Warriors & Survivors

Friday, August 15, 2025

Warriors and Survivors - Children Cancer Stories by Rukh Yusuf - Blog # 226

I am Rukh Yusuf, Clinical Pharmacist, also specialized in Total Parenteral Nutrition and Bone Marrow Transplant. I have been working in the Pediatric Oncology unit of a public hospital for several years. The mission of this blog is to bring to you the real-life stories of child patients suffering from cancer. Cancer is still a difficult disease to handle and treat. However, when it strikes the children, some so young that they cannot even speak, their agony is beyond expression and words. Let us pray especially for children suffering from cancer for early and complete remission. May Allah shower His Merciful Blessings upon them. Aameen.

In the heart of Gujranwala, life for most families is a blend of hard work, simple pleasures, and the daily effort to make ends meet. The streets are filled with the noise of motorbikes, street vendors calling out their prices, and the smell of fresh bread from roadside bakeries. For five-year-old Maria, this was the world she knew in a small rented home, the warmth of her mother’s cooking, and the laughter she shared with her older brother in the evenings.

Maria was just like any other child in her neighborhood. She loved wearing her bright pink dress, playing with her cousins. Every morning, she would eagerly pack her small school bag and rush to the gate, waiting for her father to walk her to the local nursery school.

But a few months ago, something began to change. Maria started coming home from school looking tired. She would sit quietly in a corner instead of running outside to play. At first, her parents thought it was the summer heat, or maybe she was just catching colds too often. Then came the bruises small, round marks on her legs and arms that wouldn’t go away. She began complaining about pain in her bones, and fevers became a regular visitor in their home.

Her parents took her to a nearby clinic, where the doctor prescribed medicines for weakness. But when her condition didn’t improve, a more experienced doctor recommended blood tests. The results came back with words her parents had never heard before: Pre B Acute Lymphoblastic Leukemia : a type of blood cancer that affects the bone marrow and blood of young children.

For Maria’s parents, the world seemed to stop. They were not only hearing the word “cancer” for the first time in their family, but they were also faced with a reality they didn’t know how to manage. Cancer treatment meant hospital visits, chemotherapy sessions, blood transfusions, and regular lab work all things that cost far more than the family’s modest monthly income.

In Pakistan, for many families like Maria’s, a diagnosis like this is not just a health crisis, it is a financial and emotional earthquake. Her father, who works long hours in a small workshop, earns just enough to cover rent, groceries, and school fees. Now, every rupee has to be stretched further bus fares to the hospital, medicines not always available in government stock, and the cost of nutritious food for Maria’s weakened body.

The hospital trips have become part of their new routine. Maria clutches her small, worn-out doll during chemotherapy sessions. Sometimes she cries, but often she stays quiet, her big brown eyes fixed on the white walls of the ward. Her mother sits beside her, holding her hand, whispering prayers under her breath. Between treatments, Maria still asks about her school and her friends. She misses sitting on the classroom floor, writing letters in her notebook, and raising her hand when the teacher asked questions.

Her parents try to stay strong in front of her, but at night, when the children are asleep, they sit together in silence counting the days until the next hospital appointment, wondering how they will manage to pay for it, and praying for a miracle.

What keeps them going is Maria’s spirit. One afternoon, during a short break from the hospital, Maria looked at her mother and said, “Ammi, main theek ho jaungi, phir main school jaungi” “Mama, I will get better, then I will go to school.” For her parents, that simple sentence is a reminder of why they cannot give up.

In many neighborhoods across Pakistan, there are families like Maria’s ordinary people who are suddenly pulled into an extraordinary struggle. Their stories rarely make headlines, but they live them every day: the fear, the financial strain, the resilience, and above all, the love that pushes them forward.

Maria’s journey is still unfolding. The road ahead is long, but with each hospital visit, each small improvement in her blood counts, and each smile she manages to give, her family holds on to hope. She is not just a patient; she is a daughter, a sister, a student, and a little girl who dreams of returning to her classroom. And in the small lanes of Gujranwala, that dream is worth fighting for.

