Its been three years since my mother left this world. She was suffering from cancer. For these three years, I have listened to the sentence "cancer never leaves until the patient is dead" so many times. But I never agreed to the fact.

Being the only daughter, I took care of my mother from the very beginning of her illness. Also my medical background helped me to understand the physiology and pathology of the disease. I still regret a few mistakes we and the doctors made in managing her, although life is a gift of God and He can claim it back anytime...still there is an everlasting regret which will haunt me for years to come.

The incidence of cancer is very high now. The cancer hospitals of Lahore now look like general hospitals. People from all age groups, genders, regions and ethnic background are seen there. Most commonly, Pakistani public is suffering from breast and oral cancers.

CAUSE OF DEATH OF A CANCER PATIENT

One may disagree...but I will insist upon saying:CANCER CAN'T KILL...Yes..look around. You must have come across atleast one patient in your whole life who was suffering from cancer. But do you think he/she died of cancer? Well all people I have witnessed dying of cancer, were actually suffering from a respiratory tract infection or some other infection. Pneumonia leading to a heart failure and cardiac arrest. For the non-medical people, its simplified as:

1. Cancer decreased the resistance of patient to counteract minor infection attacks which you and I will seldom get.

2. If the infection involved the respiratory tract of the patient, it will eventually end in infecting/involving the lungs of the patient.

3. Water(edema)accumulates in the lungs.

4. Heart has to work more and more to get the proper amount of oxygen to the body.

5. Patient will be short of breath, have palpitations, and will deteriorate of infection is allowed unchecked.

6. Heart attack(infarction)

7. Cardiac arrest!!!

TREATMENT

There are three treatment modalities available in Pakistan namely:

1. Surgical management
2. Radiation therapy
3. Chemotherapy

None of the treatments is safe and absolute. But still the risks of danger to life can be avoided or atleast reduced.

SURGICAL MANAGEMENT

Surgical management involves the removal of the tumor mass from the body. It can be either the mass alone or it could involve a massive portion of the body. The area removed can be later repaired with the help of reconstructive surgery. By far surgery is the most suitable therapy for most of the cancers if the cancer has still not spread to a vast territory.

Surgery is a form of major trauma, and does require the proper care of the wound and the patient as a whole. However, it is still the safest of all the treatments if it does not involve any vital structure like the veins of head and neck or larynx.

The disabilities caused by surgery of tumors are manageable to some extent. There is least risk of immunosuppresion after the recovery is complete. Therefore surgery is suggested to be the best treatment for the majority of benign cancers and the early stages of malignant changes.

CHEMOTHERAPY

The medical treatment targets the actively growing cells and as a result,affect the normal cells of the body, including skin, mucosa of mouth, stomach, blood cells, hair.

With chemotherapy, people fear of loosing hair, but the worse outcome is if the patient catches some infection during the course of treatment. The white blood cells which are the main soldiers of the body’s defence to infections are greatly reduced in number as a result of which the body is very much prone to catch any minor infection which could result in a disaster.

RADIATION THERAPY

Without the intentions of insulting any individual and institute. I will say that it is the worst treatment of cancer. Just because the proper management is not available, the death rate is very high in the irradiated patients.

Radiation cures the cancer by burning the cancer affected area but in the attempt, it also hurts the normal adjacent structures. And the time taken by the irradiated wounds is very long so, unless proper management is available, this treatment is best avoided.

WHAT CAN BE DONE

You cant let go the people you love, you can't let them suffer for anything .If someone is suffering from this deadly disease the treatment is necessary evil but making it in the right way will improve the outcomes of the treatment and will improve the quality of life of the patient.

If surgical therapy is possible, don't prefer any other treatment.

Take care of the immunity. Keep a regular watch on the blood count of the patient. Get the regular hemoglobin and WBC count done.

Maintain nutrition feed regularly with supplements and high protein diet for it is necessary for repair and making of new hemoglobin and White blood cells.

If nutrition by mouth is not possible, get it done from some other source. Use the nose pipes (NG TUBE) or infusions of protein supplements.

For patients undergoing radiation of areas which are related to stomach like mouth, neck, chest (food has to enter stomach through the food pipe which follows this course) get an alternative treatment done for maintaining the nutrition.Usualy they intubate the stomach directly so the food can be directly fed to the stomach until the burns caused by radiation heal. Remember it is very painful for patients who are irradiated to swallow even there own saliva rather than eating food.

Avoid social contacts during the peak of treatment.

Avoid contact with people suffering from infections even if it is minor flu.

Eat clean and healthy food.

Prefer to take juices that are packed rather than home made because the food processor can harbor alot of germs.

Patient need support and your love..never make them feel that you are burdened because of them!