The word cancer is everywhere these days. To borrow from P.G. Wodehouse, you cannot throw a brick without it landing on someone who has either had cancer or knows somebody who has. But when this Emperor touches your person with his sceptre, the word becomes more potent; it becomes non-negotiable.
This June, I completed one year cancer free - far from being in remission, but definitely a milestone to celebrate. I remember the morning I felt the lump on my breast. They tell you that cancer is a stealthy foe. In my case, it was not so. I had fair warning. For a while before the lump appeared, I would see a grotesque carbuncle-like mass that seemed to be kind of bubbling and growing whenever I closed my eyes in meditation. Only I did not interpret the warning correctly! The moment I mentioned the lump to my husband and daughter who was visiting for the summer, they called Dr. Lalita Badhwar, the Gynaecologist who had operated on me several years ago to remove my uterus and ovaries because they were pre-cancerous, to make an appointment. She suggested that we not waste any time and go straight to Dr. Harit Chaturvedi, Surgical Oncologist, at Max Hospital. From that moment on, I was on autopilot. In his clinic, I remember Dr. Chaturvedi saying that he was 99.9 per cent sure that it was cancer but asked for a Fine Needle Aspiration Cytology (FNAC), and several other tests to be done immediately. “Oh God, not again!” Just a couple of years ago I had contracted encephalitis, nearly died, and lost almost all my memory. I couldn’t put my family, but mainly my husband, through such torment twice in such quick succession!
The FNAC report confirmed that it was stage II A cancer of grade III. The cell expression rate was rather high which meant that it was an aggressive cancer. Dr. Chaturvedi fixed the date for a mastectomy, discussed my options, and explained the procedure to me. I had never thought that I would be an amputee one day. But it was not all doom and gloom. There were several lighter moments as well. For the bone scan, I was injected with a dye and asked to return after three hours. I decided to use this time to visit my parents and break the news to them. When I returned, the reception area was completely empty but I was told I had to wait in a jam packed inside area. “You can’t be here Ma’am, you are radioactive because of the injection so you can only be near other patients.” Baffling on so many levels, and I am thinking NOW you tell me!
After the mastectomy during which 22 lymph nodes had to be removed as well, a physiotherapist came to teach me the exercises I would need to do to prevent lymphedema and to brief me on future care of the arm. One of her cautionary notes was never to get mosquito bites on the arm. I asked her what I could do in case I did get bitten some time during the rest of my life. “Umm, just don’t get mosquito bites” was the sage counsel.
I was very lucky in getting really good doctors who were very open to questions and were willing to discuss even treatment options with me. However, you should take care to identify a doctor whom you feel comfortable with because he/she is going to be a very important person in your life from this moment on. After the second biopsy during surgery, the doctors decided that a FISH test was called for since the cancer turned out to be ER (estrogen) and PR (progesterone) negative.
Dr. Amish Vora, Medical Oncologist, who was going to be looking after me during further treatment, told me that the test had come back strongly positive for the HER2 gene. This meant 17 doses on a three weekly cycle – one whole year of chemotherapy and tests. Dr. Vora warned me that the treatment regimen was aggressive and would shoot my immunity to pieces. He suggested that I think of myself as a person with AIDS during this time. Along with other advice, he also cautioned me to chop off my hair the moment it started to fall and not wait for it to come off in clumps. The hair fell, and it fell very painfully – the roots hurt unbearably. Once it was all gone though, it was fun. I looked up different styles of wearing scarves on the internet and became quite adventurous with them. My husband would feel my bare skull with his hand and say, “Awww, you look like a Buddhist monk”. Each trial comes with its own gifts for sure!
You will learn a lot about yourself as well as the people in your life. You will get a lot of morbid curiosity, advice, and many “sure-fire” cures. Do not let it overwhelm you. If something seems worthwhile to you, definitely run it past your oncologist before you start following supplementary cures.
