Surviving Hepatitis B and Liver Cancer: Vhal’s Story

Hepatitis B has had a huge impact in the life of Baltazar Lucas, 34. Known as Vhal to his family and friends, he learned he had chronic hepatitis B nine years ago. Vhal was diagnosed with hepatitis B after undergoing screening with his parents and three brothers, Aris, Joey, and Tonton. They were advised to do so in in 2008 after Tonton, his youngest brother, fell ill from tuberculosis and liver cirrhosis.

“We found out that all of us brothers had hepatitis B. My mother also had it, but my father did not,” explained Vhal.

The Philippines continues to have a high burden of hepatitis B. The country is estimated to have about 8.5 million Filipinos who are chronically infected with hepatitis B. In 2015, over 8,000 people lost their life due to chronic hepatitis.

Photo: WHO/Y. Shimizu

Living with hepatitis B

Hepatitis B is a viral infection which causes liver damage and is transmitted through contact with blood and other body fluids. Mother to child infection is the most common transmission of hepatitis B in endemic areas like the Philippines.

However, the spread of hepatitis B from mother to child can be prevented through early vaccination. The World Health Organization (WHO) recommends the use of hepatitis B birth-dose vaccine for newborn infants within 24 hours of birth, followed by three more doses to complete the series. WHO works closely with the Philippine Department of Health (DOH) to address the public health problem of viral hepatitis in the country through strengthened policies, plans, and surveillance of the disease.

This July 2017, the DOH released a policy paper to step up its efforts in the prevention and control of viral hepatitis. This includes strengthening the advocacy and awareness, research and information system, effective treatment, and monitoring and evaluation of viral hepatitis. Part of this is the government’s campaign to increase the vaccination coverage to 95 percent, including the birth-dose vaccine and three additional hepatitis B vaccine doses to Filipino children one year old and below.

In the case of the Lucas family, the brothers likely got infected by the hepatitis B virus from their mother and the four of them were probably not given hepatitis B vaccine when they were young.

“When I was born in 1983, Bulacan was not as advanced at that time and our family was poor. Our mother gave birth to us at home. I think they were not aware about hepatitis,” Vhal shared.

Despite learning of their hepatitis B diagnosis, Vhal and his brothers could not tackle their disease head on because of financial constraints. Vhal had just begun work as a software developer in a publishing company; Aris ran a computer shop, while Joey and Tonton were still studying.

“After we got tested, we knew we could not afford the checkups and medicines so we did not go to the doctor. I searched online about our case and learned that with chronic hepatitis, there’s no cure. So we decided to live a healthy lifestyle instead,” he said.

One by one, however, Vhal lost his brothers to hepatitis-related liver disease within a five year period. Tonton died in 2008, Aris in September 2013 and Joey in November 2013.

Happier times with the Lucas brothers and their mother.
Photo courtesy of Vhal Lucas.

From hepatectomy to liver transplant

After his brothers died, Vhal’s wife, Adalyn grew increasingly concerned and asked him to have another checkup despite him not feeling any symptoms. During the time of Joey’s burial, Vhal learned he had liver cancer with a 10-centimeter tumor. He then decided to have an operation in December 2013 to remove the large tumor from his liver.

“I had difficulty at first because most doctors would not do a hepatectomy if the tumor was more than five centimeters. I found Dr Dante Ang who did my operation and it was successful,” Vhal said.

The reprieve was brief. Dr Ang informed Vhal in February 2014 that the chance of his cancer recurring is highly likely and that it would be best if Vhal has a liver transplant. While waiting for his liver transplant, he also had a few sessions of transarterial chemoembolization, a targeted chemo therapy which blocks the blood supply and prevents the growth of the tumor.

After a year of stringent organ donation process and acceptance, Adalyn’s brother, Peter John Cruz, was successfully matched and donated over 60 percent of his liver to Vhal. With their savings and financial assistance from the Philippine Charity Sweepstakes Office, friends, family, and even strangers, Vhal and his wife managed to raise some funds for the liver transplant which cost Php4.7 million. By September 2015, Vhal had his liver transplant. The operation was successful although Vhal lost a lot of weight during his six-month recovery.

Now two years after his transplant, Vhal makes sure to follow his doctor’s orders, go to regular checkups, take maintenance medicines, and continue to live a healthy lifestyle. He has gone back to work and is able to resume supporting his two young children and wife, who is herself on recovery from a recent bout of stage one breast cancer.

“The total expenses I spend for my medicines is Php30,000 every month. That’s only for medicines. So if you have no money, you will really die,” Vhal said.

“But I consider myself a positive person. If not, it would have been difficult to cope with what happened to my brothers, to me, then my wife,” he added. “At least now, I’ve gone back to work and I’m able to sustain my daily medical needs, pay for this rent-to-own condominium unit, and send my children to school.”

Vhal plays with his 8-year old son, Raigel Haythan, in their home in Mandaluyong.
Photo: WHO/Y. Shimizu

Advocating for hepatitis awareness

Looking back on his experience, Vhal is happy that he was able to survive and that he himself is helping raise awareness about hepatitis with his life story.

“Since my hepatitis medical history is public knowledge, there are people who approach me even on Facebook to share their situation or ask for advice,” shared Vhal. “There are many people with hepatitis who have not told their loved ones that they have it for various reasons, but a common reason is that they don’t want to be shunned.”

Aside from financial challenges to combat their infection, Vhal said that people living with hepatitis have also experienced discrimination due to lack of awareness. People have shared with him online how loved ones have left them because they had hepatitis B.

Vhal is lucky that his immediate family members, friends and officemates supported him throughout his ordeal. But he still experienced some stigma from other relatives, sharing: “When our relatives learned we had hepatitis, even during my brother’s burial, they distanced themselves from us. Perhaps they were not aware on how hepatitis is transmitted, they didn’t know if it’s through airborne infection or saliva. I understand where they were coming from but it still hurt.”

Vhal added that increased awareness will help end the stigma to people living with hepatitis B.

“The situation today is different; there are lots of information out there about hepatitis. Even if you are poor, you will have access to information from sources such as on the internet. There are also support groups available for people living with hepatitis such as the Yellow Warriors Society Philippines,” Vhal shared.

“For me, even if you have limited amount of money, prevention is still cheaper than cure,” he added.

By Faizza Tanggol