Warriors and Survivors - 284

 Children Cancer Stories by Rukh Yusuf - Blog # 284

I am Rukh Yusuf, Clinical Pharmacist, also specialized in Total Parenteral Nutrition and Bone Marrow Transplant. I have worked in the Pediatric Oncology unit of a public hospital. 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. 

Going Gold in September: Raising Awareness for Childhood Cancer

September is recognized as Childhood Cancer Awareness Month, a time to acknowledge children and adolescents living with cancer, remember those who have lost their lives, celebrate survivors, and draw attention to the need for better diagnosis, treatment, research, and supportive care. The international symbol of this movement is the gold ribbon.

The choice of gold is meaningful, the gold ribbon represents all childhood and adolescent cancers. Gold was selected because it is a precious metal, reflecting the value and preciousness of children. 

The story behind the gold ribbon

The history of the gold ribbon goes back to the experiences of parents of children with cancer. In 1997, Gigi Thorsen, a board member of the Candlelighters Childhood Cancer Foundation, worked with other parents affected by childhood cancer to establish a universal symbol for childhood cancer awareness. The first gold ribbon products were produced as lapel pins in 1997, and the symbol gradually spread beyond the United States. 

Historical records from the organization describe how Thorsen was inspired by her daughter Kelsey, who died from leukemia in 1996. The first gold cloth ribbons appeared in September 1997, followed by gold ribbon pins in 1998. The campaign grew through parent networks and early internet support groups. 

Today, the gold ribbon represents much more than awareness. It represents children undergoing treatment, survivors living beyond cancer, parents and siblings, healthcare professionals, researchers, advocates, and families remembering children who are no longer with them.

The global burden of childhood cancer

Childhood cancer is sometimes described as rare, but its global impact is substantial. The World Health Organization estimates that approximately 400,000 children and adolescents aged up to 19 years develop cancer each year. Common childhood cancers include leukemia, brain tumors, lymphomas, neuroblastoma, Wilms tumor, retinoblastoma, and other solid tumors. 

More recent estimates from the International Agency for Research on Cancer (IARC) indicate that more than 275,000 children and young people aged 0 to 19 were diagnosed with cancer in 2024, with more than 100,000 deaths. IARC also cautions that the actual burden may be considerably higher because childhood cancers can be missed or under recorded in countries where diagnostic services and cancer registries are limited. 

Perhaps the most important message is that childhood cancer outcomes are not determined only by the biology of the disease. Where a child is born can strongly influence whether that child survives. In high-income countries, more than 80% of children with cancer can now be cured. In many low and middle income countries, however, fewer than 30% survive. 

This difference reflects inequalities in early diagnosis, pathology and diagnostic services, availability of medicines, trained healthcare professionals, treatment infrastructure, supportive care, treatment abandonment, and the ability of families to reach and remain in care. Nearly 94% of childhood cancer deaths are estimated to occur in Africa, Asia, South America, and the Caribbean. 

Childhood cancer in Pakistan

For Pakistan, the issue is particularly important. Available estimates suggest that approximately 8,000 to 10,000 children are diagnosed with cancer each year. 

These numbers, however, should be interpreted carefully. Pakistan, like many countries, continues to face challenges in comprehensive cancer registration and accurate population level data. Consequently, the reported number of cases may not capture the entire burden.

The challenges extend beyond diagnosis. Children and families may face delays in reaching specialized pediatric oncology centers, limited access to essential medicines and diagnostic facilities, financial pressures, and difficulties maintaining treatment over a prolonged period. Awareness among families and healthcare providers is therefore an important component of improving outcomes. Recognizing concerning symptoms and referring children promptly can help reduce diagnostic delays. 

There are also reasons for optimism. Pakistan has been included in international efforts to strengthen childhood cancer care. WHO reported that Pakistan was selected in 2024 as part of the second cohort of countries enrolled in the Global Platform for Access to Childhood Cancer Medicines, an initiative designed to improve access to quality-assured cancer medicines. 

Why does awareness matter?

Awareness is about creating a better understanding of childhood cancer throughout the year.

For parents and communities, awareness can encourage timely medical attention when a child's symptoms are persistent or unusual. For healthcare professionals, it reinforces the importance of considering cancer in appropriate clinical situations and making timely referrals. For health systems, awareness can generate public support for pediatric oncology services, cancer registries, essential medicines, psychosocial support, survivorship programs, and research.

