He was not our friend. Nor was he a relative. Not even a neighbor, yet he was our solace during our worst of days. This is “his” story- of Mr. Rao (name changed on request).
As we walked in to the hostile looking Oncology ward in Manipal hospital for the first time, little did we know what was actually in store. Of course we had read up on the “not so nice” side effects of chemotherapy. But we still had not seen the real picture. The first bed that greeted us in the narrow ward, had a lean man, probably as old as my Dad. He seemed to be comfortable on the tapered bed, oblivious of the thin pipe and needle that dripped chemotherapy medication into him.
The chairs in the ward placed for the respective caregivers were close to each other. So conversations were bound to happen. Similar to Dad, Mr. Rao was diagnosed with colo-rectal cancer at stage 4, with metastasis to the liver. In the 12 months post diagnosis, Rao had seen 2 surgeries and at least 12 rounds of chemotherapy to keep the cancer at bay. Having a similar condition, we discussed treatment options, doctors’ response, and prognosis. That was just the beginning. Over the years that followed, we would often bump into Mr. Rao at the Onco ward, where the conversation shifted from medical stuff to local politics, books, sports and family matters. For dad, he was the sole companion in the grim Onco ward.
It has been 5 years now. Dad succumbed to the disease in October after his long drawn battle. I called up Mr. Rao, to inform him of the demise. He said, “Could you please drop by?, I want to meet you.” I wasn’t really keen, considering I had just lost my father. I still trudged on to pay him a visit. He started the conversation. “Why do you think I am still around? Is it because the disease is being kind on me? Or because I have the fighting spirit? I simply do not know. I don’t want to go on with this disease any more”. I was taken aback at what he said.
Looking at my perplexed face, he continued, “I am 68 years old. Firstly, at this age, taking on the side effects of the medication gets to be doubly tough. From burning deep skin rashes caused by “Erbitux” ( adjuvant therapy medicine in treating cancer with liver metastasis), stomach related troubles, nausea vomiting, and a general feeling of uneasiness. I have had enough. Ok, so let us say that I still go on enduring all this.
Here is the second issue. By God’s grace, I retired from ISRO and receive a reasonable central government pension. I also saved up a substantial corpus for my retirement. Not to forget, my son is a techie in USA and he sends me money regularly. Yet, a medical expenditure of almost 10-12 lakhs a year is difficult on us. In the Indian market, the cost of a vial of Avastin or Erbitux (adjuvant therapy drugs for treating liver metastasis) is between Rs. 30,000 to Rs. 40,000. A session of chemotherapy sometimes requires 3 vials. This is a drug that aggressively fights the spread of the disease. But at what cost?
Now the third and most important thing-my wife, who is my support and immediate caregiver. My wife and I live on our own. My son has a thriving job abroad. I would say he is a dutiful and loving son. Yet, is it justified to ask him to quit his job and return home to take care of me? My wife, she is a sugar patient herself and the umpteen trips to the hospital and then getting home and ensuring I am fine, does take a toll on her health. So now can you tell me, should I really continue to fight this disease?”
I had no answer.
Cancer medication does not offer you a guarantee of life. This is especially applicable to those diagnosed at a later stage of the disease. As one doctor aptly put it- “you are only prolonging life”. Once the disease is metastatic, it would keep coming back. So it would have to be an ongoing fight, with recurring medical expenses, till probably your energy or resources are totally drained out. Mr. Rao is probably in this stage now. I left him that day without knowing if I should tell him to continue his fight or let go of life. There was no quality of life after all, and no promise of quantity of life.
The World Cancer Day this year has a tag line “Not Beyond Us”. It would focus on 4 main areas.
· Healthy life choices
· Treatment for all
· Taking care of quality of life
· Early detection
I am glad that these four areas are being focused upon. At least for people like Mr. Rao, the last two options, would mean a great big deal.