Ch 7:

Cancer in Children in Belize

For many of us, birthdays are about food, friends and festivity. But for ten year old Lizette Perez and her family, her last two birthdays have been more than just cake and candles, they have been celebrations of the very fact that she is alive.
Thelma Perez, Lizette's Mother
"Everything for me was work, work, work, work. When I started working like I tell you, Mom my head is hurting, mom I have fever...just Tylenol, Tylenol, Tylenol, Tylenol. That was it."

That was Thelma Perez's routine when it came to sickness and her four children. But then one day, the simple pain reliever didn't work on her youngest daughter's aching leg.

Thelma Perez
"My husband took her to the doctor. I went to work and I was at work when he called and told me I have to come down. They have to talk to me. My daughter is really sick.

I didn't expect that bad news. And the doctors said my daughter has cancer. I said oh. Is it going to get better? And they said no.

Lizette's diagnosis in December 2008 was osteosarcoma, one of the most common but aggressive types of bone cancer. From the outset, the odds of survival were not in Lizette's favour.

And I say I'm going to lose my baby now and that's what I said she's going die. And I didn't say anything I just come out of the doctor office."

For adults, accessing cancer treatment within Belize is extremely limited but significant process has been made with the launch of the Dangriga Cancer Centre. Unfortunately, for children facing cancer, the situation is unchanged...their only option is to seek medical care abroad. Desperate to save their daughter, the Perez family borrowed what money they could and took Lizette to a hospital in Merida, Mexico.

Thelma Perez
"Many times I said, why? I wish it could have been me and not her. Not her. Because I see the pain they go through with that chemotherapy and the bad feeling they have, throwing up, they stay weak, all they want to do is sleep, they don't want to eat, they don't want anything. They don't want anything. Just, I wished that I could help but I can't help because I can't do nothing. I was like helpless.

What used to frighten me more is sometimes when the doctor told us that it's not the cancer that who kills your child, it's the treatment."

As brutal as chemotheraphy was, Lizette never lost her smile, even when she lost her hair. But the worst was yet to come. If doctors were to have any chance of saving the girl's life, Lizette would have to lose her leg. Even with such radical treatment, Thelma Perez knew her child was in the fight of her life.

Thelma Perez
"I tell you...I dah wah person I no really into church but that moment I learnt to pray, I believe in my God. I believe in everything."

For an entire year, Thelma stayed at her daughter's bedside in Mexico until doctors confirmed that the child's cancer was in remission.

But not every family is so lucky.

Holly Beth Evans
"I couldn't believe it. Cancer? That was the last thing on my mind, well that didn't even enter my mind because the other doctors were saying it was just a swollen muscle. She was never a sickly child. She was never sickly. So it was something that shocked us."

In April 2008, Holly Beth Evans' eight year old daughter Ciscely started feeling pain in her lymph nodes. Despite several trips to different doctors, the young girl's health continued to decline.

And the doctors didn't know why, they kept changing antibiotics every single day and she was in a lot of pain. The last test the doctor did was a CT scan and that showed that she had a tumour in her leg. He told me that it was cancerous and I needed to take her away for treatment as soon as possible.

Rhabdomyosarcoma, a rare and even more aggressive form of the cancer that would soon strike Lizette Perez, had taken fierce hold of eight year old Ciscely.

She had pain every single night. She used to scream in her pillow at night so that the other kids wouldn't wake up. So she was conscious of that, if I would cry she would wake up the other kids so she would scream in the pillow. But in Merida she didn't have any pain. In fact the Friday afternoon she asked us for chow mein but in Merida they don't have a Chinese restaurant there so bought her a burger, she ate, she had a little TV for herself, it was in Spanish but you know she watched her favourite cartoon...she was lively that day. But when she went to sleep, she had a haemorrhage so she died peacefully.

Today this single mother can only console herself with the memories Ciscely left behind.

