WELL BEING
No room for tears
DR. SARANYA NANDAKUMAR
|
Despite a diagnosis of breast cancer, these courageous women and their families did not let the disease take over their lives.
|
No need to panic: Support systems make it easy to accept the diagnosis. Photo: K.R. Deepak
October 20, 4.00 p.m.
A ROOM filled with enthusiastic families who had gathered for a pre-Deepavali get-together to share their experiences on a common factor — Breast Cancer. These articulate women came from different walks of life, from various parts of the country and had diverse educational backgrounds. One or more family member accompanied each of them.
Hearing them talk animatedly among themselves, discussing physical appearances, the need to look well-groomed, one looking at her watch as she had to go home to make some last minute preparations for Deepavali, laughing at a joke someone made about the good calorie-rich food that was served, made me realise that time had not stood still for these immensely courageous women.
Finding solutions
Ananda, the most senior of them, laughed off her brush with breast cancer remarking that her 80-plus mother sent her to the operation theatre saying "vaidyo nArAyaNo harih". This approach, she felt, helped her accept the diagnosis with equanimity and work towards finding a solution. And a solution she did find, as today, eight years later, her life is as active as ever, flitting between continents with energy levels that could make people half her age envious.
For some it took a while, for others just a day to get over the bewilderment, shock, depression and surprise of the diagnosis. Mrs. K in her early 40s, Mrs. V a bit younger and Mrs. Lakshmi are three remarkable women who, despite having supportive husbands, did not want to become dependent on them. Instead they preferred to visit their doctors alone most of the time. As Mrs. K remarked, "the strength has to come from within, only then can the support of the husband/family, the doctor, and the treatment work." She visited the doctor alone as she felt "once the husband is around, instinctively the woman takes it for granted that he is there to listen to what the doctor says and hence does not bother to concentrate, instead preferring to refer back to the husband."
Not smooth sailing
From the identification of a lump in the breast to diagnosis was not smooth sailing for all. Other specialists examined three of them as well. In one instance, this delayed the diagnosis by four very precious months. For another, an over-supportive family with misguided attempts at showing concern suggested a series of doctors to the patient's family. Her son remarked emotionally that he wished people were aware that there were specialists to deal with such specific problems like diseases of the breast.
Three women were lucky, as their tumours were identified more by accident than by intention. For one, a routine health screen for an unconnected ailment broke the news; for another, an accidental examination of her breast identified a small lump no bigger than a pea. For Kaberi, her daughter noticed the lump first while massaging her chest for a respiratory infection.
Listening to all this, one can't help but agree with Dr. Uma Krishnaswamy, Consultant Breast Surgeon, a firm believer of using only relevant investigations and relying more on clinical skills, who has promoted breast self-examination with visionary zeal.
Valsala was diagnosed with an advanced stage of breast cancer nine years ago. A short while later, she lost her husband. Amazingly, this young woman, instead of giving in to depression, became more determined to give her only son the parental love he needed. Today, Valsala continues to work; her 12-year-old son is the pride of his mother's life. Her family has supported her on the occasions she has needed it and today V wants to give something back to society in return for the life she almost lost.
Against this context it was interesting to hear what Dr. Uma Krishnaswamy had to say about her experiences while working abroad.
While there were exceptions, according to her, the predominant emotion the patient experienced was anger. Anger at their diagnosis, anger at their husbands too which ultimately took its toll on the marriage, frustration, deep depression and a feeling that their friends too had moved away from them. A study reported in the Journal of the National Cancer Institute October 4, 2006, has documented a 37 per cent increased risk of suicide among these "patients" following surgery.
Support systems
The socio-cultural and spiritual heritage in India is, perhaps, one of the biggest support systems we have, making it so much easier to accept the diagnoses with dignity and fortitude. A concern raised by Dr. Uma Krishnaswamy was that the relative lack of these influences in other cultures could be responsible for the increased morbidity related to disease.
Mrs. Lakshmi's husband remarked that, after all, cancer was just an abnormal multiplication of certain cells in our body and had to be regarded as a recalcitrant child.
Mrs. V's son pointed out that different cancers had different prognosis and that therefore the word `cancer' should not cause panic.
Kaberi's young daughter told her mum she wanted her back home to give extend moral support for her 12th standard exams.
None of the women or their families allowed the big "C" to take over their lives. Rather, they have accepted it, worked their way around it and are, today, living examples of how much the human spirit is capable.
Mrs.V, a schoolteacher, distributed pamphlets in the local language and spread awareness of breast cancer through the economically deprived children she works with. She felt they were the best vehicles of information to their respective parents. Each onespontaneously volunteered to spend their time with newly diagnosed patients either individually or in a group.
Importance of information
Everyone reiterated the importance of information and good doctor-patient communication, which they were lucky to have at every stage. The need for improved counselling prior to chemotherapy was one area that they all felt needed improvement. Breast cancer diagnosis and treatment has made remarkable strides and clinical examination coupled with judicious use rather than misuse of laboratory tests and imaging technology can help confirm the diagnosis.
Printer friendly
page
Send this article to Friends by
E-Mail
Magazine
