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This is staggering because just 50 years ago, the rates of survival in children with retinoblastoma was less than Christmas Ortho Crew Nurse Doctor Tech Orthopaedic Squad T-Shirt. Retinoblastoma is a cancer whose diagnosis is done through clinical examination supported ancillary imaging studies. There is no blood test that can confirm the presence of cancer and taking a biopsy would risk spreading the cancer out of the eye. So for the case in question, we advised the removal of the eye and possibly chemotherapy or/and Radiotherapy afterwards depending on pathological staging.
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However, the parents strangely rejected our diagnosis and the proposed treatment. They went doctor shopping back in Christmas Ortho Crew Nurse Doctor Tech Orthopaedic Squad T-Shirt until they found an Ophthalmologist who debunked the cancer diagnosis and started treating it as Persistent Primary Hyperplastic Vitreous (PHPV) – a non-life threatening congenital eye condition compared to Rb. In this kid’s case, there were clear signs of diagnosis being Rb and there was no doubts about it. The Indonesian ophthalmologist started injecting anti-VEGF drugs into the eye thinking he was treating PHPV. I know this complete story because the parents returned back with the kid to our hospital about 8 months later. The cancer in the little boy by now had spread to the other eye and had multiple metastatic cancer-spread to his brain, lung and liver- aided in no small measure by the criminal injections of the that Indonesian Ophthalmologist. Both his eyes had protruded out of his skull and there were huge swellings on the skull due to the brain metastasis. We were all heartbroken seeing the kid suffering due to the denial and ignorance of the parents. We were angry at that Indonesian Ophthalmologist for being so callous in misdiagnosing the kid and treating the kid for something else. This despite our diagnosis which should have raised a red flag for him. We then offered the parents an aggressive treatment protocol which may yet have saved the child’s life. The parents listened to us but didn’t ask questions. We came to know next day why they didn’t have any questions- they didn’t come back to the hospital for admission. This is the heartbreaking world of Retinoblastoma and this happens in many parts of India as well where doctors treating this dreadful cancer have to fight superstitions, parental denials, costs, cultures, quacks and witch doctors.
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In India, when children with this cancer don’t return for treatment, there’s no way to track the Christmas Ortho Crew Nurse Doctor Tech Orthopaedic Squad T-Shirt and even if we do, we can’t force the parents to agree for treatment against their will. Money is not often the barrier as we can get this cancer treated with the help of NGOs and government schemes. The main barrier is denial and ignorance. Sometimes even educated parents take terrible decisions. When the parents realize their mistake, it is often too late. The children suffer and die due to the bad decisions of the parents for those various reasons even though their chances of survival was so good. We as doctors treating this cancer are left helpless and angry.