U Khin Maung Maung

GENERALLY speaking, people are scared of cancer. They think that there is more chance of death than survival. Some consider it incurable. Some are scared even to hear the word cancer. That is why, in Myanmar, unlike elsewhere, it is not unusual to hide it from the patients. Perhaps it is good for those who dare not face it, as letting them know could cause depression and accelerate the end. But I am different. When I had cancer, I was not told about it. It was I who did all I could to find out what they were hiding from me. That was 28 years ago, in 1977.

Actually it began one year earlier on a hot and humid day in early April 1976. I played golf as usual with my regular golfing friends, Dr Thein Maung (ENT), U Tun Yi (radiologist) and the late Dr Tun San Maung (surgeon). After finishing a round I went to the toilet where I noticed that my urine was reddish. I immediately told my golfing mates who were still in the clubhouse. U Tun Yi said that I should take an X-ray of my kidney, urethra and bladder to see if it was due to a stone. The other two added that my urine should be tested also. I had these tests done without delay. The X-ray did not show any stone, but the urine showed the presence of some blood, known medically as haematuria.

However, no blood appeared in the urine the rest of that day and the next. I had my urine tested for three days in succession as advised but no more blood showed up. So it was thought that it might just be a stray case and not persistent haematuria. I was advised that if it happened again, I must have an X-ray called intravenous pyelogram (IVP).

For one whole year my urine was normal but in April 1977 I experienced a recurrence of haematuria. Dr Kyaw Aung conducted an IVP, after which I think he knew I had cancer even though he did not tell me. He referred me to Dr Kyaw Lin, the head of the Department of Urology, who told me that a retrograde pyelogram test should be done to complete the investigation. This involves taking several X-rays after injecting dye into the two kidneys through the urethra, bladder and ureter.

I asked him what the problem could be. He said that I could have an ulcer or some other minor problem. His answer was noncommittal, so I asked him to tell me exactly what the problem was. He replied that since the investigation was not yet complete, he could not say anything definite. But when I pressed him further, saying that I was prepared for the worst, he told me not to worry too much, as in only very rare cases do the problems turn out to be something serious. He avoided using the word cancer.

Perhaps he considered it to be good bedside manners not to mention cancer or perhaps he did not want to commit himself to anything without completing the testing. On my part, however, I had resigned myself to the conclusion that it must be cancer. From then on, I prepared myself to face it. I was not scared at all. I considered that if I must die, it is better to know in advance.

When I came home from Dr Kyaw Lin’s office, my wife and my family came out to welcome me. My wife asked, “What did the doctor say?” I replied, “Don’t get alarmed. It could be cancer.” That answer shocked everyone. My wife said, “Don’t say such inauspicious things. It can’t be.” So I said, “Well, it may not be, but I am only telling you to be prepared for the worst. If it is not, it is well and good. But if you are prepared for it, the shock will be less. Don’t worry. I still have to undergo another test to complete the investigation.”

The retrograde pyelogram confirmed the earlier suspicion of cancer, but still the doctors did not let me know. Dr Thein Maung, who was very much concerned about me and had been closely following the developments of my illness, came over to my house and said that I should undergo an operation. I asked him, “What for?” He said there was something that should be removed. I asked him, “What is it? Is it cancer?” He did not say anything and only shifted his posture in his seat. So I said, “If you are sure it is something that must be removed, go ahead.”

When I told my wife about the operation, she said, “We will go to UK and have it done there. Never mind the expenses.” I replied, “No. I will do it here. Even though there are very good surgeons there, I have full confidence in ours here.” She didn’t argue further.

I talked about the operation with another doctor friend of mine, Dr Kyi Paw, one of the most eminent surgeons in Myanmar, who by that time must have known about my case. He said, “Such things should not be delayed. The sooner, the better.” This further confirmed my suspicion, because if it was not a case of cancer, he would not have advised me like that. I immediately went back to Dr Kyaw Lin to get an appointment for the operation. That was on April 30,1977.

The next day, being May Day, was a holiday. So he put my name down for an operation on May 2.

I as admitted to the urological ward of Yangon General Hospital. Though I had drawn the conclusion myself that I had cancer, I did not know exactly what type it was. Determined to find that out, I went to the nurses’ desk when no one was there and looked at some of the papers. I saw my name in the list of cases for operation the next day. My suspicion was confirmed. Next to my name were the words ‘renal tumour’, which I knew meant cancer in the kidney region. I was not shocked. I only said to myself, “So, this is what they have been hiding from me.” However, I still didn’t know what and how much of my interior would be sliced out.

At 8am on the day of the surgery, my wife walked beside my trolley up to the door of the operating theatre. Noticing an anxious look on her face, I told her, “Don’t worry. Everything will be fine. I have full confidence in the doctors as well as in myself. I’ll be alright.”

I did not know what would be removed from my inside, but as I was being transferred from the trolley onto the operating table, I heard one nurse ask another, “What case is this?” The other replied, “Nephrectomy”. Having learned a smattering of medical terms through my long-term association with doctors, I knew it meant removing a kidney. This also did not alarm me in any way because I have heard that people can lead a normal life with one kidney.

Dr Kyaw Lin and his team made an incision of about 8 inches on my left side and removed the whole kidney and the ureter. The malignancy was in the kidney pelvis, the funnel-shaped part between the kidney and the ureter. When Dr Kyaw Lin came and saw me later in the evening, I asked him if I could see the part that had beenremoved. He said that it had been sent to the lab to be tested. I knew he was referring to a biopsy test to confirm cancer. So, I made up my mind to get a copy of the biopsy report, which when I saw it a few days later confirmed that it was cancer in the kidney pelvis and that it had minimum chances of spreading.

The operation was 100 per cent successful. I was very lucky that I did not have to undergo radiotherapy or chemotherapy. My hat went off the people who I consider to be my saviours – the late Dr Kyaw Lin; anaesthesiologist Dr Tin Tun; radiologists Drs Kyaw Aung and Tun Yi; and ENT Dr Thein Maung. They gave me an extra lease of life.

If there is anything to learn from my story, it is that people should not be scared of cancer. Not all cases of the disease are fatal. The chance of survival is much greater if patients have the courage to face the problem, to see a doctor as soon as they realise something is wrong, and schedule necessary tests and surgeries as soon as possible.

I feel qualified to give this advice because I am a living example of how cancer can be defeated. I am now 87 years old, not only alive but string enough to play golf regularly. Everyone must die one day, and so will I, but I am confident that when that day comes, it will not be because of cancer.

Wishing all cancer patients a full recovery and long life like mine.