A courageous battle with cancer

When my mother was afflicted by breast cancer some three years ago, the first reaction, predictably, was one of shock. How could it happen to someone so dear? Why her? A picture of health one day, a patient the next? How can that happen? Soon enough, hopelessness, frustration, anxiety and a host of other debilitating emotions set in. Frantic attempts to look for information on the internet and consulting with friends only led to more negativity and anguish. I either came across the Reader's Digest kind of survivor stories or extracts that expect the patient or the caregiver to be superhuman if they have to make it through the ordeal. Not only were the precautions intimidating, the data on the sites didn't deal much with the less clinical and more human aspect of living through the disease.

Then a year ago, a very dear cousin, Chitra Vasudevan, was given the same diagnosis on the day of her 50th birthday. A management professional who gave up a two-decade career to work on community-oriented projects, she runs an NGO in south India. Residing in New Delhi, she also volunteers for National Trust, a government organisation in the area of developmental disability. She teaches classical music over Skype to village kids and other aspiring young musicians in the US, Indonesia, Sweden and various parts of India.

When she was served with what she calls the "most dramatic surprise of her life", she did what many in the age of information overload do - she surfed the internet for every scrap of information on how to survive cancer. But she did not find any account of the real issues thata cancer patient has to deal with. So she decided to write her own.

Vasudevan offers a first-person account of what it was like to be diagnosed with breast cancer, the surgery that followed and life after it:

The discovery

Like geniuses getting their inspiration for discoveries from everyday observations, I too stumbled upon my discovery routinely. One morning in August 2010, while in the shower, I felt a little lump in my right breast. I first dismissed the finding as a figment of my imagination. But soon I decided that it was something I needed to pay attention to. There was no pain so it couldn't be anything bad, I reassured myself. I mean bad things cause pain, don't they? My next dilemma was whether to tell someone about it or see a doctor. Finally, I decided to do neither. Instead I made up my mind to "will it away".

Three weeks later, the lump was still there so I made an appointment with the doctor. After she examined me, she said, "Nothing to worry [about], get a mammogram done anyway and we shall see." I was to go to Chennai to attend a family wedding but I decided not to keep the mammogram waiting. For a first-timer, a mammogram is an unsettling experience, and it didn't help that the attendant was rude and indifferent.

Looking through the mammogram reports, the doctor said I could come back to her for a "further course of action" after returning from my trip. While in Chennai, I took some time away from the celebrations to see my gynaecologist. Seemingly reassuring, she said, "Let's do a simple biopsy to rule out any malignancy." The report proved inconclusive. Nevertheless, my family doctor advised surgery to have the lump removed.

Back in New Delhi, I made an appointment to see an onco-surgeon who specialised in breast surgery.

The tests now went into full swing. While the various investigations were on, my onco-surgeon updated me on the options that I had at every stage. More and more reports came in. With every subsequent visit to the onco-surgeon, it was obvious we were only looking at a set of ‘ifs'. Nothing was proven beyond a doubt, yet. The lump didn't seem harmful but it didn't seem harmless either. Yes, no, maybe, maybe not... He finally suggesteda lumpectomy, where a frozen section biopsy could determine whether it was malignant or not.

In one of our earlier interactions, I had been told that the surgery could last about an hour. I would need to be in hospital for some 48 hours or a little more, if found necessary.

So I checked into the hospital.

The day of surgery

On October 12, 2010, the morning of the lumpectomy, I was up early as usual, had a shower and was ready by seven. My surgeon peeped in around eight. "How are you?" he asked. "Great," I replied. In the operating theatre, the doctor's first assistant chattered away, asking me my medical history all over again. I realised he was helping keep my mind off the surgery. "Could you put on some music even if I am under anaesthetic?" I asked. Yes, he could. The last I heard was an instruction to play some music and the last I remember was the anaesthetist asking me my name while pushing a tube into my mouth. And yes, I also remember praying...

I woke up some three hours later. I was quite clear-headed and looked at myself and realised they had indeed done a mastectomy. So it was cancer! My eyes welled up for a moment. Now wide awake, I looked around and realised I was in the recovery ward. Did I feel pain? Not much really. But the plaster on my chest was huge. A part of me was gone, forever.

Information overload

The moment you are told by doctors that they need to rule out "anything serious", your mind starts working overtime. You start doing your own research using the most easily available source in today's world - the internet. You also talk to doctors in the family, to friends who have counselled cancer patients and friends who have had someone in the family go through the ordeal.

The web is an exhaustive resource of information from medics, patients and cancer-care sites set up and run by companies making drugs for cancer, or at times by people getting together in an endeavour to help. To sieve through this information and get the most reliable, positive, non-depressing, non-scary site is a Herculean task. Every time I had a report on my hand, I would google for a term mentioned in the reports. The search would often lead me to sites that told me it could be cancer - even if the chances were a mere 1 per cent. I soon gave up my dependence on the internet as it was making me paranoid. I would read up to a point and give up if it suggested the worst. I wished there could be more sites offering hope.

