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  • Writer's pictureDr. Sunena Saju

Cancer - God's Injustice or Mankind's Neglect?!

“Thud...Thud...Thud…” Mani Lal could hear his heartbeat quite well more than ever before…. His silent calm world had turned upside down. The serenity of the temple or the sweet fragrances did nothing to soothe him. All he could think was about this demon sitting in his ear eating him alive…He was just diagnosed with cancer in-ear. He was angry, sad, and practically devastated, and lost hope. It’s not news that you hear every other day.

Looking at the deity’s idol, he felt an instant urge of anger and screamed….” Why me?? What did I do wrong??” He couldn’t resist the tears that burst….

All my life I worked for my family and helped everyone...I never missed a prayer meeting nor harmed a living being...Just because you live in heaven why make my life hell?”

He couldn’t take it anymore...and was on the floor just silently crying and soon fell asleep…

All of a sudden he felt a rush of cold wind around him and a bright light covering him up...and heard a sound…..”Son...wake up...It is me Your God”

Mani Lal couldn’t believe it...Am I dreaming or is anyone playing a prank on me?

“I heard all that you said...and you are indeed a very good human being and I would never harm you in any way…” the sound was clear now, he was petrified. “My Lord sorry if I was disrespectful, it was out of my despair I blurted out some nonsense1...please forgive me..” he gathered his courage and said.

“I understand that you are mad at me and consider me to have brought this upon you. Son...before you blame anyone around you let me remind you all those times when this was a small problem which could have been dealt with ease”

He felt a jerk and all of a sudden he was amidst his family and could see himself all young. It was his daughter’s wedding eve and was suffering from a very bad earache and foul discharge. He had been to a local doctor who advised him to undergo treatment for the ear, but due to his time constraints preferred painkillers and was reassured to come back later. Another swish of air and it was 2 years later when he first noticed a slight reduction in his hearing which his wife had picked up. Suddenly, he remembered how he explained that the ear discharge can cause complications if left for long. And how that day at home he convinced himself and his family members that a dose of drugs would solve the problem and can’t afford to undergo surgery because he doesn’t have time. Another swish and it was a few years later when he had this excruciating pain and had taken himself to an ENT surgeon who advised surgery and said it was imminent. A few days of antibiotics had reduced the pain, but the hearing had reduced considerably. He by then, had started to experience dizziness which the doctor explained as a complication of the same. He still opted out of surgery and kept it for later and resorted to tablets.

He now realized that this was all brought upon by himself and by neglecting his health since the beginning.

Doesn’t this story ring a bell to most of us??

We all find ourselves busy and tend to postpone things regarding our health. And fail to realize that each assault to our body, be it either skipping meals or negligence of medical conditions adds on and finally one day it’s gonna be a bigger and nastier problem someday. Cancer prevention is better talked about than practiced.

Being a medical practitioner and having dealt with many patients with cancer, I have realized people tend to bring it upon themselves many patients with cancer cases, I have realized people bring it upon themselves. A stitch in time saves nine is a dictum that applies in the arena of Cancer by word. A healthy lifestyle with regular medical checkups in many cases can keep this problem at a distance.

As in this patient, Mr. Mani Lal (name for representation purpose) 74-year-old male presented to us with complaints of blood-stained discharge after a long-standing ear disease for more than 50 years.

The patient had a long-standing history of bilateral ear discharge with a decreased hearing on both sides with a history of several episodes of dizziness and ear pain. The patient did not have any complaints of facial nerve paralysis.

For a long time, the patient was on and off oral antibiotics, analgesics, and ear drops and was counseled for surgery at various stages of his ear disease which was neglected or postponed due to financial and time constraints.

An otoscopic examination revealed an external auditory canal aural polyp obscuring the view of the tympanic membrane in the left ear and subtotal perforation of the tympanic membrane with middle ear mucosa in the right ear. Biopsy of the aural polyp revealed moderately differentiated squamous cell carcinoma.

On hearing evaluation, pure tone audiometry reveals profound sensorineural hearing loss of > 90dB on the left ear and severe sloping mixed hearing loss of 85 dB in the right ear.

The patient was managed with subtotal temporal bone resection with selective level V, II A & II B with neck dissection, partial parotidectomy with blind sac closure. BAHA BI-300 4 mm implant and a cover screw was placed on the mastoid occipital bone to restore hearing postoperative period was uneventful with facial nerve status of HB grade 2. The patient planned for postoperative radiotherapy and needs to be on a continuous follow-up for at least 5 to 10 years on yearly basis.

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