Cancer Does n’t Wait For Covid

In the midst of the pandemic, the prognosis for newly diagnosed Stage 4 cancer patients became even more dismal than usual. Tragically, this proved true for my beautiful sister, Amal.

The consequential delay in diagnosing Amal’s cancer metastasis due to prioritisation of Covid-19 patients and pandemic restrictions, proved fatal for my sister’s life.

In November 2019, Amal was told she needed urgent and risky surgery to remove a suspected small, slow-growing cancerous growth. She had just returned to London, from a dazzling holiday in Japan and South Korea with her husband, when she went in for that fateful, cancer-seeding surgery in November. Thankfully, prior to this last holiday, which would prove to be her last, she had travelled with all my family to Egypt, to attend a glamorous family wedding, by the Red Sea. Sadly, this was also the last time she would visit her land of origin, dance the nights away, and see all her Egyptian relatives.

In late November 2019, after much trepidation, Amal succumbed to her doctor’s incessant persuasion, and went in for surgery to remove the suspected growth. Amal was well versed in surgical stories, having undergone umpteem operations and procedures since the age of nineteen, when she had been diagnosed with ulcerative colitis. She had prepared herself, as she had always done, with magnimanious courage and mental strength to get through another, albeit much longer surgery (twelve hours to be precise).

By some miracle, perhaps due to much prayer on our part, the severe and debilitating risks of the operation predicted by the surgeon did not manifest, and she was sent home to convalesce for six months. But despite the excised growth having been found to be cancerous, her surgeon failed to consult an oncologist, for pre-emptive oncology treatment. Any cancer removal is a loaded gun, with the potential to “seed” the cancer allowing it to drift to other sites in the body and spread, or as it is medically called, metastasis. Indeed, this was the largest risk of all, and yet one which was completely overlooked by her surgeon. Instead, Amal was left to go home and just“rest”.

As 2020 arrived along with the onset of the Pandemic, Amal developed severe lower back pain, whereupon she was flippantly told she most likely had sciatica nerve block due to her prolonged operation, and that she just needed to “rest”.

Now, at sixty-two and having had a lifetime of surgeries, as well as bowel cancer 17 years prior, Amal was a warrior when it came to surgical recoveries. She trusted the medical profession blindly, and in particular her life-long surgeon, Mr Jenkins. “Same old” she told herself, and buckled down to making the most of her convalescence. Having been an ardent sports woman, and extremely active throughout her life, she took daily walks by the river, in Hammersmith where she lived, lifting hand weights as she watched television, and going about her almost normal daily life.But as the months rolled by, her daily routine became evermore laborious, and soon the pain was too excruciating to allow any such movement.

In March 2020, around four months after the excision of Amal’s small slow-growing cancer and potential cancer-seeding, she was finally called in for a scan. Eight small lesions on her lung and some fewer lesions on her liver were observed on the scan results, and implausibly deemed “insignificant”by her medical team. This was an unforgiveable mistaken diagnosis, for had her physicians investigated further, her life may have been saved. But then again, there were many moments in the proceeding 19 months where Amal could have been saved, but instead was atrociously let down by the medical profession. Despite these alarming scan results, post-oncology surgery, which should have sounded a thousand and one bells, she was told she was well, and to stay home and avoid hospitals. “No need to worry” they said, “you have sciatica nerve and just need to rest it”.

By the onset of that summer, Amal had become severely debilitated, experiencing relentless, unforgivable pain upon any movement. On July 3rd, 2020, approximately 8 months after the removal of her small-slow growing cancer, she was finally called in for some investigative scans.

This time, the results were definitive and calamatous-they not only showed that she once more had developed cancer, but that the cancer had spread or metastasised throughout her body, with “widespread bony disease”. The cancer had navigated and settled itself into her bones, including her pelvis, her spinal cord, and as observed but undiagnosed in March, to her lungs and liver.

Despite our devastation, we remained hopeful that modern oncology treatments would combat this inner monstrosity and prolong Amal’s life. As a family of medics and scientists, we anticipated the advent of novel oncology treatments and drugs a few years down the road and of the effectiveness of modern chemotherapy and radiotherpay treatment.

After all, Amal’s name means Hope in arabic, and she had indeed survived against all odds, innumerable times, in the past. She never gave up on hope, and neither did we.

Alas, what we failed to feature in our optimistic outlook, was the ferocity of Covid-19, and the consequential atrocious failings of the medical profession in London, both in the NHS and Private sector, in treating cancer patients, during the Pandemic (UK ranked as one of the lowest in Europe in cancer treatment during the pandemic, as well as in the survival of cancer patients in general).

Despite a seemingly promising Covid-19 vaccine rollout in the UK in January 2021, failure of the system prevented Amal from recieving this vaccine in due time, until it was too late. In March 2021 an as-yet non-vaccinated Amal underwent serious and risk-ridden spinal surgery, immediately after which she had life-threatening complications. Amal survived, but was left to convalesce on a ward with patients infected with Covid-19, and our worst fear at the time, came true, as she caught Covid-19. What we didn’t realise at the time, was that this was in essence, the all-time extinguisher of any hope, and that this heralded the beginning of the end.

