Cancer can be a scary thing to have to endure. With the diagnosis often — understandably — comes the fear of death. But it needn’t always be so. With advances in medicine and oncology, cancer doesn’t have to scare us as much as it once did.
And to prove my point, I’d like to take you through the journey of someone I know who was recently diagnosed with cancer, and what he did on finding out.
While running, I would often bump into Rohit Pathak, who always seemed to be a fit and natural runner. But he wasn’t always so. In 2016, he was 110 kg, he decided to start cycling along with Delhi cyclists, and two years later, he was introduced to running by Adidas Runners. By 2021, he was down to 75 kg and ran the Berlin marathon. Without knowing any details of his transformation, we only exchanged pleasantries.
Last Sunday, however, I found out that in April 2022, after just having turned 40, he was diagnosed with Hodgkin’s lymphoma, a rare type of cancer. And just a week ago, he got to the finish line of the Mumbai marathon, the whole 42.195 km. I believe that the story of this incredible man had to be told to the world.
Hodgkin’s lymphoma affects the lymphatic system. We all know that arteries and veins carry blood from the heart to the rest of the body and then back again. Along with arteries and veins are nerves and lymphatic channels. While arteries are like the pipes that get clean water coming into our house, veins are the pipes that drain out the unclean water. Similarly, nerves are like electric wires laid throughout the house and the lymphatic system as a whole is like a defence alarm system that detects any intrusion by any bad elements. However, once it has a breach, even the smallest nuisance would allow all kinds of problems. This is what happens when our body’s defence mechanism is down. Our immune system goes for a toss at the sight of the smallest infection.
This is what Rohit was up against. He ran over 4,500 km in 2020 and 2021 combined, while training for two full marathons. And then he met Dr Lt Col Manish Chaudhary at Batra Cancer Research. Rohit recalls, “I think meeting Dr Chaudhary was a blessing in disguise, he patiently made us go through what this cancer was, the line of treatment, the pros, cons, do’s and don’ts. My only ask from Dr Chaudhaury was if I could continue my physical workouts like running, cycling and strength training. I was allowed brisk walks and home strength workouts. It helped immensely that Dr Chaudhary is an ex-Army officer and a runner himself, so he appreciated the physical and physiological benefits of being active. Post meeting him, I don’t think we ever faced fear, chaos or confusion in the whole course of treatment. We immediately decided that he would be my treating doctor, there were no second thoughts here.”
Contrary to popular belief, Rohit’s excitement and Dr Chaudhary’s advice aren’t misplaced. Dr Darren Player, scientist and academic at the University College London (UCL) and exercise professional, with whom I have co-authored MoveMint Medicine and La Ultra – cOuch to 5, 11 and 22 km in 100 days shares what is being done globally, based on evidence and research. “Lymphoma Action (UK) promotes physical activity and suggests several benefits, including preparation for treatment, reduction in side-effects from treatment, reduced risk of infection, and reduced risk of blood clots, amongst others. A meta-analysis of studies (one of the highest levels of evidence) published in the Cochrane Database, demonstrated that aerobic exercise might improve fatigue and depression in conditions such as lymphoma.”
He added, “Given that fatigue is one of the most debilitating systems for these patients (as a consequence of the disease and treatment), this would suggest all patients should be engaging in some form of aerobic exercise. Exercise programmes combining aerobic exercise with strength or resistance exercise have also shown physical and psychological benefits (Fischetti and colleagues in 2019). Resistance exercise should not be underestimated to support patients with lymphoma, as increased muscle mass and strength will reduce fatigue as well as contribute to a whole host of other whole-body benefits.”
Rohit went on to tell me what his journey was like, “The next course of action was a series of tests and a PET scan. Post that, the line of treatment was four sessions of chemotherapy every 14 days and about 10 radiation sessions post that. Surprisingly, I experienced nothing for the first few days after chemo and I thought this wasn’t too tough. This changed after my second chemo. It began to feel like I was being run over by a truck, with weakness, pain, diarrhoea, constipation, nausea, and no sense of taste. And more, all this came one after the other in the coming days. But thankfully, it ended soon too. In the first week of July, we started with 10 sessions of radiation which was a breeze. Finally, I got a green signal from the Oncologist and radiologist that I was cancer-free.”
He said, “The beginning of August is when the entry of Tata Mumbai Marathon opened and I registered in the Full Marathon category, giving myself a little over 20 weeks to get back in a position to complete the marathon without my 5-hour timing goal. Walks turned to short jogs, and soon enough, I was running. By the time I got to the finish of the Mumbai marathon, I had done it in four hours and five minutes. Besides Dr Chaudhary, my Oncologist, I have immense gratitude for Dr Irfan Bashir (my radiologist), Dr Sudip Raina (my oncologist-surgeon) from Batra Cancer Research, Dr Chandan Chawla (my sports physiotherapist) and Dr Paridhi Ojha (my physiotherapist). I sincerely believe that having the right team of doctors is of prime importance. In my case, it was a blessing because each one of them knew my background in endurance sports and how important it was for me to get back to my fitness. My Adidas Runners family, my wife Shaifali, and my 6-year-old son were the main reason that I got to the finish line.”
Dr Darren Player, however, cautions us. “Of course, there are risks associated with exercise in people with lymphoma and they should always consult with their specialist prior to undertaking any exercise. For example, chemotherapy can cause conditions such as thrombocytopenia, which may put patients more at risk of bruising and bleeding. Treatment can also cause anaemia, which can make a patient feel more tired when exercising due to reduced oxygen-carrying capacity. Scientific evidence also suggests that supervised exercise for patients with lymphoma conveys the greatest benefits, potentially because they can be monitored and challenged appropriately.”
The take-home message, according to Dr Player, which resonates with me, is: “However, for most people with lymphoma, it is just necessary to try and maintain levels of physical activity through the course of their treatment. Managing side-effects and listening to their body (and mind) to moderate the amount and type of exercise that can be done, is something that only an individual patient can do.”
Keep miling and smiling.
Dr Rajat Chauhan is the author of The Pain Handbook: A non-surgical way to managing back, neck and knee pain; MoveMint Medicine: Your Journey to Peak Health and La Ultra: cOuch to 5, 11 & 22 kms in 100 days
He writes a weekly column, exclusively for HT Premium readers, that breaks down the science of movement and exercise.
The views expressed are personal
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