Devastation visited upon one family

Lightning can, sadly, strike twice - and for the Hanrahan family it is still a mystery why two children contracted Hodgkin's …

Lightning can, sadly, strike twice - and for the Hanrahan family it is still a mystery why two children contracted Hodgkin's lymphoma

THE DIAGNOSIS of cancer in a child is devastating for any family. For a brother and sister to develop the same cancer, as happened in the Hanrahan family, is almost unbelievable.

"Lightning doesn't strike twice. . . you think," says Myra Hanrahan, mother of Stephen (19), Ian (17), Órlaith (15) and Áine (13). But even worse was to come. Just as Ian and Órlaith had recovered from Hodgkin's lymphoma, their father was killed in a diving accident less than a year ago.

Sitting on a sofa in the front room of her Rathfarnham home, Myra says she laughs when people say she must be very strong. As she sees it, you just have to deal with what life throws at you and get through it day by day. She was never over-religious, but says she has probably lost all sense of faith: "I did believe there was some sort of a God, now I wonder."

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It started in August 2001 with Ian, then aged 11, who tended to have swollen glands whenever he got an infection.

"We were down in Clare camping and he said his glands were up and I immediately went: 'There's nothing wrong with you, you've got a sore throat'," she recalls. Back in Dublin, she rang the ENT specialist.

"He saw us immediately and it all took off from there. Ian had his biopsy in September, but it took eight weeks to diagnose. It was Hodgkin's lymphoma.

"I will never forget the phone call. I was in work and I couldn't function."

She was employed by Woodchester Bank at the time "and about to be made redundant, which was a Godsend", she says in hindsight. "I rang my husband, Michael, and we both came home and sat down, saying what do we do? Do we tell him? We just didn't know."

Then eight-year-old Órlaith walked in the door "and she goes, 'I hear Ian has cancer'. Because when I phoned her Dad, she was with him. She'd picked it up. So that was that, Ian had to be told".

"We told Ian he had Hodgkin's lymphoma. The hospital told us to be honest with him and I always used the term Hodgkin's lymphoma, but that was one thing that caused a problem for him, that we wouldn't say the word cancer. He thought we were hiding something."

The lump in Ian's throat was removed in September, but then his glands came up again so radiotherapy was necessary.

The morning he was due to start radiotherapy in January 2002, "he totally lost the plot," she says. "He was banging everything, kicking everything, threw himself on the stairs and I had to ring the liaison nurse."

Weeks earlier he had been brought into St Luke's Hospital to be shown what would happen. "He had had a mould made for his face, to pin him down on the bed. He was good through all of that, and it was just that morning he said 'And you won't even say the word cancer, and I'm going to die'. And I said 'No you're not going to die'."

After being calmed down by the nurse, he went into St Luke's for the first dose of his radiotherapy, which continued daily for four weeks. The effects of the treatment included a sore throat and tiredness, and he has been left with an underactive thyroid for life.

"Going to St Luke's was awful as we weren't in the loop of the children's hospital then. He was there with much older people and that was very frightening. Personally I found that heartbreaking, to see my child there."

To keep things as normal as possible for everybody during that time, the Hanrahans continued to send Ian to the Catholic University School in Leeson Street. "I have to say the school was brilliant. The ladies in the canteen made smoothies for him when he couldn't eat."

Ian loved the attention, his mother says, but he accepted that he had the illness: "And he knew he could get better. He loved all the scars. He wanted to keep all the stitches, wanted to keep the drain, he wanted actually to keep the lump. These were his trophies. That's a real childlike reaction. He has his mask - and takes it out to frighten people every so often."

He recovered well after the radiotherapy and progressed from check-ups every six weeks, to every three months, six months and now every 12 months, getting the all-clear each time. The family felt they could put this all behind them and move on.

Then, four years after Ian's diagnosis, Órlaith, who was 12 at the time, was on holidays with her grandparents in Co Waterford when she got sun-burned. "I was peeling it, around my neck, and I found a lump," she recalls, sitting on a sofa opposite her mother.

Myra Hanrahan picks up the story: "She told her grandad she had the same as what Ian had, and nearly frightened the life out of him. They rang us but I said there was nothing wrong, it was just puberty."

When Órlaith came back to Dublin on the Friday, there was a 50th birthday party for Myra's brother that night, and the family were going to their holiday home in Malin Head, Co Donegal the next morning. But they took one look at their daughter's neck and were worried.

"I was over to the GP at a quarter to nine on the Saturday morning, on July 16th, 2005. He just looked at me and said 'you are not going on holidays with her'. He rang everywhere to get X-rays that day but he couldn't.

"I came home really distraught, but said the rest of the family had to go to Donegal and Órlaith and I would stay and we would go to Crumlin on the Monday and that we would follow everybody up."

They were in Crumlin hospital by 9am on Monday. "Within an hour, she had been admitted and had her biopsy that day. It was very, very quick," says Myra. The results came through on the Wednesday: it was Hodgkin's lymphoma. But hers was more serious than Ian's.

"It was neck, chest and stomach: type B, stage three. I took the phone call outside, burst out crying and ran over to my neighbour's, saying 'What am I going to do, what am I going to tell her'?" She phoned her husband to tell him to come back from Donegal.

"I sat down with Órlaith, put my arms around her and told her. The two of us had a good cry. I told her she was looking at chemotherapy.

"In some ways, and everybody will think me mad when I say this, if Ian hadn't had it we would not have caught Órlaith's and Órlaith's was more serious. Because we had some knowledge of it, we could act very quickly. In some weird way, maybe it was a good thing."

