A nurse comforts a boy with leukemia while preparing for a chemotherapy session at the Cebu Doctor’s University Hospital’s Center for Cancer. (CDN PHOTO/CHRISTIAN MANINGO)
At a tender age of six, James Esparaguera already has an inkling of what he will be like 20 years from now.
“Magpari ko. (I want to be a priest),” he said, creatively expressing his thoughts by sketching out a church on a cartolina.
But his dream may have to wait a bit.
Two years ago, while he was preparing for sleep, Esparaguera suddenly felt extreme pain on his right arm. He could barely move his limb, causing him much discomfort and fear.
Not long after, his left arm got immobile and he could not stand on his feet.
He was cringing in pain and the physical torment was unbelievable.
Bruises appeared all over his body and fever sucked every bit of energy from him.
Without enough money to see a doctor, his parents tried alternative modes of body therapy and treatment, but nothing helped ease the boy’s pain.
They eventually brought him to a doctor who subjected the boy to a series of medical examinations.
The diagnosis sent chills down their spine.
The boy was found to have an acute lymphoblastic leukemia, an aggressive form of blood cancer that usually begins in the bone marrow and results in high numbers of abnormal white blood cells.
It will progress rapidly and, if not treated, will probably be fatal just within months.
“Nakuyawan ko. (I am scared),” said Esparaguera while lying in bed inside their roughly built shanty in Minglanilla town, south Cebu, one afternoon.
A child’s ordeal
In an attempt to save his life, Esparaguera undergoes chemotherapy sessions every month — a procedure that requires countless needle pricks and frequent trips to the hospital for at least three years.
Chemo drugs are injected right into his spinal cord to kill leukemic cells that has spread throughout his body.
Since chemotherapy also affects healthy cells, it causes side effects that include fever, vomiting, hair loss, and the patient will be an easy target for infections.
One day, Esparaguera’s parents were taken aback when they saw blood dripping from the boy’s mouth. When they checked his mouth, they found huge sores and lesions on his gums and tongue — one of the drawbacks of cancer treatment. The open wounds were so severe that it stretched down to the boy’s throat.
The ordeal was just too much for the child who was on the brink of giving up.
His 51-year-old mother Gloria, though terrified, egged him on to fight and never to lose heart.
“I just could not understand what I feel. Cancer is no ordinary illness. It is a matter of life and death,” she said in Cebuano.
“As a mother, I feel very sad. When I learned that my son has leukemia, my whole world crumbled. I just could not fathom why my son, at a very young age, has to suffer this way. I never saw this happening,” she added as tears flowed from her eyes.
The Big C
Esparaguera’s ongoing fight against cancer highlights the harrowing tales of agony of persons besieged by a serious disease that invades the body.
From one cancer patient to another, the stories are similar. Their families face an enormous challenge— physically, emotionally and financially.
At present, cancer is the third leading cause of death in the country after heart disease and stroke.
Records show that one out of every 1,800 Filipinos is diagnosed with cancer every year, which translates to over 277,700 persons newly affected annually.
For every two new cancer cases, one dies within the year of diagnosis.
In children, leukemia is accounted for almost 50 percent of the total incidence of childhood cancer in the Philippines, followed by brain tumor and lymphoma or the cancer of the immune system.
In Metro Cebu, 64 children are diagnosed with cancer each year and the incidence of cancer affecting children has been increasing, with a five-year average increase of 36 percent based on the Ramon Aboitiz Foundation Inc. – Eduardo J. Aboitiz Cancer Center’s (RAFI-EJACC) Metro Cebu Population Cancer Registry.
The same cancer registry shows that six in every ten children with cancer in Metro Cebu have been diagnosed before the age of ten, while 38 children die of cancer every year, with 60 percent of these cases happening before their 10th birthday.
Dr. Julius A. Lecciones, executive director of the Philippine Children’s Medical Center (PCMC), the Department of Health’s (DOH) flagship hospital for children, said over eight in 10, or 82 percent, of Filipino children diagnosed with cancer recover from the illness.
This survival rate has improved from a decade ago when only two in ten or 16 percent of Filipino children afflicted with cancer were able to recover.
Doctors said leukemia in children is mostly treatable if the patient undergoes a full cancer treatment and given access to medication.
James Esparaguera, 6, shows his drawing of a priest and a Church that highlights the boy’s dreams and aspirations. (CDN PHOTO/LITO TECSON)
Tall order
But Gloria, who used to sell candles and run a small sari-sari store, said money is a major concern for them.
