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Foods during radiation of the neck

A little about the food that one is or is not able to take during radiation therapy of the neck region.

After about a week or 10 days, nausea set in and I began to lose appetite. As radiation affects rapidly dividing cells, the cells in the mouth which are rapidly dividing, are affected. As a result, the taste buds are affected and food begins to lose taste. If chalk has taste, then most food tasted like chalk.

Initially, the ice lollies seemed to feel good. However, as the radiation progressed, they didn’t seem much palatable. Nor did chocolate or anything with chocolate flavour.

As it becomes difficult to swallow, one has to choose fluids or very soft foods. Some foods that tasted better than the others are – fruit juices, fruit shakes like mango shake, banana shake, sapodilla shake, milk with sweet syrups like almond syrup and rose syrup, thandai milk, sweet or savoury lassi (lassi is made by blending yogurt and water with added sugar and optional flavouring of cardamom/saffron for the sweet version and black salt, table salt, roasted cumin and dried mint for the savoury version) and the good old lemonade (without sugar is equally good) (with added dried mint, black salt, rock salt and dried roasted cumin).

Initially, the sour taste didn’t seem to bother, but later, I began to feel uncomfortable consuming slightly sour drinks like mango panna (made by boiling raw mangoes with sugar and blending them with added black salt). Additionally, one has to be careful not to consume spicy food as it irritates the throat and even a little bit of it can be unpleasant.

Soft foods that seem easier to swallow and are palatable  are – idli (rice and pulse steamed pancakes), upma (made with semolina and vegetables), bread toasted with little ghee.

The blander the food, the better it feels.

Soft fruits that taste better than the others are all types of melon, water melon and peach.

Hope this is useful.


The unknown causes ?

This is not to say that I do not believe in consumption of organic foods anymore or that I have stopped having preference for them whenever I can. I still believe that organic is the way to go. Whether or not claims have been proved in respect of beneficial effects of organic food on the human body, at least we are preventing unnecessary chemicals from entering our bodies. We look at this way – perhaps my condition wasn’t the worse because of the organic constituents in my diet.

And it seems, diet, though undoubtedly important, is only one of the factors affecting our health. From what one reads these days, cell phone usage, air pollution, chemicals in some of the everyday things we use, some viruses and bacteria, could also lead to cancer. Then again, there is also a view that some people are more prone to cancer than others. It seems, this is an area where definitive answers are elusive and I guess, one has to draw a balance in our modern day living on what we want to expose ourselves with alongwith maintaining a healthy lifestyle by and large. I may add, I have been a vegetarian for about last 10 years and have always been a  nonsmoker and a nondrinker.


Inspirations and questions …

How does one cope with cancer?

One of the most important things that I realised, for me, was, the positivity around me – in my family and fortunately, in a cheerful doctor and friendly nursing staff. I shudder to think what it would have been like if I had to see gloomy faces around me most of the time. It surely wouldn’t have sent good signals. It’s true I haven’t been a smiling patient all the time, but the family has made sure I didn’t get much opportunity to wallow in self-pity.

The situation has many a times made me irritable and prone to lose temper. However, of course, it is not really anybody’s fault and one has to realise then that this too shall pass.

I have also been reminded of my blessings in that the disease was diagnosed in time, that there was good medical care available and that I was fortunate enough to be able to afford it.

The visits to the hospital also brought me closer to the reality that this disease is not such a rare disease any more. Men, women – young, old – children, rich, poor – anyone could be a victim.

One such inspiration was a child with whom I happened to share the room during my very first chemo session. The child’s case was more complex than mine and he was more in the hospital for about 6 months or so than out of it. However, his generally calm demeanour made me wonder if I had any right to complain at all.

Seeing the children I wondered what is it that they have done wrong already at such a tender age to deserve this. Genetic causes could perhaps be one of the reasons but one cannot but be baffled by the sights.

The cause in my case is unknown too. As far as diet is concerned, for at least the past 7 years or so, we have been more careful with our food habits. This has meant minimum processed foods, primarily home cooked food including the breads, and mostly organic whole grains and pulses. Flaxseed (believed to be anticarcinogenic) had been an important part of our diet too.

True, a form of the disease (a different type of cancer) was there in the family (my father was diagnosed with it, almost 28 years ago, in the abdomen in a very advanced stage, though the cause of death subsequently was heart concussion). However, that is also a grey area as we do not have information about the type of cancer he had and we cannot ascertain if my cancer is inherited.


Target cancer contd. (radiation therapy)

A week has passed since I completed the RT and the effects haven’t shown much sign of receding yet. A little more about the RT:

The type of RT that I was recommended to undergo was the VMAT therapy which targets a limited area.  For the therapy, one is made to lie down and is itself painless. Though I am afraid the same may not be true of the side effects that it leads to. At least, so it was in my case. The effects are in the throat (and mouth) region as that is the area that was targeted.

Even though I was supposed to be in complete remission, I still had to undergo the RT to make sure no trace of malignancy remained. That is generally the protocol followed in case of Non Hodgkin’s Lymphoma (as I understood later).

In case of RT, the blood count is taken every week to check the WBC levels. The cut off in my case was 3,000 uL. Fortunately, it did not go below this though it touched 3,100uL towards the last week of therapy.


Target Cancer

Family and friends had often suggested the idea to join the blogging community for long. However, I wondered what could I say to the world that would not already be out there on the web.

Then, cancer dropped by, to make life different. And since, for the last almost 6 months, life has been mostly hospital visits, doctors, blood tests and medicines and living with the popular ‘side-effects’.