Prayers for Maria and all the sick children and their families who have to face this pain of cancer. May Allah make it easy for them. Aameen

Friday, August 8, 2025

Warriors and Survivors - Children Cancer Stories by Rukh Yusuf - Blog # 225

Abdullah doesn’t talk much these days. He never really talked a lot before either, only enough to tell his mother when he was hungry, or to ask for his favorite red car that had gone missing under the sofa. Now, even those small requests have become rare.

At just four years old, Abdullah has been diagnosed with Pre B-cell Acute Lymphoblastic Leukemia (ALL), a term far too long and heavy for someone so small. He doesn’t know what it means. He only knows that hospitals smell strange, the lights are always too bright, and the little pricks in his arm make him cry not because of pain, but because he’s tired of being held down.

What hurts the most is the confusion. Abdullah doesn't have the words to explain what he's feeling fatigue that turns into tantrums, discomfort that becomes silence, and fear that hides behind his big eyes. For a child who hasn't yet learned to name emotions, this journey is lonely in a way that even adults around him struggle to understand.

His mother, Amina, stays by his side. She hasn’t returned to her stitching work for weeks, though clients still call. The family’s second income is paused indefinitely. Abdullah’s father, Imran, divides his time between hospital visits, managing two shifts at a garment factory, and making sure his other children are fed and safe at home. They haven’t sat together as a family in days. They eat in turns now. Conversations revolve around test results, travel to the hospital, and how to pay for tomorrow’s blood work.

At the cancer ward, there are no grand declarations of strength. Only quiet negotiations: with pain, with time, with finances. Treatment brings hope, yes but also exhaustion. Some days, Amina watches Abdullah sleep and wonders whether he dreams of his old toys, or if those too have begun to fade from memory.

There are small joys that persist. Abdullah sometimes smiles when a nurse offers him a sticker, or when another child waves from across the room. He still smiles when he sees mango slices his favorite treat, though now he’s too nauseous to eat more than a bite. These moments are delicate and brief, but they are real. They don’t scream of victory, nor do they deny the struggle. They simply exist like Abdullah, quietly trying to make sense of a world that suddenly changed without asking him.

In many ways, Abdullah is like thousands of children in Pakistan who are diagnosed with cancer too young to understand but forced to endure. And his parents, like many others, navigate a daily equation that never seems to balance time, money, care, survival.

There is no ribbon-wrapped ending to this week’s story. Only a pause a space to see Abdullah, to sit with his silence, and to remember that sometimes the hardest part of childhood illness is not the pain, but the isolation of not knowing how to speak about it.

And yet, even in silence, Abdullah is present. Watching. Feeling. Waiting.

Prayers for Abdullah and all the sick children and their families who have to face this pain of cancer. May Allah make it easy for them. Aameen

Friday, August 1, 2025

Warriors and Survivors - 224

Children Cancer Stories by Rukh Yusuf - Blog # 224

Saqib Raza is twelve. He’s the kind of boy who didn’t sit still much. He ran fast. Played long. Knew every cricket ball in the street by its sound. His legs were his rhythm.

It was during a game that he fell. A rough patch of ground, a misstep—nothing that doesn’t happen to a boy once a week. He held his knee for a minute, then walked it off. That night, it swelled. His mother wrapped it with cloth soaked in warm salt water. She thought maybe he twisted it. He thought maybe he did, too.

But days passed. Then weeks. He started limping. Said it hurt “inside the bone.” That was a phrase that made his father pause. You don’t ignore pain when it reaches the bone.

They took him to a local clinic. Then another. Painkillers, rest, and reassurance followed. But the swelling stayed. The limp grew heavier. He stopped running altogether.

