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Ganga Prem Hospice Patients

 

India, Rishikesh, October 2018
A Young Mother Faces Tongue Cancer
Mamta Jogender, is a 29 years old mother of two young boys.

In the month of May 2018, Mamta found that a blister on her tongue would not heal and so she and her husband visited the Ganga Prem Hospice monthly cancer camp held at Rishikesh. Dr. S.K. Sharma, radiation oncology specialist from Capitol Hospital Jalander, had suggested scans to be done and brought for review at the next clinic. In the month of June, after seeing the reports of X-ray and CT scans, the blister was diagnosed as cancer at the base of the tongue.

Due to lack of funding and ignorance of the potential severity of the disease, despite counselling from the Hospice team, the young couple delayed in following up with any treatment. Now at the end of September, Mamta again visited the clinic, this time with serious symptoms including bleeding from the mouth.

 
   

Ganga Prem Hospice has managed to get the symptoms under control but now Mamta is desperately in need of radiotherapy and chemotherapy to curb the spread of the disease.

Mamta at the October clinic
   

Mamta’s husband is a labourer and earns Rs.350/ a day whenever he can find work. However now he cannot work regularly as he has to accompany his wife to the hospitals for tests and treatment. Mamta’s elder son is 16 years and has discontinued his education. He is also working as a labourer and earns 300/- rupees a day, whenever he can find work. Mamta’s younger son in studying in 1st Standard.

The family is not able to afford the treatment that Mamta needs and although Ganga Prem is helping them to apply for funding from government and private sources, any financial support would be most welcome as delay in treatment could mean her early death.

 

 


A Two-year old Girl with Leukemia
Saumya is two, going on three. However, unlike other children, she is carrying with her the huge burden of dealing with cancer.

 As a toddler, Saumya would often keep unwell, cry, and want to cling to her mother. After investigating her for various conditions, she was finally diagnosed with leukemia, for which she needed immediate medical intervention. As the child's mother was employed with Ganga Prem Hospice, the Hospice sponsored her treatment at a cancer hospital for the initial stages, and also assisted in getting the child free-of-charge chemotherapy with the help of the treating hospital and a government scheme for financial assistance for children.

 
   
The first chemo
The first chemo
Saumya and Meena
Saumya and Meena

 

The little girl's mother, Meena, was heart-broken when she came to know of her younger child's condition. After the untimely death of her husband only one year ago, she had to work to support her small son and daughter. With her own parents having passed away and having non-supportive in-laws and a daughter diagnosed with a potentially fatal disease, Meena's life became riddled with worry. She spends days staying at the treating hospital, as her daughter undergoes cycles of chemotherapy. She is overwhelmed with gratitude for the help from the Hospice which has provided her with every form of support from blood donations by the other staff to loving shoulders on which she can shed her copious tears.

 

 
Saumya watching the Hospice cat and her kittens
Saumya watching the Hospice cat and her kittens
Saumya enjoying the kittens play
Saumya enjoying the kittens play

 

Between her hospital visits, Saumya's nutrition and well-being remain top concerns for all. The child needs more than adequate nutritional intake to keep her blood platelet count stable, and her little form healthy, so that it can withstand rigorous treatment. With Ganga Prem Hospice providing for her nutritional needs, and her mother supplementing Saumya's favourite foods with herbal and home remedies, the tiny child's health has picked up a little. Her mother often brings her to the hospice, where she likes to watch the cat and her kittens play. Although Saumya looks like a quiet girl at first glance, she is vocal with telling her mother what she likes to eat. She watches her favourite shows on television, and prays to her father's photograph to make her better.

If you feel that you would like to help Saumya and Meena through the next three years of the child’s treatment, your donation would be very welcome.

 

 

INDIA, Rishikesh, August, 2018
A Destitute Patient Gets Medical Intervention
Forty-five-year-old Ranjeet Kumar came to the Ganga Prem Hospice cancer clinic in July 2018, complaining of pain and discomfort.



 
Ranjeet at the Hospice clinic
Ranjeet at the Hospice clinic

He looked tired and had a vacant expression in his eyes. It could have been either due to the physical pain he was undergoing from a malignant condition, or from the fact that for last several years of his life, he has lived like a destitute, sleeping under the sky, going to bhandaaraas to find food to fill his stomach.

   

Ranjeet has studied till class ten. His widower father died from cancer in Ranjeet’s early adulthood. After that, he left his home in the central Indian state of Jharkhand, and travelled to places like Allahabad, and Haridwar, doing odd jobs as a labourer. Ranjeet had been living in Rishikesh for a month, when he heard of the Ganga Prem Hospice monthly cancer clinic. He came to the July 2018 clinic with a bag, in which there were reports of some diagnostic tests done in charitable hospitals.

 
   

Ranjeet Kumar was diagnosed with a possible testicular cancer condition at the Ganga Prem hospice cancer clinic. What he needed was immediate surgical intervention, and it took a persistent team effort and much coordination to first find him a place to stay, and then to take him to a tertiary level hospital for investigations and subsequent surgery and follow-up treatment.

Ranjeet at AIIMS in Rishikesh
Ranjeet at AIIMS in Rishikesh

 

The patient himself needed to be motivated to go through his treatment fully.
While the Ganga Prem Hospice team counselled him at the clinic, the hospice social worker was always there to support him, and was present at the hospital during the time of his surgery on August 20th, 2018, acting as his immediate guardian. Volunteers visited him at the hospital, guiding him through diagnostic tests and OPD visits. Putting together the funds required for his hospitalization was also a challenge, which was finally met by a long time GPH supporter.

After the operation there was some infection in Ranjeet’s wound so when he was discharged from the hospital the GPH team brought him to the hospice where daily dressing and medicines will clear up the problem. When he is completely well he will be discharged to go where he wishes. Although he was missing his life on the bathing ghats, he now is speaking of finding a job and trying to live a more constructive life. If he is serious the Hospice will also help him to do this.

Every now and then, Ganga Prem Hospice finds a patient who does not have any support structure to fall back upon, and is left battling cancer completely on his own. This widens the scope of palliative care, to include giving financial, social, emotional and logistical support to the patient, to brighten his chances of pulling through an abysmal situation.

