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Submitted by PatientsEngage on 29 July 2016

Shivaji Lande was shocked when he was diagnosed with cancer of the oesophagus, an uncommon but serious type of malignancy that affects the food pipe and makes swallowing difficult. Read about his struggle to survive and how he dealt with his worries.

I was 34 years, happily married and working for an engineering company in Bangalore, when my world turned hellish. This happened in October 2014. One night, while having dinner I suddenly noticed difficulty swallowing and began coughing while eating. When it persisted the next day, I visited a doctor, who told me it could be due to acidity and gave me some antacids.   The medicines did not help me at all. The discomfort while swallowing continued. Sometimes, when I would take a big chunk in my mouth, I would land up choking and coughing. As the days progressed, my situation started getting worse. I became extremely careful while eating. I would take small bites and preferred soft, semi-liquid diet. I began feeling weak and lost 7-8 kgs in just 15 days. I would land up vomiting while eating. I felt something was wrong and couldn’t continue like this anymore.

Getting diagnosed

Finally, I was recommended an endoscopy of the oesophagus commonly known as food pipe. The endoscopy revealed a tumour. A biopsy was done which indicated the tumour was malignant. I had cancer of the oesophagus. The medical papers indicated that I had squamous cell carcinoma of middle third of the oesophagus.

I became numb with shock. I couldn’t believe what the doctor was saying.  There must be something wrong with the diagnosis. I had heard of cancer of the lungs, mouth, prostrate, but never come across anyone with cancer of the oesophagus. Besides, I was young, healthy with no major ailment or complaints before. Smoking and drinking alcohol are two of the biggest risk factors for oesophageal cancer, but I had not touched a cigarette or alcohol in my life. Also, I was not exposed to any chemicals or factory related chemical exposure. I had never chewed tobacco or betel nut. Once in a while, I would have paan.  

When I was diagnosed with cancer, my wife was six months pregnant. She had insisted that she accompanies me to the hospital on every visit. That night, when we came out the doctor’s room, we were both trembling. As we sat in the car, neither of us could hold back our tears, and we both broke down uncontrollably. My house was an hour’s drive from Narayan Hridayalaya , Bangalore. My wife kept sobbing all the way back home. I realised that I had to control myself for her sake. I held her hand and tried to comfort her, but found it difficult to hold back my own tears. We were both shattered.

I was referred to an oncosurgeon at Manipal Hospital. My case was discussed by a team of doctors. A PET-CT scan was done to ascertain the exact location of the tumour and to find if the cancer had spread to other areas. I was informed that it was Stage 3 of the oesophagus cancer. It may have started to spread into neighbouring tissues and there are cancer cells in the lymph nodes in the area.

I was recommended a combination of chemotherapy and radiation therapy as the first treatment, with surgery afterwards depending how well the chemo-radio therapy had worked.

Meantime, when I informed my father and family members, they were absolutely horrified. My father rushed from Nagpur to be with us. After consulting my best friend, a consultant metabolic physician in Mumbai, it was decided that I should visit Tata Memorial Hospital, Bombay for a second opinion. But the diagnosis was the same there too.

I returned to Bangalore totally devastated. I remember it was the night of Diwali, but for us at home there was total darkness. My world seemed to be crumbling and there was nothing I could do except to continue the treatment. I was not sure about my future. I would spend sleepless nights and fearful days regarding the prognosis.

Every moment I used to think of what will be course of this? Will I be dying before I see my Baby? Will this process of treatment will be painful? How much time would the treatment take? Would I become disabled for life? What if I didn’t survive? It was a nightmare and most nights I would spend in cold sweat.

Starting treatment

My first chemotherapy began on November 4, 2014. It was in an intensive dosage.  It was called Multirate Infuser intravenous Baxter, an ambulatory infusion therapy with a bottle and pump attached that I was required to carry with me for four days during the chemotherapy. It allowed me to return home instead of being admitted in the hospital.

But after the first chemo, I was in dreadful shape. I was completely knocked out. I was sick, dizzy, nauseous, unable to eat or sleep and awfully restless. My intake after chemo reduced to half. Anyway, I could not eat any solid food.

Surviving on liquid diet

I was on liquid diet even before my treatment had started. But after the first chemo, I couldn’t even take liquid. Nothing tasted good. In fact, the sight and smell of food would make me throw up.

With great difficulty I would have a few sips of coconut water or some vegetable or fruit juices. A spoonful of chapati ground with dal in the blender to make it semi-liquid would fill me. My family and neighbours were extremely supportive. If it had not been them, I would have probably not pulled through. My father and mother-in-law, who were staying with us, made huge adjustments to build my health.  They compromised with their resolute beliefs about vegetarianism, and encouraged me to have eggs, mutton soup, chicken broth, generously prepared by my neighbours all through my treatment. My wife and I cried the first day I had non-vegetarian food. Our entire life, we had been staunch vegetarians. In fact, non-vegetarian food was not even allowed into our house. So, it was a heart-breaking moment for us.

My second chemotherapy was as bad. But with the help of my wife, family, friends, I mustered up enough courage to carry on. Also, my company helped me with extra leave on medical grounds.

In between chemotherapy, work from home was allowed to me. Whatever work was possible I did sitting from home. That was positive for me and helped me fight my anxiety, at least temporarily. Also, sleepless night turned into peaceful small naps. I got mental satisfaction and felt confident to go through this painful process.

My third chemo on January 3, 2015 was the most excruciating. Not because of the side effects of the treatment, but it was the day we were blessed with a baby girl. I cried all through my chemo that day because I couldn’t be next to my wife to share the joy. It was during one of my treatments that we thought of name ‘Advika’ meaning ‘Unique’ for our little one.

Radiation

After chemotherapy, I was given high dose of radiation for 27 days. I had barely completed 2/3 sessions of radiotherapy when another problem surfaced. I had developed esophagitis. It is an inflammation (swelling) of the oesophagus that causes pain and acute discomfort with swallowing, or gives a sensation as if the two walls of the foodpipe are stuck together. Esophagitis is a common side effect of cancer treatment that can be caused by radiation therapy or chemotherapy. There was unbearable pain in my whole body. I could not take even a sip of water. The moment I tried to sip even a drop of water, it was as if my oesophagus had been set on fire. I thought this was the end now and I was going to die.

I was admitted to hospital and administered intravenous fluid. I was also put on some medications to ease my pain and discomfort. Subsequently, I was put on self-expanding stents. This is another method of relieving the symptoms of dysphagia (difficulty in swallowing). The treatment involves placing small metal tube into your oesophagus. The stents expand to hold open the oesophagus, which helps to make swallowing easier.

Free from cancer

Finally in April 2015, all my treatments were over. I have had 3 scans after that, fortunately they were all clear. According to my medical reports, I am cancer free now. The tumour in the oesophagus had shrunk and there was no requirement for a surgery.

On the whole, it was immensely terrifying journey for me. If it had not been for the unwavering support and faith of my family, friends, neighbours and excellent doctors, I would probably not be here today. I feel I have been given a new lease of life.

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