“One cannot begin to imagine the pain and hardship she went through during the process of chemotherapy,” says 29-year-old Mohsin* of his mother Mahnoor’s recent bout with cancer. “After some time, she became so fragile that she could barely walk. Her body temperature would fluctuate drastically. She lost weight, hair and eyebrows and could barely chew properly because her teeth hurt. As her son, it was a terrible sight.”
The troubling time lasted about six to eight months, after which Mahnoor fortunately emerged completely cancer-free. “Her chemo was followed by radiation and surgery but she truly beat all odds,” adds Mohsin. “All the rest of us could possibly do was being there for her as family.”
Mahnoor’s experience is typical of a cancer-patient undergoing chemotherapy. The process of chemotherapy, one of the main remedies of cancer, involves injecting of combination drugs to remove or prevent the growth of cancerous cells in the body. The process is individualised in that the drugs are administered depending on the situation of each recipient. Unfortunately, while chemotherapy can indeed work wonders, there is no way of keeping the healthy, non-cancerous cells from coming under its fire, increasing the risk of severe side effects. Most commonly, the drugs damage the immune system by reducing the white blood cells in the body, rendering the patient vulnerable to infections. Similarly, a low count of red blood cells causes anaemia and fatigue, chest pain and other complications. At times, chemotherapy leaves long-term side effects that can take months or even years to go away, including damage to the heart, lungs, kidneys and reproductive organs, etc.
However, while the physical disadvantages of cancer and chemotherapy are well-known, little is said of the emotional and psychological baggage that comes with it. In many cases, there is a lot more damage done to the soul than the body. Dr Adeel Ahmed, fellow of oncology at the Aga Khan University Hospital, sheds some light on the typical stages a patient passes through upon diagnosis. “Almost every patient goes into shock and denial when they are first told of their illness,” he says. “This is followed by anger at the situation they are in. Gradually, after some time, they begin to accept it.” Dr Adeel also shares the process by which he and his team deliver unfavourable news. “In Pakistan, there is a culture of informing the patient’s family before the patient himself which, in my opinion, only adds to the psychological trauma for the patient,” he claims. “I find it better to tell the patient directly. We offer them a thorough explanation of the problem, and counselling, support and motivation.”
25-year old Ambreen* recalls her mother’s reaction the day of her first dose of chemotherapy. “My mother literally lost all her hair in one day, can you imagine that?” shares Ambreen. “I remember she just stood there, weeping uncontrollably as large chunks of her hair fell out.”
“Out of all the side-effects of chemotherapy, loss of hair is the most noticeable and so, feels the worst,” says 33-year-old Yasser Khan who has been battling cancer for over nine years. “When you are young with your whole life, career, marriage and childrem before you, news of cancer lands like an explosion. But eventually, you make peace with it. You accept that you have a battle to fight and guts come naturally as there is no other way out.”
Despite over 60 chemotherapy sessions, a bone marrow transplant and immunotherapy, Yasser remains as steadfast as ever. “I never wanted to be or look like a victim of cancer so I had my head shaved naturally before chemo. My passion for my work strengthened my resolve and I continued working throughout my treatment — even if I felt weak. It is a game of mind over matter.”
For breast-cancer survivor Samreen Faruqi*, however, hair loss was the least of her concerns. “Yes, losing hair and the weight fluctuations can be traumatic but for me, the idea of losing one half of my feminity was the worst,” confesses Samreen. “You see, one kind of accepts the different side effects of chemo upon diagnosis — they are inevitable. What felt completely surreal to me was having to let go off the affected part of my body and what I would look and feel like after. I even opted for reconstructive surgery to maintain my appearance.”
As a single-mother of a toddler and owner of her own baking business, Samreen was under immense stress during her entire treatment. She recalls an incident wherein she smashed a cake she had been working on all day, just because she had forgotten to add one of the ingredients. “I would try to prepare my daughter and everyone else around us but I myself couldn’t handle the effects of chemo,” she admits. “The nature of the medication is such that it reduces your thinking skills — your sense of reasoning is handicapped. I started to forget things, lose my temper and have regular ‘chemo meltdowns’.”
Nonetheless, Samreen had no choice but to pull through for her daughter. “Everything seems like the end of the world while the chemo stays in your system,” she explains. “Cancer alters your personality and temperament and there is no escaping that. But as with everything else, you need to try your best to remain calm, if not for yourself then your loved ones.”
Qazi Saad, who was diagnosed with stomach cancer a few years back, agrees with Samreen. “The physical aspects, like vomiting, infections or pains, etc, can all be dealt with but the psychological imbalance really throws one off,” he shares. “Emotional stress, chronic depression and insomnia are major problems. There was a time I went into complete isolation from friends and family because of the pity in their eyes. They looked at me like I was a dead man.” It wasn’t until the first signs of improvement came along that Saad reconnected with his loved ones.
“They say an idle mind is a devil’s workshop. I would say that during my treatment, the devil was working overtime,” recalls Saad. “Any serious illness gives you a good reality check — an analysis of your life thus far. Regrets, worry, financial strain drive you insane. Staying motivated can help but real perseverance comes from within.”
For Mohsin and his family, the easiest way to cope with his mother’s illness was by being as normal as possible. “I think the right way to help is to talk to them casually, make them feel relaxed and divert their mind with other things,” he says and Dr Adeel agrees. “Unfortunately, there are no proper support groups here that a patient can turn to here. Visiting a psychologist or psychiatrist is still a social taboo,” he says. “There are few outlets to relieve stress. While one person falling sick is indeed a trauma for the whole family, the healthy ones must try and keep life as normal as possible. It is also important for them to learn about and comprehend the side effects their loved one is experiencing.
Published in The Express Tribune, Ms T, June 8th, 2014.