ELLA L. Florida of Sta. Cruz, Davao del Sur, felt a lump on her breast last year. She thought nothing about it but still felt the need to seek a doctor's advice. Her doctor prescribed she undergo a mammogram since it was only through this test that they could tell if hers was malignant and needed surgery procedure the soonest time possible or if it was just a benign tumor.
Her mammogram results yielded negative for cancer, meaning that her tumor was just benign. But since the size of the lump was already alarming at 13cm in diameter, and still growing, her doctors advised her to undergo surgery to remove it.
At first, she was hesitant not only because she was afraid to go under the knife, but also because she didn't have the money for an operation.
"Wala sad koy runner ug watcher. Naa koy mga igsuon pero naa nay mga pamilya, ang akong mga pag-umangkon naa na puy mga anak ug pamilya ilaha. So wala gyud koy mapamalihogan (I don't have a runner and a watcher at the hospital. I have siblings but they all have a family of their own, and my nephews and nieces also have their own children and family. So, I don't have anyone to request to help me with at the hospital)," she said during an interview outside the Southern Philippines Medical Center's (SPMC) Adult Cancer Unit as she was queueing for her radiation therapy.
A runner is a person, either a relative or a friend of the patient, who is tasked to buy anything a patient needs outside or inside the hospital. He or she usually patiently waits outside for a call from the nurse station whenever a patient or her doctor needs him to buy something, such as medicines or medical equipment needed for a procedure.
Meanwhile, a watcher is a caretaker of the patient while he or she is inside the hospital. They could either be a relative or a friend of the patient who could help the latter in changing clothes, taking a bath, or anything that a patient cannot do by herself.
Although still living, Ella's mom is already 84 years old and she cannot be Ella's watcher nor runner. Ella narrated that she had a live-in partner before but he died five years ago and they had no child and she didn't bother to fall in love again.
Fortunately, Ella's two friends encouraged her to undergo the operation as they were willing to be her runner and watcher.
To make the story short, Ella went to SPMC, the largest government hospital in Mindanao, to proceed with the surgery to remove her breast lump.
Since she was not a member of PhilHealth, she was advised by the social worker manning the Social Welfare office inside the SPMC to register for emergency PhilHealth for Indigents so that her hospital bill, medicines, and laboratories would be covered.
"Maayo na lang gani kay naa ra diha sa sulod ang PhilHealth office (pointing to the hospital), makapa-register dayon ka, dire-diretso na (It's a good thing that the PhilHealth office is already inside, you can easily register, and then proceed to next step)," she said.
After the removal of her breast lump, it was biopsied to verify whether it was indeed benign.
However, after around three weeks of an agonizing wait, Ella had gotten the result and took it to her surgeon. Her world crumbled apart upon hearing that she already had breast cancer stage 3-A.
Phyllodes tumor
She questioned the doctor how it came to be when they told her that her breast lump was just a benign tumor, as the result of her mammogram stated.
There she first heard the words Phyllodes tumor.
According to her doctor, she had a Phyllodes tumor - a relatively rare fibroepithelial neoplasm that presents a morphologic continuum from benign to malignant. (www.ncbi.nlm.nih.gov, Jan. 2023)
In layman's terms, this kind of tumor usually behaves benignly but has a tendency to become malignant without any known provocation.
"Nakaingon ko sa akong sarili ato nga naa nakoy cancer, stage 3 pa gyud. Mamatay na diay ko (I told myself, I already have cancer and it's stage 3 at that. I am dying), Ella said.
However, oncologists at the SPMC assured her that there's still hope for her and that she only needs to do is to act immediately.
Ella narrated that since she was diagnosed with the Big C after her operation, she did not experience undergoing chemotherapy. Her oncologists told her she had to undergo radiation therapy or radiotherapy immediately.
Gathering the amount she needed
She was given an estimated bill of P400,000 for the 28 days of radiotherapy. She said the majority of the amount was covered by her PhilHealth's Z-benefit package, the Cancer, Supportive Care, and Palliative Care Medicines Access Program (CSPMAP), and the Department of Health's (DOH) Disbursement Acceleration Program (DAP) but she still had to pay around P80,000, the excess amount of what is covered by these government programs.
Ella shared that before their radiotherapy starts, all the cancer patients were advised to fully pay their remaining balance on or before they have completed their sessions. She added that the hospital also informed them of the offices they can go to to seek medical assistance.
Without wasting her time, she started approaching the government and politicians' offices to seek medical assistance, armed with all the necessary personal documents and those provided by the SPMC, such as the clinical summary.
She also shared that the Social Welfare office at the SPMC provided her with the PWD certificate, which all cancer patients are entitled to have, for them to be able to line up at special lanes for PWDs, which are more convenient and faster.
"Ako ra naglinya-linya ma'am, kay mas lisod man kung imong relative or representative kay daghan pa'g pangitaon, mga SPA (special power of attorney) or kung dili sad authorization letter unya pangitaan pa siya ug ako og ID. Samok ug kuti kaayo. Naglinya lagi ko ma'am nga naa pay bandage akong totoy gikan sa operasyon (I was the one who lined up personally, ma'am, because it would be more difficult if it's your relative or representative who would line for you because these offices would require you several documents, such SPA or authorization letter, and then both of you and your representative will be required an ID. Very hassle. I lined up with my breast still had a bandage on due to operation)," Ella narrated.
However, when asked whether she encountered any problem when queueing for medical assistance, Ella says: "Wala man pud ma'am. Nah! Dali ra kaayo kay naa man mi PWD certificate, hatagan man ka sa social worker sa SPMC. Tanan cancer patients tagaan ana aron dali lang ka kung magnilinyahay na (No, I didn't encounter any problem! In fact, it was very easy since I have a PWD certificate, which was given by the social worker at SPMC. All cancer patients are given this PWD certificate so that it will be easy for you to queue at any office)."
She narrated that it was very easy for her to gather the remaining balance of P80,000 and proudly said that she was able to gather the whole amount before her radiotherapy schedule even started.
Among the offices that have given her financial assistance through a guarantee letter were the Office of Senator Bato dela Rosa with P10,000, the Office of the Vice President (P20,000), the Office of the Congressman in their province (Rep. John Tracy Cagas) with another P20,000, and some fewer amount from the offices of partylists located in Davao City, such as the Marino, PBA, Tingog, and Dumper, and the PCSO. The Office of the President in Mindanao also extended financial help to her, also through a guarantee letter.
Her wound dressing needs after her surgery were also covered by the Department of Social Welfare and Development (DSWD) in their province.
"Nalibre gyud siya tanan-tanan ma'am. Imoha nalang is ang plite-plite (All have been covered for free ma'am. Your only expenses would be the transportation fare)," she said. (To be continued)
