Wednesday, July 11, 2012

SSC in Oncology


We have to do two SSCs in year 3 and two more in year 4. SSC stands for Student Selected Component and it takes 4 weeks to complete.
Towards the end of semester, the choices for SSC will be released and students are to rank 8 of them.
I don't know how the selection is done but, after a few weeks the result of the matching will be out. Last semester I got my first choice, that is in Cellular Pathology. This time I got my second choice, that is in Oncology.
Syahidah, my housemate got my first choice; Pleural Diseases. That was her first choice as well.

Last semester during my Cellular Pathology SSC, I get to watch a post-mortem for the first time and even wrote about it. This time, I was too preoccupied with the project itself and some other matters, I always procrastinate writing about my project.

"Onco" means cancer. And "logos" as most of us know, means the study of. So Oncology means the study of cancer. Make sense?
But Oncology is such a huge and specialised topic, how am I supposed to do a 4 week project on it? Well, the name of my SSC is actually "An Introduction to Oncology".

The first day saw me following one of my supervisors (there were two of them), a Brain and Gynae Oncologist to his "planning" session. That is him looking through the scans and images of people's skull on the computer, looking for the tumour and marking its perimeter with various different colours. He was actually marking the sites on the head where the respective patient will get the radiotherapy at. The markings he planned on the scans in the computer will be interpreted by a radiotherapist and marked using some sort of a tattoo on the patient's scalp/face/skull. That will mark the site of highest radiotherapy radiation. It is like watching movies where people has the blueprint of a building with beautiful designs on the computer but this one, is a brain rather than a building.

Then he went to his ward round where I saw a lady who was recently diagnosed with cervical cancer that has spread into her pelvic cavity.
She has not come to terms with her cancer, and was expecting the doctor to cure her to her normal self, free of diseases and discomfort, while the doctor saw no other reason for her to continue being in the ward and has ordered for her discharge and to meet only as an outpatient. She refused to be discharged saying that she wants to get better before leaving the hospital. And she looked horrible, crying her heart out.
I felt so bad for her.
In a way, I was unsatisfied with the doctor's way of explaining the current situation to her, since he did not even mention the prognosis explicitly. I think he made the lady think that her cervical cancer is curable. But, the lady has been in the ward for almost a month and that was not the first time the doctor had to explain things to her and perhaps, he is sick and tired of it? Perhaps he explained to the patient before this that her cancer is incurable? Hmm..I don't know. But I always have a soft spot for any woman with any kind of female cancer; ovarian, uterine, cervical or breast.

I spent the next day in the clinic with my other supervisor; the one that will be marking me based on my report, attendance, attitude etc. This is the one I have to show my face to often. Haha..

She is a Breast and Upper GI Oncologist so she deals with Oesophageal, Stomach and Breast cancer.
The 2nd SSC day was another gloomy day in my medical school history. I saw about 10 people crying in a day, patients and their carers. A lady was newly diagnosed with oesophageal cancer, after she noticed difficulty in swallowing for a few months. She presented with a typical oesophageal cancer symptoms; subconsciously changing her diet from solid to semi-solid and softer food. The cancer has unfortunately infiltrated her lymph nodes and the doctor said surgeons might not be willing to "cut her tumour out", since the lymph nodes will be very hard to reach through a surgery and if the lymph nodes are left there untouched, the chance of the tumour to regrow is almost 100%. She thought her symptoms were just reflux. So now, the only option left is for her to go through the horrible chemotherapy and see if the tumour shrinks and lymph nodes become normal again. Thin chance.

Another lady cried because she couldn't stand seeing her 70+ y.o husband suffering due to the side effects of the chemo. "If I have to lose him, I will lose him. I understand that. But I can't see him sick. Please don't give anything that will make him sick..."
Such a sad day.
A very very sad day.

I once thought of becoming a specialist in Paediatric Oncology, that is dealing with kids with cancer. I think kids are easier to deal with since they are more genuine and sincere to us, unlike adults. But will I have the heart to see young kids succumb to their cancers?

Perhaps I should stop here, this post is getting too long.


-Because life is a test-


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