By her own admission, Geethalakshmi, a corporate lawyer who came to Dubai in 1999, lived a good life. She had a jet-setting career, a busy social life and was an avid badminton, table tennis and hockey player.
In 2014, her parents Saraswathi and Ramachandran were enjoying their holidays with Geetha in Dubai. On the day they were preparing to return to India, Saraswathi informed Geetha of a few small boils in her chest area right below her neck which she had noticed a few days ago in the shower.
‘Immediately alarm bells started blaring in my mind as one of my friend’s mom, who had similar boils, was later diagnosed with breast cancer. As soon as mom went back to India, she visited her gynaec in Apollo hospital Mysore,’ recalls Geetha.
A few tests later, her mother was detected with breast cancer.
Saraswathi, who was 65 at the time, underwent surgery and endured eight sessions of chemotherapy. She recalls experiencing complications, including Peripheral Neuropathy and thrombosis, which caused widespread pain across her body and limited her mobility. Adding to her challenges, her diabetes slowed down the healing process, and she had adverse reactions to some medications.
Witnessing their pillar of strength go through such a gruelling ordeal was devastating for the family.
Geetha was particularly sad because she couldn’t be with her mom as her son, Aditya, had board exams back then. ‘She was always our rock in our times of need. She was also amazingly resilient. In fact, since she couldn’t complete her education when she was young, she did her BA course with me while I was doing LLB and we graduated together,’ she says.
‘My sister who lives in Bangalore, relocated to be with mum during her ordeal. It was such a blessing as chemo sessions are the most difficult to endure, unless there is proper support.’
For Saraswathi, her healing was a family effort. ‘I come from a generation where you confront problems head-on and avoid self-pity. I could not allow my husband and my daughters to breakdown in front of me. More than my pain, their pain made me face all my tests and treatments bravely as issues that needed solutions rather than mope about the condition that I had. This attitude helped all of them grow confident in my healing and that helped me,’ she says.
In her journey towards recovery, Saraswathi adopted a holistic approach, finding solace in listening to her beloved Carnatic music and reading books. Given that knitting was one of her favourite hobbies, she went on a knitting spree, crafting scores of sweaters for friends, family, and charitable causes.
‘These activities helped divert my attention away from my illness and the constant pain, and brought me peace of mind,’ she says.
In 2015, almost a year after she was diagnosed, Saraswathi was declared free of cancer though she continued medication for seven years.
Pain and the pandemic
While the family was slowly recovering from the shock they suffered and getting their lives back on track, fate decided to throw another curve ball.
In 2020, six years after her mother was diagnosed with cancer, Geetha noticed that a scar she had following an injury she sustained when she was young, had changed shape and was dimpled. Also, her toenails and fingernails were not looking very healthy but she didn’t think too much about it.
On relaying these facts to her mom over a call, it was Saraswathi who convinced her to get herself tested.
‘I was rather confident as I thought my healthy and active lifestyle would protect me from all ailments,’ Geetha says. ‘The gynaec in Aster suggested a sonography. And when the report came in, my world turned upside down – I was detected with 95 per cent malignancy.’
All alone in the hospital when she heard the news, Geetha was shellshocked. With all the courage she could muster, she went to meet Dr. Sivaprakash Rathanaswamy, Consultant, surgical oncology, Head of the Department of Surgery and Oncology, Aster Hospital Al Qusais, Dubai. ‘He laid out my treatment plan of 14 chemos, surgery, radiation and what not,’ says Geetha. ‘Later that night when I shared the news with my family, my dad broke down, while my sister and my son went totally numb. Once again, it was mom who braved it like another war to be won.’
Most common cancer
Being the most common cancer and cancer-related deaths in women in UAE with more than 20 per cent of breast cancer diagnoses happening between the 30-40 years of age group, it is our foremost responsibility to be aware and get screened for breast cancer, says Dr.Sivaprakash.
‘The most indicative signs of breast cancer that women should look out for are newly formed painless breast lumps, pink or red coloured nipple discharge, retracted/sore nipples, skin colour changes/nodules, mass in the axilla (arm pit), among others.
According to the doctor, the chances of breast cancer occurring in women who have a history of it in the family, especially their mothers, is approximately 5-10 per cent more compared to the normal population. Recommendations for high-risk/family history-positive women includes annual screening mammogram (30 to 40 years whichever comes first) and/or annual breast MRI (25 to 40 years whichever comes first), and clinical examinations every 6-12 months after 25 years of age.
As per the risk assessment and genetic counselling criteria, high-risk women can be subjected to high penetrance breast cancer susceptibility gene tests and next-generation sequencing technology. These could help early detection of cancers.
Dr. Sunaya S Puranik, Gynaecology And Obstetrics at Life Medical Centre, Al Warqa, Dubai, agrees.
