It was not Big B but Big C that made our acquaintance some time back. We did not get invited on KBC but BC (Breast Carcinoma), a most dreaded visitor came knocking on our door. How the small berry like mass popped up in her right breast was a shocker for mom who was abreast of all tips on self- examination and routinely performed the same. A 2 cm tumour changed family conversation from climate to chemotherapy, state politics to state-of-the-art precision radiotherapy and surviving bad air quality to surviving cancer. Unwittingly, we were set upon a tough journey that cancer chose for us. It was my family pitted against Ductal Carcinoma of the breast, stage II.
Beyond the “why us?” a slew of investigations awaited and we went through all the necessary and unnecessary tests, as mandated by surgeons and oncologists, recommended by friends of the doctor dad, demanded by the pathologist daughter and a couple of hearsay tests. We wanted mom free of cancer as much as our conscience clear of any laxity. 12 years know-how of cancer biology and its behaviour seemed muddled in my head and I felt like I was none the wiser when it came to my own.
Surgery was a given but mastectomy seemed radical. Despite mom’s initial fear of disfigurement and diminished womanhood, she grudgingly realized that letting go of mankind’s lopsided, conformed notions of beauty was in her b-r-e-a-st interest. The unbiased onco-surgeon ruled in her favour anyway and saved the day, err breast. The tumorous lump was out with mom’s sense of dignity intact.
As for the tests, some good and not so good results emerged. I have seen patients go in denial when diagnosed with Big C. It irked me as the denial led to delay in treatment and impacted prognosis. Ironically, I found myself in denial over the bad hormone profile displayed by the reports and doubted the competency of dad’s trusted lab. I repeated the tests at my trusted lab and at a third lab trusted by our government. All the results pointed to a lack of cell targets for mom’s chemotherapy. The cancer cells were cleverly camouflaging and there had to ensue a Kargil War like strategy (therapeutic) to contain enemy pockets of intrusive tumour cells, nab hidden assailants (receptors) and regain LOC (Life Over Cancer). Extra tests, advanced hunt for additional receptors, gene sequencing, brain storming with molecular biologists, few promising results and yet chemotherapy might be a shot in the dark! There was to be collateral damage as in any war. Some of mom’s normal body tissues would fall prey to the toxic effects of chemo.
We were unconsciously seeking out stories of cancer survivors and repeatedly narrating them to each other, planning post-therapy-dine-in at mom’s favourite restaurant and family vacation to Vietnam; the looming shadow cast by cancer seemed a tad bit smaller that way. Mahatma Gandhi was right about the indomitable human spirit and the strength we drew from it. I certainly drew ounces of strength by swallowing some of it as well
Amidst major chaos and some clarity, mom was only interested in the results of one specific test- the BRCA geneanalysis. “Pray why?” A mutation in her gene may condemn me and my sister to the risky gallows of BC. This thought devastated her and the day her BRCA gene gave evidence of being normal, there was no measure of her joy and relief; regardless of the uncertain outcome of her own cancer. A mother’s love is the strongest and most powerful energy known to man. It may consume her but she would still burn bright to light her children’s path.
Well- wishers suggested resorting to age- old ayurvedic formulations to avert the toxic side- effects of aforesaid chemical cocktail. Who could tell if the plant- based roots and stems would fare better in cleansing the body of cancer stem cells and prevent future onslaught as well! Every scientific discipline has its evidence and its believers. In the duel of plant therapy vs chemo therapy, the latter harnessed our faith due to more compelling proof of modern- day literature.
“The boundaries which divide life from death are at best shadowy and vague.”- Edgar Allen Poe. Cancer has a reputation of blurring those lines further. There are stories of patients succumbing to primary cancer, side effects of therapy, cancer 2.0 and so on.
We were unconsciously seeking out stories of cancer survivors and repeatedly narrating them to each other, planning post-therapy-dine-in at mom’s favourite restaurant and family vacation to Vietnam; the looming shadow cast by cancer seemed a tad bit smaller that way. Mahatma Gandhi was right about the indomitable human spirit and the strength we drew from it. I certainly drew ounces of strength by swallowing some of it as well.
Calendar dates for the chemo cycles like festival dates were marked out. Most fried and fermented food, some raw and refrigerated food, excess sugary and salty food and all processed and packaged food were written off from mom’s menu. The dietician further shoved the household into existential crisis by sweetly nudging us to ignore the presence of the fridge, microwave and sundry. She let the gas stove pass. We relented to all the dietary restrictions and relegated to the free-radical quenching and anti-oxidant beaming diet. If she had asked the family to sow, reap and eat their food, we would have considered that too.
In a faraway land, the sister was attuned to every movement on the cancer war front. No amount of cajoling could keep her away and there she was tugging her heavy luggage with an even heavier heart, punctuated with stretched airport waits and a super active 5- year- old in tow. Her arrival was strengthening for everyone’s morale and lent strength to mom’s new lifestyle programme.
