Only about a year old and just beginning to imitate the sounds of their parent’s speech, two babies are fighting a cruel disease that has necessitated that they be sent all the way to Japan by the NGO Japan Heart for medical treatment.

The two babies are from different families in Cambodia. One is 9-months-old and the other about a year old. Both have been diagnosed with an uncommon form of cancer called hepatoblastoma and were sent to Japan last January to prepare for surgery at the Okayama Medical Centre.

“We have sent cancer patients [to Japan] three times before. The first three cases were in 2011, 2015, and 2017 before Japan Heart started offering cancer treatments here in Cambodia. All three patients are healthy now,” said Kanan Nakamura, the public relations and marketing manager for Japan Heart.

“But since the Japan Heart Children’s Medical Centre (JHCMC) opened, we can treat some cases at our hospital in Cambodia.

“However, these are the two most complicated cases that we have seen since the start of the COVID-19 pandemic,” she says.

Normally the JHCMC, which is located in Ponhea Leu Referral hospital, invites pediatric surgery teams to Cambodia once every two months to perform surgeries on child cancer patients.

However, due to the Covid-19 pandemic, it has become extremely difficult for these specialised teams to travel to Cambodia.

Given the realities of the situation, the Okayama Medical Centre has selected the two most difficult cases of the 36 patients being treated by Japan Heart in Cambodia and arranged for them to receive surgery in Japan.

Nakamura told The Post that “Before COVID-19, it was much easier for us to send doctors from Japan to Cambodia because there are some risks for the patients to travel such a long distance. So if the doctors can come to the patients then the patients do not have the extra stress from travelling.”

“However, now doctors can’t come to Cambodia because of the mandatory quarantine for 14 days. We used to invite some of the best pediatric surgeons in Japan to JHCMC and those doctors are usually too busy and have too many patients to treat to stay at a hotel for 14 days and self-quarantine,” she says.

Japan Heart founder Hideto Yoshioka is a pediatric surgeon himself and he has been doing as much surgery as he possibly can alongside Cambodian doctors.

However, it was decided that it would be too difficult for Yoshioka and the local doctors to perform the surgeries for the two babies who have been hospitalized with hepatoblastoma since the summer of 2020.

Nakamura said that “in August 2020, both patients were diagnosed as having a tumor in their livers and they came to Japan Heart. This type of cancer is called hepatoblastoma.”

She said that in the past there were patients with hepatoblastoma who had successfully recovered after surgery by Yoshioka assisted by local doctors and nurses at Japan heart. However, these latest two cases have turned out to be too difficult to treat in the same way.

In particular, one of the baby’s surgeries is expected to be extremely difficult and it would not be possible to save his life in a local facility. The other baby’s condition is considered unstable and possibly subject to suddenly worsening, making it especially important that they have high quality emergency care on hand just in case.

According to Nakamura, it is difficult to perform these surgeries and manage the patient’s postoperative care at Japan Heart Cambodia because they do not have sufficient diagnostic equipment or enough specialists available who are familiar with handling this kind of surgery for a baby.

“As far as I can confirm, there was no record of hepatoblastoma surgery performed in Cambodia before Japan Heart established a hospital here, and it was thought that it was a disease that could not be cured.

“Japan Heart has now treated many cases of hepatoblastoma in Cambodia since 2018. As for the survival rate, there are no statistics available for that form of cancer so we cannot know the exact rate for it, but we know the survival rate among patients who have received cancer treatment at Japan Heart is as high as 50 percent,” she says.

Japan Heart is an international medical volunteer organization that was established in 2004 in Japan. They are the only Japanese organisation to have received an award from the United Nations Interagency Task Force on the prevention and control of non-communicable diseases.

The centre’s mission is to deliver medical care to places it otherwise would not be available and to provide free medical care and surgery for children in Japan, Myanmar, Cambodia and Laos, with a total of more than 35,000 treatments provided annually.

“Access to specialized surgeons, specific medicines and pathology tests are not as good as they used to be [prior to the pandemic]. Too many patients come to our hospital [in Cambodia] and we are struggling to make sure that all patients can receive cancer treatment on time,” says Nakamura.

The two babies are scheduled for tumour removal surgery sometime between February and March pending the results of preoperative examinations according to Japan Heart.

They have to wait for 14 days in quarantine to enter Japan but both of their cancers are considered early stage and the two week wait shouldn’t be a problem. Generally, difficulties tend to arise when patients do not know that they have cancer and miss the crucial window for treatment at an early stage before the tumour can grow or the cancer can spread to other areas of their body.

The two babies and their accompanying family members and medical staff completed testing for Covid-19 before leaving Cambodia and immediately upon entering Japan, and they were tested again after two weeks at the end of their mandatory quarantine.

“After confirming that all tests were negative, they were admitted to Okayama Medical Centre,” according to Nakamura.

Though the Okayama Medical Centre is covering the costs of medical care in its hospital, all of the other living expenses for the babies and their families still need to be paid for.

Nakamura says “we are currently accepting donations for these babies and their families. The donations will be used to pay for travel and accommodation expenses for these patients while in Japan.”

If you are interested in donating to help these two babies with expenses related to their treatment and recovery from cancer you can visit Japan Heart’s Facebook page for details: @japanheart.hospital