 

 

Once You Choose Hope, Anything Is Possible
(by Monica Ahuja)

"Life is not always a matter of holding good cards, but sometimes playing a poor hand well.

Monica Ahuja is a lively 25-year-old who has been battling cancer since she was 21. Her career in hotel management was cut short by the unexpected appearance of a malignant tumour in her thigh. Monica, who lives in Dehradun, Uttarakhand, is still going through treatment for cancer but is determined to beat it! She has written the story of her journey hoping that it might be an inspiration to others.

Life has knocked me down a few times. It showed me things I never wanted to see. I experienced sadness and failures. But one thing for sure, I always get up with my chin up!!

Life before Cancer
It was a time when things were set in the right place. We had placements in our college and there were several 5 star hotels, who all had come to pick a candidate they liked. I was targeted by ITC Sheraton, I was so happy that I got selected by a 5 star hotel but still some questions were around my mind that will my dad allow me to go out of town and let me stay there alone. I went back to home, convinced my dad and finally started walking in the directions of my dreams. It was a great place for training with endless of things to explore. I met a variety of people and also build good relations with some of my colleagues. I started experiencing an independent life, a life away from my family, when you need to think of everything on your own but I was loving it even though there was some inconvenience. My sister was also staying in Delhi for her studies, but in such a big metropolitan city it was very difficult to meet each other daily, that too when there are lots of other responsibilities to be taken care of.

During the six months training, initially the time was moving at a slow pace but after a month it was running. I started loving it. During the tenure I learned a lot and also earned lot of respect, love, friends and, most amazing, an appreciation letter from my training manager. That was an awesome experience I had in Sheraton.

I even forgot to mention that I used to be a tom boy, but thanks to my training period and a special thanks to Jasdeep maam who has always been a great support to help me out with a girly touch. I always cherish the memories of these six months, and, hahaha, I will never forget that night when I tried a drink (alcohol) with my friends at late night sitting in the park. I will always remember that time!!!
A school photo of Monica before cancer struck

The Diagnosis
Now time to go back home, 11th February 2011. I was coming back home after finishing my internship from Delhi. I was so excited to be home after 6 months and at the same time to celebrate my birthday with my family and friends. As from the past few days I was feeling very uncomfortable with my left leg I thought of consulting a doctor. After celebrating my birthday on 14 February, I took an appointment from a doctor for 16th February.

I went to the doctor for a checkup and he told me to get an MRI done of my left thigh, so I did the same. On 17th February my reports were out then I went to my doctor with the reports. After going through the reports the doctor told my parents to take me to some big hospital for better medical treatment because in our town we don't have advanced medical facilities. My luck caused me to land up in Hyderabad. We were there on 24th February and on the same day we went to Apollo Hospital. Again I underwent some tests and next day we went to the doctor with reports. After going through all my reports he said to my parents that your daughter has been diagnosed with a tumor in her left thigh which is big in size and seems to be malignant (cancerous) but till then I was not aware of anything. I was just told that there is a tumor in your leg which will be removed by surgery.

The First Surgery
The doctor's team started their work immediately, they tried to do an FNAC test before surgery, so that they could know whether the tumor was cancerous or non cancerous which could make the treatment easy and effective. FNAC- Fine Needle Aspiration Cytology is a diagnostic procedure used to investigate superficial (just under the skin) lumps or masses. In this technique, a thin hollow needle is inserted into the mass for sampling of cells that, after being stained, will be examined under a microscope. But unfortunately an FNAC was not possible because my lump was deep, so they decided for immediate surgery as the size of my lump was 10cm. The 28th February 2011 was decided as the date for surgery.

That night turned out to be a nightmare for each member of my family. Next morning, i.e., 28th February, I was feeling nervous and scared too, I have never experienced this (a surgery) in my life. Still I carried a smile on my face while entering into a different kind of world, where no one ever wants to reach. People say men are strong but when it comes to a father, it's really hard to see his daughter in this situation. I am mentioning this because when I was about to enter the operation theatre my Dad got in a panic and became a bit unwell at that moment.

So I was in and ready for the battle. I don't remember anything thereafter as I was taking a sound sleep because of the anesthesia. After some hours when I regained my senses, I realized my leg was numb and couldn't work. I tried to move my leg but I was unable to do so. I got scared at that moment and I told the nurse on duty that I wanted to talk to my doctor regarding my doubts. She asked me to calm down and told me that the doctor will be coming soon to visit you. After an hour he came to see me. I asked him, "Why can't I move my leg? Why is it senseless?" He answered, "You don't have to worry, it's a matter of a few months and you will be able to walk properly." I was bit sad after hearing that. It's easy for doctors to say that line but for me it was very tough to accept that truth.

I was there in the hospital for 8-9 days. Side by side, the main thing that was going around in my mind was the biopsy report of that lump which was taken out from my leg. It took around a week after my surgery for reports to come. As the doctor had told me bed rest my parents took the biopsy report to the doctor and after going through the reports he told my dad that the lump was malignant (cancerous) but when my dad came back home he did not tell me anything and ended up by saying that everything is fine.. .but I could sense that there was something fishy so I opened my medical file. I was going through the report but I couldn't get it exactly as there were scientific words. Then I thought of hunting on Google for some of the words so that I could make out what exactly the reports were. After searching I got to know the exact meaning of words like malignant which shattered me inside... After that I realized the tumor was malignant (cancerous).

I was feeling like hell, what is happening? Why to me? What to do? What will be next? These kinds of questions were running through my mind. Being diagnosed was a really shock for me and my family. I had no idea even young people could get cancer. As it is said "Life begins at the end of your comfort zone." I felt the same that moment.

Radiotherapy
Three or four days after surgery I went to the doctor for my first dressing, then he told my parents that as the tumor was cancerous, it was necessary to do radiotherapy. Radiotherapy is a part of cancer treatment in which high-energy rays are used to damage cancer cells, stopping them from growing and dividing. Like surgery, radiation therapy is a local treatment that affects cancer cells only in the treated area. So my dad agreed to the doctor's advice and the only words uttered by him was, "We will do everything for our child." But I was not feeling comfortable there and so wanted to go back home as soon as possible.

