Warriors and Survivors - Children Cancer Stories by Rukh Yusuf

Blog Post # 03.

I am Rukh Yusuf, Clinical Pharmacist, also specialized in Total Parenteral Nutrition and Bone Marrow Transplant. I have been working in 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.

My Today’s brave heart is 11 years old “Doll”, an active shining star who loves playing and hovering around. In the winter of 2019, a boil appeared on her foot. The local doctor did multiple dressings and treated her, but it did not reduce. Later, it revealed as tumor on x ray.  They were referred to local civil hospital and after MRI they were finally sent to Lahore for treatment.

After multiple tests, her tumor was diagnosed as EWING Sarcoma of Left foot. Her treatment started in Oncology department, tumor size reduced after chemotherapy and her pain settled down. As soon as she felt better, she started hovering again in ward with her beautiful smile. After completion of chemotherapy cycles, investigations were done for evaluation. It was revealed that her disease is metastatic, so she was sent to surgery department for further treatment.  To stop further spread her foot was amputated in surgery department. She was unable to walk, and it was the biggest tragedy of a hyperactive child and her family.

After surgery as per protocol, chemotherapy cycles started again, Doll was given wheelchair to facilitate her movement and she was happy at that too. She used to move around in ward on wheelchair and it looked like she had forgotten her pain, pain of foot amputation.

To avoid further spread, radiation was part of treatment as well. Her mother regularly took her to other hospital for radiation. Wound was healing gradually but she used to cover her foot at all times.

Doll has two brothers and four sisters; all are school students. Her father sells “Naan pakoras”. Family is running life hardly.  All the educational expenses, doll’s treatment cost and other expenses were met with great difficulty. Her parents are thankful to Allah that Doll is doing well even with wheelchair. Doll is still happy moving around on wheelchair.

Ewing sarcoma is a cancer that may be a bone sarcoma (tumor) or a soft-tissue sarcoma with swelling and pain at the site of the tumor, fever, and can be a bone fracture. The most common areas where it begins are the legs, foot, pelvis, and chest wall. It can be localized and metastatic (spreading) as well. Regardless of where it starts, it can spread to other bones, bone marrow, and even vital organs such as the lungs, heart, and kidneys.

Ewing’s sarcoma is a very rare type of cancerous tumor. It affects people from the ages of 10 to 20 and has a high cure rate. It is uncommon in adults. In Pakistan, a relatively high frequency of bone tumors has been observed in the Northern region as compared to the Southern part of the country. Childhood and adolescence are sensitive stages of life due to greater proliferative activity of cells, and environmental toxicants may have more deleterious effects in this age group as compared to adults. Most cancers result from the interaction of genetics and environment.

Diagnosis may involve a number of tests to see Ewing’s sarcoma and its spread and to what extent. This is known as cancer staging. Tests may involve from physical exam, X-rays, Bone scan, Magnetic resonance imaging (MRI), Computed tomography scan (CAT/CT scan), Positron emission tomography scan ( PET scan) and blood tests and biopsy.

Treatment depends on several things, from size of tumor to its spread. Treatment options include Chemotherapy which is usually the first step in which, medicines are used to kill cancer cells and stop them from growing. More than one type of chemotherapy may be used at a time. In some cases, surgery may also be needed, amputation of arm or leg may be needed to stop spread. Radiation may also be needed to kill any residual cancer cells after surgery.

Even after surgery and radiation Ewing’s sarcoma can return even a decade after the diagnosis and treatment. Children with Ewing’s sarcoma that hasn’t spread have cure rates as high as 80%. It’s much lower in cases where the tumor has spread.

Medical science has not definite answers for many questions about cancer, even in this century we still are not sure which patient will cure and which disease will relapse. Its only we can do our part in proper treatment, and care and pray that Allah brings out best for the suffering soul.

Moving around on wheelchair, she is under treatment fighting bravely once again with her shining smile. We all pray may Allah cure “Doll’ completely and every cancer patient and ease their families. Aameen

 

Note: Name has been changed to protect identity