Vietnam's cancer kids fight with hope against adversity

It’s a common phrase Dung’s mother – who is almost always beside the hospital bed – has been whispering sweetly into her daughter’s ear these days.

It was fun, like a secret plan or mission.

It was an afternoon in mid-May and the young girl had just finished her last chemical treatment of the day at the Department of Oncology - Hematology - Bone Marrow Transplant, Pediatric Center, Hue Central Hospital.

In a year and three months of lymphoma treatment, Dung counted this as the eighth time her mother had asked her to "escape the hospital."

Each time, a different friend had come to visit her. And this was no different. Her mother was always plotting, trying to liven up her terminally ill, and very sick, daughter.

At first, Dung didn't think much... she was just happy to leave the hospital for a bit.

But over time, her walks around the facility began to make her keenly aware of the many empty beds that had been previously occupied.

The optimist in this particular girl wanted to believe that the patients, all children, had received proper treatment and healed before leaving to take their healthy bodies home.

But Dung knew she was living in the children’s cancer ward.

What are the odds?

Children with cancer often live in hospitals, and when they do not return, it usually means there is no hope left.

Each year, 2,500 childhood cancer cases are recorded, out of approximately 280,000 cases worldwide.

Over 80% of pediatric patients in developed countries are cured, while the rate in low- and middle-income countries is only 20%.

"After seeing so many other children disappear, I didn’t think my child could survive the first round of chemotherapy," said Dung's mother, My Duyen, 37.

Shock

Two years ago, while in 8th grade, Dung was selected to take the district-level Chemistry exam.

But during her studies, she developed a severe toothache that wouldn't subside. Duyen took her daughter to Quang Tri Provincial General Hospital, where a CT scan revealed lymph nodes in Dung's neck.

The scan led doctors to diagnose the 15-year-old girl with cancer.

My Duyen was taken aback.

"You would never expect that the child you brought into this world could be cursed with such a disease," she said in disbelief.

The mother worked Dung’s way up the medical ladder by taking her to higher-level hospitals for re-examination, hoping for a different result.

But after many tests, doctors at Hue Central Hospital – the best facility in the region –confirmed early-stage lymphoma.

Dung was silenced by the news. She hugged her mother and burst into tears.

From that day on, Dung's life as she knew it has gone awry.

Topsy-turvy

Dung stopped going to school, leaving her exams unfinished. She was admitted to the hospital for treatment. Duyen also quit her job to care for her daughter.

At home in Dakrong District, Quang Tri, only the father remained to work and care for the two other children.

The doctor prescribed six rounds of chemotherapy, each lasting about a month and a half. The hospital became a second home for Dung and her mother. Eight children with shaved heads welcomed Dung into their 50 sq.m room for pediatric solid tumor and leukemia patients.

Among the 6,809 children treated there in 2023, blood system cancer cases like Dung accounted for about 37%.

Her first month at the hospital, Dung wandered around the room – her and her new cohort’s new home – which smelled of powdered milk mixed with antiseptics. Ignoring the loud cries of other children, she clung to her phone —the only connection to the outside world. Occasionally, she dreamed of going out with her friends in the countryside.

"If I get over my illness and go back to class, I don't know if I will still be close to my friends like before," Dung, a young teenager, posited.

Cut in half

Dung used her cancer diagnosis to divide her life into two halves.

Before the illness, she was a good student, an amateur volleyball player, and never got tired. She dreamt of becoming an architect, inspired by her father's profession in construction.

But the cancer changed everything, confining her to a hospital bed.

"Why me? Will I ever be like them again?" Dung often asked herself.

Understanding her daughter, Duyen used outings to distract her. She also maneuvered slyly to make surer he girl never experienced the sadness of saying goodbye to friends.

How to face the changes?

Dung's body changed significantly with the cancer.

Three lymph nodes protruded under her face, creating a what looked like an extremely large, and noticeable, chin. Her hands and feet were colored by the protrusion of pale blue veins due to weight loss. Her nails occasionally "burned" black from chemotherapy. Her hair gradually fell out due to the treatment.