The diagnosis came slowly. X-rays in Sheikhupura, referrals to Lahore, and then an MRI. A biopsy was next. It wasn’t an infection, they said. It wasn’t just an injury. It was osteosarcoma —a bone cancer. And by the time they found it, it had already spread. Metastatic - that’s the word the doctor used.

Saqib didn’t ask what it meant. He just asked if he’d be able to walk again. The doctor didn’t answer right away.

Now he’s in the oncology ward at a hospital he’d never heard of before this year. He wears a mask, a hospital wristband, and a look that’s hard to name—somewhere between boredom and fear. Chemo has started. His body is starting to feel the weight of it. His legs, once always moving, now mostly rest under a cotton blanket. Sometimes he draws, though not much. He doesn’t like showing anyone what’s on the page.

His mother hasn’t been home in weeks. She sleeps on the bench next to his bed, folded into herself. His father travels back and forth from Muridke, juggling borrowed money and missed shifts at the factory. They haven’t told Saqib exactly how serious things are, but he’s not slow. He watches people when they think he’s not looking. He knows things aren’t simple.

Osteosarcoma is rare. And when it spreads, especially to the lungs, the road ahead becomes longer and harder. The treatment plan includes months of chemotherapy, possible surgery, and then more chemo. The doctors talk about response rates and staging. But Saqib doesn’t speak that language. His language is different.

He asks if his brother is using his cricket bat back home. He asks if he can bring his dog next time. He asks if there’s Wi-Fi on the third floor.

There are moments when he seems like just another 12-year-old. But there are others quiet, ordinary moments when you see the weight he carries. Like when he tries not to wince when the IV goes in. Or when he turns to face the wall so his mother won’t see the tears.

This story doesn’t have a resolution. He’s not healed. He’s not gone. He’s somewhere in the middle, suspended between a life that was full of running and a present that asks only for patience.

His parents don’t talk about the future much. They’re too busy surviving the present. Meals are shared on stairwells. Medicines are discussed with strangers. Prayers are whispered between phone calls to home.

Saqib doesn’t say much about what he feels. But one day, out of nowhere, he asked his mother, “Am I going to stay like this?”

She didn’t have an answer. She just ran her fingers through his hair and told him to sleep.

Prayers for Saqib and all the sick children and their families who have to face this pain of cancer. May Allah make it easy for them. Aameen

Friday, July 25, 2025

Warriors and Survivors - 223

Children Cancer Stories by Rukh Yusuf - Blog # 223

I’ve seen her smile more than I expected.

Momina is eight. From Lahore.

She has beta-thalassemia major—the kind where the body can’t make enough functional hemoglobin, and life becomes a balance between blood transfusions and iron overload. Her parents bring her to the outpatient unit twice a month. I see them in the waiting area sometimes—quiet, focused. Her father mostly listens. Her mother mostly holds everything together.

You learn, over time, not to look at thalassemia only as a disease. You start seeing it as a long story—told in lab reports, ferritin levels, side effect charts, and yes, in the faces of children like Momina. She looks small for her age, but her eyes are curious, watching everything. During a recent visit, she asked me if medicine can make blood. Not a transfusion. “Medicine that tells my body to do it,” she said.

There’s no easy answer for that. And I didn’t give one. I just said, “We’re working on it.”

For Momina, treatment is a full-time commitment. Her medications include iron chelators to reduce iron accumulation caused by frequent transfusions. Without chelation, iron builds up in her liver, heart, and other organs—something that can quietly turn dangerous. We’ve shifted her from deferoxamine to an oral agent because the nightly injections were becoming too much.

We try to anticipate problems before they happen—nausea from chelation, vitamin D deficiency, potential cardiac strain. Each month, her bloodwork tells us a little more about how she's handling the therapy. Not just physically, but emotionally too. Some days, she refuses to eat after a transfusion. Other times, she chatters on about school like nothing is wrong. That unpredictability is part of the disease.

