Sunday, 1 March 2009

Sik cancer

Cancer in PNG is unlike almost anything I've seen in the States.  O.K., maybe you could compare to JPS (the county hospital in Fort Worth where I did residency) because we served an indigent population.  Maybe.  Patients here don't go to the doctor until they are really sick.  And by the time they are really sick with cancer, the disease is quite advanced and often untreatable.  Not that we have much in the way of chemotherapy agents.  The cancers we can treat are lymphoma, some leukemias (i.e. CML), early cervical or other gynecologic cancers (with a hysterectomy), and Wilm's tumor in children.  Palliative care is generally all we have to offer, which means we do what we can with medications so that the patients are comfortable until they die.

Hepatitis B is very prevalent in PNG (as high as 20% by some estimates) and is a known cause of liver cancer.  I have diagnosed three cases of liver cancer over the past one month, and will likely see many more.  Mouth cancers are not uncommon due to smoking or chewing beetle nut.  Lung cancer is another one.  If patients don't smoke they are probably exposed to smoke from cooking fires.

Paul sleeps in bed 21 on C-ward.  He has been diagnosed with CML, a type of leukemia.  He has been in the hospital for more than a month now because of a large ulcer on his foot.  I am showering him with all sorts of antibiotics, but the leukemia prevents his body from healing the wound.  For all the medical folks out there, his WBC count is currently > 100K.  The first chemotherapy medicine (busulfan) has failed, so I started him on the second line treatment today (hydroxyurea).  There is another treatment that has recently become available, but you can only find it t in Port Moresby.  Traveling to Moresby is an expense that Paul's family cannot afford.  Paul is praying and waiting for God to heal him.  Will you pray with me for Paul?

I wrote about Ai in one of my previous entry.  She is the young woman with advanced cervical cancer.  My best guess is that she is about 30 years old, because her children are seven and nine years old.  She came back to see me in clinic today.  The Tylenol and ibuprofen I had prescribed had significantly reduced her pain and she was feeling great.  Ai told me that she had shared about her diagnosis with her church, and that the pastor had prayed for healing.  She was certain that God had answered and the cancer was gone.  I examined her and found that the tumor had grown from her previous visit.  She continues to have faith that God will heal her.  He will answer her prayers.  She will have a new body someday.  Will it be in this life, or in heaven? Will you pray for Ai, too?

"Have faith in God," Jesus answered.  "I tell you the truth, if anyone says to this mountain, 'Go throw yourself into the sea,' and does not doubt in his heart but believes that what he says will happen, it will be done for him.  Therefore I tell you, whatever you ask for in prayer, believe that you have received it, and it will be yours."
~ Mark 11:22-24

Lord, increase my faith.


  1. I appreciate these specific stories and pictures of the people. Praying today for Kudjip hospital.

  2. Here is a bit of an update on these patients.
    Paul's foot ulcer very much improved on the new cancer treatment! He went home about 10 days ago. I was supposed to see him back in clinic but he has not come yet.
    I have seen Ai two or three times now. She is experiencing a bit more pain these days, but God has given her such a peace and she is doing well.