Mainstream, VOL LIV No 8 New Delhi February 13, 2016
A Cancer Survivor speaks in First Person
Saturday 13 February 2016, by
This article is being published to mark to the International Cancer Day which fell on February 4.
The screeching headline of a national daily, “Not bad luck, pollutants and lifestyle cause most cancers.........”,1 urged me to look back and pen down my personal account as a cancer survivor.
I landed at Kolkata Airport en route to Patna from Hyberabad where I had attended the Provasi Bharatiya Divas 2006 as a delegate of the Bihar Government. In that late evening on arrival at the airport, I suddenly felt an uncanny shiver within my body. It was February 9.
Back to the headquarters, I got cold accom-panied by sore throat and cough. Doctors of medicine, ENT and neurology, within the next few days, were consulted one after another. I followed their prescriptions for cure. Several tests, including a CT Scan, were carried out. My voice turned slowly hoarse. So a speech therapist was also consulted. Medical attention notwith-standing, my sore throat persisted.
I went to the All India Institute of Medical Sciences (AIIMS), Delhi which is lauded as the nation’s ‘pride’ in medical teaching, research and services. I consulted Prof Dr Ramesh C. Deka, Head of the Otorhinolaryngology Department, which is dedicated to the study of diseases of the ear, nose, and throat. My appointment with him was facilitated by a cadre colleague who, on deputation to the Union Government, was then the Joint Secretary in the Union Ministry of Health and Family Welfare. The otorhinolary-ngologist went through all the reports of investigations and pathological tests carefully. Prior to him, I had visited the AIIMS twice and consulted neurologists.
About an hour later I took leave of Dr Deka. Just before departure, as if on a premonition, I asked him: “I hope I don’t have cancer in my throat, do I?”
“No, not at all,” pat came Dr Deka’s reply. To allay my fears, he went to the extent of declaring, “I can give you this in writing.” This was on May 6, 2006.
His prescription, which I have preserved till date, noted inter alia that my “voice has signifi-cantly improved”. He advised me to revisit the AIIMS and see another professor of his department two months later. His assurance filled me with confidence and dispelled my worries.
I again consulted neurologists in the OPD and underwent all the tests and investigations. Accompanied by my wife, I paid many visits to the AIIMS. At one point, on the advice of a neurologist of the AIIMS my blood samples were taken by a private diagnostic laboratory. It cost me a sum of Rs 15,000. The samples were sent to the US as the relevant tests were not available in India.
A cadre colleague of ours, who had suffered from throat cancer in the 1990s, wanted me to eliminate my apprehension on this count. With his suggestion at the back of my mind, I had posed the parting question to Dr Deka who, in the meanwhile, travelled up the ladder from HoD, Otorhinolaryngology to Dean. And finally he was elevated to head the AIIMS as its Director.
My throat did not show any sign of improve-ment. Nevertheless, the words of Dr Deka kept ringing in the ears and pepped me up. In August 2006 my eldest son went to Texas, US to work on site for an Indian IT giant. The day he was to fly out of India, a piece of chicken stuck in my throat while we were taking lunch. It startled all of us. Soon I started having difficulty in drinking water and other liquids and involuntarily expectorating saliva. Its volume increased as days went by, impacting my health noticeably. My weight decreased. I had paid in all six visits—the last in September—to the AIIMS but lost hope for cure there.
Then in September I went to Kolkata and consulted a neurologist of a reputed corporate hospital on Eastern Metropolitan Bypass. Several tests, including MRI brain, nerve conduction, USG neck, upper GI endoscopy and biopsy, were carried out. CT scan chest revealed a large mass in esophagus causing a long segment stricture with massive mediastinal lympha-denopathy, suggestive of Ca. Esophagus. On October 27, the neurologist referred me to oncologist Dr Chanchal Goswami for manage-ment of the malignancy. Next day I met Dr S. H. Advani, an oncologist of long experience and outstanding reputation from Bombay, along with Dr Chanchal Goswami. Finally my malignancy was diagnosed as Non-Hodgkin’s Lymphoma (NHL), B cell type. By then I had entered phase-II which, for cure, warranted six cycles of chemotherapy along with radiation therapy. The delay in diagnosis and intervention had facilitated its progress. The treatment started straightway and the first cycle of CHOP, acronym for a chemotherapy regimen, was administered on November 1, 2006.