The hospital environment was giving me very negative vibrations and also I was very far from my brother, my sister and my friends. In that situation I wanted to be with my own people, my dear ones, who loved me and supported me always. At that moment, I told my dad to take me home as I didn't want to take further treatment there. He said that he would talk to the doctor and we would do that accordingly. He asked the doctor if it was possible to take the treatment from our place, i.e., Dehradun. The doctor told him that it was possible if there were all the necessary facilities available, so we inquired and got to know that there was one good hospital which has all the facilities near our home town. So we discussed it with our doctor and he allowed us to go back to our home town.

I was feeling very happy after hearing that, I was so desperate to be home. I was very frustrated staying in hospital for 8-9 days so it was very relaxing news for me that I can go back to my home. Home is Home. You can only feel relaxed at your own place, not at someone else's home. When I got discharge from hospital, I was staying at my relatives' place. Sometimes I use to feel that I'm a burden on others because there are a few things which you can only ask your own brother or sister to do for you. I really wanted to run home. We booked our tickets for the next day and we came back to my lovely home. After so many nights it was a pleasant night for me to take a sound sleep on my own bed.

As the doctor suggested the radiation therapy to be for around 25 sittings, which were supposed to be held during about 2 months, the doctors asked me to get admitted for this therapy, but hats off to my dad, that he took me to hospital on a daily basis as I didn't wanted to get admitted. That became a daily routine for me for few days.

Respite from Treatment
Now things were becoming normal, though I used to go for regular checkups after every three months. Life was bouncing back to other routine activities, college practicals, friends' gatherings etc. My family was so happy about the reports as they were coming normal and indicating my recovery. As doctors had instructed me for follow ups, I went to the hospital after 3 months, and the doctor told me to go have some scans done. After a day the reports came and the doctor told my parents, "Now your child is cancer free as all reports are normal." After hearing this, more than me, my family was happy especially my dad as he was also suffering so many things with me.

The Cancer Returns
After 3 months I again went to the doctor. The same process of tests and all were repeated, we all were pretty sure that all will be good now as I was physically fit and there were no symptoms. But I don't know why again things were turning blue. In the course of my regular check up I was diagnosed with Metastasis soft tissue sarcoma of lungs, that means the cancer had spread from my leg to my lungs.

It was dreadful and horrible news for me and my family. "Is this truly happening or is this a dream?" For some time there was a sense of disbelief and I went blank after realizing that now the cancer is in my lungs. Anyone who had known me closely would not believe that I could be a candidate for cancer. I was a very healthy and active person throughout my life. I don't know why I am into this disease and how. God alone knows what exactly caused this disease in my body. But then that's why the science is not yet sure about the exact cause of cancer.

I asked myself, "Why me?" And I immediately realized that though there would be a thousand guesses, I would never really know the exact reason as to why I got cancer. Plunged into the chaos of trying to cope with the diagnosis, I decided quite deliberately that I needed to focus every bit of my energy on coping with cancer and none of it on: "Why? Why me?" It could be a very depressing question if you make it so.

For some time my thoughts were also wandering in that direction but soon I began to realize that the question could be seen in another light as well. "It's me, maybe, because I think, and others would also agree, I can face it. I am brave enough to handle it and so is my family." It's funny how we want to ask, "Why me?" only when the situation is not the way we want. Did I ever ask this question when I was appointed as a school house captain and among 50 trainees only I got an appreciation letter from my company. Did I ever even once ask, "Why me?" Then why cry now? "So what if it's me? It's ok if it's me!!"

 
Anyway, there was no time to spare and hence not much time to think. Now my family and I were more worried that now what would be next??? This time I really felt like traveling on a road with an uncertain destination? The reoccurrence of this problem really shattered me inside. Still I know, I only have to face it. Then after listening to many people's views, my dad chose Mumbai for further treatment, as he wanted the best for me.

Chemotherapy
Without any delay we went to Mumbai, there we met Dr. SH Advani, an oncologist well known for his services in these cases. He told us that we will treat first with chemotherapy. Chemotherapy is a treatment of cancer by means of drugs. Uffff!!! Chemotherapy's name itself is enough to judge the outcome, but again I was ready to go for it because anyhow I wanted to go through all this happily as I didn't want my family to feel disappointed although I know they will be at some point. I was also worried for the expenses, though my dad didn't even say anything regarding that. But you cannot ignore it. I was feeling a bit concerned.

I reached the hospital the next morning for my first chemotherapy with a curious and anxious mind. The doctors suggested 3 sessions of 3 days cycle in every 21 days. First day of chemo was okay, but eventually it was affecting me like hell, everything was totally different in a bad way. My immune system was gradually getting so weak, but I still kept telling myself that this therapy was going to make me alright and so my spirits were up and willing to take on everything that came my way.

The first chemo went okay, and the 2nd chemo was to be after 21 days so the doctors told us to come after 21 days again. But I was not feeling comfortable there in Mumbai and also I hate travelling so I was willing to take my next chemo at my place, i.e., Dehradun. I told my dad to ask the doctors if we can go back with all the prescribed drugs and take the further treatment there. The doctors said it was possible but after taking all 3 cycles of chemo I would have to come to Mumbai for a checkup. So we left for Dehradun.

Finally we were home, and I was really happy to be home. Now everyone was more concerned as my chemo was on and doctors told me to have a good nutritious, healthy and rich diet. But I realized that I was losing my appetite, and there was a change in my taste buds, I started eating the food I never used to like.

Things were going well, but there was another shock to come. Although the doctors had warned me that I will lose hair as side effect of the chemo, in my faintest dreams I could not have comprehended what kind of hair loss I was in for. Put the hand in the hair and you could get strand after strand in your hand. Put the comb in and it would be fully covered with hair. I had pretty good hair, very thick and black hair.