Awareness also helps challenge misconceptions. Childhood cancer is not a punishment, and families should not be blamed for their child's illness. 

Most importantly, awareness can help shift the conversation from “How many children have cancer?” to “What can we do so that every child has a chance to survive?”

The WHO Global Initiative for Childhood Cancer has set a goal of achieving at least 60% survival globally by 2030 while reducing suffering among children with cancer. 

This September, the gold ribbon reminds us that childhood cancer is a global health issue but also a global opportunity for action. Every diagnosis represents a child with dreams, a family with hopes, and a future worth protecting. Going gold means remembering those children, supporting those in treatment, celebrating survivors, strengthening pediatric oncology systems, and ensuring that geography does not determine a child's chance of survival.

This September, let us turn the world gold, not only to raise awareness, but to turn awareness into earlier diagnosis, equitable treatment, stronger research, and better futures for children everywhere.

Warriors and Survivors - 283

Children Cancer Stories by Rukh Yusuf - Blog # 283

I am Rukh Yusuf, Clinical Pharmacist, also specialized in Total Parenteral Nutrition and Bone Marrow Transplant. I have worked in the Pediatric Oncology unit of a public hospital. 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. 

When the World Comes Together for a Child with Cancer

A child with cancer does not think about whether the hospital is in a high-income country or a low- or middle-income country. A child does not know whether the treatment is being given in a large academic medical center or a small hospital far from home. A child only knows that they are sick and that they need someone to help them get better.

But where a child is born can make a profound difference in the care they receive.

This is one of the reasons the work of the International Society of Paediatric Oncology (SIOP) matters. SIOP is a global multidisciplinary society dedicated entirely to childhood and adolescent cancer. Its purpose is not limited to discovering new medicines or discussing the latest research. Its mission is to improve the lives of children and adolescents with cancer through collaboration, education, training, research, and advocacy.

Every year, SIOP brings together people who may otherwise work thousands of miles apart pediatric oncologists, nurses, pharmacists, surgeons, radiation oncologists, researchers, psychologists, scientists, allied health professionals, advocates, trainees, and many others. The annual congress creates a space where these different experiences can meet.

Attending SIOP 2026 in San Antonio, and being here has a meaning beyond attending another professional conference. The 58th SIOP Congress is bringing together the global pediatric oncology community from September 14–18, with discussions ranging from basic and translational research to clinical care, supportive care, survivorship, precision medicine, and global oncology.

What makes such a gathering important is the opportunity to learn from one another.

A researcher may present findings that could eventually change treatment. A physician from another country may share a practical solution developed because resources are limited. A nurse may describe how families cope with treatment. A pharmacist may talk about medication access and safe use. Someone working in a resource limited hospital may explain a challenge that is not visible in a well-resourced health system.

These conversations matter because pediatric cancer is not only a scientific problem. It is also a problem of access.

Nearly 90% of children with cancer live in low- and middle-income countries, according to St. Jude Global. Many children in these settings face difficulties with diagnosis, access to medicines, trained healthcare professionals, treatment infrastructure, and continuity of care. St. Jude estimates that around 400,000 children develop cancer each year, yet only about half are ever diagnosed.

This is where global collaboration becomes especially important.

St. Jude Global was established to help address these disparities. Its approach is not simply to provide treatment from one hospital to another country. It focuses on building capacity, training healthcare professionals, strengthening health systems, supporting patient-centered care, developing regional networks, and advancing research.

There is an important idea behind this approach: sustainable improvement has to happen within the healthcare systems where children actually live.

A hospital needs trained people. It needs reliable diagnostic services. It needs medicines. It needs systems that allow children to complete treatment. Families need support. Healthcare workers need education and opportunities to learn. Researchers need data and collaborations. None of these challenges can be solved by one person or one institution working alone.

St. Jude Global's work with international partners reflects this understanding. Its collaboration with the World Health Organization contributed to the Global Initiative for Childhood Cancer, which aims to improve outcomes through coordinated efforts across countries and health systems. The initiative's CureAll approach seeks at least a 60% survival rate for children with six common childhood cancers by 2030.

Behind these numbers are children.

Children like the ones we meet in pediatric oncology clinics. Children who travel long distances for treatment. Children whose parents leave work to stay beside them. Children who may spend months or years moving between home and hospital.