Upon Amal’s positive covid test, she was thrown onto a fully-fledged covid ward, where, she, in her most vulnerable post operative state, contracted lethal levels of covid. Incredulously, as she seemed “well” she was sent home after 5 days of her positive test result, to “rest” at home. But covid being the savage it is (or was at the time), proved to be near fatal for Amal, and she was rushed back to hospital with critical covid two days after she had been sent home. Upon arrival at the emergency department, her prognosis was of imminent death.

Despite the terrifying prospect of losing Amal that night, she survived. However, our battle to keep her alive took on a different dimension then, as at this stage, with stage 4 metastatic cancer, and critical covid, she was simply ‘written off’. “Why do you want to live, you will die of cancer anyway” said the leading consultant on the ward, to Amal, while Amal lay struggling in her hospital bed fighting for every breath through her measly oxygen mask. Despite my medical family’s pleas to use CPAP for Amal, she was ardently refused this treatment, and left on the oxygen mask with whatever miracle she could muster. And, she did manage another miracle-Amal survived 3 more terrifying moments when she was at death’s door, (mostly due to a series of negligent medical incidents from the hospital staff) and was eventually able to recover from critical covid. Hope, her namesake, had once again prevailed, despite it having had a brutal bashing by her medical team.

Joyously, Amal was able to return home and enjoy her birthday (5th April) and have some home time with our family.

Ironically, and as her London healthcare team would have it, she was then given the covid vaccine, even though her anti-covid immune cells having by then, reached a profound level. And as she had had an “experimental” one-off drug to treat her covid, the oncologists deemed 3 months the period of time needed to elimnate this drug from her system, (despite this drug having had a half life of two weeks!) before chemotherapy could be re-administered.

Now anyone with any semblence of oncology knowledge will realise that cancer metastasis, without any chemotherapy or other therapy for an extended period of time, will spread like wildfire. Tragically, this was the case for my sister, as by May 2021, it had metastasised to her throat and neck, and to most of her spinal cord. Amal was sent to hospital, where in the absence of any interventions, her condition continued to deteriorate rapidly whereupon she lost her voice, and amongst other crtical abilities, the movement of her legs.

By June, we had the most devastating news that Amal had also lost her eligibility for chemotherapy and that she should be placed in a hospice, and wait to die.

As a family, we frantically ralied together, and my retired consultant physician sister, quickly sought and arranged for any alternative treatments to be given to Amal, at home, in order to extend her life as much as we could. By this stage, Amal had lost the ability to swallow, speak, and most of her bodily movements except for that of her arms, and head. The cancer had maliciously made its way to her skull as well, where telling lumps could be felt.

Despite Amal’s extreme debilitation, she remained bright and hopeful, smiling with much grace, patience, and silence.

Some days into August, 2021, on the weekend, Amal was able to witness the beautiful and poignent religious marriage ceremony of her son to his stunning bride, on the terrace of her home by the river in Hammersmith, from her hospital home bed, and wheelchair. She had had her hair and make up done and looked as beautiful as she always had, but we didnt fail to notice that she was, a very different Amal by this stage- quiet and pensive, when normally she would be the chatting and bubbly queen of the party.

We all carried on, happy to have a moment of happiness and celebration, and even partied the night away. It was but a brief respite from the sadness as the following day, Amal’s condition worsened dramatically. She remained mostly in a state of slumber, with difficulty in staying awake-a definitive signal that her situation was worsening. By monday morning, at a loss as to how to manage Amal’s worsening medical state, Amal’s husband and my physican sister took the decision to re-admit Amal into hospital. As soon as Amal passed those hospital doors, she fell into a coma, and without fail, as if with some relish, the medical team told us that we now just had to wait for her eternal “rest”, as she was now in the process of dying. She was left with no fluids or any other medical support, and yet her medical parameteres were all normal.

Along with my daughter, we were desperate to wake her up, to prove she could still live. Around 8pm that night, after much speaking into her ear, she woke up from her coma, and regained consciousness but seemed in some pain and was much disillusioned. She was moved to another ward, where she was tossed and turned in order to “examine” her, despite her screams of pain, and then left without any medical support again. Due to our pleas for fluid, and interventions throughout the night and into the early hours of the morning, Amal was finally given some fluid. I left her to her husband at around 3 am, somewhat optimistic, perhaps in denial, and yet unbeknown to me, it would be the last time I’d ever see Amal in this world.

The following morning, Amal’s fluid bag was removed and there was talk of sending Amal home, and a doctors meeting was scheduled with my physician sister for early that afternoon.

But it was all too late, and so little had been done to save Amal by the medical staff, that now, well and truly she was leaving us.

Around 2pm that day, on the 10th of August, Amal passed away, in the presence of my brother and physician sister. From that day forth, there has been a huge black hole in all our lives for the light of our world had been extinguished, and the skies had blackened for the forseeable future.