Cancer, begone! The day the infusion dried

MY mother Gilda and her attending oncologist Dr. Chito Abellar

MY mother Gilda and her attending oncologist Dr. Chito Abellar

AFTER more than 18 months, 54 vials of Herceptin and loads of love and support later, my mother finally finished her monthly infusions in her battle with the Big C.

“Are we done,” my mother asked soon after Dr. Chito Abellar removed the needle. “So, how come I need to undergo another round of tests and visit the doctor?”

As is typical of elderly people, especially for someone who also suffers from clinical depression and short-term memory loss, my 78-year-old mother couldn’t fully comprehend what she just underwent and the significance of such a development.

Maintenance check

My sister, on her most recent visit, "shops" with me for Herceptin at Globo Drugs using PCSO's guarantee letter

My US-based sister Farida, on her most recent visit to the Philippines, “shops” with me for Herceptin at Globo Drugs using PCSO’s guarantee letter

“Well, it’s because you’re still alive, and like all living and breathing human beings, you need to undergo regular maintenance check,” I said.

It was almost like I was referring to a car, but it was the only way I knew how to make her understand her condition.

For the next five years or so, we would be visiting her oncologist and other attending specialists every three months to find out if the cancer has recurred. But for now, the worse part is over.

I couldn’t tell how my mother actually felt because she looked for the most part stoic. I’d like to believe that, like me, she also felt happy and relieved by this development.

After all, like a child asking her parents during a long-distance drive the perennial question “are we there yet,” Mommy was already becoming impatient about the entire thing several months into the infusions.

“How come it’s taking too long? When will it end,” she used to ask my Dad and I over and over.

No matter how often I gave her a date, she would always end up asking the same question soon after a visit to the oncologist. To keep myself from losing my mind, I finally had a date written on a huge piece of paper pasted on her dresser mirror—May 2015!

The date had to be adjusted twice because there were months when we weren’t able to visit her oncologist for various reasons.

After the birth of my nephew Peter on Dec. 14, 2013, and the death of my Dad on Feb. 22, 2015, the end of my mother’s monthly infusions, which began on November 23, 2013, finally came yesterday, July 4, 2015. I never thought I’d see the day.

HER 2 positive breast cancer

Those who follow my journey are probably aware that my mother was diagnosed with an aggressive form of breast cancer called HER 2 positive in 2013.

Early morning again finds me at PCSO's office in Diliman trying to secure a guarantee letter hopefully for the very last time.

Early morning again finds me at PCSO’s office in Diliman trying to secure a guarantee letter hopefully for the very last time.

Unlike hormone-induced breast cancer, HER 2 positive is a type of protein that produces cancer cells in the breasts.

Conventional and relatively cheaper treatments like radiation and oral medications like Tamoxifen are ineffective. Instead, women with HER 2 positive breast cancer are required to undergo mastectomy, several rounds of chemotherapy, and 18 monthly infusions of an expensive drug called Herceptin.

Herceptin acts as a form of vaccine to suppress the growth of HER 2 positive protein. Once its growth is suppressed, the protein loses its power to produce life-threatening cancer cells.

No matter how financially draining it was, my US-based siblings and I were able to handle the cost of the mastectomy and chemotherapy. It was when my mother was about to begin her monthly Herceptin infusions that gave us reasons to pause.

At P41,600 per vial (we needed 54 vials), Herceptin would have made us poorer by a staggering P2,246,400 or $50,500 by the time my mother gets her 18th and final infusion. Even members of a well-to-do family would have fallen off their seats, what more struggling working stiffs like us.

In the end, we still had to cough up untold sums, but the amount became somewhat manageable because of the goodness of certain people.

On top of the 40-percent discount for each vial of Herceptin we got from Roche, makers of the wonder drug, we were able to secure financial assistance from the Philippine Charity Sweepstakes Office (PCSO) in the form of monthly and/or bimonthly guarantee letters.

Close friends knew how I had to spend a number of days almost every month lining up early in the morning with the rest of humanity to get those life-saving guarantee letters from PCSO’s Quezon City office in Diliman.

Depending on the amount PCSO gave, each guarantee letter acted as a gift certificate of sorts, which enabled me to purchase at least two vials of Herceptin from one of the government agency’s accredited drug dealers.

