage 0 to 4. You may need scans such as CT, MRI or PET before the stage is confirmed.

• Treatment intent: your doctor may describe treatment as aiming to cure, to control the cancer for as long as possible, or to ease symptoms. It is okay to ask which applies to you, and also okay not to ask until you are ready.

Questions to bring to your oncologist

1. What type of cancer do I have, and what stage is it?

2. What are my treatment options, and which do you recommend? Why?

3. What is the goal of this treatment?

4. How soon do I need to start, and how long will treatment take?

5. What side effects should I expect, and which ones need urgent attention?

6. How will treatment affect my work, family life and fertility?

7. Is there a clinical trial I could be considered for?

8. Roughly how much will treatment cost, and is it on the Cancer Drug List?

9. Who do I call after hours if something feels wrong?

Ask for copies of your reports and keep them together. You will need them for insurance claims, second opinions and future appointments.

Getting a second opinion

Seeking a second opinion is common and good doctors expect it. It can confirm a plan, offer another option, or simply give you peace of mind. Ask your current team for your reports, scans and slides, and check with your insurer whether the consultation is claimable. If your doctor says treatment should start soon, ask how much time you have to seek another view.

Getting to know your care team

Cancer care is a team effort, and knowing who does what makes it easier to ask the right person. Depending on your cancer and hospital, your team may include:

Many hospitals hold a tumour board, where specialists discuss your case together and agree on a recommendation. You can ask whether yours has been discussed.

Public or private care?

Singapore offers cancer care at public hospitals and national cancer centres, and at private clinics and hospitals. Subsidised care at public institutions depends on your citizenship or residency and a means test, while private care usually offers more choice of doctor and shorter waits at a higher cost. Many people use a mix, for example a private consultation alongside public treatment. Your insurance coverage will often shape this choice, so check it early.

Money, insurance and financial help

Worrying about cost is one of the most common concerns after a diagnosis, and it is worth tackling early so it doesn't add to the stress later.

The single most useful step: ask to see a medical social worker at your hospital. They can explain your options and help you apply for assistance.

If you are visiting private oncology clinics, the care team would likely also conduct financial counselling sessions to walk you through the estimated costs, how much your insurance would likely be able to cover, and any other associated costs during the course of your treatment that might require out of pocket payment or have a copay element.

Check what you are already covered for

Before treatment starts, gather your policies and check:

• MediShield Life: the basic national health insurance plan for Singapore Citizens and Permanent Residents.

• Integrated Shield Plan (IP) and riders: private plans that add coverage on top of MediShield Life, often for private hospitals or higher ward classes.

• Critical illness or cancer insurance: many policies pay a lump sum on diagnosis, sometimes even for early-stage cancer. Read the definitions carefully and claim early.

• Employer group insurance: your company plan may cover specialist visits or hospitalisation.

• MediSave: your CPF medical savings can be used for approved treatments, within set limits.

The Cancer Drug List

Since September 2022, MediShield Life and MediSave only cover outpatient cancer drug treatments that are on the Ministry of Health's Cancer Drug List, and private Integrated Shield Plans were aligned to the list from April 2023. Each treatment on the list has its own monthly claim limit. The list is updated regularly, so ask your oncologist whether your recommended treatment is on it and what you can expect to pay. Inpatient cancer drug treatments are covered separately under inpatient claim limits.

If you need more help

• Medication Assistance Fund (MAF): helps subsidised patients at public healthcare institutions pay for selected high-cost drugs, based on a means test.

• MediFund: a government safety net for Singapore Citizens who are subsidised patients and still cannot afford their bills after other support. Your medical social worker can help you apply.

• Singapore Cancer Society: offers several schemes, including a one-time Cancer Care Fund for newly diagnosed patients from lower- and middle-income households within six months of diagnosis, a Welfare Aid Fund for daily living and medical supplies, and transport to and from treatment.

• Other charities: groups such as the Breast Cancer Foundation, 365 Cancer Prevention Society and AIN Society also offer financial and practical support.

Schemes and limits change from time to time, so always confirm the latest details with your hospital or the official websites listed at the end of this guide.

Work and time off

Some people keep working through treatment, some reduce their hours, and some stop for a while. There is no right answer, only what works for your body, your finances and your treatment schedule.

• Sick leave: under the Employment Act, employees who have served at least six months are entitled to up to 14 days of paid outpatient sick leave and up to 60 days of paid hospitalisation leave a year. The 60 days include the 14 outpatient days. Shorter service earns a pro-rated amount, and many employers offer more than the minimum.

• Flexible work: since December 2024, employees who have completed probation can make a formal request for flexible work, such as working from home, adjusting hours or reducing workload, under the Tripartite Guidelines on Flexible Work Arrangement Requests. Employers must consider requests fairly.

• Telling your employer: you decide how much to share. It can help to speak with HR about leave, insurance and adjustments before treatment starts, and to agree who else needs to know.

• Self-employed or between jobs: speak with your medical social worker early about financial assistance, as the schemes above can help when income stops.

Practical tips for staying organised

Treatment brings a lot of appointments, paperwork and new information. A little organisation early on can save a great deal of stress.

• Keep one folder for everything. Reports, scan results, bills, insurance letters and appointment cards in one place, physical or digital. Take photos of each document as a backup.

• Carry a question notebook. Jot down questions as they come to you and bring the notebook to every appointment. Write the answers next to each question.

• Use a shared calendar. Add appointments, treatment days and test dates, and share it with the people helping you so they know when you need a lift or company.

• Keep a side-effect diary. Note symptoms, when they started and how bad they were. Your care team can adjust treatment and medicines more easily with this information.

• Save important numbers in your phone. Your oncologist's clinic, the after-hours line, your cancer nurse, and your insurer's claims hotline.

• List your medicines. Include supplements and traditional remedies, and show the list to your doctor, as some can interact with cancer treatment.

• Pack a treatment-day bag. A water bottle, snacks, a warm layer, a phone charger and something to pass the time make long days easier.

If you are a caregiver

When someone you love is diagnosed, your life changes too. Caregivers juggle appointments, medicines, meals, work and their own worries, often quietly and without much support of their own. Our caregiver guide covers working with the care team, caring at home, financial help and looking after yourself.

Finding community: you don't have to walk this alone

One of the most helpful things after a diagnosis is talking with people who have been where you are. Someone a few steps ahead can tell you what to pack for chemo, how they handled telling their children, or simply say "I know" in a way others can't.

Support groups in Singapore

Hospitals, cancer centres and charities run in-person support groups, many organised by cancer type. The Singapore Cancer Society, the National Cancer Centre Singapore, and groups such as the Blossom Support Group at Singapore General Hospital for breast cancer are good places to start. Ask your care team or medical social worker which groups suit you.

In-person groups are valuable, and we encourage you to join one. But they meet at set times, and the hardest moments often come in between: at 2am before a scan, after a difficult appointment, or on a day you can't face leaving the house.