For families, a cancer diagnosis is never simply a diagnosis. It affects transportation, finances, education, employment, siblings, parents, and everyday life. In many places, even reaching a hospital that can provide appropriate treatment can be a challenge.

This is why conferences like SIOP are important. They create opportunities for people from different parts of the world to sit at the same table and think about the same child.

The goal is not for every country to have exactly the same healthcare system. The goal is to make sure that children receive the best possible care within their circumstances, and that knowledge and experience are shared rather than remaining within the walls of one institution or one country.

For me, attending SIOP is also a reminder of why pediatric oncology requires teamwork. As healthcare professionals, we may have different responsibilities, different training, and different perspectives, but ultimately the patient brings us together.

A physician may diagnose the cancer. A pharmacist may help make sure the medicines are appropriate and safely used. A nurse may spend hours at the bedside. A laboratory scientist may provide information essential to diagnosis and treatment. A researcher may identify a new way of understanding the disease. A psychologist may help a child and family cope with what treatment brings into their lives.

Each role is different. The child is at the center of all of them.

That is perhaps the most meaningful part of being at SIOP 2026: seeing people from around the world come together not simply to talk about cancer, but to share knowledge, experience, challenges, and solutions for children who may never know the names of the people working to improve their care.

The work is complex, and progress takes time.

But every connection made, every lesson shared, every healthcare worker trained, every system strengthened, and every research question pursued can become part of a much larger effort.

Because ultimately, global pediatric oncology is about something very simple.

A child should have a chance to grow up.

And wherever that child happens to be born, that chance should matter.

Warriors and Survivors - 282

Children Cancer Stories by Rukh Yusuf - Blog # 282

I am Rukh Yusuf, Clinical Pharmacist, also specialized in Total Parenteral Nutrition and Bone Marrow Transplant. I have worked in the Pediatric Oncology unit of a public hospital. 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. 

Mehak is five years old.

She should be running around chasing her cat without thinking about hospitals. But for Mehak, the hospital has become a familiar part of childhood. She was diagnosed with thalassemia major when she was only two years old.

Since then, blood transfusions have become a regular part of her life. In the beginning, she needed a transfusion about once a month. As time passed, her need increased. Now, there are times when she needs blood twice in the same month.

For a five-year-old, this is a lot.

Mehak may not fully understand what blood is, why she needs it, or why she has to sit quietly in a hospital while someone gives her blood through a small needle. She simply knows that there are hospital visits, familiar faces, waiting rooms, and days when she has to leave her normal routine behind.

Her family understands much more.

They know that blood transfusions are essential for keeping her healthy and helping her body receive the red blood cells it needs. They also know she becomes lethargic when she needs another transfusion and that regular transfusions come with their own challenges.

One of the major problems is iron overload. With repeated transfusions, extra iron can gradually build up in the body. Unlike many substances, the body has no natural way to remove large amounts of this excess iron. Over time, it can damage important organs. That is why children like Mehak may also need iron-chelation medicines to reduce the amount of iron stored in their bodies.

There are other worries too. Even with careful screening and safe transfusion practices, repeated blood transfusions can carry risks, including infections and transfusion-related complications. Families therefore live with two realities at the same time: the blood is necessary, and the treatment itself requires careful monitoring.

For Mehak’s family, treatment is not limited to the hospital bed.

It means arranging transport, taking time away from work and other responsibilities, finding blood when it is needed, paying for medicines and travel, and planning life around hospital appointments. For families who live far from a specialized treatment center, the journey can be even harder. A transfusion that may take only a few hours can require an entire day, or sometimes much more, because of the distance they have to travel.

And then there is the emotional side that is harder to measure.

A parent watches a small child receive treatment and learns to become comfortable with things no parent should have to explain so early in life. They learn about blood counts, transfusion schedules, medicines, iron levels, and possible complications. They learn to notice small changes in their child. They become careful planners because missing treatment is not simply missing an appointment.

Yet Mehak is still Mehak.

She is not only her disease. She is a little girl growing up around all of this. She has moments of happiness, curiosity, playfulness, and laughter. Her treatment is a part of her life, but it does not define her whole life.

