the biopsy needle & vial


Smiling amidst the pain.


When you hear the word biopsy it is always associated with cancer – a dreaded disease that can take away your life.

I felt nervous when the doctor advised me to have one. They need to know whether the tumor was malignant or not.

The fear of the unknown crept in.

Questions after questions.

What if it’s malignant?

What will happen to my family and to my loving wife? I was just married for a year & a half. Too early to leave a harsh and a cruel world. I still don’t have kids.

I thought the biopsy was just a small prick versus the previous aspiration of the synovial fluid.  But, it was not.

A CT scan guided biopsy was required.

Like any medical procedure, you signed a waiver to free the hospital from any liability. I did.

Everything was prepared from the biopsy tool kit, radiation technology team, nurses and doctor.

Until, the doctor made a litany on the possible complications – pancreatitis, infection, bleeding, sepsis, etc. and many more.

“Do you still want to continue?” Asked by the doctor.

What?!? Who am I to halt the procedure?

Deafening silence.

All eyes were on me.

I muttered a resounding ‘yes’.

I laid on the scanning plate and looked at the ceiling. I hummed my favorite tune.

Entered the scanning machine, pancreas was located and anesthesia was applied just a few inches above my navel.

Suddenly, a big black tube with a 12-inch needle was pierced through my belly. I have never seen that before in my life. Not once, not twice but thrice.

Took a small specimen of the tumor and went to the vial.

A small vial and a not so tiny needle combo that forever changed the course of my life.

juices & healthy living

From baking soda treatment, daily alkaline water intake, carrot blended juice, ampalaya (bitter gourd) juice – name it, being a cancer patient you will be bombarded with different fool-proof solutions for healing from social media, family, friends, relatives, neighbors, etc.

You really have to sift through it and find what suits you. Food intake varies from one patient to the other depending on the advice of your doctor. So, you really have to consult your physician- before doing anything.

Being a PNet cancer patient – you actually can eat anything under the sun according to my doctor as long as it’s edible, healthy and rich with nutrients.

Moderation is the key- not so little or too much, just enough to sustain you during the day.

The digestion of fat or lipid is a major issue for me since the pancreas is affected by the tumor. As much as possible, I avoid eating fatty foods.

I have also a history of gouty arthritis and abnormal uric acid levels- so I need to avoid food with high purines because this will exacerbate the flare attack – a reddish inflammation of the joints in your feet or hands that is very painful.

Usually, a flare attack occurs when I eat meat – so I try to avoid it. But, who can resist the temptation of having a slab of lechon after working in Saudi Arabia for so many years where pork is prohibited? Right?

Below are my juice arsenal that I did myself, which is very easy to prepare. Even your kids can do it for you.

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Banana & papaya blitz blended juice


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Papaya, banana & mango blended smoothie!


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Fresh carrot juice

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Healthy ampalaya (bitter gourd) juice

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Papaya & honey combo – very refreshing!

where it all began


I wish the teddy bear can ease the pain.


Fatigue, a black stool, nausea and constipation were the initial symptoms of the great battle.

It was just an ordinary day that became a turning point of my life.

I went to Hamadi hospital for my regular checkup – initial diagnosis was Anemia or low blood. Blood transfusion must be done as soon as possible. Unfortunately, they cannot accommodate me anymore. Beds were full.

So I traveled from Hamadi to Al Habib hospital without knowing that I was already a walking time bomb – ready to explode anytime because of low hemoglobin levels.

I met Dr. Sulaiman Gali, a gastroenterologist from Sudan and showed him the lab results from Hamadi. Hemoglobin level was 6 versus 12-14 for normal male.

Lo and behold, I was sent to the ICU immediately.

Panic mode erupted.

Nurses were squabbling to find veins from my fatty muscles.

Low hemoglobin was caused by internal hemorrhage from my digestive tract. Endoscopy was done to remove the blood clot.

Six bags of blood were transfused.

A brutal day in the hospital – flare attack from my gouty arthritis was hell, a slight touch on my hands and feet made me cringe in pain.

Hemoglobin went up but with on and off fever.

Body was not responding to several bottles of paracetamol and antibiotics. Two (2) probable cause: the gouty arthritis and digestive tract’s continuous bleeding.

