Part 2 – A day in the life of an Oncologist
Continuing from the previous piece we join to address and see how a day unfolds in the life of an Oncologist.
Its 1997 and I receive a young lady, in her early twenties, recently married, in my outpatient’s department. She has her husband and in-laws in attendance. She has undergone a recent abortion, as she was diagnosed two weeks ago, to have a stage IIA, Hodgkin’s lymphoma!!
My heart goes out to her and her family and I experience her joy of marriage, reception in the new family, hopes of a fulfilling togetherness, conception and the loss of not being able to complete and experience the motherhood for her first born. The moment is as fresh with me today, as if it happened now.
We discuss the staging investigations, treatment for the lymphocytic predominant Hodgkin’s lymphoma confined to upper half of her body, outcomes, and chances of recurrence and future pregnancies. The evolution of sequential chemotherapy and radiation for this disease has started, however, not completed.
The family and medical tumour board discussion converge on the radiation treatment. for her. She completes her treatment by the autumn of 1997 and starts her follow up examinations along with relevant investigations over the next five years.
After five years of being disease free, we discuss the possibility of her planning a pregnancy and she is diagnosed to have endometriosis. The gynecologist is skeptical about her ovaries having received radiation and her in ability to conceive. We take out her records and share with the gynecologist that she had received radiation to neck and left armpit and the ovaries were completely protected. She undergoes in-vitro fertilization and with the help of a very skilled and understanding gynecologist she delivers a healthy baby girl in 2004. All the worries, anxieties, complaints are laid to rest. She and her supportive husband get busy with bringing up the child and the clinic visits are few and far in between.
September 2015, she walks in my outpatient’s clinic again with her husband in the tow, smiling, disease free, 18 years from first day in my clinic. The feeling of happiness and well- being is mutual.
As I complete her examination, I enquire about her daughter who will be turning 11 soon. Her face is lit up with a brilliance and she fills me on the activities the child is busy with.
I ask her, if I can share my experience of her journey with all of you, who are reading this blog. The answer is a resounding YES and here she is in her pen-portrait for all of you.
We have had moments of anxiety on her delayed pregnancy, endometriosis, questions about fertility preservation with radiation and the wonderful result that I hope is as meaningful to the readers as it has been for my patient