Some came on wheelchairs, some with oxygen tubes. Some used masks to protect themselves from infection and some used anchals to cover bare heads that once flaunted lustrous locks. But for an hour, together, they found something that often eludes cancer patients: peace.  

Hertz & Minds, a sound therapy group, had organised a session at Premashraya, the boarding facility for cancer patients of Tata Medical Center in New Town, and about 30 boarders had come to attend the session. 

They lay on mats in a circular arrangement in a dimly-lit hall and listened to a mysterious concoction of sounds by live musicians, who used Tibetan singing bowls, tuning forks, the guitar, keyboard and their voices to lead them gently into a slumber.

“This is a healing process so we keep playing even after people fall asleep,” said Sourish Choudhury, one of the founders of the CE Block-based Hertz & Minds. “Though the primary instruments and ragas used are eastern, it is the West that recognised their healing powers decades back. In the West, sound therapy is an essential part of treatment for terminal diseases. In India, the practice has yet to pick up.” 

At the onset, the therapists asked patients to think of their favourite person or memory. Debashis Das then played a sustained buzzing sound on the keyboard and Kallol Dutta strummed the guitar. He played a few notes, far apart, but the chords seemed to relax the listeners. As the patients fell asleep, Dutta walked over with the singing bowl, bent down to the patients’ ears and hit it lightly with a mallet. He let the drone linger and hovered it around their heads. Das did the same with his tuning forks. Sukanya Chattopadhyay contributed with Indian classical music.

“I’m a trained singer and technician but after years in this profession I’ve realised that classical music is not for Dover Lane alone,” Chattopadhyay said. “It is way bigger than it. It can heal, it can rejuvenate and I’m grateful to be a part of this process. I performed raga Bhairavi, that soothes the soul.” 

The therapists feel the only downside of this session is that that have to wake up the patients after an hour. “It would be most beneficial if the patients could sleep for three to four hours following the session. We’re still trying to work that out,” said Choudhury.

The patients said they felt better. “For an hour, I forgot I was sick,” smiled Amar Kumar Talukdar, who has come down from Cooch Behar with his family four months ago. He is a palliative care patient.

“We get patients from as far away as Bangladesh, Myanmar and Pakistan and they are always worried about their next chemotherapy and how to fund it. So we really appreciate such groups coming to help them take their minds off it,” said Sudeshna Dutt, head, operations Premashraya Unit, Tata Medical Center. The 10-storeyed Premashraya has a hall on its ground floor where authorities encourage activities for boarders. The home charges Rs 200 a night for a patient and an attendant and they rely on donations for their operations.

The fees charged by Hertz & Minds are based on need. “In cases like at Premashraya, it would be free of cost. But we charge Rs 1,500 per person when we hold stress or insomnia-reliving sessions for corporate houses,” said Choudhury, whose own father succumbed to cancer years ago. “If only I had known about sound therapy then, his pain would have been greatly relieved.” 

Q&A

CERVICAL CANCER

The ladies club of New Town’s Mallika Malancha complex recently organised an awareness camp on women’s cancers. Sonia Mathai, gynaecological oncologist of Tata Medical Center, had come down with her team and in the audience were not just members of Maitrayee, the women’s club, but also female domestic helps and security guards working in their complex.

The medical team had distributed a questionnaire before the seminar to check the attendants’ level of awareness. “But after facing the questions we, residents, realised that we are as ignorant about cancer as are our domestic helps,” said Sanjukta Das, president of Maitrayee. “We want every women to be safe so had included our staff in this seminar but as it transpires, our helps are much busier than us! Despite pleading with them repeatedly, only two showed up.” 
One of them, Barnali Sardar, was Das’s own cook. “I want to hear out the doctors but a lady I work for — in the neighbouring Sunrise Symphony apartments — won’t hear of it. Even now I’ve mounted some dishes to cook on the gas and come for a few minutes,” she said. So the helps and guards were given a quick session on the side before members of Maitrayee settled to hear the doctor out.

“Health of women is paramount as it is mothers who primarily nurture the family. But in looking after others, they usually place their own needs last,” said Mathai. Here’s what she shared with the audience- 

What is cancer?

A group of cells working together make up an organ. When a cell gets too old or damaged, it dies and is replaced by a new cell.

Cancer begins when some internal change (or genetic factor) causes this natural birth-death of cells to become abnormal. The cells start multiplying uncontrollably. These extra cells become a mass called tumour. Tumours can be benign (that don’t spread to other organs) or cancerous (that spread to other organs). The abnormal cells multiply so fast that they replace healthy cells. And since they do not perform their normal functions, the organs that they invade start failing.  