Aspiration of synovial fluid from my joints was done. How? Imagine a long tiny needle inserted on your ankle to get a liquid in between your bones without anesthesia.

I closed my eyes during the painful procedure. It was difficult for the rheumatologist to aspirate because the space in between the ankle joints were very small and they need to prick several times. Ouch! They got a yellowish fluid, which means a sign of infection.

In addition, the doctor advised me to undergo a CT scan to check the digestive tract. Prior to the actual scan, I drank one liter of water with contrast formula. Tasted like metal but who am I to complain it was a requirement.

Nothing compares to my first CT scan experience because it was never my last.

Initially, the radiation technologist from India assisted me but had difficulties transferring me from the bed to the scanning area. My body was in pain. The scooping board was not used.

Grateful that I was endorsed to a Filipino radiation technologist. He did it with a breeze. My heart pounded because they found “something” and I drank more water with contrast formula to see it clearer.

After a few days, the CT scan result was out. A small tumor in the ampula or head of my pancreas was found causing a blockade in my digestive tract.

I have to undergo a biopsy to check if it’s malignant or not.

The tumor was not as big as a Nutella bottle.




the long winding road


Looking at the horizon – the view from Taal Vista Hotel during my 2015 birthday celebration. A very special gift from my wife.


You’ll ask why the blog only now?

It was a tough call to write and to recall your journey back to where it started. It was never easy remembering the painful experience.

But, I believe after several medical procedures- Endoscopy, ERCP, MRI, PET & Ocreotide Scans, 9-hours of surgical operation, plus medical insurance that went overboard,  nine (9) hours travel from KSA to the Philippines few days after the surgery, being bed ridden for several months, painful bed sores, saying goodbye to your job to get your end of service awards for cancer treatment, long distance relationship with your loving wife, tons of antibiotics/pills/IVs, several syringe of anesthesia, six (6) sessions of chemotherapy/ 3 days straight per session, hours of travel from Cavite to Batangas for my medical check-up at St. Frances Cabrini Cancer Institute and many more.

I am still alive.

There are still a lot of blessings that I am thankful for.

Every day brings a new hope, a new opportunity and a new act of love to be shared to everyone.

After almost a year, I can share my experiences online as my way of thanking God and expressing my sincerest gratitude to all the people who prayed, shared financial assistance in my cancer treatment and those who offered their time to be with me in this journey.

I am grateful for so many angels sent by God guiding, loving and serving me.

I always share this to my friends in my social media accounts – the victory is not mine but God alone.

He sent me in this battle of Nutella with a faith of a warrior.

He trusted me so much – so who am I not to give it back to Him.

It’s a relief to finally write, I never knew that I will be doing this but I guess I have a purpose. It’s probably more than I can imagine.

This might be my passion that I failed to discover while being busy with the clutters of the world.

Join me as I rediscover myself as a soldier- praising and worshipping God in the most gruesome battle of Nutella.

the warrior


The little soldiers caught off guard. My brother crying, why? Your guess is as good as mine.


Growing up having a Philippine Constabulary army father, I was trained to be tough.

Sta. Ana, Manila was my big playground. I learned street games that children of today doesn’t know.

A memorable childhood- combatant but with a heart. I am not the studious type but a smart little warrior.

Honed by the public education program of the government from elementary to college – life was not a breeze but pure hardwork, dedication and commitment. There was no short cut to success.

The warrior in me – placed me in the honor roll with dignity and pride for my family.

Being the only boy from the top 5 of the class in primary years, I learned how to farm, make a dustpan & an apron, cook Morisqueta Tostada (special fried rice), recite a poem (The Child’s World), and be the representative of Sta. Ana Elementary School in the Samahang Munting Mamamayan (SMM) leadership bout among the best of the best little Manilenos that time.

During the secondary years, I was like a diesel – heating up to the end but always engine-focused. Graduated Salutatorian in Mariano Marcos High School after snatching the Best in Radio Broadcasting (National Level) Championship in the National Schools Press Conference (NSPC) up the ante of my high school life representing the Philippines in the student exchange program with South Korea. Extra-curricular activities catapulted me – inching a few points from the next best student in the line. Being a Battalion Commander from my Cadet Army Training (CAT), woke up the little soldier’s blood for courage, valor and further honor.