Now after 21 days my second cycle was to start. I went the day before chemo for a blood test and all in a hospital, to see if my body was ready or not to take the drugs, as the drugs are very strong. Unfortunately, these drugs also affect normal cells, resulting in many side effects which are fairly serious. A test reveals the blood count-number of red cells, white cells and platelets in a blood sample. My reports were normal, so next day my 2nd cycle of chemo started. My chemo would last for about 7-8 hours and had 6 different bottles comprising of combinations of chemo drugs.

I tolerated the first day of 2nd cycle pretty well. I had prepared my mind to face the worse possible pain. The first two days after chemotherapy were fine but from the third day onwards, I began to have more side effects like constipation and body ache. I could not eat properly, I could not sleep properly, weakness, lack of appetite, nausea and vomiting, mouth sores, hair loss.. ufff! I was getting weaker day by day, physically and mentally too. Actually chemo was so extremely dreadful. I was losing more and more hair, not only the hairs from my head but also from my eyebrows, eyelashes, hands and legs as well. My confidence level was getting lower day by day. But still I manage to keep myself smiling all the time especially for my family, since I knew they all were already sad and worried for me and I didn't want them to get more depressed by seeing me crying. So I had to be strong for them. There was a time when I was so frustrated and depressed that I stopped talking to many of my friends. I de-activated my Facebook account. I stopped receiving my phone calls. I was feeling very negative at that period of time, questions in my mind were killing me inside. "What is going on? Why me? Will I be ok? ", etc., etc.

Anyways I manage those days but my third cycle was about to come and with the date of my third and last chemo coming, I was feeling so anxious that once I told my dad that I didn't want to take the 3rd cycle of chemo. He explained to me and motivated me by saying that God gives his hardest battle to his strongest soldier and motivated me in his own way as every father would do, "Tu to mera sher bacchcha hai, mera sabse strong bacha hai, tujhse to hum sabko himmat milti hai." (You are my little lion, my strongest child, we are all getting our courage from you.) I was emotionally touched and said "yes" for further treatment as I could see in his eyes how badly he was fighting and wanted to see his daughter perfectly fine. I must say that with me, each family member was fighting with the cancer.

I reached the hospital for the third chemo. The first day went pretty well but the day after, everything started repeating. The same side effects came. By the time I completed the 3rd chemo I was almost bald. A few strands of hair hanging on my head made me look very funny and feel miserable. The first time after total hair loss when I saw myself in mirror, I was shattered, in tears and started hating to see my face. I remember I didn't use the mirror for a month at all. That was the worst time of my life. Still while writing this I have tears in my eyes remembering all that again. Uffffffffffffffff ! All these years when I used to go and cut my hair, not once had I given a thought as to whether it will grow back. Generally the importance of things is only understood and appreciated when one loses them. "Will my hair grow back? When will it grow back?" These were all my main worries! "Losing hair is much better than losing life," said everyone around but where could I go out with no hair left on my head? I began tying a bandana on my head whenever I went out so as to avoid the weird looks from people. Anyways my going out had become minimal - to the hospital and sometimes to close family friends.

The Second Surgery
Anyways, this time I was expecting a good result of my suffering. I went to Mumbai for my check up so as to know how the cancer has responded to the chemotherapy. Reports always give you a feeling of report cards that we used to get in our parents-teachers meeting. But trust me, these medical reports are not estimable, no matter how much hardship you have gone through, it's all about what God has chosen for you. It was a surgery again, the second time, ahhhhh, that too after facing such dreadful chemo. Doctors told me that your nodules are stable, chemo didn't let it grow nor decrease. I accepted and said, "Yes," for the second surgery of my both lungs, no other option left actually. I set up my mind and was ready to proceed.

As per the date for surgery, we all reached to the hospital and got admitted. Ten o'clock in the morning I was wheeled out of my room. My parents walked with me till the OT and then I was inside and my parents were out. That time I was getting lower and lower but tried to divert my mind by talking to the nurses and doctors there. The anesthetist was ready and told me to bend down so that she could give me a shot, and told me that there will be small prick, I started counting 1… 2… 3... That's all I remember before slipping into deep sleep.

When I woke up, I tried to speak but couldn't because there was a pipe going inside me through my mouth, I realized that I was on ventilators. I was in so much pain, even breathing was hurting me. I was getting irritated with those pipes and wires, all over my body. My hands were tied and at that time I was really feeling very helpless and was feeling like a live corpse. Suddenly my dad came in , he saw me and couldn't speak a single word, he was bit shocked after seeing my condition ,but he didn't cry in front of me, though I could make out from his face that he was very sad. He just embraced me and left the room. I was getting so frustrated with those pipes, as I could not breathe on my own and also couldn't speak. I was asking the nurse again and again through signs and sometimes in writing that when will these pipes be removed, she told me next day morning. Only I know how I passed that night, each moment was killing me like hell .. . I was in pain and totally out of my comfort zone. Next morning I was just waiting for the doctor to come and remove the ventilators (artificial respiration).

Around 11 in the morning he arrived and started the procedure but as he was checking that my lungs are working properly after surgery, suddenly the pipe which was going through my throat, got struck there and I got a panic. I was trying to tell the doctor that it got stuck but as I could not speak because of that pipe, I was unable to explain him and he thought I couldn't breathe on my own so he said we will keep me for one more day on ventilators. At that moment I felt so helpless, but then I explained to myself and left everything on the doctors. I tried to sleep but the pain didn't let me sleep. Anyways next morning, I asked for paper and pen from one of the ICU staff, and told her by writing that the doctor told me that he will remove the ventilators today. She told me that she would call the doctor's assistant and let me know. After an hour she told me that the doctor will be coming and definitely put me out from the ventilators. I was so relaxed hearing that. Around 1 o'clock he came and started the procedure of removing all the pipes and wires. I was feeling sooo happy inside as I was very irritated with those pipes and wires. That feeling was something I had never experienced in so much that I had seen in the past few months in my treatment. Finally I was shifted to a private room with less pipes and wires, which was bearable.

