“Do I look like someone who has cancer?”
That was what my 23-year-old brother said when ‘The Big C’ took a hold of him. He was diagnosed in November 2011 with anaplastic large cell lymphoma (ALCL), an aggressive and rare type of cancer of the immune system with an estimated 7 per million new reported cases in the United States in 2011. ALCL has recently received more media attention, as it is the cancer linked to the breast implant scandal associated with the French company Poly Implant Prothèse (PIP), forcing women in several countries to have their implants removed.
A healthy and active young man, my brother started developing symptoms, such as continuous coughing, night fevers and weight loss. He eventually received medical examination at a renowned hospital in Beirut, and the results confirmed he had stage four ALCL. He was advised to seek medical care immediately, as his malignant cells were aggressive and growing rapidly. To fight this foreign invader, he had to undergo a grueling treatment involving several cycles of a combination of toxic chemotherapy drugs followed by a stem cell transplant — a transfusion of healthy stem cells, which are the parent cells of all our blood cells. Not only did he have to combat the uncontrolled growth of malignant cells, which drained him both physically and emotionally, he also had to stress about the medical system in Lebanon making his life-threatening disease all the more arduous.
On one instance, at the emergency unit of the hospital, he was asked for his allergies and was provided with a red bracelet stating his allergy to Penicillin. Despite this measure, he was still injected intravenously with an antibiotic containing the drug. Had he not asked the nurse beforehand about the drug’s composition, the consequences would have been traumatic.
On another instance and on the day of his scheduled chemotherapy treatment, the cancer unit shockingly asked him to provide them with Vindesine, one of the chemotherapy drugs, as they had run out. He was compelled to call pharmacies throughout the city to find the required drug for his treatment and provide it to the hospital.
For the final step of his treatment, he felt more confident in being treated in Paris for the challenging stem cell transplant. Once in Paris, his oncologist was surprised to learn that he did not have a catheter — a tube allowing the withdrawal and passage of fluids — implanted near his upper chest and had instead been receiving the toxic drugs through the veins in his arms, which caused severe damage and pain to his veins. This also led to a very distressing stem cell collection, a procedure involving the withdrawal of stem cells from the veins in the arms, which are then frozen and injected back during the transplant. Doctors in Paris confirmed he would eventually need surgery for the damaged veins in his left arm.
Fighting the uncontrolled growth of abnormal cells wears out the body, as the current treatments available kill both the rebellious cells and the healthy ones. It demands strength and robustness. The battle is also an emotional roller coaster causing all types of reactions from fear and sorrow to motivation and a willingness to persevere. When combined with the blunders of the medical system in Lebanon, the battle is all the more frightening and exhausting.
From his room in a Paris hospital, having completed his stem cell transplant, my brother said: “I feel the monster has now left my body.” He looks forward to returning home to Lebanon soon cancer-free — Lebanon’s cancer, however, remains just as malignant.