Friday, July 14, 2023

Warriors and Survivors -117

Children Cancer Stories by Rukh Yusuf - Blog # 117



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. 





For a mother, CANCER is never an easy word to listen to as a diagnosis of her child. Kalsum Bibi is one of those unlucky & pitiable mothers who had to face this bitter reality. 

Shakeel is a 13-year-old brave boy with a big smile on his face. Shakeel belongs to Layyah. They are three brothers and one sister, and Shakeel is the youngest of all. He is a patient diagnosed with AML (Acute myeloid leukemia - a cancer of the blood and bone marrow). It is the most common type of acute leukemia. This type of cancer usually gets worse quickly if it is not treated. 

This calamity begins almost 1.5 years ago, on Ramadan, 25th 2022, when his mother took him to another doctor after visiting many, with the complaint of constant fever that was not going away with any medicine taken so far. It was the day when he was diagnosed with blood cancer, that’s why she remembers the date so accurately.

After the lab reports confirmed the diagnosis, they were referred to take Shakeel to the Children’s Hospital Multan, where considering that the case is beyond their control, they referred him to Agha Khan Hospital Karachi, which was a way more difficult thing, then they managed to take him to the Children’s Hospital Lahore on 5th day of Eid, 2022. Here they had a very satisfactory treatment. 

According to the American cancer society, the 5-year overall survival rate for pediatric AML is higher than that of adults, ranging from approximately 65–70%. And as per expectations, the symptoms were gone in 6 months, and his response to chemotherapy was brilliant. God had answered their prayers, Shakeel returned to a normal life after a tough course of 6 months.  

But all of a sudden, the misfortune returned back like a bad omen. After 5 months of recovery, his symptoms started appearing again, and his platelets count got very low (47). His condition started relapsing. “THE CANCER IS BACK”. Now Shakeel is a relapse patient of AML. According to research, the prognosis for patients with relapsed disease is extremely poor. The median overall survival for patients with relapsed AML ranges from 4-6 months and long-term survival from the time of relapse ranges from 5%-20%. Now it needs more potent chemotherapy treatment to reach complete remission, things will not be as easy as they were previously.

After the symptoms reappeared, he got various sessions of blood serum platelet infusion from Multan Children’s Hospital, but that was of no use. And then they end up here, again, at the Children’s Hospital, Lahore. On the same beds they once said goodbye forever with pleasure and gratitude … the rooms they once left with a hope for a new start in life, they had to return to the same area with more gloom and melancholy. Now after relapse, his 3rd session of chemo has started. Adding to their problems is one of the policies of the hospital, where a relapse patient is not fully entertained for his expenses. Now Shakeel’s father is managing the expense of his medicines on his own. (For instance: Shakeel needs 3 injections of Brivaracetam now, each costing Rs. 9000, they just ordered one as of now as they could afford one only). While his father owns a welding shop where he works. Furthermore, after the relapse, the relatives turned their backs, separating Shakeel’s father in property and business, accusing him that they have already spent almost all of their money on the treatment of this kid. 

Now as far as the ultimate treatment is concerned, a bone marrow transplant is suggested from a matching donor (i.e., one of Shakeel’s brothers) followed by a considerable period of chemo. But here is more of an issue now, Shakeel’s father refuses to risk the life of one son for the other, and he has no hope for Shakeel’s complete recovery either. He says, “We are already in great pain with the disease of my one child, I do not dare to put another son of mine into this situation with my own hands.” While Kalsum Bibi seems to have no opinion in this sensitive decision regarding the lives of their children.

So the next step left is, they buy the bone marrow from a matching donor, which seems impossible in the light of the recent financial grind they are having.

It’s been 1.5 years now, they are stuck in this loop of misfortunes and unfavorable situations, where finding hope is not an easy thing for them…. Kalsum Bibi weeps while pointing towards another girl in the room with relapse AML, saying that here came 4 patients with relapse in this ward, 2 are dead by now, and only Shakeel and that 4-year-old girl are left, “We don’t see anything forward” …

At that point, I was speechless… I had no word to console Kalsum. I could just tell her to show some more patience, and I could just say to her that my prayers are with you. I felt helpless there and couldn’t imagine how helpless they must be feeling all the time there. Hoping that our medical facilities and health system progress are advanced enough so I do not have to interview any such hopeless mother in any government hospital ever after. 


Please join me in praying for the complete and safe recovery of Shakeel. May he fully recover and remain in good health. Let's also pray for his parents to have a happy and easy time with him. Amen.

Lots of prayers for Shakeel and her family, and for all sick children to recover quickly and never experience their illnesses again. May they lead happy and healthy lives once more. Amen.

Note: Names have been changed to protect identity


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