Ashutosh Das Sharma
He was a man in his forties. When he noticed that the ulcer in his mouth won’t heal, even after several weeks of existence, he knew it wasn’t ‘just another ulcer’. Visit to oncology clinics, numerous tests, biopsy, expensive scans, and equal number of counselling sessions went on through the subsequent weeks. He had known the diagnosis long before the doctor conveyed it. It is Cancer.
And before the meaning of this singular word in its entirety could sink in, a gross plan of treatment that he will require is explained to him. An extensive surgery that would remove the bulk of the disease, along with the adjacent part of the jaw, cheek and the neck. As soon as the wounds are healed, a long, recurrent course of radiation and chemotherapy will follow. The entire treatment would take about eight to ten weeks, at the least.
The treatment is intensive as well as expensive. In fact, this is one of the most expensive treatments available in this country. In a case like this, the approximate cost of the entire treatment is Rs 2 to 4 lakh in a non-profit, trust based, well equipped hospital. This cost might swell up to two to four times in a corporate hospital, and may be many folds further for some other types and stages of cancer.
All these estimates are without taking into consideration the cost of travel, accommodation and inadvertent medical expenditures. And this is only the financial aspect of the treatment cost. Add to this the disruption in the patient’s, and sometimes one or multiple family member’s vocation, education, impact of this disruption on the socio-economic status of the family, and the protracted psycho-social aftermath. And above all, the unaffordable/unbearable uncertainty of the outcome of cancer treatment.
The moment it is diagnosed, or even ‘strongly suspected’, all the joy, all the plans, the very flow of life seems to come to an eternal pause. Celebrations are canceled, calendars are unchecked, and schedules are unmade. This whole ‘expense’ is what makes this disease so dreadful, and it’s treatment so abhorrent. This is the toll a tumor (tumour) takes on life.
Mutations of genes, the fundamental cause of cancer, can be practically translated into ‘misfortune’ or ‘bad-luck’ in common language. It can happen to anyone, though with different probabilities, and scares everyone equally. When it does, it strikes like a thunderbolt, mostly unexpected, invariably devastating. This is a very depressing, discomforting and morbid probability to calculate. And it can become a recurring nightmare if you are, for some reason, ‘addicted’ to worrying about it. The reason for this nightmarish fear is the notion that it is impossible for us to fend for ourselves, or, when it gets to us, it’s even more difficult to shake off.
Most types of cancers are lifestyle-related. From the day we are conceived as a zygote and start multiplying to become a fully formed being till death, the cells (and DNA) in our body is at constant threat of damage by the byproducts of their own metabolism. The DNA gets damaged, genes get mutated, and finally the cell that is being regulated by this DNA becomes rogue. Thus, a cancer cell is produced.
This cell then starts on an over-ambitious growth cycle of its own, dissociated from the rest of the body, indifferent to its needs and concerns, disregarding the biological laws of growth and inhibition, to become a tumor. This tug of war between the all-important DNA and the metabolic toxins goes on as long as we are breathing life. Our body does have a cleansing system to counter the damaging metabolic byproducts, reverse the DNA damages, and an immune system to eradicate cancer cells thus formed. Cancer risk reduction is nothing but taking the right side in this tug of war. Helping the body with the cleansing and scavenging of toxins, or at least, not overburdening it, and, helping the immune system in combat. As simple as that!
Eating right, maintaining a healthy weight, flushing your system with adequate water, and avoiding ingestion of carcinogens would help in keeping the DNA damaging toxins at the minimum and take care of the primary cause of cancer. Physical activity, stress reduction, hydration, and again, a healthy diet rich in antioxidants (they prevent oxidative damage to the cells) will keep your immune system intact and ready to counter.
Risk reduction strategies do protect us, though only partially, against the theoretical probability of getting into the problem. Sadly, the truth is, most of life’s problems lie outside the realm of probabilistic distribution. That’s the weirdness of the science of statistics: it gives assurance to the masses, but only uncertainty to individuals. Being able to mitigate, in case it does strike, is the other half that completes the preparedness against “cancer threat”.
Like any other “disaster management” strategy, a person must be psychologically and resource-wise ready to fight cancer in the unfortunate scenario of actually confronting the disease. This not only makes the blow less impactful, it helps to stand the ground without ever losing hope during, and after, the exhausting treatment. It helps in asserting the situation just like another health problem and not something that has announced the end of life.
If you are financially unprivileged, don’t worry. Either the government, one of the many charity organisations or a hospital trust would cover the cost of treatment for you. If you are privileged, don’t worry, period. But, if you lay somewhere in between, hanging by the thin thread of your salary, brace yourself! Make arrangements. Get yourself and the family insured.
And finally, tobacco! No discussion on cancer is complete without adequately demonizing tobacco, and strongly discouraging its use. Remember, the actual price of tobacco is not written on the box. There are so many hidden costs. So, the next time you go for your nicotine fix and reach out to pay for it, remember, the change in your pocket will not be enough. The toll of a tumor will definitely be much more than you can ever afford.
The writer is a practicing Oncologist at Balco, Raipur.