Warriors and Survivors - 49

 

Children Cancer Stories by Rukh Yusuf - Blog # 49

B-Cell Non Hodgkins Lymphoma

 

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.

Ali Hamza is only four-year-old young, little, cute boy. He is from Jhang and was living happily with his family in Jhang. His father is laborer and does different kinds of labor work whatever is available.  Among siblings he has an elder brother only.

Ali Hamza was healthy until he was four. He started getting pale and with puffy body, at first parents did not notice, later he developed fever and body pain as well. When the condition prevailed, they took him to local doctor who transfused blood to him.

He did not improve much, local physician referred him to children hospital for proper work up and diagnosis. Ali Hamza was admitted initially in medical unit and from there his initial investigations and treatment was started and later he was shifted to Oncology unit. Here he was diagnosed as case of B Cell NHL on Flow cytometry.

His treatment has been started since couple of months. Ali Hamza looks generally stable but little angel has stage four severe disease. His two courses of chemotherapy have been completed and more to go.

Non-Hodgkin lymphoma (NHL) is generally divided into 2 main types, based on whether it starts in B lymphocytes (B cells) or T lymphocytes (T cells). There are many different types of B-cell lymphomas. Treatment usually depends both on the type of lymphoma and the stage (extent) of the disease, but many other factors can be important as well.

B-cell lymphoma (DLBCL) tends to grow quickly. Most often, the treatment is chemotherapy, usually with a regimen of 4 drugs known as CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone), plus the monoclonal antibody rituximab. This regimen, known as R-CHOP, is most often given in cycles 3 weeks apart. Because this regimen contains the drug doxorubicin, which can damage the heart, it may not be suitable for patients with heart problems, so other chemo regimens may be used instead.

 

Little one does not know about his disease; he is too young to understand. I could see that his mother doesn’t know fully the disease and its severity. Seeing these families and parents I sometimes feel that ignorance is a bliss in some cases. As they are not fully aware about the details of the disease, so they have the courage to handle it, otherwise it is dying like condition every moment when your child is terminally sick.

Most people who seek treatment in public sector hospitals usually belong to lower middle class with little or no formal education. Even after counseling, their understanding about treatment and disease consequences is vague. But this is generally good for them to a certain extent, they keep going and have hopes for better that enables them to fight with the disease and hardships they have to face.

 

We can pray for the ease of the suffering family and the complete health and recovery of Ali Hamza and all warriors who are suffering silently and those who even don’t know their disease and what is going on with them.

May Allah ease and cure all patients and cancer warriors.

 

 

Note: Names have been changed to protect identity

 

Warriors and Survivors -48

Adrenocortical Tumor

Children Cancer Stories by Rukh Yusuf - Blog # 48

 

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.

Sawab Fatima is nine years old female with stage three Adrenocortical carcinoma from Jhang. She was all fine until seven years of age. Suddenly she had episodes of vomiting off and on with weight gain and excessive hair growth on whole body. She also had coarse voice gradually.

Sawab Fatima has a younger brother, and her mother is taking care of her both children alone as Sawab’s father had died few years ago.

She was taken to local hospital and medications were given but she did not improve. Her condition was same for few months. Fatima’s mother was seeing her worsening situation and took her to Children’s hospital on some one’s advice. It was a difficult step to move with her younger children alone to another city, but poor mother had to do something for the health of her only daughter.

She was admitted in hospital for complete investigation and work up. She was diagnosed as right adrenocortical tumor and her surgery was planned to remove it.

She was shifted to Surgery department where her tumor was removed and successfully, she was discharged and had to come for follow up.

On Follow up Swab Fatima was shifted to oncology department. Here, her investigation work up started and her chemotherapy was initiated for stage three right adrenocortical tumor.

Her first cycle was completed in early February, and she is on second chemotherapy cycle and still has more to go. Little girl is bearing chemotherapy so far patiently and her mother’s bravery is commendable who is fighting with her daughter’s disease. As she is travelling frequently from Jhang and living here with two little kids. She sews clothes and earns for her children.

Life is more difficult for single parents, especially single mothers in the age when they have younger children to take care and earn for them too. Life becomes more miserable when unluckily some of the family member has to fight with the difficult disease like cancer.

