Hello all--thought this story might be of interest, Africans too have a
high risk for hepatitis and should be screened and monitored.
Rakina
> >----------------------------------------------------------
> >
> >(1 of 1)
> >August 21, 2002
> >UNPROTECTED PEOPLE #49: YOUNG DOCTOR LEARNS HE HAS LIVER
> >CANCER TOO LATE
> >
> >The Immunization Action Coalition (IAC) publishes stories
> >of people who have suffered or died from vaccine-
> >preventable diseases and occasionally devotes an IAC
> >EXPRESS issue to such a story. This is the 49th story in
> >our series.
> >
> >Recounting a young doctor's death from hepatitis B-related
> >liver cancer, the story is a tragic example of the
> >consequence of inadequate medical attention to people with
> >chronic hepatitis B. A lack of information about how to
> >appropriately screen patients with chronic hepatitis B for
> >liver cancer puts many lives in jeopardy. For information
> >about the management of patients with hepatitis B, consult
> >a liver specialist experienced in the treatment of viral
> >hepatitis.
> >
> >*******************************
> >
> >From our table at a sidewalk cafe in August 2000, my
> >partner Mark and I took turns pointing out things that
> >made us smile: a young couple pushing a baby stroller, a
> >rambunctious puppy tugging at his leash, an elderly couple
> >holding hands. Our mood was sublime, like the day, as we headed
> >to an open-air jazz festival near San Francisco with a blanket
> >for napping on a grassy slope.
> >
> >Until a sharp stomach pain made Mark wince and double
> >over. Was it the ulcer he feared? At 30, Mark was a young
> >doctor saddled with debt and the challenge of building a career
> >after eight sleepless years of medical school and training. A life
> >with dogs and kids was only a wistful thought. He crawled into the
> >back seat of the car, cursing and writhing, as I sped him to the
> >emergency room where he worked.
> >
> >Mark didn't have an ulcer. An ultrasound of his abdomen
> >showed an ominously patchy liver. A biopsy confirmed the
> >worst: cancer. His liver was riddled with so many out-of-
> >control cancerous lesions that neither surgery nor
> >transplant was possible. Chemotherapy would only slow his
> >inevitable, insufferable demise 14 months later. But the
> >question remained, how did such an otherwise perfectly
> >healthy young man, who had a gym-toned body and never
> >drank, end up with the organ of a hard-living alcoholic
> >twice his age? The answer was chronic hepatitis B, a virus
> >that can silently harbor in a healthy liver for decades
> >before unleashing its destructive power.
> >
> >Mark knew about his hepatitis. He discovered it from blood
> >tests required by his medical internship. But experts at
> >the prestigious Midwestern hospital where Mark did his
> >residency told the 26-year-old not to worry. He was a
> >"healthy" carrier, they said. His symptom-free, nonactive
> >kind of hepatitis wouldn't have to be monitored for liver
> >cancer until he was in his 50s or 60s. Good advice, if
> >Mark were not an Asian man. (Editor's note: No hepatitis B
> >carrier, regardless of ethnicity, should wait until age 50
> >or 60 for liver cancer screening. Screening people with
> >chronic hepatitis B infection for liver cancer should
> >generally be done every 6-12 months and should start at
> >the time of hepatitis B diagnosis. Consult a liver
> >specialist experienced in the treatment of viral hepatitis
> >for appropriate monitoring guidelines.) Had he or his
> >doctors been trained to know that Asians are at accelerated
> >risk because they are typically infected as children, he
> >would have immediately gotten regular ultrasounds and
> >blood tests to catch the cancer that killed him at 31.
> >
> >Soon after his diagnosis, Mark was shocked to see a sign
> >on a city bus advertising Stanford University's "Jade
> >Ribbon Campaign," a program to raise awareness of his
> >disease. Was there really a chronic hepatitis B-fueled
> >epidemic of liver cancer among young Asian-Americans? Are
> >Asians really 10 times more likely to die from liver
> >cancer than a white person? How come he hadn't heard this
> >before? He was, after all, an Asian doctor practicing in a
> >region with a population that is nearly one-third Asian.
