By MARTIN JOHNSTON
Thirteen-year-old Aslan Perwick believes faith helped him to survive the cancer that threatened to take his life, but says he never once considered seeking alternative treatments.
"Nope. Not with the statistics they gave me. What was the point," asks the matter-of-fact teen, who was so impressed with his doctors that he now wants to become a cancer specialist.
The statistic he cites is an 80 per cent chance of being cured of lymphoblastic lymphoma, which gave him swellings on his neck, chest and head, and will involve years of treatment with debilitating chemotherapy drugs.
His confidence in conventional cancer treatment contrasts with the parents of 5-year-old Liam Williams-Holloway, and two boys aged 6 and 13 who died after their parents avoided treatment at the Starship children's hospital in Auckland.
Tovia Laufau, 13, died last September. His parents await sentencing after being convicted of failing to provide the necessaries of life.
Tovia, like the 6-year-old Cook Islands boy who died in July, expressed fears that hospital treatment would kill him. The parents of both boys were influenced by those fears.
Aslan was diagnosed on May 10 last year and immediately began treatment at Starship. Nineteen days later, the Torbay boy was rushed to the intensive care unit where he was expected to die.
He survived the worst and the disease is now in remission. He has been out of hospital for most of this year and goes to school.
The chemotherapy's "horrendous" side-effects, including nausea, vomiting and hair loss, have virtually ended. He has to continue on maintenance doses for at least another year.
His mother, Kyra Perwick, attributes her son's survival to conventional treatment, Aslan's strong character, and their spirituality, including a hanky sent by a Wellington Catholic priest who holds healing Masses.
The cancer diagnosis sent Aslan's mother "into shock," making it difficult to take in all she was told. She praises Starship staff for their support and carefully explaining everything her family needed to know.
Aslan fondly recalls the "music lady" who sang to him once a week at his bedside. "I made sure I wasn't asleep when she came."
Dr Lochie Teague, Starship's head of haematology and oncology, said yesterday that it took many meetings to explain cancer and its treatment to families. The hospital relied not only on doctors and nurses to help patients and their families, but also on social workers, Pacific Island and Maori support teams, therapeutic play specialists and interpreters.
He said the hospital had not completed its review of Tovia's case.
It did not seek a court order for his treatment. It did in the Cook Islander's case, but the family fled home before the court hearing. Such orders are rarely sought.
Dr Teague "could not conceive" of seeking an order to remove a child from a family to enforce cancer treatment, even when, as in Tovia's case, it was known the patient would die without it.
"It's so important to work with the family and get the trust and understanding both of the family and the child to ensure a successful outcome and successful treatment."
Barbara Mackay, a therapeutic play specialist in the hospital's oncology unit, involves children in putting drip lines into teddy bears or sliding tiny dolls into models of medical machinery - all part of helping child cancer patients understand what is happening to them.
"Play is the way children make sense of their world ... It's what children do," she said.
"Children don't think hypothetically until they are eight or nine so what we do has to be concrete - what they will see, what it will feel like.
"If you can work with children, giving them an opportunity to understand, giving them a coping mechanism, an opportunity to practise and discuss it with you, even a four-year-old ... can manage some of these procedures that would seem very frightening to an adult."
Dr Teague said chemotherapy was the mainstay of much child cancer treatment, although surgery was vital in many cases and radiotherapy had a role. The medicines were improving and the future held great promise of better cancer treatments, particularly gene therapy.
Acute lymphoblastic leukaemia is the commonest child cancer in New Zealand, accounting for a third of the 150 cases reported each year. A quarter are brain tumours.
The survival rate among cases detected early is 75 to 80 per cent for acute lymphoblastic leukaemia, a disease that only 35 years ago was virtually a death sentence. Oncologists largely attribute the survival rate to chemotherapy.
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