Not only Swab Fatima is a warrior but her whole family is, including the younger brother who is travelling frequently with his family being single male member. Her mother is great warrior she is really deserving family who needs help of all kinds, moral, ethical, financial etc.

We can pray for the ease of the suffering family and the complete health and recovery of Swab Fatima and all warriors who are suffering silently and those who even don’t know their disease and what is going on with them.

May Allah ease and cure all patients and cancer warriors.

 

 

Note: Names have been changed to protect identity

 

Warriors and Survivors -47

 

 "Thalassemia Major"

Children Cancer Stories by Rukh Yusuf - Blog # 47

 

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.

Zeba is 16 years old girl who has grown elder receiving thalassemia treatment. She is from Kashmir. She was diagnosed as having thalassemia major when she was less than five years old.  Not only Zeba but her elder brother was also suffering with thalassemia major. Poor father who is laborer, had been managing the treatment since more than a decade and still doing efforts for the life of his child.

Zeba’s brother passed away two years ago due to complications caused by thalassemia. Zeba too is striving hard to win this battle, but her victory seems difficult due to financial and social circumstances. Most of us know that thalassemic patients need frequent blood transfusions resulting in iron accumulation in different organs, mainly heart and kidneys. This excess iron is lethal, and iron chelators are being used to remove extra iron from body. Iron chelating agents are lifesaving medicines for any thalassemic patient.

It is sad reality that thalassemic patients do not survive longer but when they do and luckily reach teenage, they are refused treatment from a child unit being above the age of children range.

Zeba has also been refused because she is above child’s range. Poverty and children’s diseases have made her father older earlier. He does not have a fixed income source. Although Zeba gets blood transfusions from some charity institutes but she needs a regular supply of iron chelator medicines which are not so costly, but Zeba’s father cannot afford to buy. He hardly manages to travel from Kashmir to Lahore.

He is so simple and innocent at this old age with so many wounds on his heart, specially death of young son and brutal disease of a young daughter since more than a decade.

Punjab Government is already doing great, we have a very large Thalassemia center which is providing free treatment facilities since long. But when these children go to teenage, they don’t have a facility for treatment and free medication. Most of the families are poor or they get poor while fighting this battle. There is need of a center or clinic/program which can provide free medications of thalassemia major patients above 16 years or older. So that some of fortunate or may be unfortunate ones who live till the age of 16 or above can have their treatment from these units or centers. Government or philanthropists should come forward and make this happen to facilitate these miserable lives. Pakistanis are no doubt most generous and full of philanthropists.

May Allah help us to be able to help others and to do something worthwhile for the suffering of others. Aameen

I pray for healthy and smooth recovery of Zeba and all our warriors, and healthy life for all our survivors May Allah bless all those families who are fighting this cruel battle. Aameen

May Allah help us to be kind to patients and attendants and grant us courage to keep ourselves strong and updated.

 

 

Note: Names have been changed to protect identity

 

Warriors and Survivors -46

 

Children Cancer Stories by Rukh Yusuf - Blog # 46

 

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.

Yesterday, I was in HDU of our unit working on some chemotherapy of a patient. When I finished and was about to leave, I felt someone was pointing at me. I looked at her, she was a nine year old girl who was calling me pointing her finger at me. I asked without speaking, are you calling me? She replied yes. I went close to her and tried listening what she was saying as she was with oxygen mask.

She removed her mask and said to me slowly, “Will you be my api (elder sister)”? I replied, “I am already your api, you can say what you want to”. She said I like your hair, and I also had great hair but due to chemo my mother cut them. She further requested me to remove my mask so that she can see me. Seeing happiness on a child’s face who is oxygen dependent in ICU, one is ready to do something to make her happy. I removed my mask, and she was very happy to see me, and she promised me that she will come to meet me when she will be discharged from hospital. I pray may she visit me soon.

Amina is nine years old very sweet and talkative girl, she is from Vehari, and she has two brothers. She is only daughter of her parents. Amina was diagnosed as Pre-B ALL few months ago and her two chemotherapy cycles have been completed till now.

