Dear Family and Friends,
It was my privilege to return to BBH at the end of June. One of the things which has been striking since then is the amount of cancer we are seeing – ranging from leukemia and lymphoma to liver cancer (related to the high prevalence of hepatitis B in this part of the world) to breast cancer to colorectal cancer… to name those most commonly seen. As services have expanded, so has the potential to provide adjuvant chemotherapy in an attempt to eradicate some of these neoplasms – which might prove incurable with surgery alone. Yet, chemotherapeutic agents are expensive. For example, following a mastectomy for breast cancer, the cost of adjuvant chemotherapy is roughly equivalent to – and at times even exceeds – the cost of surgery. While many patients struggle to cope with the surgical bill, the addition of chemotherapy typically doubles a patient’s financial liability. One of the constant challenges in a resource-limited setting is endeavoring to develop affordable regimens for our patients without compromising the quality of their care.
Such a challenge is illustrated by the circumstances of a young man. Alassa is a 23 year old who underwent surgery for an advanced colon cancer in January. Now over 6 months later he has returned to the hospital to commence chemotherapy – which had been recommended months earlier. When asked why he was presenting so late, Alassa’s reply was that he had been “looking for money.” Because chemotherapeutic agents are costly, the hospital cannot afford to provide them independently of a patient’s ability to pay. The significant delay in Alassa’s return compelled a thorough work-up to look for recrudescent disease – evidence of which was unfortunately found. After conferring with an oncologist via e-mail, it was agreed to go ahead with chemotherapy in anticipation of yet another surgery. That is, if Alassa responds well to chemotherapy, it’s conceivable that the newly discovered lesion might diminish enough to be rendered resectable at the time of a second surgery. In that case, this young patient could potentially be cured of his disease. Of course all of this entails still greater expense, leading to more of a financial strain on the patient and his family.
Amidst Alassa’s discouragement there was the opportunity to speak with him and his father about the Savior. Even if Alassa’s cancer is successfully eradicated, what is ultimately to be gained if he forfeits his soul? It is a privilege to be able to offer the hope of the world to such as this dear man.
With Love and Gratitude, Julie Stone