Thursday, May 16, 2013

Cancer: More than touching lives - Saving them

Breaking news about fateful diagnoses is among the most difficult things I did as a medical student. I often encounter a relative or an acquaintance diagnosed with cancer, who walks into my home with diagnostic reports of various kinds and asks if she can live long enough to witness the birth of a grandchild or the wedding of her son. I am still a medical student and I am therefore not expected to give exact figures of survival rates. So, I manage the situation by entering into a cheerful conversation, boosting their confidence and encouraging them to undergo the procedures suggested to them by their oncologist.

I lost my grandpa to lung cancer - six months after the diagnosis was made - in 2010. He was the happiest man on earth when I got qualified to pursue medicine. He frequently reminded me that my purpose in life should be to alleviate pain. By the time he was diagnosed to have lung cancer, he had reached the terminal stage of the disease and all his doctor could do was to prescribe him Morphine to alleviate his physical pain. It was after his death, during the second year of my medical training, that I decided that I should specialize in oncology. I wanted to become a scientist-physician, conducting clinical research and treating patients at the same time; and work in a world-class hospital that employs cutting-edge technology for fighting cancer.
Early diagnosis is the key.
Public Domain, WM Commons
However, I was worried that I will end up in a dull clinic prescribing medicines for patients. I was afraid that I would want to break bad news to cancer patients frequently. When I shared my concern with Jithin Das, a good friend of mine, he gave me an inspiring reply which I cherish even today:

“20 years from now, you will not be sitting in a consultancy room spending most of the time looking at   CT and PET scan reports. 20 years down the lane you will not be administering chemo agents or radiation hoping that it may work. 20 years down the lane you will be working with robots that will make you feel Cyber-Knife is a kids' toy. 20 years down the lane you will not be writing names of whatever available in the market that may best suit the patients- you will be analyzing combinations of mutations of your patients be ordering custom made drugs will cure them, which in effect is a complete process, you identify the problem, you  create his medicine, you administer it, you cure. You will be creating mutations to fight mutations. You will be using viral agents to cure anti-oncogenes to target and kill malignant neoplasm. You will be having an office that looks like control rooms of space craft in science fiction movies.
Genetics is taking a giant leap now, right now, that will change profession of oncology beyond recognition. A lot more is known about genes and how proto oncos turn into oncogenes. A lot more is known now why anti onco genes fail to fix the issue and how to repair these two. You are into an exciting profession, I swear by thunder.Yes, you will be working most of the days and nights. Something you can’t dispense with. But you sure will be enjoying those days and nights. You will not face uncertainty. You will not have a hard time telling some of your patients what metastasis means and all you can do is to give palliative care. You will be part of the integrated generation of doctors, scientists and engineers who are going to finally beat cancer - this is going to happen after several hundred years of painful research about the unknown”.
 This message brightened up my spirits and made me beam with joy. Indian hospitals employ the most modern techniques of treatment of cancer. Apollo Hospitals, one of the leading healthcare providers of India, has various modalities of treatment for the prevention and cure of various forms of cancer – liver transplants, bone marrow transplants and robotic surgical system to name a few. 
Synonymous to cutting-edge technology
Courtesy : Apollo Hospitals

