Fighting Stage IV Cancer

‘Avoid the first person singular pronoun’ Father Silvera had dinned into us. Sorry Father, this time I need to break the rule. So far my blog posts under ‘satish-oneeyeclosed.blogspot.com’ have been satirical in nature. There are, however, some matters serious enough to be looked at with both eyes open. And few things are more serious than Stage IV Cancer.

It is almost two years since I was diagnosed with Stage IV--final stage--Adenocarcinoma of the lung with a secondary in the radius bone of my right forearm. It had evidently got into my blood stream. The prognosis seemed exceedingly bleak, with talk of ‘at best a few months’. Four rounds of Chemotherapy and two Supra Major surgeries –Lobectomy of the left lung and replacement of the right forearm radius bone with a custom built Titanium replica made in England –were followed by two more rounds of Chemotherapy and, to everyone’s surprise, I was declared Cancer free. To quote one of the country’s leading Oncologists from Tata Memorial Hospital, ‘with you we are entering uncharted territory’.  I have since then remained Cancer free with periodic check-ups and some new age Targeted Molecular Therapy. A few doctor friends have been urging me to speak out openly about my experience in the hope that it might help others.  What has worked for me, so far certainly, may not work for everyone but it might be worth a try. So here goes:

1.      When the news of Stage IV Cancer Diagnosis is broken to anyone, the first reaction is bound to be shock, followed by How Can This Happen To Me? Doctors goofed, Technicians goofed, Hospitals goofed …forget it. Face the problem squarely if you want to have a chance to deal with it.

2.      Don’t bother about keeping the information a secret. Cancer news is more radioactive than nuclear knowledge in Dr. Khan’s hands. It is bound to spread. Preempt it by sharing it with your nearest and dearest. They are entitled to know. One or two days of shock and every healthy person above 12 years can cope with it.  That allows you to concentrate on important decisions, without worrying about trivia like ‘x won’t be able to take it’ and ‘why was y told and not z?’

3.      To fight Cancer, you need resources. Medical Access, Manpower and Money. Assess your resources carefully even as you try to decide your line of action.

4.      Your objective, even if you are the richest person on earth, should be to get the best medical treatment at the most reasonable price. Remember, expensive does not always mean the best.

5.      Some tough decisions will need to be made---and few of us are trained for life-or-death decisions. Sincere advice will pour in: try alternate medicine, try spiritual healing, there is a miracle doctor in Gangtok. Ask yourself: which of my well wishers are knowledgeable enough to advise meaningfully and have the stamina to devote the time and effort which will be needed?  You must be smart to pick a sensible 3/4 member family/ friend decision making and support team of your own. Some people revel in researching options with long Google sessions; some excel with diets, others are smart about money and insurance and some have a knack of navigating through complicated hospital systems. All areas are important, choose a balanced team.

6.      With your support team in place, choose your main Medical Adviser. S/he need not be an Oncologist, but should be able to help you figure out who will be a good Medical Oncologist for you. S/he will help steer you through the maze of Chemotherapy, Surgery, Radiotherapy and Alternate Therapy decisions, so practically 24x7 availability at least on phone is extremely important.

7.      Select your Medical Oncologist/ Facility with care. At Stage IV, more than one organ would be involved and more than one specialist will be needed but your ‘lead’ doctor is likely to be a Medical Oncologist. Your Medical Adviser will help you choose not just your Medical Oncologist but also a facility where, preferably, all expertise/ services will be available under one roof at rates you can afford.

8.      In case of conflict, go for better Medical Expertise rather than just 5 Star Facilities: Expertise is priceless, Scans are priced and you have choices.

9.      Get your full primary line of action or Protocol sorted out before starting treatment. Also, as your second string, decide on one Alternate therapy, with the knowledge of your Medical Adviser; I chose Homeopathy. Simultaneously, have your Diet plan chalked out.  Have faith in your Med/ Alt Med/ Diet plan but review it once a month with your team to see if everything is on track.

10.   Most important, once your treatment starts, give it time to work and FORGET YOU HAVE CANCER. Concentrate on an activity of interest to you. I focused on Internet Bridge and set specific ratings goals. During reduced immunity periods of Chemotherapy, I wore a mask to work but did not miss any important working day during the 5 month treatment period. And since few things can be more devastating for a writer than the loss of his right hand, I learnt to type with my left hand--it is easier than you think-- and managed. All this to ensure that while the body fights Cancer, the mind gets a break from Cancer.

From Diagnosis to forgetting Cancer, you have about a week or two with luck. I am acutely aware that I have been incredibly lucky in other ways too. The Chemotherapy medicine which evidently worked for me with manageable side effects came into the world market only in 2008; the diagnostic technique which was the key came to India only in 2005 and some of the implants/procedures involved in my forearm surgery were among the first two or three in the world, amazingly ensuring practically no long term loss of hand functions.

Fighting Stage IV Cancer is possible and Forgetting Stage IV Cancer is also possible; forgetting the Doctors who did the fighting is not. So, in the sequence in which they did the fighting for me, Dr. Hemant Tongaonkar (Prof. of Surgery, TMH), Dr. Kumar Prabhash (Medical Oncologist, TMH), Dr. Manish Agarwal  (Orthopedic Surgeon & Oncologist, then TMH, now Hinduja), Dr Raman Deshpande, (Prof. and Surgeon, Thoracic Oncology, Raheja Hospital), and Dr. K.P. Muzumdar, Doyen of Homeopathy, here’s a sincere, heartfelt thank you!

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