Now I was recovering bit by bit. Doctors told my parents that in 3-4 days she will be discharged. I was happy hearing that. After staying two days in ICU, the doctors allowed me to have water and kept me on a liquid diet for a few days. But the pain continued and was unbearable. I was crying in pain like hell, even after having 7-8 pain killers a day, I could not eat, I could not sleep, I could not laugh, I could not talk, I could not walk, I could not sit. Then I realized the significance and function of lungs. The whole period of treatment was terrible. After four days the doctor discharged me and told me to come after 3 days for dressing. So I did what he said. The dressing procedure was repeated around 3-4 times in15 days. Just after my last dressing the doctors allowed us to go back to our home, i.e., Dehradun and told me to come for regular checkups after every 3 months.

A Trial Medicine
Now I was home and was very happy to be home as I always state, haha, meeting my brother, sister, my friends and my teachers. Gradually, I was recovering and the pain was also decreasing day by day. I continued my follow-ups every 3 months. It was bit difficult to travel to Mumbai every 3 months but no other option was left with us. Around 7 months of my second surgery of lungs I got my CT scan done, and guess what could be the results????? Everybody was again expecting good results but…again there were cancer nodules in my lungs. I was scared hearing that and was thinking that what will be next now, again surgery or chemo??? We all went to meet doctor first he told us that there are possibilities of surgery again, and I was getting more depressed hearing all this and my dad also broke down. But all of a sudden the doctor told my father about a new medicine launched but said, "It is very expensive, it will cost you 56,000 for a month, and we are not even sure that it will work or not." My dad said, "Whatever you think is good for my daughter, do that."

So the doctor told me to have that medicine for four months and told me to get the scan done after taking the 4 months medicine so that they could see if this medicine is working for me or not. So we bought the medicine and came back home. I started the medicine, but after 4-5 days I realized, I was losing my appetite, I was getting mouth sores, and terrible back ache. But I explained to myself, that it is for my betterment and it's better to bear all this than to lose a life.. .so I continued eating the medicine. After a month, I realized that my hair was turning white. I immediately called my doctor and told him about the same. He told me there was nothing to worry about and that these side effects could be considered as a good sign as it means the medicine is affecting you in a good way. I was like, "Ok if it's beneficial for me…"

After having it for six months I got my scans done and went to Mumbai to meet my doctors. We all were praying to God before meeting him. As we met and showed the reports he said, "It's fine this time, the medicine has played a very significant role. Your cancer nodules have decreased a bit and it's a very good sign that they are under control."

Now
It's been 1 year that I am taking this medicine and it's been 4 years that I am fighting a battle against cancer and I am hoping that I will be cancer free in 2015. I have never expected that this would happen with me, but obviously no one thinks this way, and if they do only it's in their nightmares. Sometimes I feel why has God chosen me????????????????? Maybe he thinks that only I can deal with this in a better way. As I always say God gives his hardest battle to his strongest soldiers and I am sure, he considers me as his strongest soldier. And I'm sure he only will make me come out from this.

I strongly feel that sometimes when you are surrounded by the persons who love you and care for you, it really becomes a little better to go with such things in life. There are certain facts about life that I have recently accepted, its just I am having a tough time adjusting and coping with them. I'm so thankful that I not only have a loving family, but also amazing friends, great mentors who stood by me, supported me and have given every piece of their heart.
 

I consider this an experience of a life time! Considering the positive things, it has given me a lot, it has given me glimpse of and a new meaning to life and death! It has made me strong, it has strengthened my old friendship, ties and bonds! It has brought to the fore how much people around love me, though they may not have been saying it in so many words. It has once again emphasized the importance of being healthy and reinforced my belief in God, his protection and guidance.

And considering what I have lost?? Well, I was forced to take a break from my professional life and new opportunities. I faced lack of good health, financial and practical issues, anxieties and worries and lot of inconvenience for my near and dear ones. Yes I am still struggling to get healthy body, and am still gulping down vitamins supplements and applying painkiller gel to the joints. Now I can say that I have made friends with aches and pains. I have come to learn and understand that I will be able to get back to a healthy life only if I am able to respect what my body and mind have been through and allow it its own pace and space.

Now I have left everything on God, whatever he will give I will take it with a smiling face and with open arms. I will be happy If I could inspire even one person with my story.

Ganga Prem Hospice
Ganga Prem Hospice played and is still playing an important role. It’s a non-profit organization for cancer patients. So when I was going all through this, one of my dad’s friends told us about GPH and about Dr. AK Dewan. When my uncle told my dad about GPH, I was like, “I don’t want to go to any other hospital now, I’m fed up of listening to many people views.” At that time I was very depressed and frustrated too, but my dad convinced me and told me to go to GPH once and said, “If you don’t feel comfortable don’t go again.” I said, “Ok.” As we were aware that Dr. Dewan used to visit GPH every last Sunday of a month, we planned for the upcoming last Sunday to meet him.

As I reached there, I saw many more patients sitting. There were some volunteers doing their work, but as I was sitting there waiting for my number I noticed how each team member is dedicated. They were not only helping the patients medically but emotionally and financially too, I was touched by seeing all this. I met Dr Dewan, he was so polite and answered all my queries. After meeting him and visiting GPH, I realized I did right by coming here because when you take the treatment from other hospitals, they provide you all the medical facilities and without any concern they will charge for the work, but they never treat you politely, they never understand the condition of the patient or family member. But GPH gave me everything, medically and emotionally, and not only me, they also helped my family to be strong, because they understand the pain of a patient and of family members too.

I would like to thank each member of Ganga Prem Hospice especially Nani ma, Dr. Dewan, Dr. Aditi, nurse Sicily, Steven, Dunia, Menakshi maam and Jamuna ji. Some of the names I don’t remember but I am really lucky to be a part of GPH. God bless you all. You all are doing a great job.

 

Skin Cancer: Causes, Prevention, Symptoms & Treatment
By Dr Charu Sharma

Dr Charu Sharma, a renowned cosmetic dermatologist, has a wealth of experience from meticulously performing thousands of aesthetic dermatology procedures. Having graduated from Bangalore and Wales (UK) Universities, she also holds diplomas from the USA and Dubai. Her articles have been published in leading newspapers including The Times of India.