What is cervical cancer? 

The cervix is the lower end of a woman’s uterus (womb). Cervical cancer is cancer that starts in the cells lining the cervix.
Currently this is the second most common cancer in women in India, with one woman dying every seven minutes because of it.  

How does one get cervical cancer?

Nearly all cervical cancers are caused by a virus called human papillomavirus (HPV).

HPV is a common virus and most people will be infected with it at some point in their life. It can be passed on through any type of sexual activity. There are many different types of HPV, but only some of them can lead to cancer. These high risk HPV, which cause cervical cancer, can infect the cervix without causing any symptoms at all. 

In most cases, the woman’s immune system will clear the virus out naturally. But sometimes HPV infections can cause cells in the cervix to become abnormal. These abnormal cells are called precancerous lesions which, if not treated, can lead to cancer. 

Cervical cancer takes 10 to 15 years to develop after the virus has caused pre-cancer changes. So a woman of 20 is unlikely to test positive for the cancer but women in the later age groups are likely to develop cancer if not treated.

What are the risk factors? 

• Recurrent genital infection 
• Sex at early age
• Multiple sexual partners- this increases risk but a single partner can pass the virus too 
• Multiple pregnancies 
• Abortion 
• Smoking and alcohol, as they reduce immunity  
• Compromised immune system due to HIV, poor nutrition, hygiene 

What are the symptoms? 

• Vaginal bleeding other than periods 
• Vaginal bleeding during or after sex
• Vaginal bleeding after menopause. (Note that menopause is defined as 12 months without 
menstrual bleeding)
• Vaginal discharge, typically pinkish in colour 
• Pain or discomfort during sex 
• Constant lower pelvic pain 

How can I protect myself from cervical cancer?

Most women show no symptoms in the pre-cancer/ early stages so do not wait for symptoms to appear. Get yourself screened for cervical cancer by a pap smear test or HPV DNA test. 

All women aged between 25 and 65 years, who have been sexually active and have not undergone a hysterectomy, need to undergo these screening tests. 

The pap test detects abnormal cellular changes of the cervix and is to be done every three years. However, this test is being replaced worldwide with HPV DNA test due to its increased sensitivity in detecting women with high risk HPV which can cause precancerous lesions. This test costs about Rs 2,000 and is to be repeated every five years.

Is there a vaccine to prevent cervical cancer?

There is an HPV vaccine for primary prevention but it needs to be administered to young girls before sexual exposure. It is most effective if administered in two doses between the ages of nine and 14 years, but is extendable to the ages of 15 to 26 with three doses of the vaccine. The vaccine costs about Rs 3,000 per dose. Even after vaccination, one should undergo screening when one is eligible for it.

If I hadn’t taken the vaccine as a child, will it benefit me now? 

A 30-year-old woman would not benefit from this vaccine but she needs to go for screenings to detect any changes in the cervix and get appropriate treatment before it develops into cancer. Screening must be done before any symptoms appear. 

Q&A

PROSTATE CANCER

Cancers that affect women, like breast cancer and cervical cancer, are now being increasingly discussed in India but awareness is still low about prostate cancer, that affects men. “This is why we decided to host a men’s health check-up, with special emphasis on prostate, on the occasion of Father’s Day,” said Pranay Kumar Patra, the marketing in-charge of Ohio Hospital & Medical Centre in New Town. 

The camp had been organised by social groups Bidhannagar Upasana and RK Communications with Ohio Hospital as venue and medical assistance partner. The Telegraph Salt Lake spoke about prostate problems to Dr Rahul Anand, director of the accident and emergency medicine department and himself a resident of New Town’s Uniworld City.

What is the prostate? 

It is a walnut-sized gland in the male body that facilitates sperm flow. It is situated under the bladder and above the penis. Urine from the bladder passes the prostate on its way out of the body. So if the prostrate gets enlarged it constricts the passage of urine flow. As a result less urine passes. 

What are the symptoms of an enlarged prostate?

Incontinence of urine, reduced flow of urine, difficulty, discomfort or pain while passing urine. “Often patients complain that even after passing urine they feel they could have urinated more. But there is no more flow,” said Anand. “Consult a doctor if you feel any of these symptoms.” 

Does an enlarged prostate mean cancer? 

