Tales of joy and hope in oncology

Monday October 18 2021
Oncology pic

By Dr Kheri Tungaraza

Often times, from family and friends, I am confronted with the question of why I became an oncologist.

This inquiry is usually followed by a discussion around sadness or suffering brought about by cancer.

In my mind, when such questions are put before me, the thought in other peoples’ mind is that my work is the epitome of depression and that I must clearly be unhappy.

I must admit, although the burden varies, cancer is still very scary across the globe.

Generally, it is a disease that the human race has a significant lot to do to combat.

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As the global burden increases, some countries like USA have seen declines in cancer deaths by nearly 30 percent, especially in lungs and melanoma.

So one would want to think that there are a times we win whilst there are times we lose.

Unfortunately, we talk more of the losses than anything else.

A win is a win, define it whatever way you want. In cancer, something trivial in an ordinary day will look big in the midst of a cancer diagnosis scare.


Anecdotal story

More than six months ago, we received a beautiful 30-year-old lady, happily married with lots of dreams.

She had lived her life full of optimism, doing everything right with no serious risk behaviour.

She however found herself at the towering gates of our hospital after months of observing a painless swelling on the side of her neck.

Worried for the worst, she surrendered herself to the doctors who did an evaluation and took a piece of the swelling through a small cut of the skin covering it.

The small piece taken out was examined under the microscope following special preparation.

The results confirmed her worst expectations.

She had been diagnosed to have a type of blood cancer called lymphoma.

Her life had been attacked by unknown assailant, a real contender of her life as she knew it.

Over the next six months, she underwent treatment in an attempt to get rid of the disease.

The treatment entails infusing her with drugs that have the capacity to kill the cancer cells all over her body.

It is a gruesome experience because these drugs, as much as they are deadly to the cancerous cells, can still do much damage to the healthy ones too.

They are like soldiers who are engaged in the battle field to kill the enemy but in doing so end up with innocent bystanders as casualty.

The treatment for cancer overwhelms patients in many ways much like the cancer itself, sometimes worse than the disease itself.

When the cancer diagnosis is disclosed to a patient, life changes immediately for these individuals; but the beginning of chemotherapy adds even more hurdles to everyday life.

It was no different for this particular patient but she did handle it in her own way, gracefully and with lots of hope, battling each cycle of chemotherapy as it came.

She encountered setbacks of all sorts as she was travelling this journey for the first time.

Everything she came across was new to her especially the body pains associated with the disease and chemotherapy.

She had to adjust her life to accommodate the new normal.

She had to survive this and she believed she had what it took to do so.


Here is a good ending

After a long haul of hardship, she conquered not only time but the disease itself.

The chemotherapy kept working cycle after cycle.

Instead of losing weight and dying from the treatment as tales of such are told in the streets by laymen, she marched on.

Her battle was going to end with a sweet victory.

She endured eight rounds of chemotherapy and when tests were done to assess the status of the disease, it was revealed that there was no sign of it.

She was free to go and only come back for check-ups every three months.

A transition to normal life was given a go ahead and it was time to pick up her life from where she had left off.

As she went on with her life, she regained more than just the 100 percent of it that she had lost when she was diagnosed.

She conceived a few months after conquering the emperor of all maladies.

A really sweet victory.

No loss of life but rather, a renewed sense of it.

Her God was more than faithful.

She carried her pregnancy to term and delivered a cute baby with no abnormalities and without any complications to the mother.

The new addition to the family was not only sign of love in the family but one of hope.

He is a gift for a battle fought well and won.

There are wins in cancer but it is possible they are never told as much.

We tend to hear of more losses than wins, thus painting a picture of misery all year around.

This patient’s story had to be told to ignite the lost hope among patients, caregivers and health care workers involved in oncology care.

It should be clear that with oncology, it is not all that gloomy for all the patients that are diagnosed with cancer.

We know that for most types of cancer, once diagnosed early, the chances of beating that cancer are very high.

Stages I and II of cancer provide a very good opportunity for gaining a win for more than 80 percent of all cancers.

The challenges of not having a lot people in early stages are chronic in Tanzania and they are attributed to many hurdles in our health system, community and individual levels.

However they can and are being worked on in order to change the cancer narrative that seems to be more of despair than hope.

One way to reduce the numbers of patients presenting with late stage cancers is by having preventive programs and diagnosing early.

The preventive programs include adhering to good wellness habits for all of us and as early as possible.

We need to eat well (more veggies, fruits and fish, nuts ,less red meat), be more physically active, vaccinate, stop tobacco smoking, reduce alcohol intake and screen for cancers as recommend by expert bodies.

These habits do need to go beyond the diagnosis and finishing of treatment for cancer.

It’s crucial to understand that the cancer has the possibly of coming back if not well treated and more so if we don’t take care of our bodies.

Therefore the habits as part of wellness should be for a lifetime

I must admit this particular win is huge by all accounts because the same life that was saved gave a new life that will be source of joy to many here on earth.

However a win is a win, and in oncology it could mean just extending one’s life.

Or improving the quality of the patient’s life.

When we can’t cure we aim at controlling the disease to different degrees.

The ability to keep the disease at bay or a corner is a win too.

We take all forms of wins, we don’t wait for them to be big or miraculous.

Oncology reminds one to be grateful to most of the time and hence able to appreciate the small things life has to offer.

The things to be counted as wins can be as small as having a peaceful night sleep, with no pain or being able to enjoy a meal without nausea or vomiting.

We, in oncology, appreciate these and count them as wins more often than others.

Life has to be appreciated for all that it has to offer, from the little things to the extraordinary ones like going to the moon.

Beating a deadly disease or surviving near death experience usually teaches people to look at life differently.

A cancer diagnosis and finally later on getting that green card is a really special experience.


Given us hope

There are several people out there who have had to go through this and are now living their life to the fullest, better than before after gathering lessons from their experiences.

It’s possible that their stories are told less.

However, these are, in my world, heroes and heroines.

They have shown me what seems to be impossible to many.

They have given me and colleagues hope and continue to do what we do.

I celebrate them and I wish everyone else would.