"I thought I’d be dead soon with stage IV cancer…"

By Munaza Hashmi
Tue, 10, 21

I performed my hajj, but my abdomen became very swollen during it. I had to go through a surgery after I came to Multan, in which they removed a mass weighing 6.5 kg....

Munaza Hashmi after treatment
Munaza Hashmi after treatment

one from the heart

I see myself as a strong and independent woman who has been running the house and taking care of her family since her father passed away. In 2019, I felt fever along with pain in my abdomen, which led to an ultrasound. The results showed a rupture in my reproductive system, requiring immediate surgery. My left ovary was removed at a local hospital in Multan and I was advised to test for cancer antigen 125 (CA 125), which is a tumour marker suggestive of ovarian cancer.

On July 28, 2019, my CA 125 levels came back as elevated, only a few days before my flight, which was scheduled for hajj on August 3rd. Regardless of this life-altering news, I decided to leave for hajj and deal with my health situation later. I performed my hajj, but my abdomen became very swollen during it. I had to go through a surgery after I came to Multan, in which they removed a mass weighing 6.5 kg.

A sample was sent for analysis to the Shaukat Khanum Pathology Laboratory and soon after, the doctor broke the devastating news about my biopsy results. I was diagnosed with stage IV ovarian cancer. They said that there were almost no chances of surviving and perhaps I would live for another three months.

Despite having giving me this distressing news, the doctor recommended that I should visit Shaukat Khanum Memorial Cancer Hospital and Research Centre (SKMCH&RC) in Lahore. He gave me a glimmer of hope that I would receive comprehensive care for my disease, which was at an advanced stage, only at a tertiary care cancer centre.

Last year, in August 24, I came to Lahore and visited the Walk-in Clinic of SKMCH&RC. The cost of travel and initial tests made me extremely worried for the uncertain future. Having lived a simple life, I had never imagined unexpected health expenditures. More than the battle inside my body waged by cancer, it was the worry of financial implications that left me feeling helpless.

In the OPD waiting area, I saw the office of the Financial Support Services where I learned about the process of applying for receiving financially supported treatment. I decided to submit my application along with a referral from the local Zakat authorities. After evaluation, I was declared eligible for 100% financial support for my treatment, which was estimated to cost around Rs 2 million. In those moments, my tears bore witness to feeling an immense sense of relief.

When you have lived an independent life, asking for money from anyone feels extremely difficult. Fortunately, I felt that the process of receiving financial support was remarkable because my dignity and self-respect remained unhurt.

On October 20, 2020, I underwent surgery that revealed cancerous tumours had spread to several other organs including my intestines and a kidney. The complicated operation was done over a period of eight hours and a temporary colostomy bag had to be inserted in my abdomen. This put me under great psychological stress as I struggled with the idea of seeing the bag. It represented something impure. A psychologist helped me during that difficult time and I felt grateful for the holistic care available.

During treatment, patient participation was encouraged and I was treated as a partner in my fight against cancer. In December, just before I was planned to receive chemotherapy, my doctors detected a problem in one of my kidneys. It was one of many moments that made me realise how every aspect of my care was integrated, which was a source of great consolation for me. We had to decide whether to go forward with a stent or a bag to collect urine. I could not bear the thought of another bag and chose to go with the stent, which had to be periodically replaced. My first chemotherapy was scheduled on December 31, 2020, on New Year’s Eve. I could not help but think how my life had changed drastically since the previous year. Instead of celebrations in the court and with my friends, I was lying in a hospital bed, battling cancer. I asked a nurse about how she was planning to celebrate the New Year. The nurse responded, “With you.” And in that moment, I was no longer alone.

It was these little moments of kindness and compassion by my caregivers that that gave me courage and helped me stay positive throughout this battle. I had to undergo six cycles of chemotherapy, that were eight hours long each, ending on April 16, this year. I felt extremely lucky when the post-chemotherapy results showed that my cancer had responded well to the treatment, meaning that my active cancer treatment was coming to an end.

As I look back, the most remarkable aspect of my treatment was the nature of multidisciplinary care that I received under one roof. My case, like every other case here, was discussed in multidisciplinary team meetings and I felt the positive effects of receiving well-coordinated care. The multi-disciplinary team model is now established as the most effective way of managing cancer care worldwide. According to my doctors, the online hospital management information system played a critical role in ensuring that reliable clinical data and test results were available in a timely manner for effective management of my care.

In June 2021, my colostomy bag was removed and the stent in my kidney was replaced. The removal of the bag was another milestone for me that marked the return to a normal routine of life. I started going back to work, which included me going to the court and running my organisation for protection of women’s rights.

At this point in life, I do not have any regrets even if I have to go from this world. I fought with the best treatment possible. It is already a miracle that I am alive and working. I was able to perform Hajj despite my diagnosis. I witnessed sufferings of many other patients at the hospital and it made me determined to change their lives.

I thought I was going to be a dead patient when I came to SKMT but they saved me. They took care of me as if I were a child with a broken body and they fixed each part with utmost care until I was whole again. I wanted to share my story so that whoever may be battling cancer right now, may take courage from my story and not give up. It is important to know that not all stage IV cancers automatically mean a death sentence. Doctors should not abandon treatment and care for such patients and patients should not give up either. In today’s world, we are more connected than ever. I believe that each one of us can choose to support reliable institutions like SKMT and make miracles possible for those who need them the most.

The writer is an advocate of the Multan High Court and a human rights activist.