[V.Narayan]

Background

Our lives are always a mix of some blessings and some hardships. And once in a while the Good Lord above tosses in a surprise – at times pleasant and at other times not so pleasant. All of these are an integral part of our karmic journey of learning and evolving.

God had blessed me with many many things – material success, a wonderful spouse, great kids, and robust health. However 4 months ago I received a blessing of a rather unexpected kind. My doctor called me out for suffering from cancer in both my prostate and one of my kidneys. By the time you get to my age most of us have seen a lot in life but trust me nothing can prepare you for this news. And like most others I went through my cycle of anger, denial, low morale and then finally batten down the hatches and into battle we go.

This article is not on my cancer but on my lessons over the past 4 months and I hope readers who ever have to face this dreaded illness can in some tiny measure be helped by this essay.

My wife suggested I pen it down not only for any little benefit it can provide to others, but also as a therapeutic exercise for my own self. I'll be sharing it on the Whatsapp class alumni groups of my two universities too.

Before I jump into the learnings – I underwent a major surgery to remove my right kidney as no other cure was possible and am currently undergoing radiation therapy and hormone therapy for the prostate. The former will conclude in a month. The latter goes on till early 2025. It is a long battle with the side effects often more difficult to cope with than the initial treatment. But it is a part and parcel of a karmic journey and I am happy to embrace my cancer, make friends with it and move forward.

[V.Narayan]

Key lessons I’d like to share

Annual medical checks.

An annual medical check up is a great way to catch this disease early. An earlier catch improves the chances of a full recovery geometrically. Cancer typically, though not always, gets broken into 5 stages. So the Doc will say, “you’ve got Stage III cancer”, for example. The depth of the disease at Stage V is 2X or 3X worse than Stage IV which in turn is 2X or more worse than Stage III and so on.

I used to get a check done each year since IIRC 2003. Then covid19 came and I skipped 2021 and 2022 and boom come January 2023 and I get hit by this double whammy. If I had got my normal medical checks done in ’21 and ’22 the likelihood of an earlier catch would have increased significantly. My mistake. The first sign I might be in trouble came from a routine blood test I got done by chance. I was very fortunate that the prostate was at Stage III progressing to Stage IV. A few months later things could have been much worse for me.

Cancer does not grow in a linear fashion. It can hide.

My prostate cancer has evolved between August 2020 and December 2022. I have a test from August 2020 when I’d undergone an unrelated day care surgery which tested my prostate and found it to be normal. However my kidney, where the cancer is unrelated to the prostate and evolved separately has it seems, been growing slowly over a much longer period of time even though there were no signs of trouble whatsoever.

Consult at least two doctors to determine your course of treatment

It pays to talk to more than one doctor. While medicine has advanced cancer remains a mysterious disease that has a knack of outwitting us. Talk to 2 doctors/hospitals to understand the array of treatments available to you then go with the doctor you are most comfortable with. I chose the one most competent even though he is gruff and a little uncommunicative and I had his recommended course of action vetted by an oncologist friend in USA.

List out your questions. Write down the answers.

You will need several visits to the Doctor even before your treatment starts. It helps to prepare a list of questions and go with a note book to write down the points the Doc makes. You may not recall everything later unless written down. No matter how strong we are inside these meetings especially the first few can be quite stressful.

You may ask:

• What kind of cancer do I have?
• Where is the cancer?
• Has it spread?
• Can my cancer be treated?
• What is the chance that my cancer can be cured?
• What other tests or procedures do I need?
• What are my treatment options?
• How will the treatment benefit me?
• What can I expect during treatment?
• What are the side effects of the treatment?
• When should I call my health care provider?
• What can I do to prevent my cancer from coming back?
• How likely are my children or other family members to get cancer?
• What happens if I don't get treatment?

Consider bringing a family member or friend with you to your appointments. They can help you remember what you hear.

Get in touch with your feelings

Just as cancer affects your physical health, it can bring up a wide range of feelings you’re not used to. Having cancer can also make many feelings seem more intense. These feelings may change daily, hourly, or even by the minute. These feelings are all normal.

Learn how to recognize the wide range of emotions you could be experiencing, including:
• Feeling overwhelmed
• Denial
• Anger
• Fear and worry
• Hope
• Sadness and depression
• Stress and anxiety
• And always, “Why Me”?

For some people, looking for an answer to “Why me?” can cause sleepless nights and soul searching. Others find that it doesn’t really matter why something has happened – how best to deal with it is more important. Worry can drain you of energy that is needed to help cope with the illness.

Don’t fight to be happy or brave. On days you are down just go with that flow, accept it, curse if you need to and lower your targets for the day. Tomorrow is another day.

No matter how strong we are inside ourselves, how spiritual, how mature trust me cancer creates unspoken stress of a new order altogether. After having faced my own fair set of challenges and tragedies in life I can say hand on heart that cancer knocks you off your feet. Accept it, curl up and have a nap, go for a walk, have a cry, say a prayer; just don't burn your limited emotional reserves trying to put on a fake brave front.

