Escaping the clutches of oral cancer through compassionate care

It was a regular day at the newly started Head & Neck Oncology OPD of Kachhwa Christian Hospital (KCH). Dr. Honeysh George our Head & Neck Oncology Consultant was seeing patients as usual when Mr. Jayprakash turned up.

Jayprakash was at his wits end: he had been journeying to different parts of the country for the past eight months showing different doctors a non-healing ulcer on his tongue. Not only did he not receive the right treatment, none of the practitioners had advised him to get investigations like a biopsy or scan. The poor, fearing high expenditure in bigger hospitals, usually end up going to local practitioners with neither expertise nor ethics.

Jayprakash was a machine operator and the only bread winner of the family – his wife and three young children. Already struggling to make ends meet, this unexpected health challenge sunk them deeper into poverty as he had not been able to do regular work for eight months.

The moment Dr. Honeysh saw the ulcer on the right side of the tongue he feared the worst. A scan and biopsy confirmed stage 4 tongue cancer. This news was devastating to the family. If they went to any private hospital, the surgery alone would cost Rs. 300,000-600,000. Radiation and chemotherapy would add a few hundred thousand rupees more – impossible for this family.

Oral cancer in India
India is one of the largest tobacco producing nations and second largest consumer of tobacco worldwide. Mortality due to tobacco usage in India is estimated to be 1.3 million annually: one million through smoking and the rest through smokeless tobacco use. Tobacco accounts for almost half of all oral cancers in the world.

Uttar Pradesh (where KCH is located) is one of the biggest consumers of tobacco related products. Amongst men head and neck cancer (HNC), appear to be the most common preventable forms of cancer in the region. Over 2,00,000 cases of HNC occur each year, and about 40%of these are oral cancers. Most of these are in the north and northeastern belts of the country, due to higher consumption of tobacco products, along with lack of awareness and low literacy rates.

Glimmer of light in the dark for Jayprakash
Jayprakash used to chew tobacco in a powdered form. Dr. Honeysh explained the treatment plan to the family – extensive surgery removal of more than half his tongue that would compromise his speech, eating ability and the possibility of facial disfigurement. This was the only curative approach that could be offered.

The hospital team also assured him of our commitment to see him through the surgery at KCH with whatever little money they could arrange. Jayprakash said that he wanted a couple of days to arrange for the money, because if he lost his ability to speak after the surgery no one would be there to plead for help on his behalf.

His moving statement exposed the challenges and suffering of the poor when some major health issue strikes them.

The following week Jayprakash underwent a daunting 12-hour long operation, including removal of the major portion of the tongue affected by cancer, reconstruction to form a new tongue, a temporary breathing tube through his neck and whatever else could be done in our limited resources setting. God carried the team throughout the surgery and the entire journey with Jayprakash. He was discharged within a week and then underwent chemotherapy and radiotherapy. He is now on the way to recovery. He is able to eat well, talk well and lead a fairly active lifestyle at the moment. This is a testimony of God’s amazing grace and mercy in his life.Since the surgery both Jayprakash and his wife have been seeking the Truth attracted by the love and compassionate care received at the hospital. He mentions a newfound peace and joy that he continues to experience as he is walking away from darkness slowly towards the light.

Our endeavour is to support many poor patients like Jayprakash who do not have the finances to undergo oral cancer surgeries. Hence our efforts are ongoing to develop the Head & Neck Oncology department, under the leadership of Dr. Honeysh George, into a state-of-the-art facility that it will be a beacon of hope and light to the thousands suffering from this dreaded disease.

Article by:

Shankar Ramachandran, MD of Kachhwa Christian Hospital