After the third round of chemotherapy, Dung asked her mother to shave her head. Duyen borrowed clippers from a roommate's parents. Later, she bought her own tools and shaved Dung's head every time her hair grew back: to avoid infection.

Since shaving her head, a brimmed hat became Dung's inseparable companion.

At one of life’s most awkward social stages, the teenage years, she felt self-conscious about her new appearance.

"It's extremely painful," lamented Duyen. She had never cried as much as she did while caring for Dung in the hospital.

Suffering all around

In the first week of Dung’s treatment, Duyen lost 7 kg.

Seeing her daughter struggle, she couldn't eat or drink, overwhelmed by the fear of losing her child.

Cancer made Dung extremely frail, and as her immune system deteriorated, she became easily susceptible to every kind of malady. Small environmental changes and the use of chemicals nearby could cause infections anytime. Duyen had to learn how to care for her daughter’s every need: taking the girl for walks, feeding her, and handling seizures, which became common as Dung’s strength deteriorated.

Duyen familiarized herself with medical terminology and chemical names. The most notable was Doxorubicin, a cytotoxic antibiotic she called "red medicine." The overpowering drug nearly took Dung's life during the first round of chemotherapy.

At one point, Dung's blood clotted up to 85%, causing convulsions and severe fever. She fell into a coma for three days, requiring a blood transfusion. Most pediatric patients experience such side effects after chemotherapy. Without immediate emergency treatment, patients can easily fall into dangerous situations.

On the fourth day, Dung slowly regained consciousness. The first thing she did was borrow the doctor's phone to call her mother: "I'm afraid I won't be able to see you anymore." Hearing her child's voice, Duyen burst into tears.

"Many times, I couldn't help but think about the worst case scenario," she said.

After more than a year in the hospital, Dung became familiar with the doctors, nurses, and the pain of each injection or spinal tap. Gradually, she learned how to show the nurse where to take the vein to make it more comfortable. She began to wear a smile on her face.

"Since that near-death experience, I no longer argue with my mother. Thanks to her, I have more motivation," Dung said.

At 15 years old, Dung was well aware of cancer, but the younger kids in her room were not. Many children under six struggled to survive.

Childhood inside hospital wall

At the mere age of three, Siu Huan from Gia Lai Province had undergone all main treatments for childhood cancer. The Jrai boy's 34-week regimen included chemotherapy, radiation therapy, and surgery.

For the past year, Huan lived in a white room that smelled of disinfectant. The boy, dark-skinned and smooth-headed, had arms and legs bruised with broken veins. Growing up with cancer, Huan did not fully understand his disease. When in pain, he cried. When not, he laughed and ran around the room, often being scolded as a "super naughty boy."

Siu H Phuc, 26, often couldn't hold back her tears, looking at her son’s innocence. His face always carried a hint of sadness.

At the end of 2022, Phuc panicked when Huan had seizures, high fever, and constant nose and mouth bleeding.

The family took him to the doctor, but no abnormalities were found.

After a year, his stomach swelled, and he lost weight. At the district medical station, an ultrasound revealed kidney damage, and Huan was transferred to a higher-level hospital. The tumor did not shrink but grew larger. It even invaded the intestines.

At the Children's Hospital No. 2 in HCMC, the doctor diagnosed nephroblastoma, prescribed surgery to remove the kidney with the tumor, and transferred Huan to Hue Central Hospital for chemotherapy and radiotherapy.

For the first time, through her barely-alive son, the "shape" of cancer appeared clearly to Phuc. In early 2024, she and her husband abandoned the fields they farmed in their hometown, borrowed over VND15 million (US$590), and took Huan to Hue.

By the 19th week of their regimen, the debt had soared to VND70 million, an amount they couldn't repay. The couple had planted a field of cassava, planning to sell it once it ripened to cover both the debt and interest.

"Being away from home for over a month, I don’t know if the fields have died or not," Phuc said, worried about their only remaining livelihood.

