Friday, July 04, 2008

The story of Erwin P. Cabanag

The story of our friend the late Erwin P. Cabanag is heart wrenching.
Someday, we shall find meaning to his story.
As many of us believe, "there is a purpose for everything".
It is our obligation to find that purpose, even if at times, we don't see it in the horizon.
Here is the story of Erwin P. Cabanag, as narrated by his sister physician Erlyn Cabanag-Demerre:

Science looses opportunity
due to US VISA denial.

Atty. Erwin P. Cabanag was a city Fiscal and prosecutor of the City of Dumaguete, Negros Oriental Philippines.
He was diagnosed to have Acute Myelogenous Leukemia at the age of 44 for which he underwent intensive chemotherapy at the Asian Hospital and Medical Center in Alabang, Metro Manila on November, 9 2003 to induce a remission of his leukemia so he can undergo bone marrow transplant (BMT) also at the Asian Hospital as a strategy to go for cure.
He was successfully brought to remission and was discharged from the hospital on Dec 22, 2003. The intensive chemotherapy that Erwin had caused a severe fungal infection of the lungs for which he had to undergo a surgical procedure to take out the diseased part of the lung. Due to this development, the attending oncologist told Erwin and family that undergoing bone marrow transplant would be very risky and a full transplant would not be feasible.
The success rate of BMT in the Philippines for even the most uncomplicated case is low, roughly estimated at 60%. So for Erwin’s case that was complicated by a severe fungal lung infection, the success rate would go down to about 40%. The high cost and the low success rate of BMT in the Philippines pushed the family to seek help from various foundations locally and in the United States that could help Erwin get a better chance for a successful BMT.
The family’s search led them to the National Institute of Health (NIH) in Bethesda, Maryland. The National Cancer Institute (NCI) in NIH found a protocol that could include Erwin. In other words, Erwin had to consent to be part of an experimental drug or regimen that would be incorporated in the bone marrow transplant procedure that he would undergo. In the interest of Science and the human race, Erwin’s consent would mean a free bone marrow transplant procedure as well as a significant contribution to modern science and the treatment of leukemia. After some convincing and prayerful consideration, Erwin consented hence formal correspondence with the NIH/NCI started sometime November 2004. Hence he had to get a visa to allow him entry into the US.
Erwin’s US visa interview was scheduled on February 3, 2005 along with sister Evelyn Cabanag-Tubo, an accountant who took care of Erwin throughout his critical days during chemotherapy. Unfortunately, Erwin was denied a visa. The consul bluntly said she could not believe Erwin was sick and that the US would pay for Erwin’s BMT and more so she could not believe Erwin would return to the Philippines after treatment. Erwin and the family including the NIH could not believe that the US could deny a visa to a patient seeking medical attention and whose participation in the study protocol would benefit not only Americans but the entire world.
After this denial, the family sought reconsideration. The family tried many ways to be heard again by the consul. The family was able to seek help from people with access to the US embassy who were more than willing to help since they themselves could not believe why Erwin had to be denied a visa. Time was running out since leukemia is a disease that would not remain silent. Erwin’s disease progressed. After many follow-ups and days of waiting, a ray of hope for Erwin came when he was called for interview on April 29, 2005. Erwin was then granted a visa along with sister Cynthia Cabanag, an accountant who was to be his donor for the BMT. He then returned to Dumaguete City to prepare his things saying, “God must be giving me a chance to live since I have been granted a visa at last”.
Unfortunately, it was too late. Erwin got very sick and was admitted at the Silliman University Medical Center and in a few days was airlifted to Manila. At this time the NIH kept on contacting Erwin’s sister Dr. Erlyn Cabanag-Demerre (correspondent to NIH) asking about Erwin and that a relative should also be with him to attend to his needs while undergoing chemotherapy and BMT at the NIH. So the family sought help to expedite visas for at least two of Erwin’s siblings who could accompany him as advised by the NIH. At this time the NIH had to answer a lot of questions posed by the US embassy including faxed letters to request for sibling-caregivers to be granted visas in order to accompany Erwin to NIH for treatment. The US embassy still did not act on Erwin’s case with extreme urgency. We waited long for the siblings, Evelyn Cabanag-Tubo and Dr. Oliver Cabanag to be called for interview, still no call.
After 6 days of hospital care, Erwin succumbed to his leukemia on May 12, 2005, three days before his scheduled departure to the US. At this time, the two siblings still were still not called for interview.
During the wake, a call from the US embassy came for Evelyn and Oliver to come for interview. Oliver regretfully refused the interview saying it was just too late.
Erwin’s death brought many issues to the fore especially the critical delay in proper treatment all because of an initial visa denial which would have saved Erwin’s life.
Dr. Erlyn Cabanag-Demerre made the full circle for Erwin and visited the NIH. The BMT team headed by Dr. Dan Fowler with the BMT nurse Ms Kate Castro could not believe the US embassy did not grant a visa on the first interview.
At this time, the first Adult Leukemia Foundation in the Philippines, the Erwin P. Cabanag Adult Leukemia Memorial (EPCALM) was born. The NIH pledged to help every Filipino that would seek help at the NCI/NIH.
- Cardiology Consultant, St Luke’s Medical Center
- 279 E. Rodriguez Sr Blvd. Quezon City
- Tel. mobile 0917-857-9451
- Tel. landline 723-1058 St Luke’s ; 724-4490 –Res.

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