|Year : 2013 | Volume
| Issue : 1 | Page : 50-52
A physician's personal experience with breast cancer: An interview
Moushumi Lodh1, Natasha Das2
1 Department of Biochemistry, Institute of Lab Medicine and Research, The Mission Hospital, Durgapur, West Bengal, India
2 Freelance Medical Writer, B12, Dronacharya Apartment, Mayur Vihar Extension, Delhi, India
|Date of Web Publication||11-Jan-2013|
Freelance Medical Writer, B12, Dronacharya Apartment, Mayur Vihar Extension, Delhi
Source of Support: None, Conflict of Interest: None
Dr Moushumi Lodh is a physician who was diagnosed with breast cancer in the year 2009. In this interview, she speaks to childhood friend and freelance medical writer, Dr Natasha Das about her life with cancer. When she was 22, Moushumi had a fibroadenoma removed from her breast. She had noticed a small new lump in her breast 16 years later and ignored it for over a year believing that it was one of those benign lumps again. She believes an early diagnosis could have paved way for better treatment options for her. In this interview, she urges women to be better aware, to do regular self-exams and to go for screening. If diagnosed with cancer, she says, one should not lose heart but should fight it with a positive spirit. Cancer, after all, is only another chronic disease that needs lifelong treatment and care.
Keywords: Breast cancer, physician′s experience, doctor′s experience, fibroadenoma
|How to cite this article:|
Lodh M, Das N. A physician's personal experience with breast cancer: An interview. South Asian J Cancer 2013;2:50-2
| Introduction|| |
Dr Moushumi Lodh is a physician who for the past few years has been tackling with her breast cancer with an immense amount of positivity. Moushumi was born in West Bengal to Bengali parents. Her father worked as a research scientist with the Central Rice Research Institute (CRRI) at Cuttack. Moushumi studied medicine at SCB Medical College and Hospital in the same city. She went on to specialize in Biochemistry and currently works as Senior Consultant at the Mission Hospital, Durgapur in West Bengal.
In the year 2009, she was diagnosed with breast cancer. Joan Walsh Anglund once wrote, "Adversity often activates a strength we did not know we had." Cancer revealed an inner strength within Moushumi. Today she lives the busy life of a doting mother, a caring wife, and a hardworking physician.
Moushumi Lodh spoke with medical writer and childhood friend, Natasha Das about tackling life with breast cancer.
| Truth is Revealed|| |
For a person who works in the healthcare domain and knows so much about cancer, it must have been odd to be declared a patient. Tell me about how your cancer was detected
I was lucky. My breast cancer was detected early. I had access to adequate treatment facilities. To add to all that, I am a doctor, which means I know very well that cancer is not a death sentence. With adequate and timely treatment, it is possible to lead a normal life like I do now. However, like for any other patient of cancer, it did come almost as a bolt. I never thought I could have cancer.
When I was around 22 and a student in medical college, I had a fibroadenoma in the left breast. The lump was excised and the biopsy report stated that it was benign. Most fibroadenoma of the breast do not transform into malignant lesions.  But having a fibroadenoma did mean that I was at an increased risk of developing breast cancer.  So I used to do self-examination every now and then.
A few years ago I felt a breast lump around 1 cm in diameter. It was not fixed at that time.
Did you get it checked immediately by a breast health specialist?
That's where I think I got it all wrong. Like many more Indian women, I too believed there were much more important things in life to work on than this tiny lump sitting in my breast. My son needed my attention. Both my husband and I were changing jobs. We were also moving to another city. So much was happening around me that I did not have the time to go for a check-up.
I had had a benign lump earlier and I believed this one could be benign too. Not that I forgot about the lump completely… I wanted to get it checked the moment I had the time.
Finally, a year after I first noticed the lump, I found the time to get myself checked. I was advised a Fine Needle Aspiration Cytology (FNAC).
How did you first react when you saw the FNAC result?
It was the first of April, the All Fool's Day. My husband broke the news. He told me that the FNAC report of my breast lump said I had a locally advanced ductal carcinoma in stage II. At first, I thought he was joking but his wet watery eyes made me numb. I did not know what to do next. For a moment I was blank.
Then I gathered myself. As a doctor, I knew that cancer was like any other chronic disease such as diabetes and hypertension that needed lifelong care and treatment. I had to get myself ready for the next step.