Here are a few tips that I found helpful:
1. Write down your questions for your doctor before each appointment. In the early stages (right after diagnosis) have somebody accompany you to your appointments, and ask them to take notes. Even if you feel that you are calm, you will find that you are not able to recall all that was discussed.
2. Do your research, but trust your doctors – they are the ones who have dedicated their lives to learning about cancer and treating it. Experience has taught them what works and what does not.
3. Keep a diary of your daily symptoms between treatments. It will help you plan for the worst days in the cycle; and believe me, each cycle will have its trough!
4. Keep surgical gloves and Vaseline or some lubricant handy. On some days you might feel too weak to excrete and might have to finger extract the faeces.
5. Do not use any mouthwash with alcohol in it. Rinse your mouth with Betadine solution even if you have one mouthful to eat or drink. This will prevent mouth ulcers.
6. Use either an ultra soft toothbrush for brushing your teeth or, preferably, use a children’s one.
7. If you floss, use the unwaxed variety.
When to Call the Doctor:
Immediately, if
1. you have a fever of, or above, 100.5 degrees Fahrenheit, chills or uncontrolled shivering.
Within 24 hours, if
2. you have persistent pain anywhere.
3. you have swelling of ankles or legs.
4. you experience shortness of breath.
5. you have severe diarrhea and stomach pain, or constipation.
6. you have black or tarry stools, or blood in stools or urine.
7. you experience persistent burning/itching during urination or have a vaginal discharge.
8. you have severe nausea/vomiting and are getting dehydrated.
9. you have yellowing of skin or eyes.
10. you have sudden weight gain.
Ultimately, you cannot but admire the cloning skills of cancer. As Siddhartha Mukherjee says in The Emperor of All Maladies “In cancer, unbridled growth gives rise to generation upon generation of cells…Nearly every known cancer originates from one ancestral cell that…gives rise to limitless numbers of descendants”. Tough opponent it may be but remember that advances in medical science have phenomenally improved survival rates, and as my doctor said, if you are going to get cancer then breast cancer is the best one to have.
- A slightly abridged version was published in the October 2013 issue of Prevention, India Edition
This June, I completed one year cancer free - far from being in remission, but definitely a milestone to celebrate. I remember the morning I felt the lump on my breast. They tell you that cancer is a stealthy foe. In my case, it was not so. I had fair warning. For a while before the lump appeared, I would see a grotesque carbuncle-like mass that seemed to be kind of bubbling and growing whenever I closed my eyes in meditation. Only I did not interpret the warning correctly! The moment I mentioned the lump to my husband and daughter who was visiting for the summer, they called Dr. Lalita Badhwar, the Gynaecologist who had operated on me several years ago to remove my uterus and ovaries because they were pre-cancerous, to make an appointment. She suggested that we not waste any time and go straight to Dr. Harit Chaturvedi, Surgical Oncologist, at Max Hospital. From that moment on, I was on autopilot. In his clinic, I remember Dr. Chaturvedi saying that he was 99.9 per cent sure that it was cancer but asked for a Fine Needle Aspiration Cytology (FNAC), and several other tests to be done immediately. “Oh God, not again!” Just a couple of years ago I had contracted encephalitis, nearly died, and lost almost all my memory. I couldn’t put my family, but mainly my husband, through such torment twice in such quick succession!
The FNAC report confirmed that it was stage II A cancer of grade III. The cell expression rate was rather high which meant that it was an aggressive cancer. Dr. Chaturvedi fixed the date for a mastectomy, discussed my options, and explained the procedure to me. I had never thought that I would be an amputee one day. But it was not all doom and gloom. There were several lighter moments as well. For the bone scan, I was injected with a dye and asked to return after three hours. I decided to use this time to visit my parents and break the news to them. When I returned, the reception area was completely empty but I was told I had to wait in a jam packed inside area. “You can’t be here Ma’am, you are radioactive because of the injection so you can only be near other patients.” Baffling on so many levels, and I am thinking NOW you tell me!
