Poverty and Dilemma

Any person suffering from cancer has tremendous disadvantages. The financially well endowed atleast have resources to search and seek some answers. At times cancer makes a person poor, especially in India.
Yesterday I came across a 60 year old prostate cancer patient. He had underwent Prostatectomy in 2002 and Orchidectomy in 2005 and was put on Bicalutamide. From the time of initial diagnosis the tumor had invaded the bladder. Last month he underwent P-32 treatment for bone metastases with no pain relief. He was reffered to me by an urologist for possible consideration for hemostatic radiation. When I reportedly saw him he had bled for more than 12 hours, his Hb was less than 4 gm%, his platelet count was less than 80,000 and had deranged PT, BT.
I explained the grave prognosis and offered them hemostatic radiation as only a palliative measure. The need for blood transfusion was also explained. Initially the relatives agreed to do whatever possible but with in restricted financial considerations. I offered not to take any charges for radiation but they said they cannot afford the cost of blood transfusion and they decided to go without taking any treatment. I am still to recover from the whole episode. I have no judgements but as a Doctor it is difficult to reconcile with the fact that "nothing was done for the patient".

In Transit

My hibernation got extended on account of me shifting base from Mumbai to a peripheral cancer hospital at Belgaum.
I am amazed by the number of rural patients and the dearth of adequate facilities to treat them. We are developing a multidisciplinary team to offer our services in North Karnataka.