Thalassemia is a chronic inherited blood disorder that remains a significant health problem in many parts of the world. For children with thalassemia major, regular treatment can continue for many years. How well a child does depends on many factors, including access to safe blood, appropriate medicines, monitoring, management of complications, the child's response to treatment, and the ability of the family to maintain long-term care.

Prevention is also an important part of the story.

Because thalassemia is inherited, carrier screening and genetic counseling can help couples understand their risk before having children. Knowing whether both partners carry a thalassemia gene can allow families to make informed reproductive decisions.

For families like Mehak’s, however, prevention is a conversation for another time.

Right now, there is a little girl who needs her next transfusion.

And there is a family that will once again pack a bag, make the journey to the hospital, sit beside her, and wait.

For Mehak, this has become part of growing up.

For her family, it is simply what they do because they love her.

Note: Patient name has been changed to protect privacy. 

Warriors and Survivors - 281

Children Cancer Stories by Rukh Yusuf - Blog # 281

I am Rukh Yusuf, Clinical Pharmacist, also specialized in Total Parenteral Nutrition and Bone Marrow Transplant. I have worked in the Pediatric Oncology unit of a public hospital. 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. 

A Six Year Old's Courage: Ahad's Journey Through Leukemia

The Day Everything Changed: Ahad was always full of energy. At six years old, he was the kind of child who couldn't sit still always running, always playing, always asking questions about the world around him. His mother, Fatima, remembers those days with a bittersweet smile. She remembers his infectious laugh echoing through their modest home in Lahore. She remembers him insisting on helping her cook, standing on his tiptoes to reach the kitchen counter. She remembers thinking life was exactly as it should be.

Then came the fevers: It started subtly. A fever here and there, nothing alarming by itself. Ahad's parents, like most parents, attributed it to seasonal illness. They gave him over-the-counter medication and waited for it to pass. But the fevers kept returning, more frequently each time. What concerned Fatima more was the unusual tiredness. Her energetic little boy, who once played for hours, now needed to rest after just a few minutes of play.

"I knew something was wrong," Fatima recalls quietly. "A mother knows her child. I could feel it in my heart before my mind could name it."

The Diagnosis That Stopped Time:  The journey to diagnosis wasn't straightforward. Their local doctor initially suspected a prolonged viral infection. When antibiotics didn't help and the fevers persisted, they visited a specialist. More tests were ordered. More waiting. More uncertainty.

When the word "leukemia" was finally spoken in a quiet hospital room, Fatima felt as though the ground beneath her had disappeared. Ahad's father, Hassan, sat motionless, unable to process what the doctor was saying. Leukemia! childhood cancer, was something that happened to other families, not theirs. Not to their perfect, joyful little boy.

The diagnosis was acute lymphoblastic leukemia (ALL). It meant that Ahad's bone marrow was producing abnormal white blood cells at an alarming rate, crowding out healthy cells and weakening his immune system. It meant chemotherapy. It meant months, possibly years of treatment. It meant their lives would never be the same.

The Reality of Treatment: Ahad's treatment began just days after diagnosis. The first round of chemotherapy was brutal in ways the family hadn't anticipated. The side effects, nausea, hair loss, mouth sores, extreme fatigue transformed their little boy into someone they barely recognized. Yet somehow, Ahad adapted with a resilience that humbled his parents.

"He never complained," Fatima says, her voice catching slightly. "When his hair fell out in clumps, he would ask, 'Mama, will it grow back?' When the medication made him sick, he would say, 'It's okay, Mama. The medicine is fighting the bad cells.' A six-year-old shouldn't have to be this brave."

The Unseen Battles:  While Ahad fought his physical battle against leukemia, his family fought their own invisible wars. The financial burden was crushing. Each hospital visit, each round of chemotherapy, each medication drained their modest savings. Hassan, a shopkeeper, had to reduce his work hours to accompany Ahad to Lahore's tertiary care hospital, an hour away from their home. The loss of income created stress that rippled through everything.

Fatima abandoned her small tailoring business. She needed to be with Ahad full-time managing his medications, monitoring his symptoms, providing the emotional support a frightened child requires. The emotional toll was equally devastating. Watching your child suffer, feeling helpless despite doing everything right, carrying the constant fear of relapse these are weights no parent should bear. The stigma was another burden. Some in their community avoided them, as if childhood cancer was somehow contagious. Relatives who once visited frequently became distant. Ahad noticed the whispers, the worried glances.

