Peter W., 13

Peter is a 13 y.o. boy who had a swollen left cheek and was treated for sialadenitis. Peter lives with his grandmother, mother and 2 other siblings. His mother works as a housekeeper in a nearby homestead, and is the sole breadwinner of their household. Their family lives beyond the poverty line, and is unable to afford the treatment for Peter. Peter was first treated at a subcounty hospital which is close to their home but later transferred to a higher level hospital for further diagnostic tests. He would like to be an international football player.

Peter's journey has been long and difficult. It began the previous year with a small swelling on his neck, just below his mouth. The swelling grew larger and became very painful. At times, the pain was so severe that oral analgesics were ineffective, and he had to be injected with pain medication. He was initially treated for sialadenitis at the nearby subcounty hospital, but the doctors there felt he needed further investigations, which were not available at their facility. Peter was referred for a neck ultrasound and subsequently reviewed by an ENT surgeon, who requested a CT scan. He was then admitted for a fine needle aspiration for cytology (FNAC). The FNAC results revealed that Peter was suffering from Hodgkin's lymphoma. He was referred to a national referral hospital to begin chemotherapy. The family, unable to afford the treatment, used their land title deed as collateral to receive the necessary care. Peter completed his chemotherapy sessions. Tragically, he passed away in early March 2024, just days after his last chemotherapy session, when he was about to be given a clean bill of health. He was diagnosed with severe anemia, likely induced by the chemotherapy. The nearest hospital to his home, Bokoli Subcounty Hospital, is not a transfusion center. Peter passed away while being stabilized before he could be referred to the nearest Level 4 hospital for a blood transfusion.

Hodgkin's lymphoma tends to be a progressive disease, meaning it can continue to grow and spread to other lymph nodes and organs, making it more challenging to treat. As the disease progresses, symptoms like enlarged lymph nodes, fever, night sweats, weight loss, and itching may become more severe and debilitating. As the cancer advances, it can potentially spread beyond the lymphatic system, affecting vital organs like the lungs, liver, and bone marrow. Delaying treatment can lower the chances of successful treatment and long-term survival. Treatment options may include chemotherapy, radiation therapy, targeted therapy, or stem cell transplantation, and the choice of treatment depends on the stage and type of Hodgkin's lymphoma.