Upon further reading, my assumption right now is that she might have gastric carcinoma with secondary metastasis to the liver and neck LN. (these are just my mere postulations since the results are yet to be known.
As I continue my reading, my heartbeat was drumming faster and faster. I find myself reluctant to know more, since the reality is too painful to swallow.
"Gastic carcinoma is a HIGHLY MALIGNANT adenocarcinoma” was the 1st sentence of the subtopic Gastric Carcinoma. I braved myself to read more.
"This aggressive cancer metastasizes early by way of lymph nodes, blood stream, and peritoneal spread".
As I scrolled more down the topic, I learned that treatment of this cancer involves radical surgical resection, either partial or total gastrectomy with resection of adjacent lymph nodes as well. It provides the only hope of cure and is also the best way to palliate the patient’s symptoms.
Unfortunately, the few last sentences were really heart-wrenching to me: “A palpable tumor in the left upper quadrant or an enlarged liver is an ominous finding, usually indicating advanced, inoperable disease. Radical gastric resection is contraindicated if liver metastases are present. These patients cannot be cured.” And in another book, “The detection of liver metastases often alters the surgical management of patients with cancer. Since most of these patients will have incurable disease, the primary goal of surgical intervention is to palliate distressing symptoms rather than undertake radical surgical resection. Overall, less than 10% of patients will survive more than 1 year after diagnosis."
Ya Allah… Beratnya rasa dada ni… Innalillahi wa inna ilaihi raaji’un...
"Setiap bencana yang menimpa di bumi dan menimpa dirimu sendiri, semuanya telah tertulis dalam Kitab (Luh Mahfudz) sebelum Kami mewujudkannya. Sungguh, yang demikian itu mudah bagi Allah. Agar kamu tidak bersedih hati terhadap apa yang luput dari kamu, dan tidak pula terlalu gembira terhadap apa yang diberikanNYA kpdmu. Dan Allah tidak menyukai setiap orang yg sombong dan membanggakan diri…” (Al-hadid: 22-23)
This patient is religious too, she is the only patient in the female ward whom I saw praying when she was sick. Sometimes when I visit her during my oncalls, she would ask, “Ni semua ni kerja tak tentu masa ya?” I replied, we have oncalls every week. Then she adviced me so softly, “Nanti dah kerja esok, sebelum keluar rumah tu niatlah dua perkara, nak cari rezeki dan redha Allah. Barulah dapat kedua2 perkara ni. Kalau nak cari rezeki je, dapat satu je.."
Atau, setiap kali kita jumpa patients tu, hanya utk kepentingan studies kita semata-mata? Nak cari case best2, nak cover patients utk case presentations, nak cari case write-up, nak present case kat OT… macam selfish je bunyinya kan?
10th February 2009