A Light in the Darkness: Yet within this darkness, there are moments of light. Ahad's oncology team at the hospital has become like family doctors and nurses who celebrate his small victories with genuine joy. A complete blood count that looks better than last month. A week without fever. The ability to play for an hour without exhaustion. Now, eighteen months into treatment, Ahad is in remission. He's still undergoing maintenance chemotherapy a gentler phase designed to prevent relapse but he's healing. His hair is growing back, curly and thick. His energy is returning. He's returned to school part-time, and his teacher says he's the bravest student she's ever known.

Ahad's story is one of millions. Pediatric cancer affects thousands of children in Pakistan annually, yet awareness remains tragically low. Many families, like Ahad's, discover their child's illness only when it's advanced. Better screening, earlier detection, improved access to treatment, and financial support could change these stories.

As you read this, somewhere in Pakistan, another mother is watching her child endure chemotherapy. Another family is struggling with impossible choices. They need not just our sympathy, but our action, our advocacy, our support, our commitment to ensuring that every child, regardless of where they're born, has access to hope and healing.

Ahad's journey continues. And with every day he fights, he reminds us all why pediatric oncology awareness matters.

Note: Patient name has been changed to protect privacy. 

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Children Cancer Stories by Rukh Yusuf - Blog # 280

I am Rukh Yusuf, Clinical Pharmacist, also specialized in Total Parenteral Nutrition and Bone Marrow Transplant. I have worked in the Pediatric Oncology unit of a public hospital. 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. 

The Eight Year Old Who Still Makes Plans for Tomorrow

There are some children who make you forget, for a moment, that they are sick.

Not because the illness is not there, but because childhood has a way of continuing even in places where it seems it should have stopped.

He is eight years old and He has leukemia.

And unlike many children his age, he understands what the word means.

He knows why he comes to the hospital. He knows why his blood is checked so often. He understands that the medicines are not simply medicines, but chemotherapy. He knows that some days will be harder than others. He knows that cancer can sometimes take a child's life.

Perhaps the hardest part is that nobody had to explain all of this to him in one conversation.

He learned it gradually.

From the conversations around him. From the hospital rooms. From the questions his parents asked doctors. From seeing other children come and go. From hearing words that adults sometimes lower their voices to say.

And somehow, he still gets up each morning and asks what is happening today.

That question has stayed with me. Not How long do I have?  Not Will I survive?

Just: "What are we doing today?"

For an eight-year-old, today can still be an entire world. There may be a blood test in the morning. There may be medicine later. There may be a long wait in a hospital chair. There may be nausea, tiredness, or a day when getting out of bed feels like too much.

But somewhere between all of that, there may also be a cartoon.

A joke. A favorite snack. A video game waiting at home. A drawing that needs finishing. A football match he wants to know the score of.

Children do not stop being children because they have cancer.

That is something cancer teaches us again and again.

We sometimes describe children with cancer using words like strong, brave, and fighter. Those words are understandable. They come from love. But perhaps we should also remember something quieter.

A child should not have to be extraordinary simply because he is ill.

He should be allowed to be eight. He should be allowed to complain that the food is terrible. He should be allowed to cry when a procedure hurts. He should be allowed to be frightened and to laugh five minutes later about something completely ordinary. That is what makes his story so moving.

He knows the seriousness of his illness, but he does not spend every waking moment talking about death. He still thinks about tomorrow. He still has preferences.

Perhaps that is one of the most remarkable parts of childhood: even when the future becomes uncertain, children continue to build little pieces of it.

He might tell his mother what he wants for dinner. He might ask when he can go home. He might ask if he can return to school. He might make a plan for the weekend without knowing exactly what his body will allow him to do. And yet, in a cancer unit, ordinary questions can carry extraordinary meaning.

Behind every question about going home and school is a child imagining life beyond the hospital. Behind every question about tomorrow is a child who, despite everything he has learned, is still making room for tomorrow in his mind.

His parents carry a different kind of knowledge. They know the medical language more than they ever wanted to learn.

They know laboratory values. They know treatment schedules. They know the names of medications and the meaning of scans and blood counts. They know what to watch for when their child is unwell. And they carry the uncertainty that comes with loving a child whose illness has made the future difficult to predict. But their son does not need them to explain the entire future every morning.

