From fright to fight: Charting a cancer survivor’s journey
Kanika Gupta and Anupama Rajesh
“Why me?” This was the first thought 56-year-old Sunita (name changed) had when she was diagnosed with Stage 3 breast cancer. Dealing with a maelstrom of emotions, she started questioning what she did wrong. A resident of Bengaluru, Sunita had been a sportswoman in her younger days and ate nutritious food throughout her life. She and her family had no history of diabetes or heart disease. Her diagnosis was a bolt from the blue and all kinds of thoughts ran through her mind. She wondered ‘how my life will be, will I recover, will I be able to continue the normal routine, will I have to quit my job, will I ever be able to live a normal life, and how will my family be affected’. It was difficult for her to believe that something like this could happen to her.
In 2013, Sunita was visiting the US to take care of her grandchild. “While in the US, I decided to take better care of my health. My daughter too helped me by taking charge of my grandchild’s needs while I took a break. I used to go for a swim in the morning and a walk in the evening every day. I lost nearly 8 to 12 kgs and was feeling healthy and trim,” she said.
After staying in the US for 6 months, when Sunita was leaving for India, her daughter reminded her to undergo the annual medical examination. Upon returning home, Sunita visited her general physician. After a few preliminary tests, the doctor asked her to consult an oncologist. Sunita then fixed an appointment with the oncologist who recommended a mammogram. The results were a shock to her and her family as she was diagnosed with Stage 3 breast cancer.
Edited excerpts from the interview with Sunita.
Q. How was the cancer detected? A. Due to international travel in 2013, my annual check-up was delayed. I give all the credit for the early detection of cancer to my daughter who insisted that I get a medical examination done immediately after returning to India.
After the mammogram, I was asked to undergo a fine needle aspiration cytology (FNAC), a type of biopsy. This was also positive for malignant breast cancer. I also underwent a PET scan to detect the exact areas where the cancer had spread. The doctor explained the results and confirmed that I had Stage 3 HER2+ breast cancer (a particularly aggressive form of cancer) and it had spread to the lymph nodes (present under the armpit) on the left side.
Q. What were the next steps in your journey? A. While dealing with mixed emotions and preparing myself for unforeseen circumstances, my family and I read up extensively on HER2+ breast cancer. As the treatment journey began, the doctor patiently explained all the steps. He suggested two rounds of chemotherapy to reduce/shrink the tumour, followed by surgery to remove the left breast. There were 6 rounds of chemotherapy post-surgery and lastly, 25 short radiotherapy sessions.
Q. What were the side effects of the treatment? A. I suffered from multiple challenges during the treatment but I focused on the fight and not the fright. I underwent very strong chemotherapy which destroyed both healthy and cancerous cells. This resulted in several side effects like hair loss and haggard looks. In addition to this, after every session, I felt listless and extremely tired. I also lost my sense of taste and had no desire to eat. I struggled with nausea and vomiting which also made eating difficult. Moreover, I would typically suffer from high fever on day 4 after chemotherapy.
After two chemotherapy sessions, I underwent a mastectomy where my left breast and adjoining lymph nodes were removed. The absence of the lymph nodes resulted in the accumulation of fluid in my arm which swelled. After the second and third sessions of chemotherapy post-surgery, I developed boils all over my body and had to apply medicine over them.
After 6 cycles of chemotherapy, I underwent radiotherapy. After each session, my skin tone used to turn bluish black. I had to apply a lotion twice a day and wear a cotton covering below my clothes.
Although there were no food restrictions, the doctor had strictly advised not to have any food that has been cooked and kept for more than 4 hours. Now, I mostly eat less spicy and plain food and have some fruits for dinner.
Q. How did you and your family cope with the emotional impact of the disease? A. Although the physical effects of cancer are well known, the emotional toll on the patient, the family, and the caregivers is also great. Understanding the treatment plan and disease is one thing, dealing with the emotional fallout is quite another. People may go through a plethora of emotions such as anger, resentment, guilt, shock, stress, anxiety, depression, and many more. Along with the treatment, these emotions can also be overwhelming. Therefore, enormous patience and strong support, especially from the family, are often required.
The biggest pillar of strength in my difficult journey was my husband. From an independent person who had been working for years and managing finances, I became completely dependent on my family for trivial things. My husband took a long leave from work to become my primary caregiver and kept my spirits high. My family, friends, and colleagues also banded together to help me in various ways.
To avoid infection, I restricted myself to a single room and my husband used to clean the room and bedsheets with disinfectants on a regular basis. Each chemotherapy session would take almost an entire day. He developed a schedule so that I could take the sessions on weekends and arranged for the necessary medications to be available. He and my son read extensively about the medications, their side effects, and the possible remedies so that they could anticipate and patiently deal with all my needs. My son also fixed a speaker in my room so that I could listen to Bhagavadgita and other chants to soothe and calm my mind. A co-worker who had undergone breast cancer treatment two years earlier visited me before every chemo to advise on what I could expect. Hence, I was prepared to fight this disease from the very beginning.
Even a few years after my recovery, we missed out on a lot of family functions and get-togethers because I used to get tired easily and could not put myself at risk of getting infected. Even now, after 10 years, I still feel the remnants of the condition, but I do push myself to exercise regularly and eat properly.
In this journey, my husband is an unsung hero. With little thought of self and no training, he took over the responsibilities with aplomb. A family caregiver’s journey is also difficult as they need physical as well as mental strength to manage the day-to-day needs of their loved ones while watching them suffer without knowing how long this period will last.
After finishing a major part of the treatment, my husband suggested that I resume office to slowly get back to the normal routine. My organisation was very supportive and shifted me to a role that involved coordination mainly via phone or email. It was indeed a proud moment for me as I walked into the office after nearly 6 months. I was wearing a wig, but I was comfortable in my skin and did not allow the disease to take my confidence away.
Q. How long did the treatment cycle last? A. The entire chemotherapy, surgery, and radiotherapy sessions lasted for nearly a year and a half. Later, I was placed on some other supportive medications and asked to come in for follow-ups every 4 months. Though the medications were stopped after a couple of years, the monitoring continued. After 8 years of remaining cancer-free, I was asked to come in every 6 months. I have now been cancer-free for more than 10 years.
Q. How has this journey changed your outlook towards life? A. I remain eternally grateful for the enormous support that I received during my journey towards recovery. Cancer has changed me, but this change is beautiful as it has taught me the true worth of the incredible people I am surrounded with. I am now in a much better place both mentally and physically. As a survivor, I also feel a sense of responsibility to help other cancer patients. I have seen some people suffer from cancer in my workplace and have provided support and guidance. My husband also reaches out to his colleagues or their families who fall victim to this condition and offers them support.
Like Sunita, many women are falling prey to this insidious disease because of a lack of early detection and awareness. Breast cancer remains the leading cancer in Indian women. As per recent estimates, one in every 29 women in India is at risk for developing breast cancer during her lifetime1. Since most types of cancer do not present with symptoms, let us pledge to undergo our annual physical examinations without fail to catch this disease before it becomes unmanageable.