The medical fraternity believes in being objective about what they tell you. The underlying philosophy is to call the situation black or white; it can never be grey. And most often it is black unless proved by all tests to be white. But then they are in the business of curing people and so the accent is always on the disease.

Friends and relatives always worry for you. You are inundated with concern. Despite great advances in its treatment, cancer is still believed to be a disease without a cure - dangerous and life-threatening. There is much panic at the mere mention of the word. To see your near ones so concerned makes you feel worse. I therefore took a decision to talk about my illness to select people only. Official contacts and colleagues were told I was going through a surgery and would need to rest.

Post surgery

It took me a while to realise that there was a little pump attached to a discharge tube fixed under the plaster. Some liquid was collecting in there. This tube was to become an integral part of me through the week that followed. I was put on intravenous feed. The surgeon came by, examined me and said all was well. He helped me to my feet and to walk a few steps. I could have a normal diet from the next day. Did I feel pain? Not much, except when I tried to lift my right hand. I could not raise it even up to the shoulder. The area under plaster was completely numb.

The next morning, the doctor asked me if I wanted to stay a day longer at the hospital. I opted to go in, assuring him that I would take care and monitor the post-surgery discharge every 24 hours.

At home

Back home, I recalled another operation I had undergone 20 years ago - a simple appendectomy. That was theother time I had come home straight from the hospital after a surgery.

A week later, the doctor took off the discharge pump and replaced the big plaster with a band-aid strip. The sutures were big, pink and bold. "You can have a shower, but avoid water on the surgery patch until we remove it next week," he advised.

The following week, the junior doctor came along andI pleaded, "Give me some local anaesthesia [LA] please;I am told this is a painful procedure."

"No LA, no GA [general anaesthesia], only VA for you," he said with a straight face.

"What's that?" I asked. "Vocal anaesthesia!" he shot back, and we burst into peals of laughter.

As he removed one stitch after another, putting them neatly in a little saucer, he kept chatting to keep my mind off the stitches. But he need not have been so kind because it was practically a painless process.

"It's done," he said, dropping the last suture in the saucer. Little pin-pricks and after a while, no sensation at all. "We cut off some nerves when we do the surgery so it will be a while before you regain sensation in these parts," he explained. He advised some exercises for me to regain movement in my right arm. "Crawl your hands up the wall," he said, "until such time that you are able to stretch without pain." Sure enough, over the next four weeks, I became perfectly fine.

As for everyday life, it was business as usual during all phases of the treatment. I continued teaching music over Skype even between the chemo sessions and carried on with my work.

Chemotherapy begins

On November 9, 2010 the chemotherapy sessions began. One of the well-known side-effects of chemotherapy is loss of hair. It was among the first things the doctor had mentioned. "But it will grow back, quickly," he had also added reassuringly. "The medicines you are being given attack all the fast-growing cells (fast-growing cells area characteristic of cancer). However, not all fast-growing cells are cancerous - like those in your hair and nails. But the medicine affects all fast-growing cells irrespective of their nature and that's why you lose your hair."

And how amusing it was to see that happen. After the first week of chemo, brushing my hair meanta mass of tangles. Undoing them meant watching my hair come out in bundles. By the end of the week, my thick braid had turned into a pony's tail, then intoa mouse's tail and finally, there was no tail at all. Just a few strands still valiantly sticking to the scalp. These were reminders of the fact that one day, the hair cells would grow back.

Getting a wig was easy but getting used to it wasn't. Particularly when you are talking. As you speak, you feel it moving this way and that and soon it's almost coming off! Wear it tight and you get a headache and want to be rid of it the next moment. Wear it a little loose, it falls off without warning. To find the right fit, takes time and I learnt that by trial and error.

Last treatment

On March 3 this year, I had my final chemotherapy session. As you go through the treatment, you realise it is just as good as you take it. If you get bogged down by the disease and feel sick, you will only feel sicker as the treatment progresses. On the other hand, if you start to notice how all the dire predictions by people of the things that can go horribly wrong don't go wrong, you feel there is much to rejoice about your condition.

I counted my blessings. I looked for positive affirmations. A friend who has counselled several patients emailed me some healing music. All these helped me keep my mind healthy. If you keep the mind healthy, the body stays healthy too. This realisation is not easy to come by, but once you accept and start working on keeping your mind healthy, the treatment becomes that much more effective and tolerable.

Final tests and the verdict

In March this year it was time for my final tests and the verdict. "All is fine," the doctor told me. It was finally over. I was free of cancer.

I have been advised to have a twice-a-year checkup for the first two years, and once a year thereafter.

My take from this entire experience? Form your advisory/support group with care. Look for positive, objective and caring people to be with during this ordeal. Faith is the greatest healer. Have faith in God, in your doctor, in yourself. The only way is forward.

Inside info

Chitra's experience has helped a few people whose lives have been affected by cancer. If anyone needs counselling or wants to talk about the condition, Chitra is willing to share positive energy at chivas@vsnl.com