Breast cancer blog: The very long queue for radiotherapy

PUBLISHED : Tuesday, 11 June, 2013, 8:40pm
UPDATED : Tuesday, 11 June, 2013, 8:50pm

The trip is a schlep, weaving through the intensity of the heat and crowds, waiting for the mini bus to go to Queen Mary Hospital. Thus starts the second phase of my breast cancer adventures. As a woman who has been through the same procedure told me, “this will be a long journey.” It sure feels like that with the all-encompassing humidity of June.

Now that the pathology report is complete the breast surgeon shakes my hand firmly and passes me off to the oncologist. Before that she gives me a choice, referral public or private?

And it comes down to cost. There is a Grand Canyon-sized gap when it comes to the radiation cost. The radiation round for women who choose lumpectomy is typically 4-6 weeks. The price under private is typically HK$3,000 each time whereas it is HK$80 in the public hospital. Although the trip to the HKU neighborhood would be a haul, as someone who is uninsured I had to go with the practical. Public of course, I told the surgeon swiftly.

In the meantime, I try to resort to my sunny side mantra by telling myself that I’m lucky to have family and friends. I’m lucky Queen Mary is the crème de la crème of public hospitals. I’m lucky I’m in Hong Kong and not in Timbuktu.

The father arrived from the U.S. the day before the oncologist’s appointment to accompany me into foreign territory. Having spent the past 36 years teaching the MDs he has a good idea of how to deal with the white coats.

Queen Mary is huge, a tremendous assuming structure that sits atop HKU territory. We follow the chocolate-coloured line on the floor that leads to the cancer centre, home of nuclear medicine, oncology and radiology.

We make the schlep without much choice (who can say they want to skip work and head to the cancer ward?), but with a purpose. We want to tell the oncologist that I want to start the radiation ASAP. Radiation can start one month after the surgery. Let the games begin, I keep thinking.

Like most patients I come with my unique story and needs. The story becomes important because despite our differences in similarities in economic, social and cultural background, we the cancer patients all share the common goal of seeing the doctor, getting treated as soon as possible, getting well, and getting our lives back. Deep down we all want to believe that our unique story will move us on the queue, and perhaps we will wait less.

I have a speech prepared.

“Dr. X and Y nice to meet you, I want to start the treatment on X and Y date because I need to be on an airplane back to the United States the first week of August. I need to return to my homeland. I have a PhD program to start.” And then the unspoken: I don’t want cancer to steal any more of it than at times I feel like it has. I have a life to live.

The waiting room is packed. The moment I enter I become a number and the waiting game starts. I take in the landscape and note that I am by far the youngest and one of the healthier ones. I subconsciously categorize my fellow patients: the most serious frail and thin in wheelchairs with IVs (is that the chemo? I wonder), the more serious wearing hats to cover up their heads made bald by chemo. The less serious are like chameleons, we look like ordinary people.

A volunteer comes around and settles down next to a middle aged couple. The woman is clearly upset although trying to feign politeness. She had surgery a month ago and she’s waiting for radiation. We are in the same sorority only she’s twice my vintage.

The father and I try to think on the sunny side (I wonder what the cafeteria food here is like? Good thing the weather is so nice... not a bad center at all), and not think too much about what could have been, what should be, the inequality of this all. I remind myself of the celebratory sushi and tell myself I’m lucky to be alive, I’m lucky that chemo isn’t in the picture. Dealing with cancer is a mind game, at times exhausting.

After what feels like forever (in reality it is an hour), I am called. The doctor is a pretty woman who looks about 16. She’s seen my records and she gives me the 411 and sheet about radiation, how it works and side effects. I nod, uh huh, yes and then I try to get down to business. “When can we start?” I ask her. She glances at the calendar and says, “Well there’s a very long queue, I’d say maybe August at the earliest.”

Can this get any worse? Before I completely lose it the father steps in explaining that we would much appreciate it if they would give my case special consideration - I would like to be home with family. If they can that would be great, if not we totally understand. I quickly can my speech and shut up.

There is an art to being a patient, the father later says. You need to maintain your calm, request and honour the system. I am no longer a journalist, I am a patient and a number and a record. The pretty doctor nods and says she will try her best.

And she delivers. By the end of the session I’m told the breast radiation planning appointment has been bumped up by a week. I want to hug the woman. It is a small victory in this marathon day defined by mini buses, hospital hallways, and paperwork. When we exited it was late afternoon and I discovered the breathtaking view from the hospital. I posed and the father snapped a picture and then we headed towards the mini bus for the long ride home.