What was Ian's reaction? "Terrible. It is to this day. In a lot of ways he still suffers from it. He constantly blamed himself. He was sure it had to be because of him that she got it, even though everybody told him there was no connection."

Lots of tests were run on Ian to see if there was any link. "It's a mystery why two children in the same family would get it. They found nothing."

Órlaith had to embark on six months of chemotherapy as a day-patient in Crumlin hospital, just as she was due to start in first year at Sancta Maria secondary school in Ballyroan.

"I had no connection with the school and no knowledge of the teachers. I marched in, in the middle of August, to the headmistress, with Órlaith, with her bandana on her head, and I said 'This is Orlaith, she's starting in September, she has cancer and I expect you to look after her'. I was totally off the wall when I think about it," Myra winces at the memory, but she had wanted to do everything she could to pave her daughter's way.

"She changed from this little 12-year-old with her long hair, to an adult size 14 on the steroids with no hair. She looked completely different; even the girls who knew her from primary school were very wary of her.

"There was one good thing; she made friends with all the Muslim kids. All the headscarves stayed in one corner!"

"I did get bullied in school," says Órlaith, "by girls who didn't know what was going on with me. One girl never stopped throwing lollipop sticks at me. It was horrible. A few girls came up to me and asked could they catch what I had," she adds. But Myra is full of praise for the teachers.

Soon after Órlaith was diagnosed, the Hanrahans contacted CanTeen Ireland, a support group for young people between the ages of 12 and 25 who have, or have had, cancer.

"She was painfully shy, and I thought it might be good for her." And she had Ian to go with her to events.

"CanTeen is absolutely amazing," says Myra. "Órlaith could see other kids who had the same or more serious cancers, all out having fun. This didn't have to be something that would bring her down, that she could actually enjoy her life and do things."

While teenagers with cancer grow up fast, they miss a lot of their formative years. "When they go to CanTeen, they are away from over-protective parents and they are allowed to be teenagers."

Every six months, Órlaith has an ultrasound, chest X-ray and her bloods checked, with all tests showing she's clear of the cancer. The prognosis for both her and Ian is good, although Myra says their immune systems are lower than the other two children's.

Ian and Órlaith's illness inevitably had a profound effect on their other two siblings. "We tried so hard to keep everything going," says Myra, "but they had to grow up very quickly, all of them."

It may have been some sort of preparation for the even worse trauma they then had to cope with.

On October 2nd last year, Michael Hanrahan, who had become a taxi driver during Órlaith's treatment so he could fit his hours around her and the other children while Myra Hanrahan went back out to office work, was diving off the Co Donegal coast. He was filming the wreck of a German U-boat that Derry City Council wanted to raise.

According to a news report at the time, he and three other divers were preparing to surface, when Michael (45) fell back and appeared to have stopped breathing. Despite desperate attempts by fellow divers to revive him, there was nothing they could do and they had to leave him.

"We still don't know what happened," says Myra. "I am awaiting the inquest."

A friend of Michael Hanrahan's in Dublin got the phone call and he went over to the Hanrahans' house. "I saw Gavin come to the door and I said 'What are you doing here, you look awful'. And then he told me and I let a roar out of me." Then she grabbed the four children and brought them into the front room. "I sat them down and said 'Dad has drowned'. You go into the same place as when you're told about them being ill. It's a very surreal place, as if you are outside your body looking at what's going on. You function, you just do everything."

They all flew to Derry. "This comes from the cancer, everything that happened had to be the five of us. Decisions about the funeral, everything was made by the five of us. We had a cremation and then at the end of October we went back up and put his ashes back."

Myra shared his love of diving, but gave it up after Áine was born.

Ian, who is on a school trip playing rugby in Argentina as we speak, had particular problems in the wake of the bereavement. "Complicated grief is what they call it," says Myra. "A lot came out about the cancer, how he felt about the cancer and how he felt about Órlaith's cancer. He also had to deal with the bereavement of a friend he had met through CanTeen, Nicola."

Ian's older brother, Stephen, took her to his debs the night before Michael died. Four days later, she was dead too.

"We knew they had stopped her treatment, but we didn't expect anything to happen for six months to a year."

It was all just too much for Ian to deal with but, says Hanrahan, he is through the worst now.

"Stephen has dealt with everything. He grew up that night, he has become such a strong man," she says. But she is adamant that he must not be expected to take on the responsibility of the family. "He is a student, he has to enjoy those years," she says of her eldest, who is studying computer science at DIT in Kevin Street.

"I did sit down with him and go through the whole financial aspect with him, because they were worried about it."

Live "day by day" is the mantra of Myra Hanrahan, who is an accounts manager with Abacus Property Management in Knocklyon, five minutes away from home. "I stopped taking everything for granted when they got cancer, that changes you totally as well. The death just compounded that.

"I'm always turning things around to a positive. Thank God I had a really happy marriage for 20 years. I'm sorry it didn't last another 20, but thank God I had that.

"Even with their cancers, it was awful, but we got through it and thank God I still have my kids."

Through CanTeen, of which Ian is now a committee member, they've had a lot of positive experiences, says Hanrahan, with trips within Ireland and abroad.

"They have learned so much, made so many friends, met so many fantastic people, it's good the opportunities it opened to them. I feel there is nothing they can't do."

For further information on CanTeen Ireland, tel 01-872 2012. The National Cancer Helpline Freefone is 1800 200 700

swayman@irish-times.ie ]

Sheila Wayman

Sheila Wayman

Sheila Wayman, a contributor to The Irish Times, writes about health, family and parenting