After the mastectomy during which 22 lymph nodes had to be removed as well, a physiotherapist came to teach me the exercises I would need to do to prevent lymphedema and to brief me on future care of the arm. One of her cautionary notes was never to get mosquito bites on the arm. I asked her what I could do in case I did get bitten some time during the rest of my life. “Umm, just don’t get mosquito bites” was the sage counsel.
I was very lucky in getting really good doctors who were very open to questions and were willing to discuss even treatment options with me. However, you should take care to identify a doctor whom you feel comfortable with because he/she is going to be a very important person in your life from this moment on. After the second biopsy during surgery, the doctors decided that a FISH test was called for since the cancer turned out to be ER (estrogen) and PR (progesterone) negative.
Dr. Amish Vora, Medical Oncologist, who was going to be looking after me during further treatment, told me that the test had come back strongly positive for the HER2 gene. This meant 17 doses on a three weekly cycle – one whole year of chemotherapy and tests. Dr. Vora warned me that the treatment regimen was aggressive and would shoot my immunity to pieces. He suggested that I think of myself as a person with AIDS during this time. Along with other advice, he also cautioned me to chop off my hair the moment it started to fall and not wait for it to come off in clumps. The hair fell, and it fell very painfully – the roots hurt unbearably. Once it was all gone though, it was fun. I looked up different styles of wearing scarves on the internet and became quite adventurous with them. My husband would feel my bare skull with his hand and say, “Awww, you look like a Buddhist monk”. Each trial comes with its own gifts for sure!
You will learn a lot about yourself as well as the people in your life. You will get a lot of morbid curiosity, advice, and many “sure-fire” cures. Do not let it overwhelm you. If something seems worthwhile to you, definitely run it past your oncologist before you start following supplementary cures.
Here are a few tips that I found helpful:
1. Write down your questions for your doctor before each appointment. In the early stages (right after diagnosis) have somebody accompany you to your appointments, and ask them to take notes. Even if you feel that you are calm, you will find that you are not able to recall all that was discussed.
2. Do your research, but trust your doctors – they are the ones who have dedicated their lives to learning about cancer and treating it. Experience has taught them what works and what does not.
3. Keep a diary of your daily symptoms between treatments. It will help you plan for the worst days in the cycle; and believe me, each cycle will have its trough!
4. Keep surgical gloves and Vaseline or some lubricant handy. On some days you might feel too weak to excrete and might have to finger extract the faeces.
5. Do not use any mouthwash with alcohol in it. Rinse your mouth with Betadine solution even if you have one mouthful to eat or drink. This will prevent mouth ulcers.
6. Use either an ultra soft toothbrush for brushing your teeth or, preferably, use a children’s one.
7. If you floss, use the unwaxed variety.
When to Call the Doctor:
Immediately, if
1. you have a fever of, or above, 100.5 degrees Fahrenheit, chills or uncontrolled shivering.
Within 24 hours, if
2. you have persistent pain anywhere.
3. you have swelling of ankles or legs.
4. you experience shortness of breath.
5. you have severe diarrhea and stomach pain, or constipation.
6. you have black or tarry stools, or blood in stools or urine.
7. you experience persistent burning/itching during urination or have a vaginal discharge.
8. you have severe nausea/vomiting and are getting dehydrated.
9. you have yellowing of skin or eyes.
10. you have sudden weight gain.
Ultimately, you cannot but admire the cloning skills of cancer. As Siddhartha Mukherjee says in The Emperor of All Maladies “In cancer, unbridled growth gives rise to generation upon generation of cells…Nearly every known cancer originates from one ancestral cell that…gives rise to limitless numbers of descendants”. Tough opponent it may be but remember that advances in medical science have phenomenally improved survival rates, and as my doctor said, if you are going to get cancer then breast cancer is the best one to have.
- A slightly abridged version was published in the October 2013 issue of Prevention, India Edition
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