Young Boy Overcomes Hodgkin Lymphoma in Mexico

Whenever he wasn’t at school or helping his family in the coffee fields, Meynor Perez loved playing basketball. For the last couple of years though, he wasn’t up to it. He felt feverish. He was tired constantly. And he preferred staying inside his home in rural Chiapas to going out to shoot hoops.

There was something else that worried his family—their little boy with a wide, toothy grin had a mass in his neck that had been slowly growing and was now the size of a baseball.

“People made fun of me, saying that I was going to die,” Perez says. Some would even chant, “’Tú al hoyo, y los vivos al pollo.’” A childish rhyme that, loosely translated, meant he was going to the grave and they, the living, were going to carry on without him. His classmates even started to hit him. “I didn’t defend myself because I don’t like to hit,” says the 12-year-old. “Maybe they thought I was a coward or stupid.”

For two years, Perez’s family tried herbs and olive oil treatments thinking they would help. They even took him to a traditional healer who brushed him with a small branch and tied a handkerchief around his neck. For that, the family paid 1,000 pesos—more than one month’s salary. Nothing helped. Until he visited Azucena Espinosa, a social service doctor, or pasante, working in Laguna del Cofre with Compaňeros En Salud (CES)—Partners In Health’s sister organization in Chiapas.

Espinosa examined Perez in March 2014 and his symptoms immediately sent up red flags. With the help of CES clinical director Patrick Elliott, she presented Perez’s case to her fellow pasantes, who meet monthly at CES headquarters in Jaltenango for global health seminars. The young doctors strongly suspected the boy had a malignant form of Hodgkin lymphoma and that he needed immediate care.

Although the incidence of lymphoma has not been widely studied in Mexico, a 2015 article in Cancer Causes & Control provides a glimpse of the cancer’s reach in the capital, Mexico City. The overall incidence of lymphomas between 1996 and 2010 was 11.8 per one million children per year. For Hodgkin lymphoma specifically, it was 4.4 per one million children. While this is significantly lower than rates found in the U.S. and Europe, it is similar to rates found in African countries.

Getting Perez to care was easier said than done. He lived an hour’s walk from the Laguna del Cofre clinic. His parents, coffee farmers like most of their neighbors, were barely making ends meet for their family of 12. Finding additional resources to pay for transportation, food, and lodging throughout their son’s treatment was daunting.

“Laguna del Cofre is a place with a lot of poverty, but this boy was an extreme,” Espinosa says.

Thankfully, CES’s Right to Health Care team stepped in. Elliott, Espinosa, and Valeria Macías—the team's coordinator at the time—organized every detail of Perez’s treatment, from paying for medical bills and arranging transportation to doctors’ appointments to finding food and lodging for the boy and his family when he had to travel to distant hospitals for specialized care.

Perez’s first appointment was six hours away in Chiapas’s capital of Tuxla Gutiérrez, where doctors performed a biopsy and conducted tests on the growth in his neck. Espinosa’s diagnosis was accurate; her patient had Type 3B Hodgkin lymphoma, one of the cancer’s most aggressive forms.

Perez was immediately put on chemotherapy. He traveled to Tuxla Gutiérrez for his treatments for eight months, and every month the Right to Health Care team provided him and his family with the logistical and emotional support he needed to make it through. When he returned home after each session, Espinosa monitored his progress and gave him injections meant to stimulate the production of white blood cells.

“One of the side effects of chemotherapy is that it causes immunosuppression,” Elliott says. “Azucena had to be an observant clinician and take him through some really risky points in his care when he was outside of tertiary care centers and at home at risk of developing severe infections.

“That’s a lot for one young clinician to manage,” Elliott adds, considering such care is otherwise managed by an oncologist and a team of specialists.

The treatment was a lot for Perez to bear too. He didn’t eat, vomited, always felt dizzy, and was often in pain. Despite the side effects, he made the hourslong, monthly trek to visit Espinosa for his shots, sometimes with his younger siblings in tow, and sometimes alone—his mother’s arthritis was often so severe she couldn’t move for days.

Once he finished chemotherapy, Perez needed radiation three times a week for nearly two months. But no hospital in Chiapas was equipped for that level of care. The closest such facility was in Campeche, a city at least 12 hours away that bordered the Gulf of Mexico. Again, the Right to Health Care team accompanied him and his mother so that they could stay close to the hospital during his treatment.

Perez had plenty of reasons to feel down—the chemo, the radiation, and the distance from nearly everyone and everything he knew. Instead, he was excited about going to Campeche. After all, he’d never seen the ocean, and he could visit the beach there every day. “The people were very kind,” he says. “They told me that whenever I wanted to return, I was welcome.”

Espinosa was shocked when she saw Perez again. He’d gained a lot of weight. Even more surprising, he’d completed his treatments without any complications and showed no symptoms of Hodgkin lymphoma.

Several weeks ago, Espinosa—now CES’s Right to Health Care coordinator—went with Perez to his oncologist for follow-up tests. The results? She’s happy to report that he is officially in remission. The whole experience confirmed her desire to work in pediatrics. Only now, she wants an additional specialty in oncology.

Had Espinosa not been there, she and Elliott agree that Perez’s story wouldn’t have had such a happy ending. But the young doctor hesitates to say she saved his life: “I only did what I had to do—fight as much as I could for the life of a child.”