Breast cancer: “I am a stronger person today”

Seeing us at the entrance, Simran’s face lights up. “I am coming here after a very long time,” she says.

In India, most women go for a breast screening only when they notice a lump, and Simran’s case was no different. When she consulted her gynecologist, she was advised to go for an ultrasound. It didn’t reveal anything alarming. Days went by, and the lump grew bigger, causing discomfort. She went back to the gynecologist. This time, the doctor advised Simran to get more tests done, and from a good radiological laboratory. Simran visited a private hospital in south Delhi with the reports. But her friends insisted she visit government-run All India Institute of Medical Sciences (AIIMS) in south Delhi, which has one of the largest tertiary-care cancer centers in the country.

Dr Ajay Gogia, Associate Professor, Department of Medical Oncology at the Dr B.R.A Institute-Rotary Cancer Hospital at AIIMS asked her to repeat the biopsy, which was undertaken at the institute. The biopsy report showed the presence of an invasive carcinoma in her breast. 

Simran’s was a typical case of HER2-positive, fast-growing breast cancer. Between all those visits to her gynecologist and various radiological laboratories, her breast cancer had spread to the lymph nodes. By the time it was detected (November 2020), her breast cancer was at stage III¹ with a 50 percent chance of survival. “The survival rates are a lot higher for patients detected with stage I and II breast cancer – at 95 and 85 percent respectively,” says Gogia. The chances of survival dim to 20 percent for those detected with stage IV breast cancer.

Today, breast cancer is the most common cancer in India. “Fifteen years back, when I joined the profession, it was cervical cancer,” says Gogia.

According to a study undertaken by AIIMS between January 2014 and December 2019 of 997 patients, only 40 patients (or 4.01 percent) had been detected with stage I breast cancer, 326 (32.7 percent) with stage II, 419 (42.02 percent) with stage III and 212 (21.26 percent) with stage IV breast cancer.

The diagnosis shook Simran and her husband Rajesh (51). They live in an extended family with Rajesh’s parents. Simran is the mother of 20-year-old Archa and 15-year-old Parth, and the anchor of her family. “It was difficult to believe this could happen to me,” says Simran.

In India, specialists like Gogia see hundreds of patients in a week and find it difficult to counsel each one. He told Simran and Rajesh about the lengthy treatment plan, a mix of mastectomy, chemotherapy and medications.

“The diagnosis was devastating. My husband and I used to wake up at night and cry. It seemed like my life is over,” she says.

Simran drew sustenance from Gogia’s words. “He said in a couple of years you won’t even remember this phase. You can choose to face this bravely, or cry over it,” reminisces Simran. She also took inspiration from a neighbor who was diagnosed with breast cancer five years ago. “If she could have the strength to go through it, so could I.”

Chemotherapy tends to cause a lot of discomfort. For the first ten days, Simran would have nausea, vomiting and her hair would fall out. “Those were difficult days,” she says.

Simran had grown up in Delhi and was fortunate to have strong family support to see her through the crisis. Her biggest support was her husband, who owns an electronics shop in Delhi’s Bhagirath Palace. He stopped going to the shop.

“Rajesh said I will earn money later. First, I have to tend to you,” recalls Simran. Her son was a calming influence. “He also took care of my diet,” she says. Her daughter studies in the UK and wasn’t able to visit them due to the pandemic. But she was always just a video call away.

Her parents and siblings were a huge support too, as was her husband’s family. Her sister-in-law in the UK follows Buddhism and got her into chanting.