‘I went through six doctors until I discovered cancer at the age of 25’ – 05/22/2023 – Equilibrium

In June 2021, pharmacy student Fernanda Pereira, aged 25 at the time, noticed a small lump on her neck. Believing it might just be a strained muscle, she resorted to a relaxing massage.

During this period, the young woman was already undergoing several routine tests, which did not show any changes. Upon complaining about the lump to the gynecologist, she was referred to a general practitioner. However, in that time interval, she noticed that other ganglia had appeared in the region.

“It felt like a golf ball on the side of the neck”, he recalls to BBC News Brasil.

From then on, it was a saga, as she defines it, until she reached a diagnosis and found out what she had and why some symptoms only got worse.

In one of the blood tests he did, he even had mild anemia as a result.

After months of undergoing various analyzes and going to consultations, Fernanda discovered that she was suffering from cancer of the lymphatic system.

However, until reaching this result, the student went to six specialists and suffered, according to her, from a lot of negligence by the doctors.

As it is a disease that evolves quickly, she says that there she was afraid of dying.

“I got the result of the exam and opened it on the subway and it was like ‘what now?’ for people,” he says.

Fernanda had to deal with cancer alone for just over a year, as she has no contact with her parents and only a few friends helped her through this phase.

‘Lumps’ on the neck

One of the main symptoms of this type of cancer is the appearance of ganglia or lymph nodes in some parts of the body.

Usually, the most common lymph nodes affect the neck and go unnoticed, as they are easily confused with throat inflammation and even tonsillitis. But they can also appear under the arm, inguinal region and groin.

When an enlarged and unusual lump appears, one should pay attention to the number of days it remains in the region or if it is increasing in size.

“Lymph nodes that grow and do not return to normal size deserve attention. If they remain for more than 30 or 40 days, the ideal is to look for a hematologist or head and neck doctor”, explains Guilherme Perini, hematologist at Albert Einstein hospital.

Even though she already had a noticeable lump on her neck, Fernanda says that, when looking for a hematologist, the doctor didn’t even touch the region and even asked for repeated tests.

“I tried to explain what was going on and he cut me all the time. I showed him the medicines I was taking, my hair was already falling out a lot and I was still weak. He said that if I didn’t get better with that new medicine, I was to come back from here a month,” he recalls.

After that professional, she looked for another hematologist to try to understand what she was going through.

According to her, in that consultation the new doctor, in fact, looked at all the exams and picked up the lumps that were in the region. After that, he ordered ultrasound and x-ray of the abdomen and chest.

“He said I had to be strong because it could be lymphoma”, he recalls.

Extreme tiredness and sweating

In addition to the lymph nodes in her neck, the student also felt unusually tired. She says that even taking a shower was difficult and she had to sit on the toilet for a few moments before returning to the shower.

It had been almost six months since the onset of the first symptoms.

“I was exhausted and tired when taking a shower. I would get up, wash my hair and in the middle of the shower, sit back down. My hair fell out a lot too”, she says.

During the night, the young woman still had trouble sleeping and left the bed soaked.

“I looked like someone had thrown a bucket of water on me,” he says.

According to Jayr Schmidt Filho, leader of the Reference Center for Hematological Neoplasms at the ACCamargo Cancer Center, sweating is classified as “symptom B”, which accompanies the other manifestations of the problem.

“The person can also have a fever and a weight loss of 10% of the current weight”, highlights the specialist.

Prostration frames are very common in various types of cancer and this happens due to the stage of the disease. And that’s what happened to Fernanda, since the disease was advanced, but she still hadn’t had confirmation of the lymphoma.

She recalls that her anemia symptoms worsened and she needed two sets of blood transfusions to recover.

In late November, she was finally diagnosed with Hodgkin’s lymphoma, a cancer of the lymphatic system that is most common in people in their 20s and 30s.

“This type originates in cells of the immune system, which undergo mutations and transform into tumor cells”, explains Schmidt Filho.

Through the image exam called Pet-Scan, she was able to see the severity of the condition.

“I did imaging tests and the cancer was already all over my body. My spleen was increasingly swollen with so many lymph nodes. They found out that it was already in stage 4 and there was infiltration in the pelvis, in the spleen and in my pelvis”, he says.