Her family doesn’t use big words like “cure.” They talk about “next steps,” “this month’s numbers,” “how long this medicine will last.” They’ve stopped asking for guarantees, but they haven’t stopped showing up. That, in itself, is something I’ve come to admire.

There’s talk in the medical community about gene therapy for beta-thalassemia, and yes, it’s promising. But for under developed countries it still feels distant—too costly, too experimental, too far from Lahore. So, for now, we work within the limits of what’s available. Medications. Monitoring. Blood donations. Hope that’s measured, not idealized.

Lately, her response to transfusions has slowed. Her pre-transfusion hemoglobin dips lower than before. Her spleen is slightly enlarged. These changes are small, but they add up. This is what we call a “slow decline.” Not alarming, but unmistakable.

There’s no dramatic shift to mark the moment when a child starts to worsen. It’s a gradual series of small adjustments—lowering activity levels, adding a new supplement, shifting a medication dose. These are the ways we try to hold her steady, even as her condition quietly shifts beneath us.

Not a Story of Triumph—Just a Story Still Going

This isn’t a story of beating thalassemia. Not yet.

It’s a story of living with it—of managing symptoms, watching numbers, adjusting medications, and holding onto routines. It’s about an eight-year-old girl who still jokes with the phlebotomist, and a family that asks thoughtful, specific questions, and a pharmacist who follows every small change in her case like it matters.

Because it does.

Prayers for Momina and all the sick children and their families who have to face this pain of cancer. May Allah make it easy for them. Aameen

Friday, July 18, 2025

Warriors and Survivors - 222

Children Cancer Stories by Rukh Yusuf - Blog # 222

Naveed’s Story: A Dream Interrupted

Naveed is a 14-year-old boy from Bahawalpur, a city where fields stretch far, and life moves gently with the seasons. Before illness came into his life, Naveed was known in his neighborhood as the child who never stayed still—always running between classes, cricket games, and sketching small machines in his notebook. He had a quiet smile, a love for drawing, and a serious dream: he wanted to become an engineer one day.

He was the kind of student who remembered what teachers said the first time. His parents often said he didn’t need reminders to do homework. He understood how things worked—how a bicycle chain moved, how electric switches-controlled fans—and that fascination turned into a goal: engineering. He would speak about it with pride, sometimes shyly, sometimes boldly.

A few months ago, everything began to change. It started with a fever that wouldn’t go away and an unusual swelling in his abdomen. His family thought it might be an infection, something treatable. But the tests that followed told a different story—one that no family ever wants to hear.

Naveed was diagnosed with hepatocellular carcinoma, a type of liver cancer. For someone his age, it’s rare. For his parents, it was confusing. There had been no long-term illness, no warning signs. He had always been healthy, playful, and full of energy. Yet, now, he was being admitted to a hospital, surrounded by medical teams, tests, and quiet conversations between doctors and nurses that he tried not to overhear.

At first, there was hope. The oncology team began his treatment with a plan. Medicines were started. His family held on tightly to every small improvement—when his appetite returned for a day, when his fever stayed down, when he smiled at a visiting cousin. But cancer, especially this kind, doesn’t always follow a predictable path.

A scan taken weeks later revealed something unexpected and painful: small nodules had appeared in his lungs. Pulmonary metastasis—the disease had spread. The medical team gathered to discuss his case in a multidisciplinary team meeting (MDT). His name was spoken with seriousness, with compassion, and with the weight that doctors carry when science begins to offer fewer options.

Now, the conversation has turned towards palliative care—a shift from trying to cure, to trying to keep him as comfortable and pain-free as possible. It is a different kind of medicine, one that holds the child more gently, that speaks more softly, that listens not only to symptoms but to fears, wishes, and quiet silences.

Naveed understands more than his parents sometimes wish he did. He knows he’s very sick. He asks fewer questions now but watches more. His sketchbook lies open on the bedside table. One page shows a bridge he had started drawing weeks ago. It’s only half-finished.

