Stiliyan Petrov’s fight against leukaemia

The date June 23, 2016 will go down in history as the day the people of the United Kingdom voted to get out of the European Union. As the referendum made big headlines all over world, one would be forgiven to miss the announcement, done on the same day, from newly-relegated Aston Villa Football Club that their former captain was returning for pre-season training. Surely, such news is trivial in the context of Brexit; but, is it really? This is, after all, the story of a man who came back fighting after being diagnosed with a terrible disease. This is the

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Surely, such news is trivial in the context of Brexit; but, is it really? This is, after all, the story of a man who came back fighting after being diagnosed with a terrible disease. This is the story of one of the greatest soccer players to come out of the Balkans whose career was so cruelly halted at its peak. This is the story of Stiliyan Petrov.

Petrov joined Aston Villa in 2006 after seven trophy-laden years north of the border with Celtic. He soon became a vital cog in Martin O’Neill’s side as the Birmingham-based side hovered just below the top four in the Premier League. In 2009, following the retirement of the injury-prone Martin Laursen, Petrov was named the side’s captain, a title he held until that fateful Arsenal game in March 2012.

Up until that point, Petrov was arguably one of Europe’s best in his position. At 32 years of age, he had already amassed 105 caps for Bulgaria and could boast of 13 major honors in his trophy cabinet. He had also managed to transform from the all-action Celtic midfielder who scored 62 league goals over 7 seasons in Scotland to the more cultured and tactically astute lynchpin in an impressive Villa side.

All this changed in March 2012 when, following a 3-0 defeat to Arsenal, Petrov developed a fever. A simple blood test two days following the match showed that there was something terribly wrong going on and a few days later he was diagnosed with acute leukaemia, specifically Acute Lymphoblastic Leukaemia (ALL). Moreover, chemotherapy needed to start immediately.

In acute leukaemia, as opposed to the chronic form, things move at a quick pace, making it particularly ominous.

Broadly speaking, our blood contains three types of cells: red blood cells, white blood cells and platelets. Red blood cells’ main role is to transport oxygen, while white blood cells are vital in combatting infections and other insults to the body. Platelets are central to the body’s coagulation mechanisms, i.e. the mechanisms that promote blood clotting and thus avoid bleeding and bruising.

Leukaemia is usually a malignancy of white blood cells, but similar problems in red blood cells and platelets are not unheard of, but admittedly very rare. Nevertheless, as the white cells go haywire, the whole bone marrow, i.e. the factory where all these cells are produced, is affected.

This is important to point out as one tried to understand how leukaemia patients initially present. Bruising and bleeding gums can occur due to ensuing defective platelets while faulty red blood cells result in a feeling of tiredness, shortness of breath and possibly heart problems as the body struggles get oxygen in vital areas. Leukaemia patients also struggle to fight infections due their abnormal white blood cells.

This is why Petrov felt so fatigued during the Arsenal game and eventually developed a fever. Unfortunately, leukaemia’s presentation is never straightforward and with symptoms being very specific.

In Petrov’s case, a simple blood test showing his “complete blood count” ensured that the abnormality was detected early. This allowed for more specific tests, including a bone marrow biopsy, to be done to diagnose the exact type of leukaemia he had and thus what treatment could be initiated.

I will not dwell on the different types of leukaemia, but I do want to mention that incredible advances have been made in their treatment. As terrible as the Petrov diagnosis is, he was actually told that his type of ALL had a success rate of more than 90% of going into remission after treatment.

Nevertheless, treatment is a long journey. Multiple cycles of high dose chemotherapy are usually necessary. After starting on high dose steroids for his first cycle, Petrov actually admitted to gaining 8 and a half kilograms in one week!

The main role of the chemotherapy is to “format” or “reset” the bone marrow. This, all the blood cells are wiped out with the aim of allowing new, healthy cells to be produced from the cleansed factory, that is the bone marrow. Depending on treatment response and the type of leukaemia, a bone marrow transplant can also be considered.

Well, I think I have bored you enough with all these medical details.

Nevertheless, my aim is to raise awareness of such a condition that can usually be initially determined by an easy, readily available blood test, while also sharing my admiration for a great fighter. The former Aston Villa skipper participated in his first pre-season session on Wednesday, 29th June, fifty-one months after the diagnosis was made.

A day after the diagnosis was confirmed, Aston Villa faced Chelsea at Villa Park where fans staged a hair-raising standing ovation and chanted Petrov’s name. This was done during the 19th minute (19 was Petrov’s shirt number) and was repeated in subsequent home matches.

A few days after the Fabrice Muamba incident, this gesture further showed that soccer is not just the money-making business many would have you believe.

Petrov has won many midfield battles on the pitch. Thankfully, the news coming out in the past week shows that he seems to be also winning the battle with the highest possible stakes.

(P.S. I would like to dedicate this article to all the medical doctors and health staff involved in the treatment of haematology patients, especially those working in the Haematology Unit in the Sir Anthony Mamo Oncology Centre in Malta. I have had the pleasure to work in this Unit for three wonderful and humbling months.)

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