She said she had to stop selling goods to attend to her ailing son. Her husband, a truck driver of a cement company, has a steady income of P300 daily.
But the amount is not enough to feed a brood of seven, much more to buy medicines for his cancer-stricken son.
Gloria said they had to borrow money from anyone, including their doctor, to make sure her son would be able to undergo the scheduled chemotherapies, a session of which costs P1,800.
They also have to spend for antibiotics to treat complications brought about by chemotherapy.
“There are times when I want to give up. This nightmare is just too much to handle, but we’ve learned to entrust everything to God. He gave us our son, and if He wants to take him back, then we will accept it,” Gloria said.
“We just have to be ready. We know he can go anytime. We, nonetheless, remain hopeful that the Lord will heal him and give us the chance to take care of him,” she added.
Wearing the brown scapular of the Our Lady of Mount Carmel on his chest, and a surgical mask over his nose and mouth, Esparaguera expressed his desire to fully recover from his illness.
“Magpatambal ko aron maayo ko. Naa man si Papa Jesus. (I will submit myself to treatment so that I will be healed. I know Papa Jesus is there for me),” he said.
Ray of Hope
Amid the disappointments, Esparaguera’s family found a renewed sense of hope when they learned about an organization that extends financial and moral help to children with cancer.
For over two decades now, Kapwa Ko, Mahal Ko Foundation, Inc. – Cebu (KKMKFI-Cebu) has become the refuge of children inflicted with cancer, particularly those from the underprivileged sector.
A special program they call “Pangga-a Sab Ko” serves as a bridge to people who are in dire need, and to those who have the resources and are willing to help.
“We just felt the need to step in and help. Children with cancer have a high rate of survival and yet when we started our program, many of them died because they didn’t have the means to sustain the treatment,” said Dr. Rolita Mission, founder of KKMKFI-Cebu.
When the foundation began in 1995, each cancer patient had to spend at least P20,000 per week for chemotherapy and laboratory exams.
Mission said many families disposed their properties to sustain the medical needs of their loved ones.
“There was one family who sold their gas stove, the last property they have, in order to continue the chemotherapy of their daughter. It is just so sad to think about it,” she said.
To recover from the disease, Mission said the patient must go through the full chemo treatment which lasts three to four years.
“We don’t want to stop in the middle of the treatment. It’s a bit expensive only to lose the child. We need to really complete it,” she said.
At present, costs for chemotherapy vary, ranging from P300,000 to P500,000.
KKMKFI-Cebu, Mission said, has been providing financial assistance to children with cancer whose family are poor.
“The challenge is to respond to those in need of medical care. Ideally, we wanted to help all those afflicted with cancer, not just kids. But due to our limited resources, we give priority to children who still have a long way to go in life,” she said.
“These kids have dreams. They want to conquer the world. They have the potential of contributing to society. But here comes cancer — a very painful illness. Just imagine these little angels suffer from too much pain. It is not good to waste their lives. We want them to be cancer-free and fight the big C,” she added.
(Part 2: Helping hands)
In fighting cancer, collaboration is key. Donations pour in for kids with cancer in Cebu and other parts of the Visayas as shown in one of the money boxes of Kapwa Ko, Mahal Ko Foundation in a pharmacy in Cebu City. (CDN PHOTO/ADOR VINCENT S. MAYOL)
Plastic donation boxes at mall cashiers and pharmacies in Cebu speak volumes about a group’s commitment to help ease the plight of kids besieged by cancer.
In a year, Kapwa Ko, Mahal Ko Foundation, Inc. – Cebu (KKMKFI-Cebu) collects about P700,000 in donations from 200 charity boxes spread throughout Metro Cebu.
The amount, along with other donations and pledges from regular benefactors and entities, are used to provide chemo drugs and other medicines to children with cancer in the Visayas region and Zamboanga province.
“We know that deep within each human being is the desire to help,” said KKMKFI-Cebu project manager Lolita Baguio.
“There’s just the innate goodness to help despite the scarcity in funds. A peso or so is a big help,” she added.
If there is one way to fight the feared disease, Baguio said, collaboration is key.
“Cancer is a formidable disease but we should not be afraid of it. We should join hands to counter it,” Baguio said.
In Cebu, there are at least seven cancer centers and foundations—all run by private entities. The government, which is supposed to promote the physical well-being of its people, has none – so far – in the province and city of Cebu.