His parents spend their days by his side. They speak to him about school, friends, and Bahawalpur. His younger siblings come to visit when they can. In their presence, he tries to sit up straighter.

There are no perfect words for this kind of journey. His story is not about beating odds, but about a boy who had dreams, who loved learning, and who continues to mean everything to his family. He still matters—deeply—even in these most uncertain days.

Naveed’s life may now be measured in smaller ways—days without pain, mornings when he asks for mango juice, evenings when he listens to stories from home—but it is still his life. One that deserves gentleness, dignity, and remembrance.

Some dreams get interrupted. But some, like Naveed’s love for understanding how things work, don’t truly disappear. They live on in the hearts of the people who knew him, who cared for him, and who now hold him with quiet love through each moment.

Prayers for Naveed and all the sick children and their families who have to face this pain of cancer. May Allah make it easy for them. Aameen

Friday, July 11, 2025

Warriors and Survivors - 221

Children Cancer Stories by Rukh Yusuf - Blog # 221

I first met Faizan in early 2021. He was nine years old then—a quiet boy with deep, serious eyes. His chart read B-cell Acute Lymphoblastic Leukemia (ALL), newly diagnosed. He had just been admitted for induction chemotherapy. Like many young patients, Faizan didn’t ask questions. He sat beside his mother, holding her hand, trying to make sense of the strange hospital world around him.

Faizan is from Arifwala, a small town that’s few hours away from the cancer center. His family traveled here on borrowed time and borrowed money, trusting strangers in white coats to help their child. I remember his father sitting outside the pharmacy, trying to understand what PEG-asparaginase was, why he had to find it outside, and whether a cheaper brand would “work the same.” As a pharmacist, these are common conversations. But in Faizan’s case, I remember his father didn’t ask too many questions. He only asked, “Will this make him better?”

Treatment began. Vincristine, steroids, intrathecal methotrexate—all laid out in protocols with complicated names, but each dose marking a step toward hope. And Faizan responded well. By the end of 2021, he was in remission. His blood counts normalized. His hair began to grow back. There was laughter in the ward again—careful, cautious laughter.

In 2022, he celebrated his remission. He rang the little bell we keep in the pediatric oncology wing. I remember thinking how different he looked—still small for his age, but louder now, curious about the IV pumps and asking me why medicine sometimes “burns the vein.” He said he wanted to become a “doctor or a pharmacist” when he grew up—he hadn’t decided exactly.

But then, in late 2022, the blood counts started to shift again. I remember seeing him in OPD one morning and feeling the weight of numbers I wish had stayed stable. Flow cytometry confirmed it—relapse. The disease was back. The pharmacy team got the order for reinduction, and we started the process all over again. The same meds. The same nausea. This time, he didn't ask as questions.

Now, Faizan is 11. He’s in the second year of treatment again, and he’s tired. His ANC drops often. He misses a lot of school. Sometimes he forgets words. His mother says he used to be good at math but now struggles. Some days he sleeps through most of his visits; other days, he watches cartoons on a donated tablet while the infusion runs. He rarely complains. But I notice the subtle changes—he no longer flinches when the IV line is flushed. He can name most of his chemotherapy medications now. And he doesn’t ask when treatment will end anymore.

As a pharmacist, my role is critical. I review doses, adjust for organ function, manage side effects. But in practice, pediatric oncology care goes far beyond pharmacokinetics. You remember faces. You memorize schedules. You carry quiet pieces of their stories with you. And with Faizan, I carry the image of a child who never got to stop being a patient.

Faizan’s story isn’t over yet. He’s still in treatment, and he still travels with his family from Arifwala for every cycle. His parents still ask careful questions, and I still do my best to answer them in plain language. He still wears the same worn blue slippers during his visits. I don’t know what the outcome will be—but I know Faizan is more than his lab values. He’s a boy who once wanted to be a “medicine person,” and maybe one day, if life allows, he still could.