> >But as a victim among healers, what happened to Mark
> >precisely illustrates the problem, says Dr. Samuel So,
> >director of Stanford's Asian Liver Center. "Only in a
> >medical world that relies almost entirely on a Caucasian
> >model for diagnosis and treatment could such a great
> >health disparity exist," says So, who lectures on
> >ethnicity and medicine at Stanford in addition to his
> >surgical and research duties.
> >
> >Liver cancer is rampant in Asia. The main culprit is chronic
> >hepatitis B, a virus transmitted by blood or semen. Exposure
> >to it at childbirth is the real problem, because that's when
> >the risk of chronic or lifelong infection is greatest.
> >
> >Unsanitary living and medical conditions throughout Asia
> >have fueled hepatitis B infection rates there, as large
> >percentages of mothers unknowingly pass the virus to their
> >kids. Since it can take 30 years to manifest, all adult
> >children of Asian immigrants--even those born in the
> >United States--are at risk. Especially sons. The virus may
> >infect the sexes equally, but it triggers deadly cancer
> >more often in men.
> >
> >Mark was born and raised in suburban Chicago by Chinese
> >parents who had lived in the Philippines. While many
> >newborns are vaccinated for viruses such as hepatitis in
> >the U.S. today, an entire generation now entering
> >adulthood was not. Stanford's Dr. So estimates that up to
> >10 percent of adult Asian-Americans have chronic hepatitis
> >B and do not know it. Of those, a quarter will die from
> >liver cancer or failure. That is an alarming number, since
> >the Asian-American population is one of the country's
> >fastest-growing minority groups. In California, 30 percent
> >of San Francisco and 12 percent of Los Angeles is Asian.
> >How many unaware young Asian men will double over in pain
> >one day like Mark did?
> >
> >Before Mark died last October, he became a spokesperson
> >for the Jade Ribbon Campaign (http://liver.stanford.edu),
> >urging all Asians to check their hepatitis status.
> >Confronting his own mortality wasn't easy for him. "It's
> >scary to think of your life in months, instead of years,"
> >he told me as his death approached, our dreams of that day
> >at the sidewalk cafe shattered. I am still feeling the
> >anger and despair that can engulf you when the person you
> >love is taken away. It hurts most because Mark Steven Lim
> >was such a vibrant and vital force to his family, friends,
> >and patients. As a talented doctor and consummate human
> >being, he had so much potential to do good. Yet his life
> >was so short, and his death so horrible. In the end, the
> >most he could do was hope his words might inspire his
> >medical colleagues to offer--and his Asian peers to seek--
> >the information that can save thousands like him from his
> >fate. If only they listen.
> >
> >*******************************
> >
> >For a camera-ready copy (PDF format) of this story, go to:
> >http://www.immunize.org/nslt.d/n26/story26.pdf
> >
> >To read other IAC Unprotected People stories, go to:
> >http://www.immunize.org/stories
> >
> >DISCLAIMER: The Immunization Action Coalition (IAC)
> >publishes Unprotected People stories for the purpose of making
> >them available for our readers' review. We have not verified
> >this story's content, for which the authors are solely
> >responsible.
> >
> >DO YOU KNOW OF STORIES OF UNPROTECTED PEOPLE? Please let
> >us know if you have personal stories of people who have
> >suffered or died from vaccine-preventable diseases or if
> >you know of stories that have appeared in the media
> >describing suffering that occurred because someone was not
> >immunized. Send your stories or case reports to IAC Express by
> >email to [log in to unmask] or by fax to (651) 647-9131.
> >
> >=====================================================
> >THANK YOU FOR READING THIS WEEK'S IAC EXPRESS
> >
> >We hope you will forward this newsletter to
> >others who work in healthcare and medicine.
> >
> >Managing Editor: Kristine Vesley
> > (email: [log in to unmask])
> >Editorial Assistant: Janelle Tangonan Anderson
> > (email: [log in to unmask])
> >
> >Visit IAC's website: http://www.immunize.org
> >=====================================================
> >
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> >
> >This publication is supported in part by Grant
> >No. U66/CCU518372-02 from the National Immunization Program,
> >CDC, and Grant No. U50/CCU518789-02 from the Division of
> >Viral Hepatitis, CDC. Its contents are solely the
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> >
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> >
> >
> >PROBLEMS OR QUESTIONS? PLEASE CONTACT US AT:
> > Immunization Action Coalition & the Hepatitis B Coalition
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> > ISSN: 1526-1786
> >=====================================================
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