I really do think that any deep crisis in one's life is an opportunity change it into something very special. I would like to take this opportunity to help in understanding the disease of skin cancer and also to suggest a few precautions which can help in reducing the risk of contracting the disease.

Skin cancer is one of the most common of all human cancers and living with it can present many new challenges for the patient and for his/her family and friends. Many people feel anxious and depressed; some people feel angry and resentful; others feel helpless and defeated. But it is possible to be happy without having perfect health... Thank goodness our happiness doesn't come from our body, but from our heart. I believe in this and hope faith will help others in believing the same.

Cancer

Cancer occurs when normal cells undergo a transformation during which they grow and multiply without normal controls. As the cells multiply, they form a mass called a tumor. Tumors of the skin are often referred to as lesions. Tumors are cancerous only if they are malignant. This means that they encroach on and invade neighboring tissues because of their uncontrolled growth. Tumors may also travel to remote organs via the bloodstream or lymphatic system. Tumors overwhelm surrounding tissues by invading their space and taking the oxygen and nutrients they need to survive and function.

Skin cancers

Skin cancers are of three major types: basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and melanoma. The vast majority of skin cancers are BCCs or SCCs. While malignant, these are unlikely to spread to other parts of the body. They may be locally disfiguring if not treated early. A small but significant number of skin cancers are malignant melanomas. Malignant melanoma is a highly aggressive cancer that tends to spread to other parts of the body. These cancers may be fatal if not treated early.

Like many cancers, skin cancers start as precancerous lesions. These precancerous lesions are changes in skin that are not cancer but could become cancer over time. Medical professionals often refer to these changes as dysplasia. Some specific dysplastic changes that occur in skin are as follows:

  • Actinic keratosis is a patch of red or brown, scaly, rough skin, which can develop into squamous cell carcinoma.
  • Dysplastic nevi are abnormal moles. These can develop into melanoma over time. Dysplastic nevi are not cancer, but they can become cancer. People with dysplastic nevi often have a lot of them, perhaps as many as 100 or more. They are usually irregular in shape, with notched or fading borders.

Causes of skin cancer

Ultraviolet (UV) light exposure, most commonly from sunlight, is the most frequent cause of skin cancer.

Other important causes of skin cancer include the following:

  • Use of tanning booths (not a common cause in India)
  • Immunosuppression—impairment of the immune system
  • Exposure to unusually high levels of X-rays
  • Contact with certain chemicals: arsenic (miners, sheep shearers, and farmers), hydrocarbons in tar, oils and soot (may cause squamous cell carcinoma)

The following people are at greatest risk

  • People with fair skin, especially types that freckle, sunburn easily
  • People with light (blond or red) hair and blue or green eyes
  • Those with certain genetic disorders that deplete skin pigment such as albinism, xeroderma, pigmentosum
  • People who have already been treated for skin cancer
  • People with numerous moles, unusual moles, or large moles that were present at birth
  • People with close family members who have developed skin cancer
  • People who had at least one severe sunburn early in life

Basal cell carcinomas and squamous cell carcinomas are more common in older people. Melanomas are more common in younger people 25-29 years of age.

Prevention

You can reduce your risk of getting skin cancer.

  • Limit sun exposure. Attempt to avoid the sun's intense rays between 10 a.m. and 3 p.m.
  • Apply sunscreen frequently. Use a sunscreen with sun protection factor (SPF) of at least 15 both before and during sun exposure. Select products that block both UVA and UVB light.
  • If you are likely to sunburn, wear long sleeves and a wide-brimmed hat.
  • Perform regular self examinations of your skin and note any changes.
  • Healthy diet.

Symptoms of skin cancer

 
   
Squamous cell carcinoma
Malignant melanoma
   

A basal cell carcinoma (BCC) usually looks like a raised, smooth, pearly bump on the sun-exposed skin of the head, neck, or shoulders.

A squamous cell carcinoma (SCC) is commonly a well-defined, red, scaling, thickened patch on sun-exposed skin.

The majority of malignant melanomas are brown to black pigmented lesions. Warning signs include change in size, shape, color, or elevation of a mole. The appearance of a new mole during adulthood, or new pain, itching, ulceration, or bleeding of an existing mole should all be checked by a health-care provider.

The following easy-to-remember guideline, "ABCD," is useful for identifying malignant melanoma:

  • Asymmetry. One side of the lesion does not look like the other.
  • Border irregularity. Margins may be notched or irregular.
  • Color. Melanomas are often a mixture of black, tan, brown, blue, red, or white.
  • Diameter. Cancerous lesions are usually larger than 6 mm across (about the size of a pencil eraser), but any change in size may be significant.

Many people, especially those who have fair coloring or have had extensive sun exposure, should periodically check their entire body for suggestive moles and lesions.

Examinations and tests

If you have a worrisome mole or other lesion, a dermatologist will examine the entire skin surface. A sample of skin (biopsy) will be taken so that the suspicious area of skin can be examined under a microscope.

A biopsy can almost always be done in a dermatologist's clinic. If a biopsy shows that you have malignant melanoma, you will probably undergo further blood tests, a chest X-ray and other tests as needed.

Treatment of skin cancer

Treatment for basal cell carcinoma and squamous cell carcinoma is straightforward. Usually, surgical removal of the lesion is adequate. Small lesions may be removed through a variety of techniques, including simple excision (cutting it away), electrodesiccation and curettage (burning the tissue with an electric needle), and cryosurgery (freezing the area with liquid nitrogen). Larger tumors, lesions in high-risk locations, recurrent tumors, and lesions in cosmetically sensitive areas are removed by Mohs micrographic surgery. The surgeon carefully removes tissue, layer by layer, until cancer-free tissue is reached. When treated properly, the cure rate for both basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) approaches 95%.

Malignant melanoma, however, may require several treatment methods, including surgery, radiation therapy and chemotherapy. Because of the complexity of treatment decisions, patients with malignant melanoma may benefit from the combined expertise of a dermatologist, a cancer surgeon, and an oncologist.

