Lying weakly on his bed in the haematology ward, Lam Fai-man was feeling his mouth dry and his stomach painful after a treatment on 28 January.

 

The 35-year-old first apologised that he could not speak much.

 

“It’s very painful, like something cramping,” he admitted. “But I tolerate.”

 

Mr Lam had been at the most critical time in and out of the intensive care unit (ICU). He described his illness as uniquely complicated, as if all the strange diseases happened onto him.

 

“It’s the same. No improvement,” he said of his condition, which was going downward in fact. “I have no choice, and just try whatever advice I get from the doctor.”

 

His intravenous morphine was still dripping, which his doctor hoped would sedate his pain and sustain his life.

 

Mr Lam said he usually thought of nothing on bed, because of feeling tired and sleepy all the time.

 

Despite a pale face, he looked calm and determined to fight his battle. “I think I will not recover so soon. I still need certain time to recuperate,” Mr Lam said with a bit of a smile.

 

Unfortunately, his time was fast to the end. He passed away in the morning of 18 February.

 

“As doctors, unfortunately, we see this every day with patients and their families, transplant candidates or not. It all depends, on a case-by-case basis,” said Dr Joycelyn Sim Pui-yin.

 

Bone marrow transplant is not a sure treatment, but half way to cure and half way to incurableness and even death. The success rate of allogeneic transplantation, which depends on the disease type and stage, is on average 50%, with patients achieving a sustained, long-term cure after transplant, according to Dr Sim.

 

“For me, there is no cure, only relieving therapy to resist the cancer cells,” said Leung Tze-yan, 34, an acute lymphocytic leukaemia (ALL) patient, even though she has undergone three bone marrow transplants.

 

Diagnosed with ALL since 2011, she recurred twice and received three new bone marrows, which the first two were from her brother since she could not find a match the second time, and the last donor was from South Korea.

 

Before the Korean donor, Ms Leung thought the possibility of finding a donor was high until a mainland donor refused her, so she was keen to promote bone marrow registration within her friend group and at school.

 

“[Bone marrow donation in Hong Kong] is rather passive. The general public thinks it is dangerous and painful,” she added. “But it is not.”

 

However, her doctors are not helping her to search for other donors because of the high risk of recurrence and the balance of medical resources to other patients.

 

Now, Ms Leung takes chemotherapy and Chinese medicine to treat her illness and suppress the cancer cells. “It’s fine,” she said of her current condition. “There are uncomfortable times, such as muscle pain, back pain, bone pain and stomachache.”

 

“I have been receiving lots of chemotherapy to sustain my life,” she continued. “The good thing is I am young with a better rate of metabolism, but inside me has already fallen apart.”

 

She only worries the medicine cannot restrain the cancer cells. “But it is meaningless to worry as I cannot control the effectiveness of the medicine,” said Ms Leung.

 

Although there is no hope of a cure, she is still positive in keeping her life. “For now, I walk when there is a way. And leave things to God.”

 

In her daily life, she spends time with family, in hobbies and exercises like strolling and hiking to maintain strength. When she leaves home, she is prepared with sufficient protective measures.

 

“I am happy every day because my family loves me,” said Ms Leung, whose relationship with her family has greatly improved during her illness.

 

“In the past, I was very busy, having insufficient rest,” Ms Leung would blame herself for not taking good care of her health, resulting a poor immune system. “Now I have learnt life balance and the importance of family, health and attitude.”

 

On the other hand, Mr Lam was one of the worst cases.

 

Mr Lam was diagnosed with myeloid sarcoma, which is a rare type of leukaemia where cancer cells are found in white blood cells, but not in bone marrow.

 

After diagnosis in April 2014, he endured four doses of chemotherapy and a bone marrow transplant within a year. Mr Lam and his friends and family all believed he would get well soon, as the doctor said that recovery was a likelihood of 70%.

 

“We were positive that he would be well after the transplant,” said Sean Lam Shui-ching, Mr Lam’s younger brother and also donor.

 

Mr Sean Lam was willing and sure to have the donation, and more importantly, it was their only choice.

 

“The doctor said that if my brother did not receive transplant, he only got a 20-30% chance of survival,” Mr Sean Lam continued. “I have no choice so I do not think more. I must donate.” But he admitted that he wouldn’t donate to strangers.

 

“I did not worry about myself but instead I was worried about my brother and the rejection effect after the transplant,” said Mr Sean Lam, who did exercise like running and ate vitamin tablets before the donation to keep his body strong.

