A lump on her neck alerted Shirlean Alexander that something was not right but she did not expect to be diagnosed later with a form of thyroid cancer. Looking back now, she believes it was teachable moment and today she can face whatever life throws at her.
In June 2014, she thought all was well after she followed the advice of doctors to have an operation to get rid of a lump by removing one of her thyroid lobes, but less than two weeks later she was again on the operation table to remove the second one after the cancer was discovered.
She now has a scar on her neck as a constant reminder, but as a cancer survivor the married mother of one said she is grateful to be alive and is not ashamed to talk about her experience, which she describes as âjust one of lifeâs journeys.â
She was diagnosed with papillary thyroid carcinoma, said to be one of the most common thyroid cancers which arises as a solid, irregular or cystic mass that comes from otherwise normal thyroid tissue and which also has a high treatment rate.
It was in January 2013 while having a bath that Alexander realised there was a lump on her neck, and she decided to check with a doctor after a week passed and it still remained. The doctor recommended a biopsy and suggested having the lump removed since the biopsy showed nothing, but because âit was hardâ.
While she agreed to have the surgery, she decided to get a second opinion. The same suggestion was made, but it was also recommended that some other tests be done, at the end of which, she said, the doctor, stated âthis is a lump, but it is hard, and you need to do a surgery.â
But months later the surgery was not done as Alexander developed a cough that stayed with her for months even though according to her, she âdrank all the cough medicine I could find.â She was later diagnosed with acute bronchitis and following a two-week treatment the cough finally went away. During that process a friend, who is a doctor, encouraged her to have the surgery since the lump could be cancerous and âit get me a little serious but I was not scared in anyway.â
Not satisfied, Alexander said, she saw an ear, nose and throat specialist and he also suggested the surgery.
âI rest up a bit, but I wasnât still really serious to go and do the surgery because the lump was not bothering me, I wasnât feeling any pain or anything. But it is my husband who say you need to go and do what the doctors recommend and get it done,â she told the Sunday Stabroek.
She finally decided to get it done and the doctor recommended that one of her thyroid lobes be removed as the other would help her with the thyroxine that her body needed.
Alexander was on her second week of sick leave in October 2013 healing when she received the dreaded news through her husband who was called by the doctor.
âWhen he stepped out the car, his facial expression alone, I say this is it. And I say, âOkay I know, I donât need to see that report I know what it is letâs go,ââ she said.
It was while being driven to the doctor that she looked at the results and began her own research on her mobile phone. At that time, she said, âthere was no tears, nothing. I donât know where I got this strength from, but it was there, cool and calmâŠâ
The doctor suggested that she needed a second surgery to remove the second thyroid lobe and at that point she became scared as it had only been just over the week that she had the first surgery. The second surgery was done within weeks and it was recommended that she travel to Trinidad for treatment of the cancer since it was not available in Guyana.
âWhen I went home [after the visit with the doctor] is then I break down because⊠when you hear the word cancer you think it is like death⊠so many people dying of cancer and little is being done with the different types of cancer⊠the only types of cancer that people are aware of most are breast and cervicalâŠâ
At that time, she had a one-year-old son and Alexander said the baby and her husband gave her the strength to continue; she wanted to live to look after her child and to see him right through to adulthood.
At that time, the young couple had just made a deposit on a house (they had made a New Yearâs Resolution to move into their own home by Christmas of 2013) and finance was an issue, especially since she had travel overseas for the treatment. She suggested to her husband that they ask for the return of the down-payment on the house, but he refused and assured her that she would access the treatment and also move into their new home as they had agreed.
She returned to her job after three weeks of leave and in desperation she approached her boss to inform him that she wanted to make a public appeal for assistance, but he talked her out of that path and indicated that the company would assist her with some of the funds needed.
But the real help came when a friend suggested she visit the National Insurance Scheme (NIS) where after a process, once it is ascertained that the treatment cannot be accessed in Guyana, she could be given an advance sum for the treatment.
âI didnât even know thisâŠâ she said, adding that she continues to praise her friend for the information she gave her.
âBut there I went, and I got the advance from NIS; 80 per cent [of the cost for the treatment]. Eighty per cent and people does talk down NIS, but it is just that you have to find out⊠those people deal with me so nice and they told me even if you go for a little prescription you can claim it backâŠ,â she said.
With six months of the diagnosis, Alexander accessed the treatment she needed, and she said during that time her husband was her biggest support as even though she told her parents she gave minimal details since she did not want them to worry.
