Sunday, November 11, 2007

Ray of hope

Cancer in children is occurring more frequently but the good news is that it is curable most of the time

By Shevlin Sebastian

"Amma, I am feeling hungry," says three-year-old Jayalakshmi.

“Yes, baby, I will give you something to eat,” says her mother, Mini Jayakumar.

Jayalakshmi is sitting on the bed in the children's cancer ward at Welcare hospital in Kochi. She is resplendent in a purple paavada (skirt) and blouse, red glass bangles on her arms, and small gold earrings. The only telling sign that she is suffering from neuroblastoma is that her head is completely bald. "She has gone through nine sessions of chemotherapy," says Mini. "The tenth one will be done on October 22. Following that there will be a bone marrow examination and a CT scan."

Mini is married to Jayakumar, who works as a salesman in a textile firm in Kochi. They live in Vaikom. Jayalakshmi is their only child. Her illness was discovered when a doctor pressed her stomach and noticed a bulge. She has been undergoing treatment for the past six months. "We have spent Rs 2 lakh so far," says Mini, as her eyes fill up. "We have taken loans from friends and relatives."

The doctor has told them that the treatment will continue for another year, at the least. “In the beginning, they said it was a difficult case, but now there has been a lot of improvement,” says Jayakumar.

How was the child taking the treatment? “She is happy most of the time,” says Mini. “But when there is chemotherapy, Jayalakshmi gets angry or irritated. But that is the case with adults, too. Chemo is like a fire in the veins.”

In the next bed sits Ajay Ramesh, 3 ½, from Trissur who is suffering from acute lymphoblastic leukaemia. "He has spent 35 days in hospital," says his mother, Bhuvaneshwari, 27. "Ten chemo treatments have been done. The doctor says that he will need regular treatment for two and a half years." The total cost is Rs 2.5 lakh, which is a huge sum for a family, whose bread-winner is a labourer. The family has taken loans, but there was one piece of good news: A plea for money, which appeared in The New Indian Express, resulted in donations amounting to Rs 55,000.

On one side, there is Rafiq (name changed), who is only two years old, a plump, smiling boy, bare-bodied and in green shorts, who is suffering from acute myeloid leukaemia. “He is a very playful child,” says his mother Ameena, 27. The father, Majeed, 37, has a haggard look on his face. He works as a labourer in Calicut and the expenses are beginning to wreck his life.

“The doctor says the treatment will continue for four months,” says Majeed. “We hope he will get better soon.” Later, oncologist P.S. Sreedharan would say that Rafiq’s prognosis is bleak and his life hangs in the balance.

Cancer among children is rising steadily. "Every month, we get ten new patients," says Sreedharan. "The reasons for paediatric cancer are several."

One reason, he says, is hereditary. Around 10 per cent occurs because of this. Then, viral infections can lead to cancer. There are a lot of chemicals and pesticides in food, which can cause cancer. Some of the chemotherapy drugs can produce cancer as a side-effect much later.

“The commonest form or cancer among children is leukaemia or blood cancer,” says Sreedharan. “Then there are brain tumours and they develop other malignancies like sarcoma.”

But the good news is that cancer among children is curable, if detected early. However, to ensure a cure, the treatment has to be aggressive. “So, doctors tend to combine chemotherapy, radiation and surgery," says Dr. Yamini Krishnan, oncologist at Lakeshore Hospital. But, surprisingly, the child is able to tolerate the treatment better than adults because their organs are healthy. "Elderly patients will be having problems like hypertension, diabetes, cardiac problems, and strokes," says Krishnan. According to both doctors’ estimate, around 65 per cent of the children are cured, while the rest have a relapse after a few years.

Sreedharan says he knows of several children, who, when they become a little older, forget the traumatic experience. “They have some vague idea that they have been to this hospital and seen that doctor and this nurse,” he says, with a smile. “But they have forgotten everything and are absolutely normal now. This is the best part! Children teach us a lesson: we should live in the present, instead of the past or the future, as we tend to do most of the time.”

When you stand around for a while in the ward, you can sense the intense emotional charge among the people present. Says M.T. Cherian, the administrator of Welcare: "Why does God give these innocent children so much hardship? When I see them, my heart breaks. To be honest, I don’t come too often to the ward."

Staff nurse, Jessy Benny, 32, says, "I feel sad when I look at these children, because my children are of the same age. We get attached to the children, and know the stories of their parents and what a financial blow it is for them.”

Not all parents can withstand the emotional and financial burden. On Tuesday, 25th September, Dasan 52, his wife Kamalam, 46, and son Jisilin, 15, committed suicide at Lakeshore Hospital by consuming pesticides. Jislin was suffering from acute lymphoblastic leukaemia, Kamalam, from kidney failure, while Dasan had suffered a partial stroke some time ago. Relatives said the acute financial crisis, caused by the medical treatment, forced the family to take the extreme step.

In Jisilin’s case, Sreedharan, who also works in Lakeshore, felt that the boy was on the way to recovery. So, although it might sound bleak and hopeless when you hear that a child has leukaemia, “the majority get cured and later lead full and fruitful lives,” he says. “Parents should remember this.”

However, Dasan lacked the fighting spirit to go through the dark night before the dawn and extinguished the most precious gift that we have: a life. But, in the overall context, Dasan’s is a rare case of defeat. Most parents, when faced with a child’s life-threatening illness, will react like Jayakumar, the father of Jayalakshmi, who says, “I will do anything so that my daughter can live.”

(Permission to reproduce this article has to be obtained from The New Indian Express, Kochi)

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