For now, he remains under our care—between pharmacy doses and doctor rounds, between uncertainty and the quiet hope we don’t always speak out loud.

If you're reading this, I ask only one thing—remember Faizan in your prayers. Not as a statistic or a case report, but as a real 11-year-old boy who wants to be a health care provider. His story matters.

Prayers for the Faizan and all the sick children and their families who have to face this pain of cancer. May Allah make it easy for them. Aameen

Friday, July 4, 2025

Warriors and Survivors - 220

Children Cancer Stories by Rukh Yusuf - Blog # 220

A Silence Too Heavy – Wareesha’s Fight Against Nasopharyngeal Carcinoma

There are days when words come easily, and then there are days like today—when I sit in front of a blank screen, knowing I must write about a child whose suffering feels too immense to put into sentences. Today’s story is about Wareesha, an 11-year-old girl from a small town called Buray Wala. She’s facing something that no child should ever have to know: Nasopharyngeal carcinoma, a rare and aggressive cancer growing in the upper part of her throat behind the nose.

Her story is quiet, it’s a slow, difficult silence—a silence that fills a room when her mother watches her sleep through pain. A silence that hovers when the doctor enters the ward with scan results. A silence that feels unbearable when you're 11 years old and can't swallow without discomfort and can't breathe clearly through your nose anymore.

Wareesha used to be a student who never missed school. Her teachers say she was shy but sharp, the kind of child who would quietly help a classmate with homework or clean up without being asked. That was before her headaches began. At first, her parents thought it was just a flu that wouldn’t go away. Then came the nosebleeds. Then the swelling in her neck. By the time they reached a hospital in Multan, she had already lost several pounds and was having trouble hearing from one ear.

A biopsy confirmed what they feared but didn’t yet understand, “Nasopharyngeal carcinoma” a cancer rarely seen in children, particularly in rural Pakistan. The doctors explained that it tends to be diagnosed late because its symptoms mimic common illnesses: ear infections, allergies, sore throats. But this wasn’t something common. This was cancer, and it had already begun to invade.

For most of us, it’s hard to imagine what cancer looks like in a child. We think of tubes, of shaved heads, of quiet hospital rooms. But what I saw in Wareesha’s eyes was more than that. It was confusion—about why she had to stop going to school, why the other kids could play outside while she lay in a hospital bed. Why food didn’t taste like anything anymore. Why she had to hold her mother’s hand so tightly just to walk down the hallway.

Wareesha is currently undergoing chemotherapy, a procedure she neither understands nor welcomes, but endures with more patience than most adults could muster. There are days her throat is so sore she can’t even whisper. Yet when her younger brother visits, she forces a smile and asks if he’s done his homework. That’s Wareesha—still thinking of others even while her own world is quietly collapsing.

Her parents have sold most of what they own to afford her treatment. Her father, a seasonal laborer, now lives part-time in Lahore just to be near the oncology unit. Her mother stays by her bedside. They don’t complain. They don't beg. But you can see the fear sitting quietly behind their eyes.

There is something unbearably unjust about pediatric cancer. It interrupts dreams before they’ve had a chance to form. It turns bedtime stories into whispered prayers. It replaces laughter with IV drips and chemo schedules. But Wareesha’s story is also a reminder of the hope that exists in the most fragile of bodies. The dignity in small endurance. The courage of children who don’t even know what courage means.

I don’t have an ending for this story—not yet. Wareesha is still in treatment. Her prognosis depends on many things: how the tumor responds to treatment, whether her body can handle the side effects, whether her family can continue to afford the medical care she needs. But she’s fighting, quietly, bravely, every single day.

If you're reading this, I ask only one thing—remember Wareesha in your prayers. Not as a statistic or a case report, but as a real 11-year-old girl who once loved to read, who now fights to breathe. Her story matters. And maybe if we keep telling it, the silence will start to break.

Prayers for the Wareesha and all the sick children and their families who have to face this pain of cancer. May Allah make it easy for them. Aameen