Last year, the Department of Health (DOH) announced it would establish cancer centers in strategically located hospitals, such as the Vicente Sotto Memorial Medical Center (VSMMC) in Cebu City, Davao City’s Southern Philippines Medical Center, Cagayan Valley Medical Center in Tuguegarao City, Baguio General Hospital and Medical Center, Bicol Medical Center in Naga City, Zamboanga City Medical Center, and the Lung Center of the Philippines in Quezon City.
The centers will be meant to ensure the patients’ access to radiation therapy especially for those who could not afford treatment in private hospitals.
Inadequate
Cebu Vice Gov. Agnes Magpale explained that government’s limited funds were most likely spent on other programs that benefit the vast majority such as people stricken with illnesses that are easy to cure.
“We cannot play God. We cannot choose who to help. But then we are not a very rich country. Our resources are too limited so government opts to prioritize other diseases, including poor nutrition.
We just have to find ways that are doable,” Magpale said.
“Can we institutionalize cancer-related government policies? I don’t know. Chemotherapy is just too expensive. For every 10 patients, we can spend P3 million already. But then one life saved is well worth it,” she added.
In her desire to help kids with cancer, Magpale has gone beyond the confines of her government office to wage a personal crusade for seriously ill children who could not afford cancer treatment.
For over two decades, Magpale has helped organize KKMKFI-Cebu where she now sits as vice chairperson.
“We want to help children who can still completely recover from cancer. And true enough, we now have a high success rate. The foundation is moving heaven and earth to gather funds to support cancer-stricken kids, and help them finish their chemo sessions,” said Magpale.
Since government cannot do it all, Magpale said non-governmental organizations and private institutions, like KKMKFI, should come in to help.
“We know that the children are the hope of our country. Let us help them. Giving up is a natural reaction whenever we know that cancer sets in. But we should not surrender,” she appealed.
KKMKFI-Cebu which started in 1995 has helped over 500 kids with cancer.
At present, 33 children undergo chemotherapy with the help of the foundation which provides P8,000 to each of the newly-diagnosed patients for the first eight months of treatment.
In the succeeding period, each cancer patient receives at least P5,000 per month over a period of two to three years, depending on the duration of the therapy.
The money is often used by patients to buy chemotherapy drugs, antibiotics, and vitamins.
Although most spend more than the amount provided by the foundation each month, the financial help gives patients and their families a huge lift.
‘Cancer Act’ needed
Lawyer Mundlyn Misal-Martin, president of the Integrated Bar of the Philippines’ Cebu City chapter, said government has rolled out programs that raise awareness about the disease and assist cancer patients.
These include the creation of the Philippine Cancer Control Program under DOH with goals to reduce disability and mortality due to common preventable cancers.
Republic Act 10526 also declares the month of January as liver cancer and viral hepatitis awareness and prevention month.
While there are cancer-related programs of government, Martin noted that the coverage is limited, and treatment programs were offered only for certain kinds of cancers and not for all stages.
“I believe we need to step up programs for cancer patients. We need to be vigilant and ready. Government should be readily equipped in terms of information drive, research and cure, and most importantly, financial aid,” she said.
Misal said a law or a comprehensive Cancer Act that will institutionalize cancer-related government policies should be made.
Such a law would establish early prevention and detection measures nationwide as well as increase and regularize financial support for cancer patients, giving them a better chance at survival.
In 2012, the Philippine Health Insurance Corporation (PhilHealth) launched “Z benefit” for catastrophic illnesses that will not just cover the hospital expenses of patients, but also ensure their total care to attain better health outcomes.
Initially, the cases identified under PhilHealth’s “Z benefit” program include childhood lymphocytic leukemia, breast, and prostate cancers.
The package cost for the complete treatment of these cases are P210,000 for the childhood leukemia, and P100,000 each for breast and prostate cancers.
Dr. Jose Antonio Quitevis, president of the Philippine Society of Pediatric Hematology and a consultant of the Cebu Doctors’ University Hospital, shares a light moment with cancer-stricken kids and encourages them to keep fighting. CDN PHOTO/ADOR VINCENT S. MAYOL)
Watch out
Dr. Jose Antonio Quitevis, a pediatric hematology and oncology specialist at the Cebu Doctors’ University Hospital, said cancer has become a major concern due to industrialization.
“Cancer is caused by an interplay of environment and genes—an interplay of many things so to speak,” he said.
