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Smoking causes cancer

2022; Medknow; Volume: 5; Issue: 3 Linguagem: Inglês

10.4103/crst.crst_204_22

2590-3233

Vandana Mahajan,

Cancer Risks and Factors

This is the story of Mr. Mehul Vyas who was given a month to live in 2014. It has been 8 years since that diagnosis, and he continues to thrive and inspire many patients with cancer to hold on to hope and not give up. "It's not about how much time you have. It is what you do with it."- says Mehul. Mehul was addicted to tobacco and gutka. He used to smoke and consume alcohol with friends since his college days, knowing that tobacco abuse causes cancer but believing that cancer could never happen to him. He smoked a packet of Gold Flake cigarettes every day. In March 2014, his wife left for the United States of America (USA) on a job assignment. It was around that time that he began to lose weight, his voice became hoarse, and it hurt to swallow. He also felt a lump in his throat. Breathing became difficult. He went to a local doctor who prescribed antibiotics; when there was no improvement, the antibiotics were changed. Nothing helped. Every day he would make a promise to himself to stop smoking. But such was the addiction that the very next day he would smoke again and would renew his promise to himself that he would quit smoking. In his mind, he had it all: a call center job, a team leader, nightlife, parties, outings, dinner meetings…the list went on. Alcohol and cigarettes became a part of his life. He just could not give up his addiction. Quoting Mehul: "Do you know what it is like to be unable to breathe? You try hard to draw air deeply into your nose, but the air will not reach your lungs. And the harder you try, the more it frustrates you. I was breathless, scared, and miserable." Mehul went to his mother's home. Hearing his breathing that night, she convinced him to go to a hospital. The endoscopy revealed a big lump on his right vocal cord. Mehul shared, "I cannot express how I was feeling. The earth had stopped rotating for me. I knew life would not be the same from then on. A thousand thoughts ran through my mind in those ten minutes. I was trembling and sweating. I started the car and drove straight to Alandi (a pilgrimage place close to Pune). Jalaram is a saint of Gujarat in whom my mother believes a lot. I trust in God too. I sat in the temple, in front of Jalaram's idol. I do not remember how I reached there. I sat there till it was time for the temple to close. Now, I don't remember what I thought about, but I am sure it was about my son, my wife, my parents, my brother, and what to do next." He had made up his mind to go to the biggest and most advanced hospital in town to get the correct diagnosis about the nature of the lump. As the tumor was blocking the airway, surgery was planned. An incision was made in the throat and a tracheostomy was performed. A pipe was inserted so that he could breathe. The nasal passage was bypassed. He was unable to speak or talk. In Mehul's words, "I felt as if I were half killed but I had no option either." A biopsy confirmed that he had Stage IV cancer of the larynx (voice box). He was advised a surgery to remove his voice box. This meant that he would never be able to speak and would have to breathe through the external tracheal tube for the rest of his life. The family started seeking second opinions about alternative treatment options. His wife was looking for options in the USA as well. That was when he made the decision to move to the USA. Air travel was difficult because Mehul was still breathing through the tracheostomy tube. The treating doctor in India made a medical kit for Mehul, in case there was any emergency during the journey. She also trained the person traveling with him in case of an emergency. Mehul was taught how to change the tube which was in his throat. On arriving in the USA, they went directly from the airport to the hospital where he was admitted. After consultations with the oncologists, Mehul was handed his prognosis—he was given only a month to live. Mehul was shattered. Cancer had now touched his spine. Mehul says, "I did not want to die. I wanted to see my son grow up. I wanted to be with my wife. I desperately wanted to correct my mistakes." The doctors planned aggressive chemotherapy. The protocol decided included paclitaxel, cisplatin, docetaxel, and 5-fluorouracil. By now, Mehul had a tracheostomy tube in his throat to breathe, a percutaneous endoscopic gastrostomy (PEG)/Ryle's tube in his nose and stomach, and intravenous lines in his arms. He was so heavily medicated that he could not feel much. He fed himself through the PEG tube in his stomach. The chemotherapy was set for three cycles lasting 1 week each (with about 2 weeks break in between cycles). Each cycle lasted for 120 h. Mehul shared that the chemotherapy felt like thousands of insects crawling over him. Long hours of treatment and being in the hospital with the unending saga of pain and weakness was making it hard for him to push away the negative thoughts. Many of his friends, acquaintances, and relatives had distanced themselves from him and his family. He felt alone and dejected. Fortunately, his body started responding to the chemotherapy. The scan that followed after three cycles revealed some traces of cancer. He was given a choice—removing the vocal cords or continuing with chemotherapy and radiation together. Mehul did not want to not be able to speak to his son and family, so he bravely chose the latter. He wanted to talk again. He wanted to get into arguments with his wife again. Finally, after over a year of aggressive treatment, Mehul was declared cancer-free. Chemotherapy and radiation had many side effects, some of which were severe, which were managed with medications. He had lost all his teeth due to radiation, had to get 12 implants in the mouth, and developed permanent hypertension and tinnitus (ringing in the ears) for which no cure has happened yet. His thyroid glands are damaged and require medication. His brain does not communicate properly with his legs, so he is unable to run due to the fear of falling. He says, "I lost precious time, friends, and a lot of money for the treatment. What I won back was my life. Cancer taught me to be positive and optimistic. It made me realize that small things matter a lot in life. Eating ice cream or just taking a shower. You learn to appreciate small things when you miss them. Cancer taught me to live life today! I started working hard, got good jobs, bought a house, car, learned to fly a plane, travel to different places, enjoy nature, and spend time with my family. Smoking being the reason for my cancer, I go to schools, colleges, and other institutions sharing my story to create awareness on cancer and the ill-effects of tobacco and smoking. I also run a cancer support group and try to help and motivate fellow fighters to get through. In all of my journey, my wife has been my pillar of strength. I owe my life to her." "Never knew that life could be so beautiful! Miracles happen, you need to make them happen!" says Mehul Vyas. About the patient Mr. Mehul Vyas is a senior fraud investigator, SME-Credit Card fraud and disputes, RPA analyst at Bread Financial Card Services. He lives in Columbus, Ohio, with his wife Anagha, son Arjun and their dog. He has dedicated his life to the cause of fighting cancer and is very passionate about raising awareness about the ill effects of tobacco consumption. He runs a Facebook page called Cancer Survivors in India. He can be reached on his following social media handles: https://www.instagram.com/arjunmehul https://www.linkedin.com/in/mehul-vyas-b0bb5ba5/?original_referer = https%3A%2F%2Fl.facebook.com%2F https://www.facebook.com/arjunmehu About the author Ms. Vandana Mahajan is a Palliative Care Counsellor. She is associated with the Mumbai-based non-government organization, Cope with cancer-Madat Trust. She works as a volunteer counselor in the thoracic disease management group at the Tata Memorial Hospital, Mumbai, and also provides cancer counseling across India via online platforms. She is a Cancer Survivor too! E-mail: vandanamahajan. [email protected] Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.