arun and tas

In the midst of life we are in death. While seeming poignant, this is not merely a truism, it is true also about our bodies at the most basic level – cell growth and programmed cell death. Yes, Machiavellian though this sounds, all our cell growth is also accompanied by regular cellular death, always well programmed so that our cell numbers as well as their boundaries are limited to parameters that should fall within normal – a process known as apoptosis. Even while we begin life’s journey as a fertilized 2 –PN, we are already using apoptosis to kill certain cells at precisely timed intervals and thus grow into well designed structures that throughout life will need this self-destruct programme to keep ourselves free of uncontrolled, untrammeled growth.

Because basically, that is all that cancer really is. A wild wanton proliferation of certain cells which somehow have got around this mechanism and are like rouge elephants on the rampage, eating into the reserves that allow the rest of the body to grow . They are in a sense, wanting to be eternal and there are certain cell lines in labs over the world where these really have gone through umpteenth cycles of cell growth without signs of dying. While arun and tas grapple with this unfair and seemingly thoughtless, senseless suffering of their mothers we are all rooting for them- hang on in there because this war is won not just with drugs, surgery and radiation, but also with your mind. And that is what your mother has already grasped on a fundamental level- optimism and confidence are going to help her cope more than medication will though that is a given and cannot be bypassed. But here I want to stress a few things – cancer is curable and often detectable quite early, if you pay heed to the warning signs that your body is showing. The 7 cardinl things to look for are well known, but a quick look will often revise our memory.

Warning Signs: What to look for 

1. Unusual bleeding/discharge: Blood in urine or stool. Discharge from any parts of your body, for example nipples, penis, etc. 
2.  A sore which does not heal Sores that: don't seem to be getting better over time are getting bigger or getting more painful starting to bleed 
3. Change in bowel or bladder habits Changes in the color, consistency, size, or shape of stools. (diarrhea, constipated) .Blood present in urine or stool 
4.  Lump in breast or other part of the body: Any lump found in the breast when doing a self examination. Any lump in the scrotum when doing a self exam. Other lumps found on the body. 
5. Nagging cough: Change in voice/hoarsness. Cough that does not go away Sputum with blood 
6. Difficulty in swallowing : Feeling of pressure in throat or chest which makes swallowing uncomfortable Feeling full without food or with a small amount of food .
7. Obvious change in moles Use the ABCD RULE 

• Asymmetry: Does the mole look the same in all parts or are there differences? 
•  Border: Are the borders sharp or ragged?
• Color: What are the colors seen in the mole? 
•  Diameter: Is the mole bigger than a pencil erasr (6 mm)? 

While I am quite aware that we still have no fool-proof method to detect and unfortunately, to treat cancer, there are a number of screening tests that are often not pushed well by the medical fraternity and if so, not seriously taken up by the layperson. I will quickly go through these as a pointer, - you can ask your local doctor for details.

For women- 

1. A yearly PAP smear and a trans-vaginal ultrasound scan to pick up that smallest increase in your ovarian size, shape etc. and to detect early changes in the lining and shape of your uterus. Endometrial and ovarian cancer occur at all ages, are most difficult to detect in early stages and this is the only fool- proof method known to docs right now. The PAP and TVS are both painless girls , so off with your inhibitions ( as also necessarily your clothes- your docreally does not look at you that way!)! If required your doc can recommend an additional CA_125 blood test to determine if you are at risk. 
2. A monthly self- examination of your mammaries ( aka breasts) preferably before your periods- you can read details of this simple exam on the net. Again, a small stage -1 growth here is easily removed without disfiguring surgery now, so please don’t be an ostrich, go and see that surgeon even if the lump feels just pin-head size. He/she will not laugh at your fears and there are very few pawing perverts among us, believe you me. For those with a strong family history of oestrogen –dependent growths- fibroids ( in the uterus), fibroadenosis(benign lumps in the breast) and h/o uterine cancer in first degree female realtives, a 3-5 yearly mammography is a must have. I know the mails doing the rounds for this investigation, but seriously traveling in delhi by DTC would probably have you at more risk of being squeezed and feeling worse off mentally. Your doc can recommend BRACA gene testing if you have a really strong family h/o breast cancer/ovarian cancer.

For men 

1. Your yearly health check up should include a per-rectal examination to detect changes in your prostate- again an uncomfortable but not necessarily painful procedure. A better option would be a trans- rectal ultrasound, machines aren’t subjective, can give you a base-line report for further ref and are highly sophisticated now. 
2.  A yearly or six-monthly blood pressure reading and basic levels like a lipid profile, a sugar level and a total count- wbc levels, rbc parameters and a differential count and most important a routine urine and stool analysis will pick up certain aberrations. This holds true equally for the women.

In the meantime from someone who’s seen this disease up close, and not just professionally, please don’t think its only curable, its preventive- eat healthy, pref vegetables- their fibre is a sure shot way to waylay colonic cncer, cut down on that pan-masala and spit out that paan, go easy on the caffeine, the theobromine and the nicotine- do we really need these props 2 feel good? Exercise as much as you reasonably can. Keep a positive gung-ho attitude and enjoy the small pleasures. Do smell the coffee (only don’t drink humungous amounts!), try for the stars (not the tinsel type-u’ll have a grt fall), fly for the stars, crawl on the carpet, growling at your pooch- (who is giving you quizzical looks with half-cocked head- wot? Has she suddenly decided to become 1 of us? But where in gods name is her tail? ), hug your children as many times as they allow you and kiss them resoundingly (despite bad faces and howls of – Maww!), go crazy in the rain, insist that your partner holds you tight at least once before sleeping and once before getting up and guys that means just a cuddle, not an invitation to u-no-what each and every time! And finally our miss has it pat down- she doesn’t have cancer- it’s the poor deluded bacchas and the equally clueless docs who think that she is sick- her faith will move mountains and this cancer is merely a molehill. So take care, we are with both of you, tas and arun. And for all the countless who have traversed this journey or will have to god-forbid, sometime go thru it, I can only quote – for even though I walk through the valley of the shadow of death, I will fear no evil, because my deeds and my goodness protect me and I shall triumph.