9 years ago, I left the world of US Family Practice and became a Missionary Physician. As a Missionary Physician I care for patients and administer treatment in ways that I would have never have done if I was still in the US. Diagnosing and treating cancer are some of those things that I do now, that I wouldn't be doing if I was still in the US.
One of the hard parts about caring for patients with cancer in PNG is that our options of treatment are limited. We have about 6 basic drugs that we can give, but we have to balance the doses we give with our ability to support someone whose immune system is weakened. Along with chemotherapy, we have surgery and at times radiation. We hope and pray that the combination of the 3 will be enough for our patients, but way too often it isn't. Outside of a surgical cure, we rarely get cures in patients with cancer.
Topias is treating to beat those odds. Topias came in almost 2 years ago with an abdominal mass. It was initially too large for surgery, so we gave him chemotherapy, suspecting he had lymphoma. Thankfully, the chemo shrunk it down to a size that was small enough for surgery. As surgery, the biopsy came back as a Wilm's tumor, a tumor of the kidney found in kids and one of the most responsive to chemotherapy. We altered our chemotherapy a little bit and thankful Topias continues to do well.
He is usually happy when he comes inside to be seen, but still cries when Aunti Letti (what he calls me - where he got that name I don't know) and Dr. Bill do ultrasounds to look for any sign of the mass returning. So far, we haven't been able to find any recurrence of the mass and are very thankful. We hope Topias, the youngest of 5 boys in his family, grows up to go to school, get married and have kids of his own. Until then, we will keep checking him for recurrence and thanking God for the one who has made it (at least for now), the one who has survived cancer despite our limitations, and keep praying for others to make it too.