Unmindful of her minion like form, the 5-year-old too was under duress to perform activities that the bigger folks around her were doing to help her beloved Aai (grandma). Little did she know that her majesty’s very presence and prancing around like a monkey brought wide grins on Aai’s face. Activities known to her like draw, paint, dance and sing in a foreign tongue were readily and steadily performed in the blink of an eye. Lesser-known activities of counselling and soothsaying were carefully observed and perfectly copied. One fine morning, we found mom panting, puffing, and vociferously undergoing physical training in the supervision of a 2-foot-tall, double ponytailed, metre scale- wielding guru who had last evening overheard adults say that her Aai must get in some daily exercise. Oh man! the power these little freaks exercise over their grandparents can charge up a thousand Iron man suits. Not to mention the power of four simple words “Are you okay Aai” queried by another freak lodged in IIT Guindy that had his Aai overwhelmed with joyful tears. The college- goer and pre-schooler literally had their Aai eating out of their hands but this fondness was exactly what was putting a smile back on mom’s face.
Come autumn when leaves fall, marked mom’s fall of hair too. When clumps of hair fell into her hand as she combed, there was not a tear or trace of fear in attendance. As rapidly dividing cells of the hair follicle rapidly succumbed to chemotherapy; without delay, we too dived into online scarf shopping and were soon neck deep in the amazonian sea of choices.
Mom’s long- drawn chemo sessions spanning over six months corresponded to the number of SAARC nations. The air-conditioned hall where the 4- hour long regimen was routinely administered had 18- 20 fellow patients in different stages of various bodily cancers, lounging on tan-coloured recliners, their bodies sipping in the dripping chemical diet. The patients got friendly over time and a noticeable camaraderie prevailed. Veterans in the club (4/5 chemo down) had a poised, matter-of-fact bearing and were seemingly oblivious to the intravenous line stuck in their arm or chest wall; more stuck on the spiritual podcast streaming in their ears or in comforting the inducted nervous newbies. Owing to obvious hair loss, one common denomination marked the whole bunch. Akin to the NCC cadets donning the neck scarf, an omnipresent head scarf appeared as part of the chemo cadet uniform.
Dad was actively befriending strangers who were waiting on their loved ones that belonged to the chemo club, founding a club of his own on the bench outside. Members of the attendant club were offered his contact number along with the privilege of food and accommodation in his abode lest the need arose.
Merry Christmas came and went and so did Happy New Year for a large share of mankind. Amidst new resolutions, popped a tiny new nodule in the same breast mom was operated for. There was no comfort in knowing it was just a teeny- weeny focus of carcinoma in situ. What if it was cancer 2.0, making a comeback with greater vengeance?
I and dad dashed off to consult experts in presumably the best centre in the country joining the countless lakhs who make a journey of faith to this Mecca to be granted salvation from cancer. True to its reputation, like a well-oiled giant machinery, each unit and sub- unit of this vast, dedicated system ran smoothly and seamlessly to provide succour to distressed souls. Expert opinion indicated in-situ disease and not a recurrence. Contented and rearmed with a deeply- deliberated treatment regimen, we were back to our home-grown shrines of healing and known messiahs to resume treatment 2.0. By now, mom had eased into her new lifestyle, excluding certain 3 S (Sugar, Sluggishness and Socialisation) and embracing certain others (Stewed vegetables, Surya Namaskar and Streaming OTT content).
While the first set of chemo drugs went for mom’s scalp hair, eye brows and lashes, the next set of drugs were sorely interested in her body muscles. Slowly but surely, mom was getting determined to fight the side effect challenges the drugs would toss now and then. It was refreshing to watch mom show enterprise and self-appoint a very bangled, messy hair tangled, rustic, good-humoured masseuse who insisted on package deals only. Thus, a 3- month deal coinciding with 2nd chemo regimen was secured.
After a couple of cycles, the adamant chemo-drugs went for mom’s immunity and body electrolytes, landing her in ICU in the near past. A haemoglobin count of 6 gm% begged for urgent packed cell replenishment. Bollywood has corrupted our perception of how blood is transfused. It is not a two-beds-side-by-side affair of the doting heroic son on one hand draining litres of blood from his veins and his mother on the other bouncing back after an equal measure get pumped into her. Only vampires suck out as much blood in a jiffy. Real world transfusion needs a non-menstruating healthy donor to donate about a pint of blood at a go which takes all of few minutes; which is then screened in next 24 hours for presence of various infectious diseases. If found free of potential harm, it is stored for future use. The deal was a donor’s blood in exchange for a stored and matched one to mom’s blood group. A gift of 350 ml of blood seemed so miniscule for this gift of life with 5.0 litres of blood coursing through my veins – courtesy mom and dad. And yet the flavoured milk and pack of biscuits I received post transfusion felt like the best return gifts thus far. Tender coconut water and potassium chloride solution had competing interests in restoring critical potassium levels in mom’s body. Consuming the latter produced a grotesque facial expression of ‘The Mask’.
Recovery has been on slow trot. From administering medicines to monitoring mom’s blood parameters and diet, my 75-year-old dad has been caregiving with the energy of a 30- year- old. Alongside exercising her mandate and casting her vote, mom is exercising per se and voting in favour of all things healthy and all that makes her happy. She has completely cast aside anything unhealthy that makes her happy as well. The fight may not be over, yet there is faith, family and caution in our armoury in case the enemy strikes again. We might take that trip to Vietnam after all.
“Out of suffering have emerged the strongest souls; the most massive characters are seared with scars”- Khalil Gibran
The writer is an Associate Professor in Oral and Maxillofacial Pathology, SCB Dental College & Hospital, Cuttack, and regularly posts write-ups on Rachnacreates.com