Adjust to the new normal.

Cancer will most likely result in pain and discomfort. Each cancer brings along its own unique basket of troubles. In my case as there is only one kidney left pain killers of any kind are forbidden for life. So there was no choice but to bite my tongue and get on with it. Fortunately that phase is over. It was the first fortnight of March where even posting on Team BHP came to a halt! – that much pain !!! :-)

Depending on the kind of cancer and its stage there will be a new normal to adjust to. It could come in many forms – weakness, degeneration of muscle & bone tissue, imbalance in body salts, drop in iron, need for a walking stick, nausea, bleeding, difficulty or pain in bowel movements, loss of appetite, significantly reduced stamina for work & movement, insomnia, loss of hair on the head and so on. All of these other than loss of hair I am dealing with. The treatment more than the cancer per se cause these multitude of side effects.

For me cancer has been a great exercise in ego deflation. Nothing like not being able to perform basic bodily functions without the help of a grown-up child or a male nurse to carpet bomb all your material success, titles and awards.

Even after you recover from cancer you are often not the man/woman you once were. That takes some getting used to.

Re-prioritize your goals to the reduced time and strength you now have

Figure out what's really important in your life. Cancer forces us to relook at our aims and ambitions and focus on the priorities only because we are now short on energy and time. Find time for the activities that are most important to you and give you the most meaning. Check your calendar and cancel activities that don't meet your goals. Re-look at your longer term life goals. Try to be open with your loved ones. Share your thoughts and feelings with them. Cancer affects all of your relationships. In my case I got off one company's Board. My tenure 5-year was ending in any case, and I requested they don't renew it. I used to serve on the resident's association of my complex - a rather aggravating role and have resigned from there. Each of us will have items like these to weed out.

Communication can help lower the anxiety and fear that cancer can cause. Even if they don’t voice it your loved ones will be worried about your longevity, even if you are not.

Work out your finances

In cancer treatment, money flows like a river. My bill is in lakhs of rupees and cost wise I’m not even half of the way through assuming no other surprise crops up, which easily could. Depending on your insurance cover and financial resources you should plan out your cash flows. Having to stop a treatment halfway could be lethal. In our case my wife and I have a joint plan with Max Insurance and it covers everything from head to toe. For years premiums went out without us ever using it and then in 2022 my wife needed a minor surgery and in 2023 I will end up consuming up all the premiums we paid over the years! If you are in your 30s or 40s please take out your own health insurance right now.

Please don’t depend on your employer's insurance alone because one day when you retire the insurance wallah will often find you too old to insure on a standalone basis at an affordable price.

As a part of re-organizing yourself, write out a will and register it. God forbid if something were to happen to you this is the least you owe your family.

In my case a couple of days prior to my surgery I walked my eldest child through the family finances and whom to contact for what in case something were to happen to me. Macabre but practical.

Stress on your family. Your own physical depletion

Other than the patient cancer creates physical and mental stress for the immediate family. As you can imagine the multiple visits to the hospital, various therapy sessions, the burgeoning bills, the need to help the patient with basic physical movements all take their toll. One has to account for this factor to make it sustainable.

Similarly take care not to overestimate your strength {your body, bombarded by cancer drugs, injections and ray is weaker than you think} or underestimate your weakness. In my case my moment of truth came when one evening doing my walk in the garden after 2 kms I was so tired I needed help of a neighbour to help me get home. For a person like me this was a shock on the nth order. We discovered that an injection I am taking depleted the sodium, chloride and potassium levels in my blood far more than anticipated. Everybody responds to cancer inputs in its unique way.

Alternate Medicine

Every well-wisher will become an expert on suggesting alternate medicine full of anecdotal miracles to cure cancer. I prefer the tried and tested route of allopathy and modern medicine when my life and limb are at stake. So, this route is simply not for me.

Try alternate medicine if you must but please don’t replace your main line treatment under modern medicine for this.

[V.Narayan]

Conclusion

In conclusion:

In addition to the above there are several other facets you may have to learn to deal with such as anxiety of your loved ones, your own fears of your mortality, accepting the fact that you will never ever be the man or woman you were, and so on.

As I said earlier nothing prepares you for the 360-degree 4-dimensional war that cancer wages against you. One thing to come out of a battle with cancer is that once you have fought and won over cancer generally speaking most other battles or problems in life are likely to seem simpler. Cancer envelopes you totally – physically, spiritually, emotionally and financially. It is a total war, winner takes it all situation unless you catch it in Stage I. So, if you need to, fight the good fight. As the old cancer quote goes, 'you never know how strong you are till being strong is the only option left'.

The best thing I have got out of my ongoing tryst with cancer is that earlier I had 7 days in a week and 30 days in a month. Now I have 168 hours in a week and 720 hours in a month. Nothing like a reminder of mortality to suddenly widen the time available exponentially.

Thank you for reading.

[Aditya]

Thread moved out from the Assembly Line. Thanks for sharing!