Surviving cancer is no more a miracle. With precise instruments, cutting-edge technology and skilled physicians, survival rates of patients diagnosed with cancer is going up every year. Yuvraj Singh battled against a mediastinal seminoma for more than an year, and finally emerged victorious. He was quoted saying:
People are aware about my battle with cancer and my resolve to win it, and live a normal life like all. You and We, together, can fight cancer.”
Steve Jobs, the former CEO of Apple Inc., had a quality life for nearly 10 years after having diagnosed of pancreatic cancer. In fact the best period of his life was during the treatment – he shined both as an innovator and manager during this period and took Apple to heights.
“About a year ago I was diagnosed with cancer. I had a scan at 7.30 in the morning and it clearly showed a tumour on my pancreas. I didn't even know what a pancreas was. The doctors told me this was almost certainly a type of cancer that is incurable and that I should expect to live no longer than three to six months. My doctor advised me to go home and get my affairs in order, which is doctor's code for "prepare to die". It means to try to tell your kids everything you thought you'd have the next 10 years to tell them in just a few months. It means to make sure everything is buttoned up so that it will be as easy as possible for your family. It means to say your goodbyes.I lived with that diagnosis all day. Later that evening I had a biopsy, where they stuck an endoscope down my throat, through my stomach and into my intestines, put a needle into my pancreas and got a few cells from the tumour. I was sedated, but my wife, who was there, told me that when they viewed the cells under a microscope the doctors started crying because it turned out to be a very rare form of pancreatic cancer that is curable with surgery. I had the surgery and I'm fine now”.
Jobs’s story is an incredible example of how modern healthcare touched his life. He lived like a normal man for a long time before he succumbed to death. Lately, it was Angelina Jolie who revealed that she had undergone a prophylactic mastectomy to reduce the risk of getting cancer. Jolie’s choice is profound because it is so serious, and so well and bravely played against the background of the shallow celebrity culture. Jolie’s decision emphasizes that one is no less a woman without her natural breasts, and that one is not just a sum total of her body parts. I applaud her for the choice she made to go public about the mastectomy and inspire millions of women to get tested for genetic mutations and take preventive measures for the same. For cancer, early detection is the key. Jolie wrote in New York Times thus : 
“Cancer is still a word that strikes fear into people’s hearts, producing a deep sense of powerlessness. But today it is possible to find out through a blood test whether you are highly susceptible to breast and ovarian cancer, and then take action. For any woman reading this, I hope it helps you to know you have options. I want to encourage every woman, especially if you have a family history of breast or ovarian cancer, to seek out the information and medical experts who can help you through this aspect of your life, and to make your own informed choices”.
I read Angelina’s article ‘My Medical Choice’  over and over again. May the medical choices of powerful women like Jolie help women and men from all over the world to line up for the pink ribbon revolution and be aware about the diagnostic and treatment facilities for the same. Detailed description about breast cancer and its treatment facilities are included in the website of Apollo hospital here: http://www.apollohospitals.com/breast_cancer.php

I recommend that all the readers of my blog go through this web page  and be aware about options of breast cancer treatment and prevention. As of now, testing for BRCA mutations and getting silicon breast implants like Angelina did would be a costly affair in India, but the modern healthcare system is so rapidly touching our lives that such cutting-edge technologies become affordable for Indians in the near future.
Breast Cancer Awareness, U.S.A
Public Domain, WM Commons

Yesterday, Theo, a good friend of mine, wrote to me via the Gender gap mailing list in the context of Angelina undergoing mastectomy. A relative of his had passed away last year who had breast cancer and the cancer had metastasized after a mastectomy and several rounds of chemo. He wanted to organize all data related to breast cancer on Wikipedia and beef up the existing articles, and wanted help from knowledgeable writers to do this. I had been a writer on Wikipedia for more than three years (my Wikipedia profile can be seen here), and I am glad that I got hooked up with Theo to do something as worthwhile as writing about breast cancer. Theo’s appealing message can be read here. 

During the discussion on this issue, it was pointed out by John V.  that the ‘Getting tested’  section of the article on BRCA mutation is largely first-world centric. He urged the participants from different parts of the world to document how they would tackle the problem involved – where is the nearest place that the test/procedure can be done, and how frequently do they do the test/procedure as that may be a major consideration in whether you would travel further to receive more experienced care. I being one of the very few medical students writing on Wikipedia, and an Indian by nationality found it my obligation to write about this aspect of treatment from an Indian perspective. I shall spend my spare time to research about the advanced diagnostic technologies in India and help the readers of Wikipedia get empowered with medical information. It is essential that we Indians have reliable and updated information about the various cutting-edge technologies for the treatment of cancers. My job would be to make sure that this kind of knowledge is delivered in a click of the mouse.

As Angelina Jolie said, “Life comes with many challenges. The ones that should not scare us are the ones we can take on and take control of.” 

Let us take control of our lives, empower ourselves with latest diagnostic and treatment modalities, live a life free of cancer and encourage others to do the same.

Thanks to Indiblogger and Apollo Hospitals for inspiring me to write this article. For more information on various cutting-edge technologies available in Apollo Hospitals, go through this link : http://www.apollohospitals.com/cutting-edge.php

I have also written a poem about diagnosing cancer and a semi-fictional story about fighting cancer.


Neatly done! A very informative post. Good luck! :)....n keep visiting my blog :)

Nice post ! check out www.sehat.com to research doctors under any specialization and choose the best!

Thank you, Bushra, for those kind words and for visiting my blog.

@ Shravani,

Thank you for the link. Keep blogging!

Just checked the stats now and found that the number of visitors to my blog has just crossed 25,000! Thanks to all of you who visited my blog and encouraged me to write!


Dr. v p gangadharan ezhuthiya ''jeevithamenna albutham'' enna pusthakam vaayichitundo? in this book he shared his experience with cancer patients....ee post malayalathil onnu ezhuthaamo?

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You have collectively added all the piece of positive outcome of Cancer, citing great peoples examples as a moral. Good Luck for your future dream.

I always wished you to be a Gynecologist its real Joy in giving more hopes to this earth.