"Turn your face to the sun and the shadows fall behind you. Turn your worries and pain over to God." - Dr Charu

 

 

INDIA, Gohri Maphi, January, 2017
A Patient Weeps for her Daughter
In late November 2017, Ganga Prem Hospice got a phone call from one of its volunteers asking for help for a 43 year old underprivileged woman who had just been diagnosed with cancer.

A hospice volunteer was helping the woman financially so that she could get a hip surgery done for a broken bone. When the injury was investigated at a local hospital, a diagnosis of extensive cancer came to light. The patient lived in a roadside hut and used to work as a domestic help when she was still able. As she was bedridden her daughter had had to leave her cleaning job to care for her and the two were struggling to find food.

Ganga Prem Hospice immediately made a home care visit after which Parul Mandal was transported to the hospice on December 1st, for admission to the inpatient facility.

 
   

Since then, Ganga Prem Hospice has cared for Parul, giving her medical care, and providing for all her needs. In winters, Parul enjoys lying on a cot in the sun in the hospice verandah, that overlooks the Ganga and the forest. "Had I known of this place earlier, I would have worked here for a living - done some seva as well as stayed here," says Parul to a Hospice worker.

 

 

The nurses take constant care of the patient who does not receive any other visitor except for her lone daughter, about who Parul worries day and night. The daughter, who is in her mid twenties, now has a small job at a local restaurant during the day and cooks in someone’s home in the evening. Her mother is worried about her being alone at night and about what would happen to her if she dies. The debt the daughter has incurred for her mother's treatment is another source of worry. Knowing of this situation, a Ganga Prem Hospice volunteer spoke to the restaurant owner, who assured that they would keep their employee's best interests in mind, especially at a time when she was facing such a difficult domestic situation.

Parul, who was very malnourished, was also suffering intense pain from her broken leg and bedsores which have developed because she is unable to lie in any other position. The bone could not be set due to extensive bone cancer. Parul also has lung and liver cancer but has found pain relief at the hospice. 

As a patient who came from an economically disadvantaged background and who has struggled hard to bring up her only daughter after her husband left her, she often experiences great emotional distress. The hospice team spends time with her listening gently as she repeats her story over and over again and comforting her as she weeps for her daughter.  The team is thankful to be able to offer social and emotional support as well give her medical relief for her pain.

16.3.2018

Parul passed away peacefully in the early afternoon of the 16th March. As the team waited for her daughter to arrive a lamp and incense were lit next to Parul’s body and the Srimad Bhagavad Gita was chanted in her room. Later the nurses helped Heena to wash her and she was dressed in a beautiful new pink sari (her favourite colour). Parul’s  face was serene and she really looked beautiful. Two vehicles and two scooters accompanied her body to the funeral ghat where the GPH completed all the traditional rites for her. She would have been happy at the respect and love which surrounded her on her last journey. As promised to Parul, GPH will make sure that Heena is well looked after.  

 

 

 

INDIA, Gohri Maphi, December, 2017
MY STORY by Vikas
My name is Vikas Singh Jhethuri, age 17, I was born in Mindath, Silesara village, Uttarakhand in the year 2000 to Dina Devi, age 40, mother and Raghuvir Singh Jhethuri, father.

My father passed away when I was 13 years old. I have three sisters and one brother. I am the eldest of five in the family. After my father passed away the living condition at home was very difficult. In 2014 I left home and travelled to Dehradun in search of work. I found a job in a house, where I worked from 6 am to 12 pm. I washed cars and helped with small jobs around the house and in the kitchen. I was paid 3000 rupees per month. I felt compelled to help my mother financially because the villagers who had helped us started asking for the money to be repaid. In order to repay the loan i stopped school and went to work. I did not complete my 10th Standard . Round about 2015 my voice started changing then there was trouble breathing. I went to a nearby hospital where i was told that being winter I was suffering from cold and I was prescribed homeopathic medicine to take for 4 months but my condition got worse. I then went home.

When my mother saw my condition she consulted the village people who said that the goddess and god are angry and I should do pujas to worship them. This of course required some money.  Even after paying some money and doing the necessary pujas, my condition did not change. When my condition got intolerable I was advised to go to AIIMS hospital, Rishikesh.

 

 

At the AIIMS hospital,  Rishikesh, the doctors told me that I had papilloma. The hospital did not have a laser machine to do a laser surgery.  The doctors referred my case to AIIMS in Delhi. I became frightened by the situation. I knew my mother could not afford the cost of the surgery, let alone travel to Delhi. She could not leave my sisters and brother, and the animals to accompany me. The prospect of travelling to Delhi and undergoing surgery on my own scared me. Furthermore I was told that there was a month’s waiting list for laser surgery. I could not afford to stay in Delhi for a month waiting for a laser surgery. I was totally dejected and depressed because during this period we were under enormous financial strain, we had no income of any kind and no food at home. In desperation I called my grandfather who gave some money and also accompanied me to New Delhi. Some relatives with great difficulty managed to lend us a small amount of money.

We arrived in New Delhi and stayed for a month waiting for the laser surgery. After a month the surgery was done.  It went well. The surgeon told me to return in a month’s time. However within 20 days I had the same problem with the throat.  We returned to AIIMS New Delhi and after the checkup I was told that the papilloma had increased and that I may need another laser surgery. An urgent surgery was done. But 8 or 9 days later the problem returned. I returned to the hospital and was told that further laser surgery could not repeated within such a short period however an operation was done to allow a tube to be placed in my throat. It was during this operation the doctors mentioned that I had cancer. On hearing this I broke out in cold sweat and thought I had not much time to live. I cried for days and did not eat food.  Then the doctors assured me that i will be okay after radio therapy however if the cancer returned I would require another surgery.

The ENT specialists said that I had advanced local cancer and that I had to undergo radio therapy soon after the operation.  I had a tracheostomy followed by a total laryngectomy, total thyroidectomy. A tracheo-esophageal puncture (TEP) was inserted into my throat to allow me some  way of speaking. After three weeks my radio therapy started, which lasted for 2 months.  Today I have  a hole at my throat.  I am unable to sound out my words and therefore cannot carry out normal communication. Two more surgeries are required to widen the stoma which will then hopefully allow the TEP to work.