‘Although breast cancer remains a global health concern costing millions of lives, we have made remarkable advancements in breast cancer research and treatment,’ she says. ‘These are revolutionising the way we diagnose, treat, and support patients of breast cancer.’
According to Dr Sunaya, technological advances in imaging are creating new opportunities for improvements in both screening and early detection. ‘The advent of targeted therapies has transformed the treatment landscape for breast cancer.’ Immunotherapy has also shown promise in breast cancer treatment, she says.
Radiation therapy, a vital component of breast cancer treatment, has also seen significant advancements.
So, what are the major risk factors for breast cancer?
Age, genetic mutations (BRCA 1 and BRCA 2 gene mutations), family history of breast cancer, previous treatment using radiation therapy, exposure to drugs and radiation, says Dr Sunaya. ‘Another contributing factor is the reproductive history of the woman. Starting menstrual periods before age 12 and attaining menopause after age 55 exposes the woman to hormones longer, raising her risk of getting breast cancer.’
Weathering the storm
Geetha’s mother Saraswathi was quick to realise the storm coming over the family and took over command. Although she wanted Geetha to go over to India for treatment, the pandemic did not allow this.
Not one to be defeated Saraswathi and her husband sent all of Saraswathi’s records to Geetha so it could be shared with the doctor. On zoom with the doctor she explained every detail of her ordeal since she thought this would make Geeta’s treatment easier. She even suggested a port for the chemos as her veins were thin, so Geetha’s could be too. And she was right!
Every day she called Geetha or her son in the morning and evening and was ready with home remedies and stories to take Geetha’s mind away from depression. She ensured her daughter was mentally fit to face all of it and fight. ‘I kept telling her she is a warrior and that she has fought several battles and had won. This too is a battle that needs to be won,’ says Saraswathi.
Facing cancer and undergoing treatment during the pandemic was a challenge. Living in the Green Community with a wonderful network of friends and neighbours, Geetha made an emergency support group of 15 people whom she knew she could count on to help her through the crisis. Her colleagues and clients chipped in moral support too. ‘Without these souls I really can’t imagine what I would have done,’ Geetha shudders.
Upon comparing Geetha’s history with her mother’s, Dr Sivaprakash found that Geetha had exactly the same set of conditions as her mother. For instance, both of them were 85% ER (Estrogen Receptor) positive and non-progressive in their diagnosis. Both were diagnosed from Stage 3 to Stage 4 and both had absolutely no symptoms or any other comorbidities except that the mother was diabetic.
This made it easier for the doctor to decide on a treatment plan for Geetha. Since she had adverse reactions to a few drugs, they used the same medication that Saraswathi used which worked very well for Geetha too.
After 14 chemos, surgery and 25 radiation sessions, Geetha was finally declared as cancer-free and in remission from October 2021.
A second lease of life
After battling cancer twice within the family, it was time for Geetha to reexamine her priorities. She has decided to take the holistic approach and cut down stress and toxic company altogether from her life. Being a single mother with a hectic career, she has incorporated the much needed ‘me time’ into her routine where she would just disconnect herself from her phone and unwind in the garden, listen to music in her home DIY studio, read a good book, play with her dog or do some cooking.
It is something Dr Sunaya would support. She advises women to lead a healthy lifestyle, with adequate physical activity.
She offers a few pointers to reduce risk of cancer. ‘Breastfeeding reduces the chances of a woman developing breast cancer,’ says Dr Sunaya. She also suggests avoiding oral contraceptive pills beyond the age of 35 years. Also, Hormone replacement therapy should be taken with supervision and regular followup. ‘If there is a family history of breast cancer, seek medical attention and screen yourself for the genes.’
Active lifestyle
Geetha does a lot of charity and spreads cheer as best as she can to create a conflict-free environment. ‘Anger, remorse, jealousy, negativity, toxic companionships, all add a lot of stress to our already loaded lives and these fertilize cancer indirectly. I am done with all that,’ she quips.
Geetha is very active and participates in several breast cancer awareness campaigns in the UAE. ‘Awareness is key’ she says.
Due to her age and medications Saraswathi does have mobility issues and recurring pain in her body, but that hasn’t stopped her unwavering optimism in her life or her love for knitting and advising Geetha on her garden and plants.
The family makes it a point to connect with one another every night at 6:30pm over Zoom, irrespective of what their schedule is.
Not one to be deterred by pain, she recently completed her certifications in Block Chain Management. She also became the BNI Konnector’s New Dubai Chapter President and will join the Chapter’s Cricket Team to try her hand at the game. ‘They have promised me two runs on the score board for every run I make, so that’s definitely a motivation to aim for at least one sixer,’ she laughs.
