This is a real life incidence of one of my patients who suffered from Breast Cancer and was treated successfully. It is said “doctors can only treat but cannot decide destiny of the patients”. To unfold this quote, I am writing this story of a 27 yrs old female, presented in OPD with complaints of lump breast. She underwent a detailed diagnostic workup which revealed a localized disease. She was operated and received post op chemotherapy and radiotherapy as indicated. She must have dealt with a great amount of physical, financial and emotional setback to deal with the situation. She was on regular follow-up for one year and was disease free.
But, fate had something else stored for her. She was lost to follow-up for a period of 2 years due to unknown reasons, which I realized after seeing her again in OPD. This time she walked in with pain with one side of her face covered. She looked unhappy and disgusted. I greeted her the way I normally do. She entered into the room and sat on the stool. She uncovered her face and I saw a visible swelling on her left side cheek. I got a little impatient and inquisitive. On enquiring, she had developed the swelling around 2 months back. She had visited many doctors of varied specialities but not an oncologist, but to no respite and it seemed a futile goose chase as the swelling continued to grow in size. Finally she let her guards down and visited our oncological centre. I ordered an FNAC from the lesion which should have been done way back with a modest belief of it being malignant. Reports reconfirmed my belief and it was labelled as metastatic disease.
The moment I disclosed the report to her and her family, their anguish was beyond description. The news wrecked her completely and she was devastated. Complete systemic examination revealed multiple visceral metastasis, which further added to her misery.
I sat with my team and counselled the patient and her family. She agreed to her next line of treatment with palliative chemotherapy. Interim response assessment revealed partial response. A ray of light flashed again from the dark sky. She became hopeful again and completed her scheduled therapy. Her general condition improved.
But every story has an ending which might not be happy every time. Despite all the efforts to treat her condition, she was didn't follow up yet again. Nobody knows where is she, how is she coping up with the situation.
The incident shared shows the current scenario of oncology in INDIA. There is negligence seen everywhere whether on the patient’s part and in this case even on doctor’s part. Importance of regular follow up is a duty of the treating doctor to lay emphasis on. It is his duty to explain the importance of the same and duty of the patient to follow it religiously. As debilitating the condition might be, there are measures to deal with it and win this battle against cancer.
We as citizens of developing nation must become aware and be responsible for ourselves and our deeds. Cancer is not just a battle against the disease but a battle over our shortcomings. You must be aware of the tips to reduce breast cancer risk. With the upcoming advancement in the field of oncology, we must not be negligent. After all, this is what we all deserve “Health for All”. As a perfect ending to this incident “ we might have won the war but have lost the battle in the end.”