A week before she was admitted due to fever and her raised serum creatinine, her renal profile was so disturbed that doctors were planning for her dialysis. I met her while I was managing her medications as per her renal profile. She was on treatment since that day, and I was happy to see today that her serum creatinine was normal, and she was no more oxygen dependent. She was happily sitting saying hello to me. She again promised me today that she would come to visit me. On 15^th Feb Amina was sitting on wheelchair and was looking too sad despite celebrations around her.

Here I want to mention two things, First importance of clinical pharmacy and pharmacist services. Presence of clinical pharmacist and their active participation in medication management can bring excellent results in overall management of oncology patients. Doctors and nurses in public sector hospitals are overburdened and, in this scenario, clinical pharmacist can better manage medication related issues and errors. Pharmacists’ seats are not as per requirements in any public sector hospital. There is dire need to increase number of pharmacists in proportion to number of beds in all hospitals to improve health sector.

Secondly, pleasant behavior and fresh looks of health care staff leaves a refreshing effect on pediatric patients. Healthcare staff with their positive attitude and fresh look can brighten up patient’s days and this definitely affects better outcome of therapy.

Children and their parents who are already suffering with pain and hardships can have a sigh of relief with positive personalities and their kind attitude.

May Allah help us to be kind to patients and attendants and grant us courage to keep ourselves strong and updated.

I pray for healthy and smooth recovery of Amina and all our warriors, and healthy life for all our survivors May Allah bless all those families who have lost their child in fighting this battle. Aameen

 

Warriors and Survivors -45

 Children Cancer Stories by Rukh Yusuf - Blog # 45

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.

Every Child Should have Equal Right to Fight Cancer

International Childhood Cancer Day 2022: Every year, February 15 is observed as the International Childhood Cancer Day (ICCD) to highlight the danger and impact of this deadly disease among children. It is a global collaborative campaign to raise awareness about childhood cancer and to express support for children and adolescents with cancer, the survivors, and their families.

According to the World Health Organization (WHO), more than 4 lac children and adolescents below the age of 20 years are diagnosed with cancer every year. While the chances of their survival are close to 80 per cent in some high-income countries, the rate of survival for such patients from low-income countries is as low as 20 per cent.

Every year In Pakistan, approximately 8,000 new childhood cancer cases are reported but actual number may be too high as a large number of cases are not reported.

Contrary to the common understanding, if diagnosed and treated properly at an initial stage, cancer is a curable disease. It is common practice in our part of world that patients reach very late at proper diagnosis and treatment stage.

In Pakistan, leukemia (a type of blood cancer) is the most common childhood cancer. Unlike the west where survival rate of leukemia is more than ninety-five percent, this is much lower in our country.  Factors leading to these poor outcomes include severe malnutrition, infections, and delayed diagnosis.

In addition to leukemia, other common types of cancer also seen in Pakistan include lymphomas, bone tumors, retinoblastoma, and Sarcomas.

Mostly pediatric cancers are not preventable, so early diagnosis and appropriate treatment is mandatory. One of the biggest reasons of rise in cancer incidence is lack of awareness about cancer and its symptoms. Consequently, timely diagnosis and treatment is delayed. In our part of the world, instead of reaching to the oncologist on priority, parents often attempt alternative medicine options like spiritual healing and other ways which further delays curative therapy.

Lack of treatment centers and their access are also big hurdles in timely diagnosis and

treatment.

To spread awareness International Pediatric World Cancer Day was organized at Children’s hospital. Children who could come and attend the ceremony took part enthusiastically. They were holding placards mentioning their courage and strength. Hiding their pain, they were standing to show their bravery.

Let’s create awareness about pediatric cancer and make it possible to guide every family to go for timely evaluation and treatment in case of need.

I pray for healthy and smooth recovery of all our warriors, and healthy life for all our survivors May Allah bless all those families who have lost their child in fighting this battle. Aameen

 

Warriors and Survivors - 44

 

Children Cancer Stories by Rukh Yusuf - Blog # 44

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.

 

I first met Abdullah in playroom of our unit, He is cute, lovely ten years old child with a calm smile. He came to play there for some time. I asked, “what is your name?”. He said, “Muhammad Abdullah”. What a great name.