College was a different ballgame- graduating as the only Magna Cum Laude from the Bachelor of Mass Communication, batch of the new millennium (2000) at Pamantasan ng Lungsod ng Maynila (University of the City of Manila) made me delusional of success. I thought landing a job was easy but it was not.

Being an honor graduate is just but a small piece in the puzzle of success that can make or break you.

Jumping from one company to the other, I found myself in the retail marketing field. It was a roller coaster ride – ups and downs – twirling politics on the side, dog eats dog, name it you will be devour alive for being stupid. Head held high but feet on the ground.

Always on the prowl for growth, I took a big leap to the land of black gold.

Middle East was a farfetched destination of working abroad when I was young. Of all the places in the world, the Kingdom of Saudi Arabia (KSA) was my training ground. Scorching heat of the desert to another level and mustering corporate politics was part of the game plan.

But, the Battle of Nutella was a force to reckon with. A raging war that the warrior was not prepared to deal with.



Being diagnosed with PNet, it was not easy to live a life that you were not used to before.

After a few days of the big breaking news, I lost my appetite. The PNet tumor in the pancreas head blocked the digestive tract from my stomach and liver to the small intestines. It was very difficult to digest the food.

I was not able to eat properly. I puked.

The bile from the liver was secreted directly to the blood stream. It did not pass through the usual digestive tract because of the blockade caused by the tumor.

I was like a yellow bruised banana from my scalp to the sole of my feet.

Bilirubin was to the roof. Salt was my perspiration.

The itch threw me to the wall.

Sleepless nights.


Several visits to the hospital yield nothing but nausea.

I never knew that it was a tough battle.

Prior to my PNet diagnosis, abnormal uric acid level was my new normal. Gouty arthritis left and right at my hands and feet.

Pain after pain – but the warrior is just on the initial stage of the battle.

Onward we go.

Can I carry on?

the journey

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A foreboding symbol of a battle- a suprise welcome gift from my wife after my Qatar business visit.


What will you feel if you find out that you have only few months to live?

I am Ramed R. Borja – a Pancreatic Neuroendocrine Tumor (PNet) warrior from the Philippines.

What is PNet? It is a rare type of pancreas cancer.  Steve Jobs of Apple & Prince Sultan of the Kingdom of Saudi Arabia – are some of the victims of this cancer.

My wife Maria Judith Borja, asked me to chronicle my cancer journey. I am doing this blog out of my love for her and also to share my PNet journey to the world.

When I was diagnosed last February 3, 2015, I was shocked.

Dr. Wael Kattan, a Saudi doctor from Dr. Habib Hospital in Riyadh, KSA broke the news: “The biopsy is out, its cancer.” Kind of slap on your face breaking news update. Don’t get me wrong, I appreciate the candidness, but I was not prepared for it.

My wife should have not cried if the Jordanian nurse did not put a box of tissue in front of her. Maybe they were use to this type of convo and they know the sequence of events.

As we drove home, I felt numbness on my body. So many questions and I can’t find answers. I was not able to speak for few days. Thankful that my wife was beside that time.

Before the diagnosis, there were symptoms.

I do love my job in the retail industry but the stress at work will get a toll on you. The nature of my work entails travel in the Gulf Cooperating Countries (GCC) of the Middle East. I was incharge of marketing for the largest computerstore in the Kingdom of Saudi Arabia (KSA) and also for the branches in Qatar, Kuwait & United Arab Emirates.

I came from a business trip in Qatar when I noticed a combo of nausea and constipation for several days. I felt fatigue just putting my pants & longsleeves. Putting a single step on stairs was hard. Moving an inch was tiresome.

I  pushed myself to go to the hospital.

Lo & behold, my hemoglobin dropped to 6 – normal male is 12-14. Internal hemorrhage in the digestive tract. Panic mode in the hospital, rushed to the emergency then to the ICU. Six bags of fresh Arabic blood transfused to my chubby nerves.

My hemoglobin was stabilized at 11 but I have on & off fever for few more days. Doctors investigated and found out from a CT scan that I have a tumor on the ampula of my pancreas.

It was the start of the Battle of Nutella.