It could be a sign of cancer but not necessarily so. That’s why one needs to get it checked immediately. An abnormal growth can corrected with surgery and cancer too can be treated in the early stages.

What are the risk factors? 

• Age- With age, immunity reduces and chances of a prostrate enlargement increases 
• Heredity- Be alert if a relative has had a prostrate enlargement
• Smoking - Even one cigarette a day is one too many 
• High intake of alcohol- “More than one peg (30ml) a day more than five days a week is considered high intake but this measure is not sacrosanct,” said Anand. “Everyone’s physiology is different and what amounts to “high intake” differs from person to person. So get to know your body.”

What are the precautions one can take?

“Most people take their bodies for granted and lead unhealthy lifestyles. The body takes it while it’s young but then comes an age when it can no longer sustain,” said Anand. “So lifestyle modification is one’s best bet.” 

4 Food- Eat home-cooked food with less oil. “Not just the quality of food, even hygiene is paramount,” said Anand, asking people to avoid street food.  

“Street food is exposed to exhaust from cars and dust from the air. Care is not taken to cover the food, the water used is likely to be contaminated, everyone’s plates are washed in the same bucket of dirty water all day,” pointed our Anand. 

4 Drinks- “Go easy on alcohol (see risk factors above) but also avoid packaged drinks. We hear about worms and the like being discovered inside packed fruit juices… These show that they are not free from contamination. One can’t be sure of the environment they are packed in. 

4 Exercise- Work out for at least 15-20 minutes a day. Try brisk walking or any other activity that makes you shed some sweat. “What happens if you refrain from using a water tap for a month? It gets rusty, the water coming out isn’t clean and the entire process slows down. It’s the same with your body. With exercise, keep your body in running condition,” said Anand. 

What is the screening process for prostate cancer or enlargement?

“Every male above the age of 40 years should go for a check-up once a year. The check-up would include an 
ultrasound of the lower abdomen and a serum PSA test.

Q&A

BREAST CANCER

The bad news is that breast cancer is the most common cancer in women in India. The good news is that women can check themselves for early signs of the disease. 

Ananya Roy, clinical nurse specialist cum research nurse on gynaecological oncology at Tata Medical Center, explained that post-50, women should get a mammogram done every year. “Post-40, they should get clinical breast examination done at least once by a doctor. But regardless of these, every woman should do a self-examination every month. Mothers should train their daughters in this and it should be part of their sex education,” she said, before explaining how - 

How often should I do breast self-examination?

Every woman aged 20 years and above must do this every month. Avoid this test during your period as the breasts are likely to be sore and nodular. Perform the test on the fifth day after your period ends. Make this a part of your lifestyle. 

How should I do it? 

1. Stand before the bathroom mirror, disrobed. Bow slightly to the front and place your hands on your waist. Observe the shape and size of both your breasts. The norm is for one to be slightly larger than the other but is difference appearing significant? 
2. Still in front of the mirror, stand upright and place your hands behind your head. Observe your underarms and the area above your collar bones. Does anything look different? Touch the area and feel for lumps. 
3. Still in front of the mirror, lift your left hand up. The palm and fingers of your right hand will now examine your left breast. Move them in concentric circles, from the outer ring of the beast till they reach the nipple. Repeat with the other breast. 
4. Lie down. The breasts will spread to the sides and you can feel them better. Softly, move your hands in concentric circles as explained above. 
5. Still lying down, place your fingers on one particular point on the breast and rotate gently, looking for abnormalities. Repeat all over.  
6. Still lying down, place your right hand’s  fingers on your left nipple and send them out to the edges of the breast like cycle spokes — up, down, left, right… 
7. Still lying down, palpate the entire breasts from left to right to detect any lumps. 
8. Squeeze the nipples softly. Is there any discharge, particularly yellowish or reddish in colour with an offensive odour?

What abnormalities do I look for?

• Breast tissues are meant to be soft so look out for any hardness or lump 
• A pulled-in nipple instead of the usual protruded nipple 
• Dimpling on the breast, like on an orange-peel
• Skin damage in the breast
• Reddish skin or a rash 
• If you notice anything suspicious, note it down. Compare your findings with that of the next month. Does the lump persist? Has it changed position? Does the redness persist or was it only a pimple the last month? Is there a pain that has persisted since your last check? If these symptoms remain, consult a doctor.

 

Have you ever done any screening for cancer?
Write to The Telegraph Salt Lake, 6 Prafulla Sarkar Street, Calcutta 700001 or email to saltlake@abpmail.com