[keroo1099]

Thank you for this honest from the heart 'as it is' post which I hope others will follow. Wishing you a swift recovery

[rajeevsulu]

Sir, you have taken the dreaded disease on the chin. I doubt if anyone could write out the gamut of feelings that a cancer patient goes through better than this. I deal with oral cancer and the toughest part is getting the patient motivated enough to co-operate with us and to actually go beyond and fight the disease. We often see that fighting cancer by medical, surgical and/or radiological means is 10% the battle. The rest of the battle has to be won by the patient along with his family and friends. You, sir, are a warrior!! You will win the battle and the war as you are so prepared! Congratulations already, good sir!

[dailydriver]

God has given us two kidneys so that we may live long even if we lose one; don't worry sir!

God has very strange ways of testing us; after directing you to help scores of kids get through their health concerns, he is making you taste your own medicine! Reading the above post, it is pretty clear that the trick is indeed working.

Not for nothing have our forefathers coined the phrase: God helps those who help themselves.

I am glad you are recovering; am proud that you have mustered up the courage to share the lessons learnt; am hopeful that course of treatment will be short, sharp and successful.

What surprises me is that even while going through a weighty health crisis you have maintained your usual mojo, as can be evidenced in your recent posts on the forum. My respects sir!

From your various inputs and anecdotes across different threads, you have been an inspiration to many; you will no doubt be the same here too.

Wish you and the family all the strength to tread through the path of recovery. Our prayers are with you.

Best wishes.

[Axe77]

Thank you for sharing this very personal experience with so much clarity. Even in your illness, you’ve been conscious to educate and spread awareness for the benefit of others - I think that alone shows a certain bend of mind, which one can only appreciate as well as attempt to emulate in one’s own life.

I wish you a very speedy recovery sir. This is definitely an extremely useful reminder as well as articulate guide. The first thought that came to my mind was my extremely long overdue full health check up that took a back seat because of covid but no reason not to have done it in the last couple of years. The second is to revisit and audit our comprehensive family health policy periodically to check for the strength and adequacy of its coverage (although I had taken care about this while taking it).

If I may ask one question, has it been easy to continue receiving the health policy even in old age (I am taking the liberty to assume you are in your late 60s or maybe early 70s) assuming you had started this well before your 50s? Can insurance companies refuse to offer coverage at some point or are they bound to do so regardless of age if you have started your policy at an earlier age and continued it without a break.

[volkman10]

Wishing you a swift recovery and appreciate the fact you continue to educate each one-of us even in the situation you are in.
Wishing you and the family all the strength to the path of recovery. Our prayers are with you.

[vb-saan]

Thank you for sharing your experience, and the effort to spread the awareness. At least in my small circle I see more and more success stories recently of brushing away the C (just in the last two years), and I see one more addition into that

And thank you for the timely reminder. The insurance policies are all in place, but I need to add nominees to my CPF and insurance; been slacking on that for a while.

[kiku007]

Thanks for sharing your deeply personal and challenging experience to educate others.

Your handling of the situation is yet another example of you standing tall from the rest of us to demonstrate your high level of grit, resilience, humility and maturity. Huge respect.

I wish you the very best in your path to recovery.

[noopster]

This is shocking to hear Narayan, sir. I wish you all strength to fight this battle and come out healthy.

Cancer always takes you unawares. My wife has lost both her parents to the dreaded C, her mother just in 2019 to a fast-acting terminal cancer in the brain. We hardly had any time to grapple with the diagnosis, let alone process the rapid deterioration and the ultimate end. Logic and science go out of the window sometimes in dealing with this disease, which is why your rational and step by step guide is so appreciable and useful.

You seem optimistic of a positive outcome and I wish you the very best. My late father was a cancer survivor himself, being struck in the prostate in his mid 60s. The only cure was radical prostatectomy and he opted for it. It bought him 15 more precious years, albeit with the inevitable lifestyle adjustments. We treasure each moment of that time, as does your family for you. Including all of us here at Team BHP.

Stay strong and fight the good fight!

[shancz]

Wishing you a speedy recovery and Thank You for sharing your experience
The info is quite helpful and some takeaways for everyone.

Living through a nightmare and then gathering oneself up and marching on is the unmistakable trait of strength.

Like the old saying goes,
when the going gets tough the tough get going.


Admire, Respect and Best Wishes for your recovery.

[Samurai]

Wow, thanks for sharing this shocking and arduous experience. Both my paternal grandparents, all 3 of my paternal aunts were victims of cancer. So my father was very sure he was going to get it. But he didn't, and passed away peacefully and quickly one day in his early 80s. It skipped my father, but will it skip me? That's a thought I get once in a while.

What are the specific medical screenings for cancer? Is it something we can do every year?

I wish you very quick recovery...

[androdev]

Wish you a very speedy recovery sir. May the good wishes of thousands of people who have been touched by your work give you and your family the strength to come out of this unscathed. Thank you for sharing your experience, though I sometimes wish I live a very ignorant life like our ancestors.