In addition to dealing with cancer I was told that the MRI and CT SCAN of my chest indicate that I have tuberculosis (TB) of the lungs.  I am currently on medication for TB for next 6 months.

My mother worries about me because she cannot accompany me for visits to doctors in Rishikesh or Delhi. When I am away from my home I have no way of communicating with my mother or my siblings. The reason being i cannot speak, I can only text them via WhatsApp but my family do not have a mobile phone, we simply cannot afford one. It was only through the generosity of volunteers of GPH that I was gifted a mobile phone. This enables me to communicate with my uncle.
Pending the clarification of my disease I stayed at Ganga Prem Hospice. As of 24th December my chest xrays shows improvement and it has been confirmed that I do not have cancer in my lung but I do have TB and that I should continue to take medication for this disease for further 5 months. I will be returning to home now and will continue taking the TB medication till I am cured of this disease.

I am very grateful to Nani Ma ji, the staff of Ganga Prem Hospice and volunteers for taking good care of me and for all the help rendered to make my stay at the hospice a pleasant and memorable one.

 

 
 
Vikas during art therapy at GPH inpatient facility
Vikas during art therapy at GPH inpatient facility

 

 

GANGA PREM HOSPICE - HOME VISIT REPORT

Date of Home Visit: 3rd December 2017
Name of patient: Vikas Singh Jethuri
Caregivers: GPH Volunteers Jyoti Jayan (Kerela) and Bibi Hamel (Rishikesh)
Address: Mindath,  Silesara village, Uttarakhand

Vikas, Jyothi and Bibi left Rishikesh in GPH’s vehicle at about 10.30 am.  Approximately at 12.30 pm we arrived at his village Mindath. The simple house was situated on a small hill and somewhat isolated. Enroute we did not see any vehicles i.e. shared jeeps or buses coming down from the villages. Neither did we see any facilities i.e. medical or banks or any kind of township.

 

 
Bibi with Vikas and his family
Bibi with Vikas and his family
Jyothi with Mr Jethuri
Jyothi with Mr Jethuri 

 

His mother was away cutting fodder for their cows and his 14 year old younger sister was busy with household chores. Two of his other siblings an 11 year old sister and 7 year old brother greeted us shyly when we arrived unannounced. When his mother learned that Vikas had come, she hurried home with a load of freshly cut grass. She was happy to see her son and relieved that he is alright because she had no idea where or how he was.  Jyothi assured her that he was well taken care off. The mother’s other worry was that she or her children had no way of contacting Vikas as they had no mobile phone so that  they could at least keep in touch via text messages because Vikas is unable to speak due to Laryngectomy. He was diagnosed with larynx cancer.

Mrs.Jethuri is a widow with 4 children. Her husband was killed in a truck accident 7 or 8 years ago. Vikas, then 13, stopped attending his schooling and started working to help contribute towards the household and help his mother pay off some of their debts incurred after his father passed away. In 2015 he was diagnosed with larynx cancer which required surgery. In the course of medical checks it was found that his lungs were infected either with cancer or TB. 

Pending confirmation of the disease, Vikas stayed at Ganga Prem Hospice. He is currently being treated by doctors at AIIMS hospital, Rishikesh.

The financial situation of this family is poor. Mrs. Jethur is unable to go to work as she has not only her other children to take off but also the cows. She is responsible for sourcing fresh green food for the cows on a daily basis. As she has no income other than the small widow’s pension she receives, she is also doubtful of being able to afford the cost of travelling frequently to Rishikesh or Delhi if and when further visits to doctors are required.

Vikas is keen to complete his 10th Standard. He is interested and good at sketching, painting and photography. He has got artistic talents which could be encouraged by guiding him into the appropriate college for further education.
Both Jyothi and Bibi helped the family by buying provisions and contributing some money towards their daily needs before they took their leave.

As of 24th December Vikas his chest x-ray shows an improvement and he has been cleared of cancer however he will have to continue taking medication for his TB for further 5 months, after which he can undergo two more surgeries to widen the stoma which will then hopefully allow the TEP to work.

 
 

 

INDIA, Gohri Maphi, November, 2017
A Quiet and Contented Patient
Siya Ram is a quiet sixty-seven year old suffering from cancer of the oesophagus.
Siya Ram’s neck wound is testimony to the advanced stage of his cancer which has brought him to Ganga Prem Hospice inpatient facility, where he is cared for, giving medical assistance, and nutritional support, all free of charge.


 

Reshu blows out the birthday candles
Siya Ram at the hospice
GPH team dancing and singing with Reshu
Siya Ram and Sharbati Devi enjoying the sun

 

Siya Ram has lived in Rishikesh for many decades, working as a labourer in a stone powder making unit till the factory closed down a few years ago. He has a son and three daughters, and the son and grandson visit him every alternate day at the Hospice. “I have had cancer for three years”, says Siya Ram. His movement is limited but he now walks around on the wide hospice corridor with the aid of a walker or the arm of hospice staff.

"Siya Ram is a very cooperative patient", says one of the hospice nurses, looking at him fondly, “ He is very easy to care for, never fussing when his wound is dressed, or with his meals.”

As winters set in, Siya Ram enjoys lying on a cot out in the open hospice corridor, taking in the warm sunshine, as the Hospice staff gently oil his hands and feet.

Update 7.12.2017
On the 3rd of December Siya Ram asked that his children and grandchildren should come and visit him. As many of his sons, daughters and grandchildren as were able came to visit him in the afternoon and he spent a joyous few hours with them.

On the 5th of December Siya Ram asked for his own bedding to be brought to him and he snuggled up happily under the huge, heavy and somewhat faded covers.

On the 7th of December in the early evening he passed away quietly with his grandson and the hospice staff in attendance.

 

 

   



PATIENT'S STORIES
Cancer patients and their loved ones are invited to write to us about their views, thoughts and feelings. We will include as many letters, articles and stories as is possible in these web pages.

Please send your article to Nani Ma at nanima@gangapremhospice.org.

 
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