He needs someone to sit beside him. He needs a hand to hold when the needle comes. He needs someone to answer his questions honestly, without taking away his hope. And sometimes, he simply needs everyone to stop talking about cancer for a while.

So they do. They talk about school. They talk about cartoons. They talk about what he wants to do when he gets home. And for a few minutes, the hospital becomes just another place where a little boy is growing up.

His illness is serious. His future is uncertain. There is no beautiful lesson that can make those truths disappear.

Cancer does not become less frightening because a child smiles. Treatment does not become easier because a child jokes with the nurses.

And we should be careful not to turn childhood illness into a story where suffering is romanticized as bravery.

Sometimes the most human thing we can do is simply acknowledge that this is unfair.

An eight-year-old should be worrying about homework, birthday parties, toys, friends, and what game to play after school. He should not have to understand mortality. But he does. And still, each morning, he asks about the day ahead. That is not a promise that everything will be fine. It is something more fragile and more honest.

It is a reminder that life is often experienced one day at a time.

In cancer unit, we spend much of our attention looking toward outcomes: remission, relapse, response to treatment, survival. These outcomes matter enormously.

But there is also a child sitting in front of us right now. Not a diagnosis. Not a laboratory value. Not a treatment protocol.

A child.

An eight-year-old who knows that leukemia can be dangerous and still wants to know whether he can watch his favorite show tonight.

And sometimes, hope is simply waking up in the morning and asking:

"What are we doing today?" For this little boy, today is enough.

And tomorrow can wait until tomorrow. For now, there is another day to live.

Note: Patient name has been changed to protect privacy. 

Warriors and Survivors - 279

Warriors and Survivors - Children Cancer Stories by Rukh Yusuf - Blog # 279

I am Rukh Yusuf, Clinical Pharmacist, also specialized in Total Parenteral Nutrition and Bone Marrow Transplant. I have worked in the Pediatric Oncology unit of a public hospital. 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. 

Ansa Is Five

She does not know what leukemia is.

For her, it is simply the reason her days have changed.

A few months ago, her world was much easier to understand. At five, childhood is usually made up of small and familiar things like playing, toys, going outside, asking questions, getting tired, falling asleep, and starting all over again the next day.

Now, there are medicines.

There are tablets and syrups. There are injections and IV drips. There are tests that she has to go through, even when she does not understand why they are necessary. There are appointments and hospital visits that have become part of a routine she never asked for.

She may not understand the word leukemia, but she understands that something is different.

Children do not always understand illness in the way adults do. A five-year-old does not think about diagnoses, treatment protocols, or what the next few months might bring. She knows what is happening to her today.

She knows when someone brings medicine.

She knows when it is time for another injection.

She knows when she has to sit still for a test.

And she knows that sometimes the adults around her are worried.

For a child, these things can be confusing. Why are there so many medicines? Why does she have to take them when she would rather play? Why does another person need to examine her? Why can't she simply go home and return to the things that make sense to her?

She doesn't know that every medicine is being given with the hope of making her better.

She only knows that medicine has become a much bigger part of her life.

That is one of the difficult things about childhood cancer. The child is asked to live through something that they are often too young to understand, while the adults around them are trying to understand everything at once.

For Ansa's parents, the experience is very different.

They understand what leukemia means. They understand why the medicines are necessary. They understand that treatment can take time and that there are many uncertainties along the way.

But knowing does not make it easier.

There is a particular kind of uncertainty that comes with having a sick child. It follows parents through hospital visits, through treatment, and into the quiet moments at home. There are questions they cannot always answer for themselves, let alone for their child.

How will the treatment go?

How will she respond?

What will the next test show?

When will life begin to feel normal again?

Parents often have to carry these questions while continuing to do the ordinary things that their child still needs from them. They have to remember medicines, attend appointments, make decisions, and comfort their child. And, at the same time, they have to try to give their child a sense of normal childhood.

For Ansa, that childhood is still there, but it has been interrupted.

The playground has been replaced, at least for now, by hospital rooms and treatment schedules. Toys and games still belong to her world, but so do tablets, syrups, injections, and IV lines.

She is still five.

She still has a child's understanding of the world.

And perhaps that is what makes her story so difficult to describe. She does not see herself as a leukemia patient. She is simply Ansa a five-year-old girl going through something she does not fully understand, while the people who love her try to make each day a little easier.

