When one is stricken with the news of being afflicted with cancer, there are always questions for which answers are sought, uncertainty that one is faced with, and the worry of having to cope with the fight against the disease through the regiment of treatment that one has to undertake.My name is M Prakash Dass, and such were the first experiences that pre-occupied my mind, back in November 2023, when the results of the MRI I had taken confirmed the previous diagnosis from my colonoscopy biopsy and CT scan – I had Stage 3A lower rectal adenocarcinoma.
At the age of 61 and having just retired from the corporate sector, what seemed like a new start of living a relaxing, peaceful and enjoyable life with all the well laid out retirement plans, just flew out of the window when faced with this new development of having a 7cm malignant tumour at my rectal area. It was quite a surprise because the only thing that prompted me to go for my health check was the sudden weight loss and irregular bowel movement. No other significant symptom, which goes to show that when it comes to colorectal cancer, developments can be silent and concealed.
Like many cancer warriors and survivors, my experience in coping with cancer is life-changing. It has gotten me to appreciate life a lot more, with a sense of gratitude for the many things I had taken for granted previously. It is also a very educational journey for me as I have gained so much knowledge, not just from my own experience but also from the experiences of my fellow cancer warriors as well. Such knowledge gained is not confined to the struggles and treatment of the disease alone but more on how to cope with the psycho-social and emotional aspect of a cancer patient. This is where, I feel, one has the most difficult of struggles, and one that tests the path when one is at the crossroads of accepting the choices made.
With a condition such as mine where a surgery to remove a tumour of that size, and at the location of around 2cm above the anal verge, was considered to be too delicate and complicated, the decision was to have me undergo a neo-adjuvant treatment with a combination of 25x fractions of radiotherapy and a parallel infusion of 5 cycles of IV chemotherapy in order to shrink the tumour for a more manageable surgery thereafter. With a lot of faith in my oncologist, and the medical staff at the hospital, I braved through the aggressive treatment everyday and every week for slightly over two months, not without some challenges and struggles of side-effects, mind you. Needless to say, the perseverance bore fruit as the tumour was adjudged to have shrunk to from the initial 7cm to about 2.5cm. I was elated and gave me fresh confidence to quickly ready myself for the surgery.
I had my surgery to remove the tumour in April 2024, and with it a large part of my rectum as well. I needed to have an ileostomy and have been living with it till now, while waiting for my reversal surgery. The after-surgery recovery process was another new challenge. The management of a 2-piece ileostomy bag and its ostomy base plate, the constant fear of leakage, the unsuspecting side-effects of the 10 cycles of adjuvant oral chemotherapy capecitabine tablets – which affected me with the ‘hand and foot syndrome,’ – a condition that had desquamation on palms of my hands and soles of my feet, blisters, dry skin, and general loss of muscle, numbness and weakness in body, were just some of the inconveniences that had to be tolerated.
A cancer patient’s experience of coping with the disease differs from one person to another, depending on the advancement of cancer stages that one is afflicted with. Those with early stages of cancer (stages 1 and 2), may have quite different experiences as the prospect of recovery is relatively high through the advanced medical treatment that we have today. For others (stages 3 and 4), fighting cancer may be a relatively longer journey. That being said, there is a commonality that strikes a cancer patient – the thoughts that play in the mind.
While one can appreciate the struggles of physical anguish of the cancer treatment, the psycho-social and emotional aspect of what a cancer patient goes through is something that has been largely understated. A large part of what occupies the mind of a cancer patient is the ability to conjure the strength to negotiate the overwhelming anxiety – anxiety about suffering, anxiety about loved ones, anxiety about finances, anxiety about possible death. I have gone through the ups and downs with this, and I believe that such experiences hold true to many others as well.
When we start to undergo treatment – whether its chemotherapy, radiotherapy, immunotherapy, surgery and a myriad of such therapy or a combination of the same, a new type of fear comes into play: facing pain, suffering the loss of one’s bodily control, being subjected to the tubes, the indignities of the possible ileostomy, and the incomprehensible horrors of the complications one could face. It starts playing in one’s mind.
As one experiences the many uncertain side-effects from undergoing treatment or adapting life under such new circumstances, this loss of freedom is what most cancer patients dread. The road that seemed so straight and steady can still disappear, putting a person on a fast and steep slide down. This is where the psycho-socio and emotional strength comes into play – how to make life worth living when we are weak and frail and find ourselves very much in the state of dependency to the extent that we find it difficult to fend for ourselves.
I have fortunately found enough mental strength to measure up to such anxiety, and I believe that cultivating certain aspects of life held hereafter is as important for our recovery as the treatment that is being administered. For one, there needs to be a purpose in life – something that we can look forward to. It can be a new calling in life, an occasion to look forward to such as a child’s wedding or graduation, or to be around watching a grandchild grow, etc. This provides an impetus to move ahead in life. The next, is to embrace acceptance.
Acceptance that one has cancer. There are many who succumb to denial, seeing one as a victim, or just spiraling down into recluse and depression. Overcoming this phase – fast, is important in the fight to cope with the agony of undergoing treatment and withstanding its side-effects and other uncertain occurrences that may rear its ugly head. As important also, is the acceptance that after a satisfactory spell of ‘normalcy’ the disease may recur in one form or another. The incidence of recurrence at any one stage in life is always there. Being ready and accepting its possibility is something that we all need to be aware of and be ready with. Therein also lies the undeniable fact that due to the medical treatment and the consequent effects it has on one’s body (externally or internally), our natural life-span may have been affected. Such acceptance that I have personally grappled with and embraced, has made me stronger to withstand any turmoil that may be thrown at me in this fight against cancer.
The last area which is of tremendous help for me in my continued crusade are the nurturing and preservation of the physical, mental, socio-emotional and spiritual well-being of oneself. These four elements are as critical as the medical therapy and healing that one is subject to.
Life is engulfed with choices, and they are relentless. No sooner have you made one choice than another is upon you. Such is the plight of a cancer patient, and how one navigates one’s journey affects the outlook and how well one will respond to circumstances. It is good therefore, to appreciate the power of the mind and its healing properties, especially at a stage where negative and disturbing thoughts and circumstances start to materialize.
I still have a long journey to go through, first with my impending reversal surgery, and thereafter with an adaption of life under new circumstances living without a rectum, but all the same, what has worked for me thus far in the recovery process, I believe, will augur well in whatever that I would need to go through at the crossroads in future.
I will end my story with this quote attributed to a Tao Grandmaster Zhi Gang Sha, who said, “Heal the soul first, then healing of the mind and body will follow.” God bless!