It takes a lot of strength to feel like that. Did you always believe you were so strong?
I don't know where that strength came from. When I looked at my 6-year-old son, I knew my days were not over yet. There was so much I wanted to do. I was ready to fight cancer and live an active and happy life.
I called up a professor at my medical college. She was fit even in her fifties, at least as fit as her 5-year-old breast cancer allowed her to be. And I was only in my thirties. I could not have given up so easily. There is no age that is immune to cancer and there is no age when it is good to be diagnosed with cancer. But this was not going to pull me back.
The professor was the first pillar of strength that I felt like leaning on. She asked me not to panic. Rather, she suggested I go buy a stylish wig that suited me.
| Experience with Chemotherapy|| |
Why would you need a wig immediately?
To accept the fact that I was diagnosed with cancer was a big challenge. On top of that, the very same evening when the diagnosis was made, I was admitted into the hospital where I worked and chemotherapy was started.
I knew I would lose hair. I had to get used to my new wig.
The plan was to put me on neoadjuvant chemotherapy with the FEC regimen (5 fluorouracil, epirubicin and cyclophosphamide) given 3-weekly for three cycles followed by modified radical mastectomy with axillary and supraclavicular fossa lymphatic clearance and then docetaxel given 3-weekly for three cycles. The three cycles of chemotherapy were planned to shrink the size of the tumor before surgery.
I remember talking to you about your chemotherapy. You told me you were not on a very long leave from work.
In between my chemotherapy cycles, I continued to report at my work in the hospital. Life was as normal as possible.
But the ordeal had begun. After the second cycle, chunks of hair started falling off. Chemotherapy does bring with it alopecia and I was mentally ready for it. One night, I shaved my head and the next day I wore the wig and went to work. Many of my colleagues who were unaware of my illness simply thought I had gone in for a new hair style. I even got compliments for my new hair style. I knew that chemotherapy was important and I would lose hair during the process. But I also knew that once it was over, I could regrow my hair.
| Did You Experience Other Side Effects Also?|| |
I also experienced other adverse symptoms such as nausea, weakness, and head reeling. I was prescribed medicines that took care of these adverse effects and strengthened the faith I had in my doctors.
The first two chemotherapy sessions were smooth. During the third chemotherapy session, the drugs extravasated into the surrounding tissue and my forearm was severely swollen and stayed painful for about a month. A chemoport had to be inserted below the clavicle to inject the last three cycles of chemotherapy. This was followed by 1 month of local radiation.
Are you on medication now also?
Postsurgery histopathologic examination showed that 4 out of the 66 excised lymphnodes tested positive for malignant cells. The tumor was hormone receptor positive (ER+PR+). Immunohistochemistry revealed 3+ tumor, but it was Her2Neu and FISH negative.
Since the tumor was ER+PR+, I was put on oral tamoxifen for 5 years.
| Coping With Mental Stress|| |
Coping with the issue of a possibly deadly disease requires a lot of mental strength. Has the stress been overwhelming at times?
When my son told me not to attend a function at his school because I did not look good, I could only smile wryly. With a weight gain of about 20 kg due to steroids, a wig as my crowning glory and a silicone breast implant, I often shuddered to look at myself in the mirror. But these were the least of my problems.
Every month, I used to be off my work for around 7-10 days due to chemotherapy sessions. I could hardly utilize the remaining days and work properly because of the postchemotherapy side effects. To wake up early in the morning and get my son ready for school, was really an effort and to stay up late nights was almost impossible. I developed hypothyroidism secondary to the radiotherapy that followed the surgery and I am still on medication for it.
It's really not been a smooth ride all the way.
Even though we spoke often, I did not know you had cancer till another friend told me. I wasn't sure how you would take it if I called up and asked about your health. When I called, you did not sound defeated, bereft or crushed in the least. You spoke about your cancer with great ease, frankness and positivity.
I try to be as positive as I can be. For me, the war was more psychological, than physical. I went through the chemotherapy cycles with a surprisingly strong mind. What gave me that intense inner strength? It was from the people around me who loved and cared for me so much. I obtained my mental strength by looking at my son who did not understand much, my physician husband who was there for me at all times and my parents who left their home and came over to take care of my household - taking care of their daughter, son-in-law and grandson. The prognosis had to be good! For me, there could be no other way.