Holly Beth Evans
"My whole day routine was around her, cooking special food, special occasions, Christmas, birthdays and she was this child that every special occasion she would make a card for everyone. Her aunts, her uncles, grandmother. It didn't have to be a special occasion, she would write little poems or letters. So each of us now have this stack of cards from her."

But more than just bitter sweet memories, Ciscely has left a legacy that is helping Belizean doctors in their fight to help children battling cancer.

Holly Beth Evans
"I know that I can't turn back the time but I know I'll be able to help other kids out there. And the doctors they know about her case...all the doctors in Belize. They know about this type of cancer now so they will be able to help other kids."

One child Ciscely has helped is Lizette Perez. The Perez and Evan families have never met but the same doctors, who only four months earlier had documented Ciscely's symptoms recognized the similarities immediately in Lizette. That quick cancer diagnosis is a huge factor in Lizette's survival.

A lot of the medical community now are getting more knowledgeable of it and it's now less further down on the list.

According to Paediatrician Dr. Cecilio Ek, both parents and doctors should always be on the lookout for symptoms of cancer.

If a child comes to you with growing pains, that doesn't go away, with a swelling, with wax and corner on the same part of the leg or the foot then you need to investigate further and not shy away from it.

Janelle Chanona
"Is that your message to parents?"

To parents and to doctors. The best parents I have are parents who ask questions and I implore them to do so. If you don't believe what I'm saying I tell all my parents to look it up. If you find something contrary to what I say, come back with your data and I'll go through it with you. That is what I mean by giving the parent the responsibility of their child's illness.

But perhaps the darkest side of cancer is the financial reality of the disease. Despite tremendous assistance from Mexican treatment centres, many Belizean families are hard pressed to find the funds to access the care. Doctors say some children die simply because there is no money.

Holly Beth Evans
"I got a loan for her, not thinking that she would die to help me with medical bills and now that she has passed away I'm still dealing with financially.

You know they seh one one full basket right so if everybody would come together and donate some money to the cancer society then they would be able to help kids or even older people who would come up with some type of cancer, they would be able to help them."

Thelma Perez
"We still got, [inhales] we got bills. We have bills to pay. I mek food for sale, like my husband work, his co-workers help, they buy food from me or for raise funds because sometimes I can't depend on the cancer society because sometimes they don't have because so many children are sick now so I have to try make my own money or if they give me for my passage, I have to raise still yet for my hotel, my food, for everything."

Dr. Cecilio Ek
"I think the powers that be in this country need to understand that with the little resources that we have we can provide much better care for our kids in prevention of cancers, in prevention of communicable illnesses, much more than what we are doing right now."

Beyond the physical loss of her leg, Lizette struggles to deal with her self confidence.

Lizette Perez
"Sometimes I wonder if I never get sick how things meh wah be right now. Sometime da night I used to always think about it. I used to feel sad. Sometimes ina my room I cry by myself. And I no tell nobody. But now everybody know."

Thelma Perez
"We were walking down the bridge and this man, I know if you want to say something to say it to yourself I think, no sey it loud. Oh my God, he seh, poor little girl, watch dat, eh only have one leg. And she heard it and hang down eh head.

I tell ah it's not your fault that that happened to you...you should be proud that you survived. Not everybody do it and you should be proud that you don't care what people think or say. You still go to school, you still do what you haffu do.

Once I get sad, then I start to cry. Sometimes I fraid fu mek eh come back. And I done tell my ma and pa if deh have to operate again, I no di operate it."

While none of her doctors can promise that the cancer is gone forever, Lizette can once again dream about her future...just as any 10 year old should.

Lizette Perez, Cancer Survivor
"I want to be a, I don't know, sometimes I want to be a vet and sometimes I want to work at a bank. I want to be a vet because of all the different types of animals that I have to tend to and it's kind of fun. And in the bank, I just like count money."

For now, the Perez family is simply hoping Lizette will always have a reason to smile...and a determination to celebrate life.