For more than half a year, their income from dozens of coffee trees and occasional work for others vanished. The phone they used to contact their three young children at home broke and they couldn’t afford a new one, relying instead on neighbors. They didn’t travel home because they didn’t even have a single dong to pay to get there.

The family now depends on outside support.

Charity groups often visit on weekends, giving their children VND100,000, which means meals with some vegetables and meat on those days.

In the hospital room, every bedside drawer has various kinds of milk and nutritional powder, except for Huan's.

Phuc is heartbroken seeing other children eat well while her child's meals often consist of instant noodles, sometimes with corn or potatoes, like in their poor poverty-stricken village.

At three years old, Huan weighs just 10 kg, far below the World Health Organization's recommended 14.3 kg for his age. Malnutrition has weakened his immune system, slowed wound healing, and disrupted drug metabolism, affecting treatment results. One week his white blood cell count was so low that doctors had to temporarily stop his medication until his health improved.

Mother’s heart

When children suffer from a disease that seems to come out of nowhere, many mothers like Duyen and Phuc often blame themselves.

Duyen's husband's family has a history of cancer. Her father-in-law also has the disease. She used to take her children for health check-ups every six months, but due to the Covid-19 pandemic and financial difficulties, she had to focus on her business and neglected the habit. Every time she talks about her child's illness, she feels guilty.

Phuc, too, often wishes she had known about her child’s illness in late 2022, the first time Huan showed symptoms. "I wish his illness had been discovered a little earlier," she said.

Early detection helps reduce mortality rates, improve treatment quality, and lower costs for patients, both children and adults. However, in many areas, diseases are often detected at late stages. At Hue Central Hospital, many ethnic minority children are diagnosed only at stage 4, with multiple metastases, due to a lack of medical resources and experience.

Dr. Nguyen Mai Linh from the same department explains that families often have many children and can't afford medical care. Medical facilities lack the necessary equipment and expertise. Even basic testing like ultrasound is often unavailable or underutilized.

Late detection poses significant challenges for higher-level hospitals. In some cases, intervention comes too late, and the patient doesn’t survive. Recently, a child diagnosed with asthma was transferred to a higher-level hospital after worsening symptoms. An X-ray revealed a large tumor compressing the heart and lungs, but it was too late to save the child.

Metastatic disease complicates treatment. Even if the correct regimen is chosen, the child's poor physical condition and side effects of chemotherapy may hinder the process. In case of survival, recurrence rates are higher.

Long road for these kids

Though discovered at stage 3, Huan's tumor had invaded a kidney. After removing it, doctors predicted a 70% chance of recurrence.

Despite the long road ahead, Phuc and her husband never once considered abandoning treatment.

Seeing Huan grow stronger after 24 weeks of treatment gave them hope. As Huan’s condition stabilized, Phuc returned to their stilt house in Gia Lai in early June to await the birth of her fifth child, leaving Huan in her husband's care.

"I'll do anything for you," she whispered to Huan before leaving the hospital.

Dung’s lymph nodes almost completely dissolved after the fourth round of chemotherapy. Informed by doctors that from June, she would transition to outpatient care, Dung felt a mix of relief and caution.

"Maybe after five years, my health will be stable enough to truly celebrate," she said.

Before leaving Hue, Duyen took her children out to enjoy the city, hoping to create happy memories instead of those confined to a hospital bed.

"Hue is beautiful, but always linked with sad stories," Dung reflected, gazing at the lush scenery outside the car window.

Duyen knows that Dung’s life prospects have improved, but she is cautious. Cancer often recurs within the first five years, at a rate of 10-15%. If relapse occurs, the prognosis is poor due to the lack of effective treatment.

"No one knows what the future holds," she said.

Gone home

In early June, Dung returned home after a year and a half of treatment, immediately focusing on her 10th-grade entrance exams. Determined to pursue her dream of becoming an architect, Dung pushed aside fears about keeping up with school, hair growth, and social stigma.

And the doors to her dreams are now gradually opening wider.

Phung Tien