 

Mr Lam’s disease has brought their relationship closer. Mr Lam used to praise his two younger brothers helpful.

 

“There is only one moment of worry,” said Mr Sean Lam, referring to the older generation. Since bone marrow donation was a surgery with seemingly scary scene, his mother was unsupportive and conservative that she did not want to worry about her another son.

 

Mr Sean Lam donated his bone marrow to his brother under general anaesthesia since the amount of stem cells extracted must be enough at once. “I did not feel painful as I was anaesthetised. I even went to visit my brother after the donation.” He said that he felt completely normal after a few days.

 

However, he has since experienced an emotional struggle and downturn about his donation after Mr Lam’s cancer recurrence.

 

Mr Lam’s disease recurred in October, 2015. He was predicted a 20-30% survival rate after the ineffectiveness of a dose of chemotherapy. The cancer cells went down to his bowels, causing him to suffer from diarrhea, seven to ten times a day, excreting liquid even when he did not eat. Since his bowels were dysfunctional, he had to receive nutrient injections. Later, he tried another dose of chemotherapy and targeted medicine, which were of no help to his degrading health situation.

 

“The cancer cells were running around his bowels like guerrilla,” said Phoenix Lee Shuk-yi, Mr Lam’s girlfriend. “The disease was later identified as incurable. Even doctors have no way to treat it.”

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“People suggested trying Chinese medicine. It was not that we did not want to try but there was no chance. His bowels could not absorb it,” said Ms Lee.

 

Mr Lam, a food lover, lost his appetite and felt pain at his stomach all the time. “This is really pitiful,” Ms Lee felt upset for him but she could not help.

 

Ms Lee, the closest person in Mr Lam’s life, knew everything about him and helped organise all his schedule of visits. She visited him almost every day after work, travelling between New Territories, Kowloon and Hong Kong Island, and sometimes brought soups.

 

Staying with him during his cancer battle, Ms Lee said they treasured and strived for time being together.

 

“He was always hopeful and strong. His optimism was that he knew of his bad condition but faced it with courage,” said Ms Lee. “He was helpless but he felt peaceful and had never given up. He had never asked why it was him.”

 

Suffering organ failure, Mr Lam died when a piece of sputum stuck in his throat. “He died with ease”, added Ms Lee. “The good thing is that he did not need to struggle much before death.”

 

“He never thought of leaving so soon. It was unexpected,” said Ms Lee.

 

Mr Lam’s funeral was held at the Queen Mary Hospital. In front of his portrait, his mother and aunt could not stop crying while other guests kept silent in grief, sending Mr Lam off from his last path on earth. His body was then transported for cremation at Cape Collinson.

 

“I still miss him so much. I can’t let him go,” Tears burst out as Ms Lee recalled her boyfriend.

 

From her boyfriend’s illness, Ms Lee realised that nobody knows whether a disease can be finally cured. “We have to treasure life, health and time.”

 

“Actually I was reluctant to see him suffer. I know he is good now,” said Ms Lee, believing Mr Lam to be in heaven.

 

Mr Sean Lam shares the same view, “As family and friends, we didn’t want to see him suffer so hard. [Death] is a relief for him.”

 

Regarding his bone marrow donation, Mr Sean Lam said, “Now when looking back, I would not donate because it did not work.” He thinks if there was no bone marrow transplant, Mr Lam may not have been so weak, which may have easily caused the recurrence.

 

“But now, it’s useless to say because at that moment, we believed in the doctors,” said Mr Sean Lam. “If I went back, I would still make that decision because the result is uncertain.”

 

Yet, Dr Sim feels positive about the recovery rate, “With improving techniques, equipment and astute clinical and nursing experience, the success rate of treatment is ever increasing.”

 

“We are glad to see the unrelated donor pool expanding over the years and hopefully, with the continuous support of the government and community, more patients could be cured and gain their new lives,” said Dr Sim.

 

But Ms Leung does not hold much hope towards the advancing technology. “I don’t know. Now I just sustain my life and buy time till new medicine and treatment options,” she continued. “But whether they are suitable for me, it’s unknown.”

 

“Cancer is like a bomb to my life, but since mine is not that serious, I do what I am able and don’t think about it so much,” said Ms Leung, “because now I don’t know how long my life will last.”

 

She said, “I hope to live happily and comfortably on my way. I am earning [the days I have].”