And again, the suggestion came from the doctor too to write a blog. So, convinced that I really had something to say that was unique to me, I started writing, not just this blog, but otherwise as well.

Cancer has brought me closer to the realisation that there may be many people out there who may not have the means to get themselves treated. Or, some may not get diagnosed at all due to lack of resources.

Of course, some work is already being done by many organisations to assist people without resources to get themselves treated for cancer. However, we are a huge population and the reality suddenly seems so stark. That something must be done, whether financially or in terms of contribution of time and effort by many of us.

Having come face to face with it firsthand, I can understand how cancer must debilitate many physically, and then financially.

Cancer treatment is expensive especially in our country where many people, especially the poor, live without a medical insurance. Where many live on daily wages, where can the question of paying premium for insurance arise? Many people in our country are not even aware of such a thing as medical insurance.

Therefore, the need to work towards this cause. I am currently in the process of trying to put together something towards this.

The medical details / the side effects:

For those interested in how cancer affects the human body, here are some details. I felt this could be useful for newly diagnosed cancer patients coming as it is from someone who has actually walked that path. Many a times, the patient is not prepared for all the effects, as happened in my case. The doctors do not always prepare the patient for these effects. Perhaps, they are not sure how the patient shall react to their mentioning it. However, I feel, the patient is better off if he knows what’s in store and there are less surprises in this context. It is true that two patients with the same disease could react differently to the treatment. However, I still feel a broad indication of the effects could be given to the patients.

I was diagnosed with nasopharyngeal cancer (Diffuse Large B Cell Lymphoma (Non Hodgkins) – DLBCL), a type of head and neck cancer (Stage IIE)  in December 2011. This diagnosis followed after about 3 months of frequent throat troubles. The cancer had spread in the neck and cervical regions, seemingly in ­about 5 months or so. The antibiotics would only give temporary respite and then even that relief also stopped after a while. I had difficulty reading aloud to our son. The lump in the throat became visible. This was diagnosed as a case of enlarged tonsils and I was advised surgery to remove the tonsils. As I had my reservations about getting the tonsils removed, I went to another doctor, who advised a CT scan (with contrast). The results showed a growth, which the doctor was ready to remove asap. This led to another referral to an oncologist on whose advice I underwent a biopsy. The biopsy report confirmed the malignancy. The protocol for my treatment was going to be 6-8 cycles of chemotherapy which began after a couple of days.


For the first cycle of chemo, I was admitted to the hospital. The treatment was the standard R-CHOP protocol which was initiated in the night and monitored. The blood pressure kept dropping periodically, which was expected, and the treatment was paused when it dropped beyond a point.

How does one feel when undergoing chemotherapy? The drugs leave you listless and deprived of energy. However, the same therapy is supposed to bring back one to a normal healthy life. I guess, this must be the only treatment which makes you feel unwell at first, to make you well.

The side effects after the first cycle were more pronounced compared to the other cycles. Initially, it used to hurt just to open the mouth slightly and therefore it was difficult to eat. But there was medication to take care of that and it got better in a couple of days. This also didn’t trouble much after subsequent sessions.

I lost my sleep and would barely sleep 2-3 hours for days between the sessions.

There was nausea after each session  for 1-2 days and bouts of vomiting once after each subsequent cycle but that was only on the day of the session or the following day. This affected the appetite initially for a week or so, thereafter, the appetite got better in a couple of days and the same with the energy levels. However, again, this became less pronounced after around 3 cycles. Perhaps the body becomes adapted to these.

A week after each session, a complete blood count (CBC) is taken. Thereafter if the WBC (white blood cell) count is low (neutropenia), one is injected with filgrastim (filgrastim is a man-made form of a protein that stimulates the growth of WBCs in the body) injections which boost the WBCs, which fight infection in the body. Thereafter the CBC is done again. Before the beginning of the next cycle, a CBC, RFT, LFT tests are done.

Before the second cycle, there was intense abdominal pain for which I was admitted to the hospital again. This got cured in a couple of days.

The drugs led to neutropenia  (once it was febrile neutropenia – neutropenia accompanied by fever which lasted about a week). Neutropenia it seems causes an unusual feeling in the head, like something’s going around in your head.

Around the second cycle, the nails, particularly of the thumbs, began to darken as well which I believe take a few months to get  back to normal.

After about the third cycle, the hair loss was speedier too and around the fifth cycle, it was almost completely gone.

I also developed neuropathy around the fifth cycle, which is intense pain the legs. Therefore, all effects need not take place immediately after the first cycle. However, this also stayed just for a couple of days.

Radiation Therapy

As the WBC count went low after each cycle, the chemotherapy was stopped after 6 cycles and it was decided to proceed for radiation therapy (RT). RT lasted for 25 sessions (5 days a week) which got completed a few days back. The number of sessions and the intensity of the radiation again may vary with each patient.

Initially, the RT made me feel fatigued for a couple of days. However, as the sessions progressed, the other effects like nausea, loss of appetite, lack of taste, some ulcers in the mouth, difficulty swallowing, fungal infection, throat pain, darkened and dry sensitive skin in the throat region where RT was targeted, become more pronounced. The result of all of which has been difficulty eating and the diet has comprised primarily of liquids for the last 3 weeks or so. I believe the healing takes a couple of weeks after the treatment is over.

Again, as far as RT is concerned, all this has been more than I expected. The effects have been longer lasting than those in the chemotherapy – once they begin, they last throughout the therapy and beyond for about 2 weeks or so.

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Cancer cells in motion

Cancer cells dividing


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