In the face of the looming health hazard, I went to Patna in mid-October and in a week’s time accomplished a difficult task by uprooting my family with personal effects prior to diagnosis of the NHL esophagus. To wind up an establishment of over three decades in so short a time is not an easy task!
An intense phase of repeated hospitalisation for cycles of chemotherapy alongside innume-rable rounds of radiological, gastronomical investigations and pathological tests began. Blood tests for TSH, CBC, Hb, TC, DC, platelets, LDH etc. as also CT scans, USG whole abdomen, X-ray PA view took me from lab to lab. For PET scans I was required to go twice go to Delhi as Kolkata lacked that facility till then. Each cycle of chemotherapy warranted my hospitalisation for at least three days, if not four, depending on the condition and impact or reaction of CHOP.
By March 2007, all six cycles of chemotherapy were completed. Then I received several rounds of high voltage radiation in a hospital at Thakurpukur at the other end of Kolkata. Availing all modes of transport—cars, auto-rickshaws, metro rail—I travelled some 80 kms to and from VIP Road (at Airport end) to Thakurpukur everyday of the week—except Saturday and Sunday—through some of the most crowded parts of the city during office hours between April 4 to 30, 2007. I received a total dose of 4600cGy/23 Fr. Energy @ 6MVLA a day on field site esophagus and mediastinum. The media-stinum (from Latin mediastinus, “midway”) is the central compartment of the thoracic cavity surrounded by loose connective tissue.
Hospital visits filled me with a strange feeling: Oncology OPD in any hospital in Kolkata looked as if the whole country is afflicted with cancer. People, men and women of every age including children, from all walks of life, with dark clouds of despair writ large on their faces, thronged the corridors of oncology OPD of hospitals.
Dr Chanchal Goswami, with an infectious smile ever on his face, dispelled my fears and infused in me a sense of confidence. I did not suffer from nervousness or tension any time. He explained patiently every question, query, nuance of the disease and its treatment, its side- effects as demanded by my wife and my son besides me. He was easily and always accessible on phone. Twice he received my calls, once from Switzerland and once from Korea.
My wife showed unflappable fortitude and courage during and after the chemotherapy and radiation. She braved this phase of emotional tempest and trauma wrecking her deeply without anybody having an inkling of it. My eldest son, barely three months through his deputation to Texas, rushed back to Kolkata to stand by his mother. The youngest, doing his Masters degree in Mumbai, constantly cheered me and his mother to face the crisis. In May 2007 my oncologist declared me NED which means “NO CLINICAL EVIDENCE OF THE DISEASE”.
The media has lauded the Indian oncologists who, unlike their American counterparts, do not entertain an idea of “linking bad luck to the occurrence of cancer”.2 India’s incidence of cancer is 45/100,00 persons as against 350/100,000 in the USA. Universally the causes of cancer are consumption of alcohol, tobacco products, for example, cigarette, bidis,khaini, gutkha, etc. I have assiduously avoided them all through my life. I follow the motto: go early to bed and rise early. I eat frugal meals. Morning or evening walks were in my routine, having regard for the sedentary nature of my duties.
Looking back I failed to point my finger to any of these factors as the cause for my suffering. Whatever, as detailed above, befell on me can be accounted for the nonchalance of the AIIMS’ otorhinolaryngologist Prof Ramesh C. Deka who guided the destinies of thousands of students, researchers, teachers, above all, tens of thousands of patients. I cannot live down the memories of the dark phase ingrained in my psyche. Had he taken my question—“do I have cancer in the throat?”—seriously and addressed appropriately in the embryonic state, the story, undoubtedly, would have been different.
1.Malathy Iyer, The Times of India, January 31, 2015.
2. The Times of India, January 31, 2015.
The author, a retired IAS officer and former Vice-Chancellor, B.R. Ambedkar University, Muzaffarpur, can be contacted at email@example.com