'Cancer is my live-in companion'

Strategic analyst and Rediff columnist and B Raman on how he has been living with and fighting the dreaded disease since October 2009.

I will be 76 on August 14. On October 24, it will be three years since the metastasised cancer in my urinary tract was detected and the hormonal therapy (total androgen blocade) started.

The therapy is based on the discovery that any cancer of prostate origin shrinks if it is denied the male sex hormone that acts as a fertiliser for the tumour. I had to undergo an injection once in three months and take a hormonal tablet called Calutide 50 every day. The course of injections was stopped after two years in November last. According to my doctor, if the injections are continued for more than two years, the bones tend to get brittle.

This was the least aggressive of the therapies available and I chose it. The other options, that were more aggressive and often more effective, were surgery, chemotherapy and radiotherapy. They cause considerable side-effects and hence I decided not to have them.

By the time my cancer, which started in the prostate, was detected, it had spread to the urinary bladder, nearby bones and some lymphnodes. Surprisingly, my PSA (Total and Free) levels, which give the first indication of the presence of the cancer in the prostate, were normal. The scans showed the cancer in the bladder, but not in the prostate. It was detected only during a diagnostic procedure. The spread of the cancer to some bones and lymphnodes was detected during a scan with radioactive isotopes.

It was graded as high grade cancer of prostate origin, but the cancer had no effect on my energy, weight and appetite and I had no pain anywhere in the body. The first external symptom that led to the detection was the presence of heavy blood in the urine.

The only two discomforts caused so far by the cancer and therapy are constipation and a slight pain in my right feet since last November. The doctors had cautioned me that the spread of the cancer to some bones could cause heavy back pain and radiating pain in the upper parts of the legs. This has not happened so far.

The therapy caused the cancer in the prostate to shrink totally and in the bladder partially. Since I never took a bone scan, I do not know anything about the cancer in the bones or lymphnodes. The doctor has also not insisted on a bone scan. Since I have had no pain, I have presumed that it has not spread.

Before the cancer was detected, I used to be a daily drinker of Scotch and Soda -- taking two large pegs every day and three on Saturdays. After the detection, on the doctor's advice, I reduced it to three or four days a month, but during my recent visits to Delhi I was drinking almost daily with friends.

In July last year, the Government of India sought my assistance in an advisory capacity to enable the Task Force on National Security headed by Shri Naresh Chandra, former Cabinet Secretary, complete its work. My elder brother was strongly against my accepting it since he feared that it might render me weak, but I accepted it. I used to travel to Delhi three times a month spending about 12 to 15 days every month there. In May, I spent 18 days -- 11 of them continuously.

During my stay in Delhi, I used to work from 10 am to midnight -- with an one-hour break for lunch and two hours for dinner. I withstood the strain remarkably well as if I was a 40-year-old healthy person. I was amazed by my energy level despite the two discomforts mentioned above which continued.

Normally, human reactions to the detection of cancer vary from individual to individual. Many withdraw into a shell and avoid sharing with friends and others except close relatives the news of their cancer. Some share with relatives, but not with friends. Some share with everybody. I am told the majority of the cancer patients tend to become depressed when the disease is detected.

In my case, I have remained cheerful from the beginning. I share freely all details of my cancer and the treatment with whoever is interested on my own without their having to ask me questions. An American friend of mine once jocularly remarked: "Raman is the first cancer patient known to me who brags in public about his cancer as if he has achieved something great by getting cancer."

My cheerfulness and my readiness to share have kept my morale sustained. Sometimes, some of  my Twitter buddies are surprised by the loud-tweeting I do about my cancer and think I must be depressed, but I am never depressed.

But I am bothered often by the thought not of pain starting, but of my developing a dependence on others if the cancer spreads further. I have always been a self-reliant person. Never in my life have I been dependent on others in personal matters. The feeling (not fear) that I might one day become dependent on others bothers me.

My calm disposition and my habit of always looking at the brighter side of life have helped me in my fight against the cancer. I felt proud of myself when my doctors remarked last year that I have driven the cancer out of my body through sheer will power and not through therapy.

All human beings like to be praised. Cancer patients are no exception. The morale of cancer patients goes up when they are told  that they are looking normal and do not look like cancer patients. During my frequent visits to Delhi, my morale used to go up every time I was complimented on my normal  energy level. I was myself amazed by it and I used to feel very happy when others noticed it and remarked on it.

Please don't tell a lie to a cancer patient. By doing so, you are not helping him or her. But if you find a cancer patient looking good and doing well, don't hesitate to tell her/him as sincerely as you can.

Cancer patients have their good moments and bad moments. I too, though I try not to show my mood changes. If you find us occasionally irritable or nasty, try to understand us. Those are passing phases.

There are two things I miss greatly -- my daily S & S [Scotch and soda :-)] and my foreign travels. Inside India, I have been travelling as frequently and as vigorously as I used to do before the cancer was detected in October 2009. I used to travel abroad for discussions and seminars seven or eight times a year. I have stopped all my foreign travels since September 2009. My doc has been encouraging me to resume my foreign travels. But I am hesitant due to a fear that if internal bleeding or pain starts during my stay abroad, my hosts might be put to difficulty.

As I often say, I have learnt to peacefully co-exist with my cancer. There is a lovely song of Georges Moustaki, the French singer of Greek origin, titled 'Ma Solitude'. He sings: I never feel alone because my Solitude always keep me company and sleeps with me in bed.

I never feel depressed  because my cancer and I have learnt to live and sleep with each other. My cancer is my live-in companion.

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