I am not a quitter, I told myself. I used to take leave from my work whenever I had to go for chemotherapy sessions and to cope up with the post-chemotherapy side effects. But as soon as I felt better, I was back to work at the hospital. I had to keep working. I was not ready to let cancer pull me down.
Having had such a close encounter with cancer helped me realize the value of life. I was now able to analyze what was important in my life - my family and friends. It goaded me into doing things I always wanted to. I visited places I wanted to see. I went on to win a yoga championship. I took better care of my health now and it made me feel better.
| Life Beyond Cancer|| |
How is life today 3 years after the diagnosis?
It could not have been more fulfilling. In April 2013, I am completing my fourth year in the laboratory of a hospital that has seen me through my toughest time. I have had nearly 15 publications in print in the past 5 years, in national and international journals, books, abstracts, and health magazines. I have also been speaking on television. And now, I am on the board of an international committee that is revising guidelines for laboratory testing.
| Importance of Regular Screening and Self-Examination|| |
As a physician who has experienced cancer at such close quarters, what's your message to other women?
I had ignored my lump for about a year. I knew fibroadenoma rarely increases the chance of getting cancer. I probably believed it could never happen to me.
If I had been a little more careful and paid attention to that lump, I would probably have had my cancer detected at a still earlier stage and paved way for much better treatment options.
Regular screening and monthly breast self-examination help detect breast lumps at the early stage, which is very important. There is no history of breast cancer in my family. Even the well-established risk factors such as family history, radiation exposure, androgenic estrogens, nutrition and diet habits, smoking, alcohol consumption, lack of physical activity and no or very short duration breast feeding and social status explain only about 40% of the breast cancer cases.  Something that is definitely in our hands is to facilitate an early diagnosis and then get a prompt and adequate treatment.
As I fight my cancer with a positive attitude I would like to stress on a few important points.
- Healthy living: A healthy lifestyle can help reduce the risk of cancer. The increase in alcohol and tobacco use among urban women is reflected in an increase in incidence of breast cancer in metropolitan cities. As women, our priorities tend to be the children and husband. We need to pay enough attention to our own nutrition as well and eat plenty of fresh fruits and vegetables for their antioxidant content.
- Regular screening: Cancer screening through mammography and clinical breast examination helps in early diagnosis of breast tumors. However, yearly mammography is recommended only for those above 50 years. And clinical breast examination is recommended once in 3 years for those under 40. I was in my thirties when detected with a stage II breast cancer. I had not even started going for an annual clinical breast examination when I was detected with cancer.
- Breast self-examination: Examining your breasts yourself on a monthly basis is a critical step to find a breast cancer early. You know your body better than any other person. You can easily recognize the changes in your breast if you actively look and feel for changes in them. So love and take care of yourself. If diagnosed early, many breast cancers are curable. If you find anything odd, consult a doctor immediately. This is where I went wrong. I had felt a lump in my breast but it took me over a year to get it examined. I regret not having gone for further investigations soon after I detected the lump. My cancer would probably have been detected at a still earlier stage if I did. If you find anything abnormal in your breasts, remember to see a doctor without delay.
- Positive attitude: You have to fight the physical and psychological war in a positive way with the help of positive minded family members and colleagues. There are many chronic diseases such as diabetes, hypertension, renal failure etc. and this is just one of them. Hypertension, if not detected and treated early, can lead to several complications some of which are life-threatening. Similarly, it is only when cancer is detected late that it becomes a huge burden - a long physical, psychological and financial struggle for the patient and family. Early cancers, especially breast cancer can be cured with timely and adequate treatment.
| Acknowledgment|| |
The authors wish to acknowledge the contribution of Dr. Ashok Parida, Moushumi's husband who gave her the love, care, and encouragement to fight cancer with a never-say-'no' spirit.
| References|| |
|1.||Greenberg R, Skornick Y, Kaplan O. Management of breast fibroadenomas. J Gen Intern Med 1998;13:640-5. |
|2.||Dupont WD, Page DL, Parl FF, Vnencak-Jones CL, Plummer WD Jr, Rados MS, et al. Long-term risk of breast cancer in women with fibroadenoma. N Engl J Med 1994;331:10-5. |
|3.||Peled R, Carmil D, Siboni- Samocha O, Shoham-Vardi I. Breast cancer, psychological distress and life events among young women. BMC Cancer 2008;8:245. |