Quitevis urged people to refrain from eating processed foods like canned goods, hotdogs, sausages, pickled vegetables, and charred food.
Harmful chemicals such as tobacco (cigars), asbestos (used in some cement, roof, and tiles), benzene (found in gasoline, kerosene, inks, lacquer thinner, asphalts, and pesticides), and radiation such as gamma and X-rays, are also associated with an increased risk of cancer.
The symptoms of cancer vary but usually include weight loss, fever, and extreme fatigue. People who notice something different in their body are advised to see a doctor, Quitevis said.
Although there has been no certain antidote to cancer, he said chemotherapy helps kill cancer cells in the body. If the disease is detected early, there is a good chance that patients get cured, he added.
For women, chemotherapy cycles usually run up to two years, while male patients need three years since some cancer cells hide in the testicles which need extra rounds of treatment.
The obstacles to early detection and effective management of childhood cancer include the delay in medical consultations and the absence of appropriate cancer treatment facilities in the locality.
Many parents also do not know where to go to seek treatment for their cancer-stricken children or have no means to pay for therapy.
According to Quitevis, also the president of the Philippine Society of Pediatric Hematology, some abandon cancer treatment as they have no means to sustain medications.
The cost of chemotherapy drugs and other supportive medicines, he said, remains the main barrier for patients.
“It’s about time for government to really improve its programs for people with cancer, especially children. If only given the proper treatment and intervention, many patients will survive. But how can we do that when many of them could not even afford to buy medicines,” Quitevis said.
He advised those stricken with cancer to always keep up the fight.
“Cast away negative thoughts. Be optimistic. Never lose hope,” Quitevis said.
(Part 3: Faith and Hope matter)
Mary Jean Saldaña (right) shed tears as she narrated the horrible experiences when her son John Franco (left) had leukemia. (CDN PHOTO/LITO TECSON)
John Franco Saldaña was in and out of the hospital for six years.
When he was seven years old, the young boy was diagnosed with leukemia, an aggressive form of blood cancer.
His illness caused his family much restlessness and fear.
While children his age were playing kids’ stuff around the neighborhood, John spent most of his time on his sickbed.
“I could die anytime,” he said.
But he was not one who gives up quite easily.
Instead of wallowing in misery, he persisted and continued chasing his dreams.
Though weak and sick, John managed to juggle chemotherapy sessions with his studies, making hospital visits part of his routine.
The least John expected was to fully recuperate from cancer, snap out of his awful condition, and be on top of the class.
In 2015, eight years after battling cancer, John graduated class valedictorian of the Kamputhaw Elementary School in Cebu City—a feat made extra special because of the ordeal he had been through.
“The battle was tough, but I don’t want cancer to get the better of me. I had to fight, and not let the illness bring us down,” he said.
The journey
John did not know what hit him in 2008 when one day, he felt weak and his appetite dwindled.
Soon after, he began to lose weight and found bruises on different parts of his body.
After seeing a doctor, John – then a grade one pupil — was diagnosed to have leukemia — a word his family dreaded to hear.
“At first, I felt hopeless. I felt so low. I lost my hair, and a needle was inserted into my spinal column every now and then. Many of my friends left. People, upon seeing me wore a mask and moved away from me,” John recounted of his ordeal.
Persistence
John’s chemotherapy sessions were usually held every Friday afternoon when classes were done for the week to give him the chance to regain his strength over the weekend.
In the hope of finishing his studies and helping his family, John did not want to quit school. He was right on track.
Despite having to undergo medical procedures to treat his ailment, he consistently topped his class since Grade 1.
The love and support of his parents spelled the difference.
“Mama and papa never made me feel that I was a burden to them. And if they fight for me, I ought to fight for myself as well,” John told Cebu Daily News.
Being hounded by a serious disease made John savor every moment of his life.
“When your back is against the wall, you consider every day a blessing. I’m just happy to live another day. And then years passed by, and I am still here. I know what I went through was nothing but a major test, yet I know that God is there,” he said.
And when the pain during chemotherapy was too much to bear, John said he simply would hold his mother’s hand and everything was fine.
“I draw strength from her,” he said as he relishes the thought of going into Grade 9 at the Abellana National School in Cebu City this coming school year.
The teenager continues to reap academic awards, and has been speaking in front of cancer patients to stir them up and inspire them to never give up.
