Karkinos - n. Greek. "crab" - As he was looking at a patient's tumor, the father of Medicine, Hippocrates was said to have been reminded of a crab with its legs spread in the sand, the hardness of the tumor being as hard as the crustacean's shell.
Cancer is such a complex disease. Suffice to say, I was not at all looking forward to the guaranteed toxicities of the Oncology Module of our OS 217: Systemic Diseases subject. I didn’t want to do ward works on cancer patients. I didn’t want to feel depressed and hopeless, judging by the awful prognosis statistics made even worse by the socio-cultural factors that seem to be common in our patients here in UP-PGH (Just goes to show that our society is suffering from a cancer of its own.).
The topic of cancer never fails to bring to my mind the memories of my good friend, Rishei, and my beloved grandmother, Lola Gelly.
Back when we were high school seniors, Rishei was found to have a brain tumor. A real tragedy for someone quite young, whose life has yet to fully unfold before her. During the earlier phases, we used to see each other in Mass at our parish church and she was still able to smile despite how difficult undergoing treatment was. As time passed, her disease progressed and she had to undergo surgery already. I remember how frustrated and angry (at the world – at the exam I was going to take) I was over not being able to go to her bedside come the news of her critical condition. I could only cry when my mom finally told me what happened come February of that year.
Lola Gelly was already in her 80’s when she had been diagnosed to have breast cancer. No one, even in our family of doctors and healthcare professionals, saw it coming. Lola just randomly commented one day that she felt something hard on her breast and well, even if at first no one wanted to believe it, there it was. The tumor was removed but the family decided to opt out of chemotherapy, considering how Lola might not be able to take the effects of such treatment. Cancer is just so cruel. With the passing of time, it spread until it got to almost every part of Lola’s body. The progression is such a sad thing to remember. Lola’s suffering was not at all short. It was a difficult battle. Seeing my mom and my aunt with Lola on her final hours was a heart-breaking moment. It’s okay. Let go na, Ma. Sundan mo na si Jesus.
I saw firsthand how bad this disease can get – how great the suffering of patients are, how hard it is to keep fighting, how difficult it is not to keep asking God, Why? Why? Why? – It is only understandable how hesitant I was on going about this subject. Sure, I was hiding it all under the pretense of my usual smile, laugh and easy-going disposition, but inside, there was an internal battle going on. And I didn’t want to face it.
But yesterday, I met N.B., a middle-aged tricycle driver who is currently battling stage IV colorectal adenocarcinoma with metastases to the lung and the liver s/p colectomy, metastasectomy and colostomy creation. It took quite an effort not to show my extreme surprise when he revealed his diagnosis to us while we were conducting history-taking and physical examination. He did not look like a patient with such a condition, the terminal stage that has only a 5-10% 5-year prognosis and is usually just focused on palliative and not curative management. N.B. was smiling and he was even calmly enjoying listening to music while getting the chemotherapy. His wife, ever supportive, was also smiling. Being assigned to do the physical examination, I even had the opportunity to fully converse with him, even share some laughs with him.
His positive disposition despite his condition is amazing. The unwavering support of his wife, his family and his friends is likewise amazing. I could not help but admire them. I could not help but think, Hey, maybe that’s how we should battle this karkinos.
For a disease that remains to be incompletely understood and that can be addressed by such limited modalities even in today’s age of research and innovative advancements, our preceptor, Dr. Strebel is right: we can only do what we can do and hope for the best. But I believe it helps – how we choose to see it, how we choose to face it, how we choose to fight this battle.
I continue to pray for the souls of those who have died battling cancer, especially Lola Gelly and Rishei. I continue to pray for everyone who is still battling this disease, the patients, their families, even the doctors who are trying hard to pave the way for recovery. It is definitely not easy, but once we think of it as a death sentence, then it will really be just that.
No longer am I hesitant about how to face this battle. After all, our mindset is already half the outcome. Cancer is a battle to be fought and we – everyone, as it requires a united front – must fight it head on.
"There is no profit in curing the body if in the process we destroy the soul."