Start of treatment

Even having a health plan, Fernanda managed to be part of the treatment by the SUS (Sistema Único de Saúde).

“I talked to the doctors and felt a confidence in the public system specialist that was not felt in the plan. They sent me to the hospital and I started the treatment.”

She started with chemotherapy sessions, being necessary to stay in the hospital for four to five hours. At this stage, she had two complete cycles of treatment, but when doing a new image exam, the doctors said they were not satisfied with her evolution.

“They said they would do a heavier chemotherapy with four infusions in a row. I went Wednesday, Thursday and Friday and I rested at the weekend. In the stronger chemotherapy, no hair was left, not on the leg, armpit, absolutely nothing. Everything starts to fall out “, recalls.

In this second stage of treatment, she says that she spent almost 12 hours receiving medication into a vein and could not be visited by anyone.

Even performing this more intense care, she woke up the next day with a lot of pain in her gums and the discomfort increased.

“When it was midnight it was an excruciating pain and when I went to look in the mirror there were purple dots on my gums”, he recalls.

A few hours later, Fernanda remembers that the condition got worse and she presented with necropenia.

“I was in a lot of pain and I wanted to hit my head against the wall. They gave me medicine, some ‘cousins’ of morphine and even the doctor got scared. He said I was having gum necrosis and that he had never seen that , but it was an effect of the chemotherapy”, he says.

At the end of December, the doctors said that she was not responding well to the treatment and that the best option would be immunotherapy.

This type of treatment consists of activating the patient’s own immune system.

However, each dose costs around 40,000 reais and is not easily made available by the SUS.

“The lymphoma had flared up again and I started to feel weak again. Within a week, I had several lymphomas”, remembers Fernanda.

Because of this, she had to apply for her health plan and started the new treatment.

From the second infusion, she no longer felt any lumps in her neck and, little by little, she evolved and had a better prognosis.

Almost a year and a half after the onset of the first symptoms, Fernanda says that she underwent a new exam last month, the disease has practically disappeared and there is only one lymph node under the armpit.

She is still undergoing treatment with immunotherapy and is on her tenth infusion – there will be 24. The student will have one year of follow-up to consolidate the treatment and then medical supervision.

“I feel much better. Today I work out, I can lift 70 kilos and before I couldn’t even wash my hair. The immunotherapy is incredible”, he says, beaming.

Even though she was young, she says she didn’t imagine she could have cancer. Talking with doctors to investigate what could have caused the disease, she says that in her case there are many hypotheses.

People who have the Epstein-Barr virus – transmitted directly through saliva – are more susceptible to the disease and Fernanda discovered that she had this virus, even though it is common in many adults.

Because of this, she appeals to young people not to neglect the signs given by the body, to undergo periodic examinations and to invest in healthy habits.

“We never think we’re going to get cancer. It doesn’t even cross our minds. I’ve never been a person who exercised and worked out. I stress the importance of having an annual checkup. It’s something that needs to be done”, he warns.

Finally, she also emphasizes the importance of consulting more doctors when experiencing strange symptoms.

“Don’t settle for just one opinion. Look for a third option, I had to go to six doctors to get the right one. It took me five months to get my diagnosis.”

How serious is stage 4 cancer?

Although it was at an advanced stage, the cancer discovered by Fernanda had a high chance of remission. This is because, even though it is spread throughout the body, this type of tumor has a positive prognosis.

“It’s a disease that it’s important to emphasize that no matter how it is staged, there will be a good chance of being cured”, says the specialist from ACCamargo Cancer.

The tumor level will determine the therapeutic line offered to the patient. When the cancer is at an early stage (staging 1 and 2) radiotherapy is indicated. In the more advanced cases (staging 3 and 4), chemotherapy is recommended.

When the disease persists, even if it is rare, doctors recommend immunotherapy, as happened with Fernanda, or even a bone marrow transplant.

“Hodgkin’s lymphoma is curable in the vast majority of cases, more than 88 to 92% in localized disease. It is considered the greatest success of modern oncology”, highlights Perini.

Even with the high level of healing, specialists emphasize the importance of investigating signs that deviate from normality.

“If you have any persistent symptoms, seek medical assistance. If you have an enlarged ganglion that has not gone away for one or two months, it is good to investigate”, concludes the specialist at the Albert Einstein hospital.

This text was published here