Her parents cannot promise her exactly what the future will look like.

What they can do is stay beside her through the uncertainty.

They can give the medicines, bring her to the appointments, hold her hand through the difficult moments, and keep hoping for the day when treatment is no longer the center of her life.

For now, Ansa's story is still being written.

And somewhere beneath the hospital visits and treatment schedules is a five-year-old child who deserves what every child deserves: the chance to grow, to play, to laugh, and to discover the world beyond hospitals.

Her parents are hoping for that too.

Not for anything extraordinary.

Just for more ordinary days with their daughter.

For children like Ansa, that ordinary life is a beautiful milestone in itself.

May she stay healthy and live a beautiful healthy life. Aameen

Note: Patient name has been changed to protect privacy. 

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Children Cancer Stories by Rukh Yusuf - Blog # 27

I am Rukh Yusuf, Clinical Pharmacist, also specialized in Total Parenteral Nutrition and Bone Marrow Transplant. I have worked in the Pediatric Oncology unit of a public hospital. 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. 

The Days That Became Hospitals

At three years old, he does not know the word leukemia.

He does not know why the adults around him have become quieter. He does not understand why his mother looks at him for a little longer than she used to, or why her eyes sometimes fill with tears when she thinks he is not looking. He does not know why his father watches him so closely now, noticing every little change in his face, his appetite, his energy.

He only knows that his days have changed.

There are more visits to the clinic now. More waiting rooms. More unfamiliar faces, medicines, examinations, and hospital corridors. Sometimes his mother holds his hand tightly while they wait. Sometimes she tries to smile and talk to him about ordinary things his favorite toy, what he wants to eat, what they will do when they go home.

For him, the hospital is becoming another place in his small world.

For his family, it is something much larger.

His mother is with him almost constantly. She learns the names of medicines, remembers appointments, listens carefully when doctors explain what will happen next, and tries to keep track of details that seem too important to forget. Between these moments, there are quiet tears. Not because she wants him to see her sadness, but because sometimes there is simply nowhere else for it to go.

His father has changed too, although perhaps he would not say so himself.

He looks at his son differently now. Not necessarily with fear, and not always with sadness, but with a kind of attention that was not there before. He watches him play. He notices when he becomes tired. He remembers small things that once might have passed unnoticed. Sometimes he simply sits nearby and watches.

His siblings are trying to understand the changes in their own way.

They may not fully understand leukemia either. They only know that their brother needs more time, more care, and more attention. So they try to be close to him. They bring him toys. They sit beside him. They may ask when he is coming home from the hospital or why he cannot do certain things anymore.

The whole family begins adjusting to a new routine that none of them expected.

This is one of the quieter realities of pediatric oncology.

When a child is diagnosed with cancer, it is not only the child who enters the healthcare system. Parents, siblings, grandparents, and other caregivers are suddenly drawn into appointments, treatments, uncertainty, financial concerns, changes in work and school, and long periods of waiting. Ordinary family routines can become difficult to maintain.

And through all of this, the child may not understand what is happening.

A three-year-old may not understand a diagnosis, but they understand separation. They understand when their parent is worried. They notice when home feels different. They notice when familiar routines disappear.

This is why pediatric oncology is about more than treating a disease.

It is also about helping a child remain a child as much as possible.

It means creating spaces where children can play, learn, ask questions, and feel safe. It means supporting parents who are trying to make decisions while carrying their own fears. It means remembering siblings who may quietly struggle with changes at home. It means recognizing that treatment affects an entire family, even when only one person receives the diagnosis.

For this little boy in Isfahan, leukemia is still only a word he does not know.

He knows the clinic.

He knows the hospital.

He knows his mother's hand.

He knows his father watching.

He knows his siblings staying close.

And perhaps, for now, that is enough.

As pediatric oncology continues to advance, awareness must grow alongside treatment. Childhood cancer is not only a medical story written in laboratory results, scans, medications, and treatment plans. It is also a family story made up of ordinary days that suddenly become unfamiliar, quiet moments in hospital rooms, and parents trying to make the next day feel as normal as possible.

Sometimes, awareness begins simply by seeing that story.

May he recovers soon, stay healthy and live a beautiful healthy life. Aameen

Note: Patient name has been changed to protect privacy.