20 May,2018 03:33 PM IST | Mumbai | Dhara Vora Sabhnani
Cancer care
Former ATS chief Himanshu Roy took his life earlier this month. While his suicide note didn't mention a reason, doctors and friends claim repeated recurrence of cancer had broken him, and he was low.
When the fight to overpower the disease is long-drawn, often with no light at the end of the tunnel, patients don't just need medication but also counselling and physical therapy.
Viji Venkatesh
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"There is a stigma associated with cancer in our society. Such that people even lose their jobs after it being detected, which adds to the financial stress. With such physical and mental strain, it is important to have a third person to share your problems with and help you cope," says Viji Venkatesh, region head, South Asia, The Max Foundation, an organisation that works for cancer patients.
"We get 60,000 new cases every year. We are able to sustain and offer proper support because of our network of support groups, where patients are provided encouragement at every level. In order to beat the darkness accompanying the disease, patients need something to look forward to. Every year, we take a group of patients for a trip to Goa; we organise group talk sessions with other patients and celebrate all festivals. We have identified 90 places with cheap accommodation near the [Tata Memorial] hospital, and we also have yoga sessions. All these small initiatives help build the psychological strength of the patient," explains SH Jafri, head of CSR and PR, and international patient advisor at The Tata Memorial Hospital, Parel.
Experts explain why a holistic approach to cancer treatment is essential.
The body
Patients have less muscle mass due to weight and protein loss in the body. Hence, there is a need to improve the quality of life by giving the right exercises and dietary plan based on the different stages of treatment to improve strength. "Cancer treatment is teamwork - the counsellor, physiotherapist, nutritionist and oncologist need to work together. One must understand the capacity of the body, how much it can take; this can be gauged only by a professional," elaborates Dr Nilesh Makwana, director and consulting physiotherapist, Muscle N Mind Physiotherapy Centre.
Dr. Nilesh
Chances of a relapse in some kinds of cancers reduce when the patient undergoes physical therapy. An expert will understand the fatigue level of the patient and devise a plan based on the kind and the stage of the disease. For example, during treatment, in addition to the pain medication given by the doctor, a physiotherapist will use electrotherapy modalities such as TENS to relieve the pain and block the pain channels and improve joint mobility and the properties of the muscle. The treatment for relapse patients is different as the intensity of their medication is higher. "Different cancers need different treatments. For example, one of my patients had lung cancer, for which a part of the lung had to be removed. This reduces lung capacity. So, we improved the stamina by giving rehabilitation with oxygen, so that the other part of the lung gets enough oxygen to oxygenate the rest of the body. Another patient suffering from bone cancer had the thigh bone removed, and a knee and hip replacement at an advanced stage. Plus, the chemotherapy had reduced the body mass. We devised a strengthening programme for the lower body, without oxygen procedure one would need for lung cancer, modified footwear to repair the body imbalance and other procedures," shares Dr Makwana.
The mind
"The need for counselling begins right from when the cancer is detected. Acceptance of diagnosis is difficult. The patient and the family need to know the outcome of the disease - you cannot just tell the patient that everything will be alright," says Dr Adwaita A Gore, medical oncologist, Zen Multi Speciality Hospital. Acceptance has to come from the family as only then will they have the collective strength to support the patient. Dr Gore has seen cases where a delay in treatment was caused because the family refused to accept the truth.
The link
Dr Gore says that doctors identify the main caregivers as they are the vital link between doctor and patient. Patient interaction with the doctor will be for a short period, as compared to a close member who will motivate the patient throughout. The stress also takes a toll on the caregiver, hence s/he too needs a support group.
Occupy your mind
Try and continue working unless the treatment demands one to stop. This helps to continue the treatment.
Dr Adwaita A Gore
The talk
Counselling differs for all age groups. "For someone who is going to undergo an operation for throat cancer, he or she needs to know before the surgery that they might lose their voice. It's only a counsellor who can successfully explain that while you may lose your voice, there are now techniques available to enable you to speak again," says Dr Gore.
Financial counselling
"Financial counselling is crucial to motivating patients to continue treatment. They need to know that their family can be taken care of after they are no more," says Dr Gore.
Madhu Kastia, 57, housewife
Survivor speak
You have to believe that you can fight cancer - without that, you can't do anything. Think of it as regular fever. I was diagnosed with ovarian cancer in 2014, and breast cancer in 2017. I was always into painting, and it was suggested to me that I pursue it to aid my treatment. I would finish one painting at every chemo session. I have gifted my works to my doctors, and a few have been displayed at Breach Candy Hospital. At hospitals, I would counsel other patients to be strong and take part in everything to live life like any other healthy person. I was advised by my doctors to pursue aqua aerobics and it has helped me improve my heart functioning from 25 to 40 per cent. My doctors emphasised the importance of physiotherapy. After my breast cancer surgery, I could move my hand easily because of physiotherapy. I had no hair when my daughter got married. But my supporters helped me in my fight, and to move on. Even getting a good wig that looks close to your real hair really helps build your confidence. My biggest support system has been my daughters and my husband.
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