SINGAPORE - The feeling of powerlessness Raymond Howe felt in the early years of battling cancer is one the triathlete will never forget.

Chemotherapy sessions to treat his skin cancer - with which he had been diagnosed in 2003 and spread to his left lung and brain - were a dreaded affair. He fiercely refused to go for chemotherapy and had to be carried and tied down to a chair for up to five hours as he underwent treatment.

Recalling how excruciating it was, the 55-year-old said: "Chemotherapy is death knocking at your door. I could not do anything, I had to depend on people, it was terrible.

"After chemotherapy, water tasted like mercury, I had no hair, I wanted to die."

With death on his mind, Howe prepared a suicide note and his exit.

Then he found strength in an unlikely source: disgraced cyclist Lance Armstrong's autobiography It's Not About The Bike, which chronicles how the American overcame testicular cancer.

The book resonated with him, instilling in him a sense of belief that he, too, could conquer cancer.

So much so that it inspired him to participate in an Olympic-distance (1.5km swim, 40km cycle, 10km run) triathlon in Miami with no previous training back then.

Using a $49.90 bicycle with a basket he had bought from Walmart just two days before the race, he unknowingly embarked on the first of many races to come.

He finished dead last.

But that mattered little to Howe, whose spirits were lifted as the crowd cheered him on.

It was then that a sense of urgency that had been missing over the last few years returned.

"The moment I crossed the finish line, I was overjoyed. I did it and I felt like I could do better," he said.

He has participated in over 200 triathlons, marathons, Ironmans, swims and cycling races and, on Sept 29, he will be at a race he has not missed since its inception in 2013 - The Straits Times Run.

"It's very unique because it's 18.45km. I like it, it's well-organised, it's good," he said.

Countless hours go into his race preparations. An average day for the chief operating officer of a real estate and hospitality company begins at 2.45am and consists of two to four workouts, which could be a run, swim, cycle or visit to the gym.

On the significance of exercise to him, he said: "If I don't do it, I'll just sit at home, and fear and anxiety will set into me that I have cancer. That's what I fear the most."

As dedicated as he is to the sport, listening to his body comes first.

"There have been times when I've felt a sharp pain in my left lung and I've stopped competing," he said.

In 2016, doctors diagnosed him with thyroid cancer. Two months ago, two more growths were discovered in his neck.

But this has only encouraged Howe to live his life to the fullest.

He frequently gets involved with charity causes and donates the prize money from his races.

It is through his charity work that he honours his brother, who died from cancer in 1989 at age 20.

Howe's effusive optimism towards life spills over to those around him.

His training partner of six years, Kavin Phillips, can attest to that.

The 55-year-old said: "It's tough doing a triathlon, but he makes it seem easy. He's a very positive person; I don't think there's anything he thinks can't be done.

He also noted that once Howe puts his mind to achieving something, nothing can get in the way, adding: "He has a never-say-die attitude. If you're going to run 20km, that's it, you're going to run 20km."

• Sign up for the ST Run at straitstimesrun.com