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It is not rare for me to see patients presenting with locally advanced breast cancer or metastatic cancer. Many times, I would wonder why they came in late. Till a few years back, I would judge the educated ones more harshly and enquire in my mind what education had done for them. I stopped judging them a few years ago especially after scratching their tough exteriors a bit! Six years ago, this elderly lady, speaking in impeccable English almost stumbled into my office. She was pale and weak and her daughter informed me that she had a bleeding ulcer in her left breast. I examined her and found a 15 cm large bleeding, ulcerated mass in her left breast. Her blood tests showed she was awfully low on Hemoglobin. I quickly arranged for a biopsy and also had a PET CT done, almost certain, that her disease would have spread. Thankfully, I was proved wrong. She was given blood transfusions and chemotherapy was started. She was an epitome of courage and went through her chemotherapy, surgery and radiation with a quiet resilience. During the course of her treatment, I asked her why she had presented so late. What she said shook me!She said she had a paralysed husband to look after and she had been doing that for the past 4 years. She knew about the lump and that it was growing. It is just that her husband’s need was greater. That is when the judging stopped. We may boast of a secure social fabric but many times we see these lone wagers, fighting their own battles. Their health becomes secondary. Life is not easy for many. Bless her!She is well. Her dear husband passed away 3 years ago and she runs an NGO to promote forgotten skills among women in rural Haryana. I am truly proud to have known her!
Does cancer give you a new lease of life? Today, a patient, Mrs Sharma (name changed), I had treated 2 years back, came for follow up to my clinic with her very beautiful and supportive daughter.When I saw her two years ago, I was taken aback by the fact that an educated lady like her had ignored a lump in the breast completely to let it grow to the size she came to me with. Big it was....ulcerated, infected and bleeding. She had large lymph nodes in her armpit.She was weak and it made me wonder if it was the anemia due to chronic blood loss from the breast cancer or spread of disease to other organs which was contributing to this. I was almost certain she would have spread to other organs. Fortunately for her, her PET CT did not show spread to the other organs.The lady was amazing....she knew she was in big trouble, but she was most cheerful and accepting. She was dealing with a lot in life already....a husband confined to bed for two years prior to her diagnosis and a son who had lost his bearings.I knew then her reason for self neglect. She went through the entire treatment, cheerfully and recovered. She went back to looking after her ill husband till he passed away a few months back. Today she surprised me. She looked well.....and I thought a bit relieved.I examined her, went through her reports ....she was absolutely fine. She was her happy self. She dug out a packet from her bag and gave it to me.She said she had made that bag and told me how she had started this NGO to support women in Haryana. They made the bags according to her specifications.... Beautiful bag! She was putting her talent to good use and just talking about it lit up her face.Mrs Sharma had rediscovered herself and will soon embark on fulfilling yet another dream -to paint and hold an exhibition.And then she is off to Canada to meet her friend of 50 years.Wow!!I can only salute her resilience! I want her to know, she really made me proud!! For more details, please contact Dr Geeta Kadayaprath, Head Breast Surgical Oncology, Max Cancer Centre, Patparganj, Delhi, India
I am a big fan of Angelina Jolie. So what is the big deal about it? Half of the human race is possibly her fan..her looks and her acting prowess has had the world swooning. I am her fan for a different reason. I haven’t followed her movies, her drop dead gorgeous looks or her personal life but I admire her for her courage. Some years ago, this remarkable lady announced to the world that she is having both her breasts removed. She knew that she was carrying a genetic mutation which made her susceptible to breast and ovarian cancer. Her family history was strong for both breast and ovarian cancer and once she tested positive for the mutation, she knew she carried a 60-80% risk of developing either of these cancers. She was faced with the prospect of prophylactic breast and ovarian surgeries. I can only imagine the sleepless nights, the battle within-to do or not to do, several rounds of long discussions with her doctors, family and friends, the impact on her career which relied heavily on glamour, her children... and so much more. And then she made that decision to have both her breasts removed and subsequently her ovaries. She shocked the world but at the same time catapulted herself to that realm of courage and fortitude that rarely people of her standing dare to tread. I joined her fan club and her story of courage became the benchmark for women caught in a similar situation. Why I recalled this story was when I encountered my own Angelina Jolie. This young lady of 35 had a very strong family history of breast, ovarian and colon cancer on her maternal side.Her husband was gutted when she was diagnosed with breast cancer. I advised her for a genetic consult while planning for her surgery. The genetic consultant had barely advised her gene testing and was discussing the possible implications, when she said that she had made up her mind. She very calmly told the consultant that irrespective of what the test says she was going ahead with bilateral prophylactic mastectomies and bilateral ovarian surgeries in the same sitting. She came to be and conveyed the same to me. It shook me inwardly and took me a while to gain my composure as her husband stood by her, rock solid in his support of her decision. ‘COURAGE’ as a word probably does not do justice to the tenacity with which one arrives at this supremely difficult decision. I have done these surgeries before and this one was certainly not the last. Such decisions are rationalised within the multidisciplinary board, the molecular oncologists, the psychologists, the family and most importantly, the patients!! While I see more of these Angeina Jolie clones, I will always hope and pray that these amazing ladies’ decision translates into long, meaningful and inspiring lives!
Today I complete 22 years of marriage and I thought this an opportune time to look back at my life with satisfaction. My marriage was arranged by my parents through mutual friends. My husband is an engineer and the one time we met before the process began, he had decided and I was still unsure. I was trying to peer into the crystal ball, hoping to figure out how this arrangement would work for me. I was training to be a surgeon, not a choice many sensible women at that time made. The questions kept me awake- would he understand the demands of my profession, the late hours, the middle-of-the-night zipping to hospital to deal with an emergency etc? Would he understand my need to study further, maybe go abroad and work hard to give myself a full fledged career? His being an engineer did not help the cause at all. And then I stopped thinking and gave in to the wishes of my parents. When I look back at those 22 years gone by, I have plenty to be grateful for. For a woman to pursue a full fledged career is never easy anywhere in the world.What you make of it has plenty to do with the support you have. The support I had was truly unconditional. I completed my post graduation after marriage. My in-laws wanted me to carry on, unhindered, with my studies.FRCS soon followed with my parents chipping in to look after my little daughter. I went for a year long fellowship to London, leaving my daughter behind with my husband and mother in law. And did I stop? And did he stop me from pursuing my dreams? Not once! We are all imperfect in our own ways but valuing people for their strengths is what sustains relationships. His presence in my life has been the star and I can only wish him the very best that life has on offer!!
SURGERY FOR BREAST CANCER IS NOT ABOUT REMOVING BREASTS, ALWAYS… When 32 year old Neena, an HR consultant in an MNC, walked into my clinic, accompanied by her husband and parents, I could sense an air of hopelessness surrounding this good looking young lady. The papers that were laid in front of me carried a needle biopsy report, which confirmed the diagnosis of breast cancer. Fortunately, for her, the size of the lump was about 2cms and there were no lymph nodes that I could feel in the armpit. There was no evidence of spread to the other organs on imaging. I soon realized she had been through the discussion of surgery and she had come to me for a second opinion. I soon found out why she had decided to come for a second opinion. She had been advised a modified radical mastectomy (complete removal of the breast along with the lymph nodes in the armpit). She was a successful career woman with everything going for her till yesterday and today she was grappling with this tough predicament- losing an organ, an integral part of her feminity to cancer- it was almost cruel!.......... ....To be continued.....watch this space for more.......
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