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Submitted by PatientsEngage on 30 May 2016

Nilakanta Siva recounts how his smoking habit caught up with him later in life well after he had kicked the habit. He now lives without a bladder, prostate, several lymph nodes and a solitary kidney. And wishes he had not started smoking.

“Hey, Siva, you know what. They are asking for volunteers to join the National Cadet Corps,” shouted Vijay. You get credits for the hours you spend at NCC. You need not even attend Biology classes, totally exempt.”
“That is great. Long live the NCC option.” We shouted in unison.
And while at the NCC sessions, I was amongst not only recruits but also senior cadets and a professor as the commanding officer. I really enjoyed the parades and the military-type training. And there was the mid-parade interval with masala vada and tea. And under the shade of the trees, multiple small groups would start lighting up their cigarettes.

Soon enough, I started saving money from the bus fare for my love of the cigarette, and I even started walking to college and back. Naturally, I used to be ravenously hungry the moment I would reach home because I spent the money for lunch also on cigarettes. I had also started running errands to make some extra money.

I had ended up joining one of those several groups in college that spent their free time blowing smoke rings. A friend of mine who had been with me throughout school felt hurt when others would comment on me puffing away like a steam engine. She even confronted me with her accusations. I tried to dispel her fears, and in the process mine as well, that since what I smoked had a filter at one end, my lungs were probably safe. At that point of time, perhaps lung cancer was the uppermost concern for smokers.

And this perhaps was the beginning of what manifested itself as gross hematuria fifty years later. And subsequently, my hostel life in the IIT gave me unfettered access to cigarettes. I was by then more aware of the dangers of smoking, yet I was strongly addicted to it. I was destined for what had already been written on the wall --carcinoma of the bladder.

It is well-known that cigarettes push one closer to cancer. Abnormal cells in the body are corrected by inherent mechanisms, which get damaged by smoking and bad lifestyle. When inhaled, these toxic chemicals pass directly from the lungs into the bloodstream. Blood then filters through the kidneys and these carcinogens end up being concentrated in the urine. While urine remains in the bladder, these toxins damage the cells in the bladder lining and, over a long period of time, cause bladder cancer.

And reaping what I sowed, I now find myself without my bladder, prostate and several lymph nodes and with just a solitary kidney, the other being dysplastic and hence ligated, though this is unconnected with tobacco use. Nevertheless, I still manage a decent and respectable quality of life.
Life wasn't all that bad till recently. I led public awareness programmes about nuclear medicine and radiopharmaceuticals and the use of radioisotopes in diagnosis and therapy, including radio-immuno-assays and cobalt teletherapy and brachytherapy. Could I ever have realised that I might one day need it to cure my ailment?

Nevertheless, the fear of passive smoking, the effects it can have on my wife and children, and the possibility of my children falling prey to the same addiction made me quit the habit. It was a tough thing to kick the addiction, fighting with myself for “just this one please”. Luckily, I had a very supporting wife who saw me through the entire withdrawal trauma. And I thought I had taken care of the worst. But the habit of smoking is merciless and I had to pay the price more than twenty years later. Not  even in my wildest dreams could I think of falling prey to the dreaded disease ever. 

Trying to quit smoking: Join the No Smoking Community and Take the pledge

My telephone call this morning to the Stoma Care shop specified the list of items that my present condition required. The abdominal flange/wafers, the urostomy bags, the tube of stomahesive paste, tincture of benzoin, gauze square strips, micro-tape and other such matters of essential detail belied the fact that here I was without my bladder, my prostate and several nymph nodes, all because I had chosen to smoke with so much relish. Was it really worth it?

I am in half a mind of displaying a flex board showing the abdomen with the stoma and the urostomy bag dangling just to warn the kids what they were in for with smoking.

However, every cloud has a silver lining. There is a Government diktat from April this year that tobacco product packages should have large images of the ill effects of its use. The Juvenile Justice Act has also been amended to make the sale of tobacco products to minors (below 18 years of age) punishable by up to seven years in prison and a fine of up to one lakh rupees.

Today is “World No Tobacco Day” and the autorickshaw goes screaming by into their loud speakers, 
“Beautiful Smoke rings please go away
Don’t show the crab yet another way”

Nilakanta Siva and his wife Rajalakshmi Siva have written the following book 

When Thoughts Invade the Cancer Conqueror: Solitary Kidney and No Lymph Node, Prostate, or Bladder Paperback