Introduction

To be fair, I wasn't totally honest when I said end Dec was my introduction to Cancer. A very dear friends dad has been the world's authority in breast cancer ever since i knew him but given the arrogance and naivety of youth I hadn't realised how much a difference uncle made to thousands of lives every year until I was one of those fortunates to be treated by him. The friend himself had pursued a masters at John Hopkins - the Mecca of onco research world wide.

Closer to date in Aug 2017 I had also gotten my hands on an amazing Pulitzer prize winner 'Emperor of All Maladies' by Siddhartha Mukherjee. The non-fiction was scarier than a psychological thriller and left me with a slight sense of unease. For the uninitiated and those who may not want to plough through its 600 odd pages I would like to touch upon the key pointers he makes. The interpretations or possible mistakes are all mine and I request any reproduction of below should be taken directly from the book itself:

A. Cancer cells are effectively human cells that grow at super fast rates. Sounds simple? That's coz it is. They are part of our body which means our normal immune system (the bahubali of our body) cannot distinguish between a cancer cell and a normal friendly cell (effectively making a cancer cell the first Katappa - with nonaltruistic motives of course). So the body NEVER fights a cancer cell. 

As we evolve over the years and become stronger thanks to the multiple inventions in medicines - cancer evolves too (still a part of our body remember?) So they are still stronger than normal cells even after evolution. In fact cancer has been prevalent from ancient times and mummified remains of Cancer patients have been found at multiple locations. The one and only disease to have survived the centuries.

Scared already? There's more. Because cancer cells are part of body and body can't distinguish between them and normal cells - nor can external medicines. Most medicines act on the principal of attacking a foreign substance - a virus, a bacteria, a fungus etc. Only cancer medicines attack actual existing functioning and healthy body cells along with cancer cells! In fact the blood brain barrier; which evolved specifically to keep harmful cells away from the brain; lets in cancer cells happily while stopping chemo drugs from entering (in football analogy the worst kind of self goal there could be)

B. Now since cancer cells evolve they also learn to evade tactics of getting rid of them. So a single treatment methodology almost always has lesser effect in long term than a multi treatment one - hence the deadly triumvirate of chemo, surgery and radiation is prescribed for most cancers. (Think Ravan and his heart being crushed by Hanuman at the same time as Lord Ram let loose an arrow at his body. If both are not killed together one just regenerates the other and starts killing again. In fact Siddhartha mentions this Ravan story in his book as a possible analogy for cancer used by an ancient Aryan society which had made tremendous progress in medicine due to partly Sushrut and other greats)

C. And lastly the irony of it all - since the only way to distinguish these two cells is rate of growth, medicines target ALL growth cells in body which leads to normal side effects of hair loss, fertility loss, menopause in women etc...

So by the time it was necessary for me to research on cancer I knew the disease dispassionately. What was new was the jolt that even while I was reading up on cancer, it was growing inside me (remember the lump was discovered in Aug) - insidious lil thing that it is! And that introduced me to the most difficult part of Cancer - denial. Denial in all forms and I will touch upon the ones I experienced. But at the time that our story last digressed, Ashvek and I had just spent a sleepless night reading up on cancer.

Morning had us bundling up Manasvi to school and heading for a biopsy. Mum joined in with a glum face and dad just hugged me hard before I went in. I have a horrible habit of cracking wisecracks when I'm nervous - and I remember doing the same during the 10 min procedure. I have a very low threshold to pain (ask my gynaec - Even with just a 4 hour labour ending in normal delivery I was fighting half the time for an epi and begging for a csec which thankfully he refused) and so local anaesthesia was welcomed. A needle was inserted via guided sonography and tissue samples were pulled out for a typical FNAC procedure. Multiple slides were created immediately and handed over (did I mention I'm a doctors daughter and hence the radiologist went really out of her way?) And before dad and Ashvek ran off to literally opposite ends of Mumbai to get the sample processed, I got my mammo report. A typical mammo report has a scale with the lowest for benign tumours and highest for a 95 % probability for malignancy (doctor speak for cancer) and guess where was I on the scale? The highest possible rating! As we were to find out in the next few days - we were no longer interested in the statistic of 0.01 % women at 30 with no history of cancer get breast cancer but whether i was a 100% part of that 0.01%. There were no longer any probabilities of multiple dice throws - just a simple binary coin toss - yes or no!

And after the two longest days of our life (the mum and the mum in law kept in the dark to spare them the uncertainty) the coin dropped to show Cancer rearing its ugly head!