It’s been an emotionally draining week at the hospital. So many people are suffering with cancers.

“12 cm high-grade sarcoma”

To most people this probably doesn’t mean a whole lot, but to those who have experience, it makes your heart drop. With her biopsy result back, we had to tell a 19-year old woman that the big mass involving her left cheek was this deadly cancer. I still don’t know a good way to do that and I don’t think there is one. It’s horrible.

The books say there isn’t supposed to be a lot of cancers of the colon or rectum in Africa, but we have seen quite a bit. Last week, we operated on two people with cancers of their rectum that required an operation called an abdominoperineal resection. It means removing the last part of the colon, the rectum and the anus to get the tumor out. It involves a permanent colostomy. It’s not an easy operation and I’ve only been involved in a couple during my training so it’s been a challenge. But at least it’s from the same field in which I trained… have to be thankful for something.

Yesterday, we operated on a heart-breaking young boy. He is twelve years old and came in with difficulty having bowel movements for the last several months. He has been passing blood from his bottom in addition. To look at him, you might think he came out of a concentration camp; he was so malnourished and sick. On rectal exam, there was a round bulge the size of his fist in his rectum. After resuscitating him a bit, we took him to the operating room with the presumptive diagnosis of chronic intussusception, a condition where the bowel telescopes in on itself, kind of like pulling a long-sleeve shirt inside out. We opened him up and indeed found an intussusception with his entire colon pulled in on itself and extending down into the rectum. Usually when this happens, there is something that acts as a “lead point” to start the process of pulling in. In his case, he has some kind of bad cancer that started it out. There was tumor throughout his abdomen. I don’t know how long he will live, but unless God performs a miracle, it won’t be long. Again, it’s horrible.

Well, sorry for the downbeat post but I hope it helps illustrate some of the difficulties here.