Indeed, despite life’s bummers, we still have plenty of reasons to be thankful for.

Thanks are in order

My family, including my two in-laws, and I wish to thank the following people: my good friend Ivy Lisa Mendoza for her kind words and unceasing moral support, and for introducing me to lawyer Mabel Mamba, board member of PCSO.

A warm and funny woman, Mabel, through her office, was instrumental in assisting us get those much needed guarantee letters. To Mabel and her brother Miguel, maraming salamat po.

Ivy Lisa and I pay lawyer Mabel Mamba of PCSO a visit in late 2013.

Ivy Lisa and I pay lawyer Mabel Mamba of PCSO a visit in late 2013.

I would also like to thank friends and colleagues, especially Alya Honasan. A breast cancer survivor herself, she never got tired of giving me unsolicited advice and moral support the moment she learned of my mother’s condition. Your courage and wisdom, Alya, were quite infectious.

Cathy Babao, a former colleague of mine, also proved to be a ray of sunshine. Ever the optimist, her advice and words of encouragement also helped sustain me.

But PCSO’s guarantee letter wasn’t enough to pay for three monthly vials of Herceptin. Since we had to get them at their full prices when using PCSO’s guarantee letter, we needed to apply for discounts whenever we had to shell out our own money to buy extra vials.

Thanks to Alya and Cathy’s tips, I was able to learn and work on this special arrangement given by Roche to help families afford Herceptin.

To Roche’s Lilet Potenciano, whom I have yet to meet personally, thank you for hooking me up with the right people and offices as I applied for the Swiss pharmaceutical company’s so-called Roche Access Program (RAP).

The 40-percent discount from RAP enabled us to save P16,640 per vial. Instead of paying P41,600, we ended up paying only P24,960 per vial. That was still quite a sum of money, but it was nowhere near Herceptin’s actual market price.

Paid in full

To all my friends and relatives who sent kind words via text and social media, including those who prayed for us or wished us well publicly or in their hearts, thank you! You have already been repaid in full by someone much bigger and far greater than any of us.

To all my mother’s attending physicians led by Drs. Abellar and Annabelle Salvador, maraming salamat po! May you continue to derive the strength and inspiration as you go about healing and making people whole again.

And what do you think is my biggest regret at the moment in an otherwise positive development? I guess you all know by now. This event is bittersweet, as it comes at a time when my family and I are still grieving over my father’s death.

Since my mother could no longer make heads or tails of how huge the crisis was, my father was the one who walked with me almost every step of the way until he became ill himself early this year. He would have relished this moment and, as it was his wont, offered Mass in joy and thanksgiving.

Well, Dad, you may have left us even before the last vial of Herceptin was infused, but we know you had a guiding hand in helping us arrive at this endeavor’s conclusion. I reserve my biggest thanks to you. Mission accomplished!

Three vials of gold

Three vials of gold

 

 

 

 

 

6 thoughts on “Cancer, begone! The day the infusion dried

  1. Hi alexy, thanks for the very informative posts. May i know if you buy the herceptin directly from roche? My relative will be starting her treatments soon and the price of herceptin is really shocking.

      • Thanks for the info alexy. Very much appreciate your time and effort in sharing your experience with other patients. Hope your mom is doing well.

      • Thank you, CG. If you refer to earlier blog I wrote titled “The Importance of Dressing the Part,” you’d get more ideas on how to get assistance from both Roche and PCSO. Good luck!

  2. Hi alexy,

    I found your blog very informative especially now that we’ll be starting to purchase herceptin. Would you know if PCSO can release the next guarantee letter even if the first one is not use? Or we really need to use up the first one and bring it to globo before i can apply for another GL? My mom will also need 54 vials same with your mom and im glad that your mom already surpassed this stage. GOD BLESS your family!

    • Why would you want a new guarantee letter when you haven’t used the previous one given to you? I don’t think they would allow that for the simple reason that there are countless patients in need of assistance. Besides, they check if you have used it or not. In our case, they only started processing our request for assistance a month after the release of the previous guarantee letter. There were times when we had to shell out money from our own pocket to keep up with the scheduled infusion. It was difficult, but it would have been more difficult had we not gotten help from PCSO and Roche, through their Roche Access Program.

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