A happier tryst with 9/11

I thought long and hard before "coming out".

When I was diagnosed with Cancer, I suddenly realised how little I knew about it. Was it a pain or a swelling or a scar? What was the definitive diagnosis? Is it a death sentence? What are the treatment options available? It took me a long, long time to find the answers because Cancer is the great unmentionable, the whispered-about disease that no one speaks of publicly. So, I wanted to share my experience in the hope that it may shorten the discovery process for other persons with suspected or diagnosed Cancer, especially of the prostate. It is also a little selfishly cathartic.

My diagnosis came slowly. Around 2010, a colleague told me about this amazing doctor who managed to regrow my colleague's hair through medication. The doctor started me on Minoxidil for local application on the head and Dutasteride for oral medication. Lo and behold, my hair was back. Do these medicines have anything to do with Cancer? Not really, but taking Dutasteride nearly killed me.

A routine medical check-up in March 2017 showed my PSA (Prostate Specific Antigen) level to be slightly above the permissible 4.0 and both the doctor and I ignored it. In November 2017, this had gone up to 6.47, I was duly advised a Urology consult. The doctor told me that if one is on Dutasteride (yes, the hair drug), they double the PSA score. So my PSA was actually 12.94! An MRI indicated an abnormality. When I asked the technician about the results, he hemmed and hawed about it all being shadows, the doctor will decide, and so on. I asked him not to shadowbox over the interpretation of the shadows and he was pinned down enough to say that … 'um …, the doctor would probably prescribe a biopsy'. "When you hear hoofbeats, don't think zebras." I rushed to Tata Memorial Centre (TMC), Mumbai, where a biopsy confirmed Prostate Cancer.

Doctors at TMC recommended "active surveillance" because, often, this stage of Cancer (Gleason score 3+3) did not progress for decades and surgery, radiation, chemotherapy all had potential side-effects of incontinence and sexual dysfunction. Active surveillance meant PSA tests every six months and biopsy once a year. I opted for surgery which could potentially "cure" me of the Cancer, even though this option came with possible side-effects.

While the decision to have the surgery was the easy part, finding out where to get it done was anything but. I could talk to very few people because one does not go to town with the disease. Mention of Cancer sucks all the air out of a room. Almost everyone I talked to advised me to seek treatment outside Kolkata, where I stay. I also trawled the internet and consulted a family friend, Dr Khurshid Guru based in the USA. At Tata Memorial Centre, one was assured of the best equipment and a reasonably high standard of treatment. But the crowd and rush there was a little intimidating. The doctors also appeared a little young and, in this particular surgery, a lot depends on the skill and experience of the surgeon.

I heard about another doctor in Delhi who has a different surgical technique whereby continence is almost guaranteed. I nearly switched in his favour but read a Google review where a patient's relative had complained about how negligence by this particular doctor had led to her father's treatment going awry. Someone later also told me that this was a new technique and a little less established. Finally, I found that, in India, the very best option is Dr Rajesh Ahlawat at Medanta, Gurugram. So I zeroed in on Dr Ahlawat and got a booking for June 11, 2018. When I informed Dr Guru of my decision, he gently suggested Dr Prokar Dasgupta from the UK who was a brilliant surgeon and was actually visiting Kolkata at that time.

I decided to research a little more. What I found was that the top three prostate Cancer surgeons in the world were all of Indian origin and a complete class apart. One of them was actually the same Dr Khurshid Guru whom I had been consulting long-distance without realising how big he was in the field. The other two are Dr Prokar Dasgupta in the UK and Dr Vipul Patel in the USA. I rushed to Apollo Gleneagles, Kolkata and with Dr Guru's intervention, managed to get an appointment during Dr Dasgupta's next visit to Kolkata for July 28, 2018. It had taken me six months after the diagnosis and eight months from the first suspicions and bouncing around from Mumbai to Delhi to Gurgram to find that the best option was actually available in Kolkata, at my doorstep. Truly, prophets are without honour in their own country.

In a long Police career, there are occasions when one looks death in the eye. I was not anxious when I checked into the hospital. Nor, when I was wheeled in for surgery. The pain, being bedridden for a day or two, Spirometer, tentative steps with the Catheter in place, first bath, first proper walk after surgery – all these were daily adventures. The real anxiety was six weeks later, on my own September 11, when I went for the blood test and waited anxiously for six hours for the PSA test results. PSA above 1 would indicate the possibility of Prostate Cancer cells still lurking around. Luckily it came as < 0.003 ng/ ml, i.e., undetectable. That was the personal 9/11 – with a happier denouement!

(The author is a senior IPS officer in the West Bengal cadre. The views expressed are strictly personal)