December 2020

COVID-19 alert!!! Get screened, Get diagnosed and Be safe from Cancer teaser image
While this COVID-19 pandemic has been a threat to the entire world this year, there is yet another threat lurking for some of us. Since being in the healthcare field and recently having a first-hand experience in my family, I feel it is my duty and obligation to share this information to my readers. Maybe this incident is my calling to find a way to create awareness in many other people! 
Being in the healthcare field as an oral pathologist, I always thought that I had learnt a lot about cancer. Whether it was working on molecular pathogenesis in cancer during my Ph.D. in Japan, researching the epidemiological aspects of cancer, or diagnosing cancer microscopically for many patients in Nepal, I always felt that I was doing my best to stand against this deadly disease. But alas! This summer I realized that no matter how many years I have put my tears and sweat into learning about this deadly disease, and no matter how big an impact I might have made in understanding the molecular biology of cancer cells, I failed to beat the impact of cancer itself! 
A few months back, I had the most devastating conversation with my mother that I have ever had. My mother was diagnosed with a stage 3 breast cancer during this Covid-19 pandemic, and it turned my world upside down. 
For the first few days, I kept on thinking, “Why her?” I felt betrayed and cheated by God. I felt as if this world was so unfair to those who are kind and caring. If you want to define my mother, she is like Mother Teresa. She has been the pillar of her big family, sharing resources and finances to help each family member. She helped various humanitarian organizations by organizing various donations from every capable person she knew, and lent a hand to every person who was in need of help, for her entire life! I doubted the existence of God and was trying to justify every reason why she should be the last person to get this dreaded disease. 
Well, even the timing of this news could not have been worse! I am struck here in U.S. because of travel restrictions back home! All I can do is only share my virtual existence to the most valuable person to me in this world. I felt hopeless. I felt like all my Ph.D’s and master’s degree in pathology and cancer research were useless, as they could not offer help in any way for my own mother!  This news had to come at a time when I was closer to learning a lot about cancer than I would normally be as an oral pathologist. I was doing my six months rotation in the general pathology department, and I had a lot more exposure to seeing cases of breast and other cancers through frozen sections and slides under the microscope than regular times. 
After a few days of trauma, depression, and crying my heart out, my educated brain started to come into action. I was frantically gathering my expertise and knowledge, finding about the biological and molecular characteristics of the type of breast cancer that had attacked the person I loved the most in the world. At times I even googled crazily, just like a layman! While my learned side encouraged me to have various discussions with experts in the pathology department and online consultations with the onco-surgeon and oncologist, my social side arranged meetings with friends and people who had their own experiences of battling cancer. I just could not imagine the worst outcome that I had read about and seen in patients for my own mother. I only wanted to give her the best that I could in this virtual situation. 

I was on the verge of breaking down, but giving up was the last thing on my mind! 
We had everything planned for my mother within a few days, and now she has already been treated by surgery and radiation. Her Oncotype DX test results will determine if she has to undergo chemotherapy or not. 
As I started to reflect back on what might have been the reason that my mom received this diagnosis, I could not keep myself from sharing all the things that I have learned in the past couple of months from this life experience. 
My mom was always a good listener. As a dedicated daughter, I have been telling her about the value of early diagnosis in diseases. My mom, the diligent parent that she is, has been duly doing her breast examinations and cervical examinations through yearly visits to the gynecologist. Her doctor examines her breasts for any obvious nodules, swellings, changes and also takes a smear from her cervical areas to check for any abnormal cells.  Moreover, for the extra cautious person that I am, I have also taught her breast self-examination methods and showed her videos, which she does once or twice a month. 
Friends, this COVID-19 pandemic might have affected so many of our families directly, but it has also indirectly cost many lives, as fewer people are doing their regular visits to the doctor.  
I must say my mom was one of these extremely COVID-cautious people, so much so that she felt it was risky to go to a hospital for her yearly screening program at the doctor. 

However, on the bright side, I must also say that it was through her own self-examination that she discovered a tiny nodule in her left breast. She felt that it was too tiny to let me or any family know about it. She thought to keep it under observation by herself. So after a month of observation, she was sure the slight increase in size was a bad sign, and it was then that she decided to inform us and get a biopsy done. 
Working in the pathology laboratory, I often keep on going back to our phone conversations throughout this entire pandemic. Did I remind her enough to do regular self-examinations? Did I remind her to have a regular visit to the doctor? Did I make sure to check if she had really done it? Among the various conversations I had with my mom, I always wondered, what if we had found the nodule earlier? Would it have made a difference? 
Well, YES FRIENDS! The time of diagnosis matters a lot when it comes to the overall prognosis (outcome) of any cancer. 

So PLEASE, if you know someone who is a female friend, a mother, a sister or a cousin, please encourage them to do self-breast examinations, and if ever there is a history of breast cancer in the family, the person needs to consult a doctor at their earliest for routine examination, mammography, and genetic testing if required. 

Your doctor would be the best person to provide you the information and needed check-ups. So, if you are due for a visit, or if you know someone who has been delaying a visit due to fear of the coronavirus, please suggest to them that it is also important to screen and be safe from various cancers. 
Apart from breast cancer, being an oral pathologist, I would also say that a routine visit to the dentist for screening of any oral disease besides caries and gum problems could also be a life saver to many of us. Like any cancer, the chances of having a successful treatment and a better outcome always improve with an early diagnosis. A simple visit to your dentist and your doctor may be a game-changer when it comes to cancer. 
So friends, as we are learning to survive the pandemic, we must also be aware that there might be various other diseases hovering us without our knowledge, and the best way to fight them is to be alert, be sensible, and have regular screening check-ups. The next big thing is spreading awareness. Even if you share with only one person, it might have an impact for many others. 
-Madhu Shrestha 
Madhu is a master’s student in the Department of Oral & Maxillofacial Pathology. 

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