“I simply want to give back to cancer patients like me. We need to conquer this illness. We need to keep fighting. Don’t lose hope. Dream big,” he said.
Prayer
While John was battling cancer, his mother Mary Jean clung on to her faith.
“I must admit that when we knew that my son had leukemia, we felt devastated. Cancer leaves you physically, emotionally, and financially drained. It was the spiritual dimension that kept us going,” she said.
Mary Jean said there was a time when John was shivering and suffering from night sweats. She said she and her husband had to take turns holding the boy’s body to warm him.
John underwent chemotherapy daily at the start of his treatment, until the procedure was done every other day, and then weekly, and in the last phase of the process, once every month.
“I prayed hard for God to heal my son. But I told Him that we are just stewards of one who originally belongs to God. We do not own our son. If God allows us to take care of him, then that would be a great blessing. But not as we will, but as God wills,” she added.
Mary Jean, a public school teacher, said the agony was not easy to handle, yet she was unrelenting in efforts to save the life of her son.
“We don’t know where we are heading; where our efforts would lead us. We simply want to do everything to the best of our abilities,” she said.
Financial disaster
Without enough money to complete the full procedure which cost them about P500,000, Mary Jean said they had to borrow money and take out loans.
“If your loved one has cancer, you will no longer think about the money. All you want is to save the life of your beloved,” she said.
One Christmas, Mary Jean said they barely had any food on the table for Noche Buena.
“Walang-walang na g’yud mi atong higayona. (We really didn’t have anything to spend at that time). I told God it’s all right not to have anything for Christmas as long as He will let my son live,” she said.
But God is faithful, she said, as both her prayers were answered — one at a time.
When the company where her husband worked for learned about John’s fate, they were given around P7,000 as a Christmas present.
They used the money to prepare a special meal for Christmas.
“God does provide,” the mother of three children said.
But nothing could be more wonderful than winning the battle against cancer.
In 2013, John completed rounds of chemotherapy and was cleared of the disease.
Since then, the illness has not recurred and John now lives a normal life.
“I just could not contain my joy. This is a miracle God gave us and I will never forget it,” she said.
John Franco Saldaña (left) shows the medals he received in school. After learning that he had leukemia, the teenager never gave up, studied hard, kept his hopes alive, and ended victorious in the battle against cancer. (CDN PHOTO/LITO TECSON)
Sufferings
Fr. Joseph de Aquino, who served as chaplain of Perpetual Succour Hospital in Cebu City and the current administrator of the St. John Paul retirement house for sick and elderly priests in Cebu, said sufferings and pains are inevitable in the journey of life.
“This is an imperfect world, and so in whatever situation we are in, there will always be suffering. We don’t stay here forever nonetheless. We are meant for something bigger and higher,” he said.
But where is God when people, especially children, suffer?
Fr. De Aquino said that Jesus Christ, the son of God who became man, is not a stranger to bitter sufferings and torment.
“Jesus suffered and died to save us from all forms of pains and even death. And so when we ask questions as to where God is amid all pains, the answer is He suffers with us,” he said.
In 2005, when he was newly assigned as chaplain of Perpetual Succour Hospital, Fr. De Aquino said he had a hard time comforting patients diagnosed with cancer.
But as years passed by, his frequent encounter with sick people at the private hospital run by Catholic nuns taught him a valuable lesson.
“You don’t have to explain. There can never be enough explanation as to why they need to go through all these pain and sufferings. All you have to do is to be with them. Your presence is enough to comfort them,” the priest said.
Fr. De Aquino urged people to care for those with cancer, spend quality time with them, and make them feel loved.
“Let us go visit and listen to them. We are called to love and show compassion to them,” he said.
Hope
To those afflicted with cancer, Fr. De Aquino urged them to deepen their faith and never lose hope.
“The empty tomb of Jesus means resurrection for his disciples, but for unbelievers, it suggests that the body was just stolen. The eyes of faith brings hope to what seems to be an unfavorable situation or condition,” he said.
“Through the eyes of faith, we find reasons to be joyful despite an awful illness. Faith matters in situations like these,” he added.
For Mary Jean, whose son overcame cancer, the disease failed to cripple love nor corrode her faith. It simply brought her faith and love to a higher level — even beyond the grasp of human wisdom.
“Cancer is undoubtedly a tough illness. But it is limited. It cannot cripple love. It cannot shatter hope. It cannot corrode faith. It cannot take away peace. It cannot silence courage.”