He was looking fine, having IV canula in his one hand. I asked him in which room he was, he informed me about his room. It was my first meeting with him. Though it was short meeting, but I remember his innocence.

Other day during my routine work, I saw him again. He was sitting near his bed and was not feeling well.  I came to know that he was patient of Aplastic anemia. He was having his medications and admitted due to his low counts.

His mother said that he was prepared for bone marrow transplant but due to unavoidable reasons his transplant had to be delayed.

Now Abdullah was admitted, he was waiting for his transfusions as his platelet counts were low. Suddenly he had headache and vomiting, his medications were being given to improve his counts.  But still he had episodes of vomiting.

Before leaving hospital I just went to see him, and I was saddened to see he was not well, and his father was with him doing everything a father could do for his ill child.

It was Saturday and I left hospital after my duty hours. In the evening I just remembered about him and don’t know why I called duty doctor to ask about Abdullah’s condition. I heard a heart wrenching news that Abdullah expired at 7 pm in the evening. He had intra-cranial bleed and his CT was planned but he left this world before that.

It was such a sad news that I started crying as soon as I heard it. It is not like that I first time saw or heard about some patient’s death, but Abdullah’s death shocked me to the core. I was deeply saddened for quite some time.

Working with children is a different kind of job; sometimes you are happy to meet and talk to them and sometimes you are grieving for them. Seeing their sufferings on daily basis is a constant stress. We need strong nerves to work in such an environment. Many children have lost their lives in fighting this battle. We salute to all healthcare staff who treat and take care these withering children. May Allah grant courage and strength to all of us to treat these warriors well and to do our part for the ease of their pain.

 

Let’s pray for Abdullah and for his family. May Allah give patience and courage to bear this huge loss of losing their eldest son. Aameen

I pray for healthy and smooth recovery of all our warriors, and healthy life for all our survivors May Allah bless all those families who have lost their child in fighting this battle. Aameen

 

Note: Names and pictures have been changed to protect identity

Warriors and Survivors - 43

 

Children Cancer Stories by Rukh Yusuf - Blog # 43

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.

 

I met Aiman and her mother today. Aiman was listening Sura Rehman in semi conscious condition. She was under morphine effect. Her mother was sitting near her silently crying for her daughter’s life. It was such a sad sight to see.

Aimen is 13 years old warrior, seeing her condition it is hard to say whether she will be able to be a survivor or not. May she win and survive. Aameen.

Aiman was diagnosed as a case of NPC (Nasopharyngeal carcinoma) when she was eleven years old. She developed cancer within few months. She had persistent fever with bilateral neck swelling that got worse in few days. Her parents consulted pediatric oncology consultants and managed to treat her in oncology unit somehow.

She is student of grade six only. Her education is on hold until she is able to study again. She aspires to be a teacher and loves to go to school. She has lot of school friends, and she wants to meet them again.

Aimen completed her five chemotherapy courses and her swelling started getting better. She was discharged to go for radiotherapy, but her parents could not manage the cost for radiation therapy which had to be done in another oncology center. So, they lingered on treatment until they arranged finances. But the disease does not see resources and finances. It progresses if you leave it untreated. So Aiman’s disease got worse again.

She has presented again with same bilateral neck swelling and severe pain. It is hard to see her when she is in pain. Aiman is on pain medications and waiting for her session for radiotherapy. Her parents are in the process of getting an appointment using Punjab Government’s new health scheme which has proved to be a blessing for this suffering family. I will discuss about this new health scheme in next blog.

As her disease has spread, so she needs another couple of chemotherapy cycles before radiation treatment. She is not fit for radiation therapy right now. Poor soul is not in a good condition and her mother is terrified seeing her child worsening.

She is being prepared for chemotherapy once again, innocent kid has already born many cycles of chemo. I pray that she will be able to bear these two cycles and radiations therapy as well.

 

Let’s pray for ease of Aiman and for her family. May Allah miraculously help them. Aameen

I pray for healthy and smooth recovery of all our warriors, and healthy life for all our survivors May Allah bless them health always. Aameen

 

Note: Names and pictures have been changed to protect identity