âMy support was my husband and I got my strength from my child, I donât like this pity, pity thing,â she added.
And as planned the coupled moved into their home in December 2013.
Since the treatment, Alexander travels to Trinidad every year to ensure she is cancer free and all visits have been positive.
She is now using thyroxine tablets daily along with other vitamin tablets since she no longer has her thyroid.
When people ask
Alexander said she is not ashamed to talk about her experience and when persons ask about the scar on her neck, once they ask politely, she would tell them.
âBut they have some people who are very rude⊠on the road they would say things like, âthe man was a very jealous man mek he slash youâ⊠I wouldnât answer. But if they ask politely, I would say I do a surgery and if it is somebody I know and they didnât know I would tell them,â she shared.
She recalled an unsavory experience with a customer to whom she was attempting to sell a product that treats scars.
âI was very, very disappointed in her. I was very upset,â she related.â I showed her the cream and she was like âNo I not interested, you should use the cream for that scar that you haveâ which I found was very, very rude, very disrespectful and I said, âyou know what, this scar donât bother me⊠I am a cancer survivor.â You could see she was ashamedâŠâ
Alexander said the experience has taught her not to judge anyone as persons form many conclusions when they see her scar. She is a part of the Guyana Cancer Foundation survivorâs group and she shares her experience to help others. The survivor wants to see more men talking about their experiences and she added that recently she learnt of three men who passed away from cancer, one was diagnosed with cancer of the throat.
Looking back at her old photographs, Alexander said she could see the difference and it was obvious that she was sick but did not know it at the time.
âI could see the difference in my face⊠and my eyes and so on is like now I can see myself looking healthy and glowing,â she noted.
Now 33, Alexander said she believes her life is a journey and having cancer was part of her journey which came to make her stronger.
âI used to stress a lot, I used to worry a lot and now I tell myself if you could have overcome that there nothing else that could break you⊠I am prepared to deal with anything. And one more thing, whichever God we serve we must always keep them in our midstâŠ,â the survivor said.
Having found her inner peace, Alexander said, the âglowâ she now has is infectious and persons always comment on it, but she knows a smile can go a long way.
World Cancer Day
Guyana, which the most recent figures reveal has the third highest rate of cervical cancer in the Western Hemisphere, joined the rest of the world last Monday to observe World Cancer Day, which is observed every year on February 4. This day is used by organisations and people around the world to unite to raise awareness about cancer and work to make a global health priority. The observance was held under the theme âI am, and I will.â
The Guyana Cancer Foundation joined in the observation with a candlelight vigil. Next Thursday, Valentineâs Day, the foundation will host free screenings for cancer at its Lot 9 Third Avenue and Sheriff Street, Subryanville location. The screenings will be conducted between the hours of 11.30 am and 5.30 pm and include free clinical breast examination and cervical cancer screening. Other services to be provided are blood pressure and glucose testing, on the spot counselling and free distribution of male and female condoms. For more information persons can call 618-2085.
Available figures revealed that during the period 2004 â 2011, over 3,400 persons in Guyana died from various forms of cancer, with the largest number of deaths â 621, occurring in 2011.
It was said that Afro-Guyanese account for over 65% of prostate cancer diagnosed, whereas Indo-Guyanese women account for the highest number of breast cancer cases diagnosed.
Meantime, in 2017 Dr Kavita Singh of the Ministry of Public Health had presented staggering statistics that found among other things that there was no record of treatment for 79% of cancer cases in Guyana.
She had reported that in July 2015, the ministry and PAHO launched a 10-year cancer profile, compiling reports from the National Cancer Registry, spanning the years 2003 to 2012 and that was one of the findings.
When she was asked to provide an explanation for this, Singh had related that the reason could be put down to patients being unable to access cancer medications from their relevant health centres, as these medicines are not decentralised.
âChemotherapeutic drugs, theyâre not catered for in our essential medicine list because cancer treatment is not really a pillar thatâs being offered at the primary healthcare level. So, the only place that did have that was GPHC, because theyâre a corporation theyâre allowed to have every single specialty, so they cater for that,â she had explained at the time.
During the 10-year period mentioned above, it was found that 6,518 cancer cases were reported. The overall cumulative incidence rate calculated was 867.7 per 100,000 and the annual incidence rate was recorded at 87.3 per 100,000. Of that number, 3,956 or 60.7% of patients who reported were women, while 2,561 or 39.3% were men.
Those most affected by cancers were over 75 years old.
