Fahth : Cancer taught me to become more persistent and robust.
In early spring of 2017, a short visit to the doctor changed his life forever. He had begun noticing a small mass on the left side of his neck in April, but I didn’t think much of it then and initially dismissed it. Fahth only decided to get it checked out when prompted by his friends and family. Fahth said, “I conceded for their sakes, but I wasn’t worried; it was flu season, and everyone in my family was in good health. I remained oblivious as I took sick leave, so I avoided them like I had the plague—which wasn’t so far from the stock-keeping company I worked for and made my way to the hospital. The doctors poked and prodded, hunting for a diagnosis and scouring my body for information. The doctors decided on a surgical removal of my thyroid, and in June 2017, I underwent surgery and a biopsy. They then told me that I had papillary thyroid carcinoma, a type of cancer that affects the thyroid gland.
Upon learning my condition, I was shocked. The cancer had been the last thing on my mind. The lump in my neck now felt like a noose, and my diagnosis was a death sentence. But my initial fears were put to ease by the doctor’s reassurances that this type of cancer is the most common, amongst the most curable, and my chances were fantastic. Despite my initial reactions, my mind was surprisingly straightforward, and I worked with my doctor to draw up an elaborate plan to overcome my illness. I knew exactly what I had to do and was determined to beat the cancer.
The following month, the doctors performed a surgical removal of my thyroid gland, which was thoroughly colonized by cancer cells. The surgery was declared a success, but the doctors advised me to do high-dose radioactive iodine therapy, as opposed to the standard dosage. The higher dosage would almost guarantee that the cancer wouldn’t come back, at least not for a while. However, it wasn’t offered here in Doha, so I had to travel to another country to receive the treatment. So, in September of 2017, I had high-dose radioactive iodine treatment.
I was also given a lifelong prescription of thyroxine supplements and a tiny scar to remind me of the victory. I was satisfied and ready to close that chapter and move on. I could return to enjoying my time by video-calling my family and shopping with friends. I felt carefree again. Every three months, I had routine follow-up appointments. The doctor also gave me a regular follow-up appointment, and it was during one of these that they found a 6mm mass that, thankfully, wasn’t cancerous. I had low-dose radioactive iodine therapy in June 2018 as part of my treatment.
As time went on, I was no longer thinking of obscure masses on my neck or anything cancer-related. The routine follow-up appointments every three months and the regular follow-ups with my doctor were the only reminders that I had even gone through that experience. Every visit felt like a small victory. Every time the doctor told me that there was no sign of cancer, I let out a small sigh of relief. As the months passed and I continued testing negative for any recurrence of cancer, the follow-up appointments began to feel redundant, and I felt confident that we had warded off the tumor. So, during a follow-up appointment in November of 2019, I failed to notice the unusually long ultrasound, the doctor’s careful manner, or the nurses’ sympathetic expressions. With an almost guilty expression on his face, the doctor informed me that he had found a new 3mm mass in my lymph nodes, which was a new recurrence of the cancer. Again, the medical staff tried to reassure me that this was a fairly common phenomenon, that 75% of patients with thyroid cancers exhibit metastasis to the lymph nodes. They advised me to complete another round of high-dose radioiodine therapy.
I felt sorry. I had followed through with the plan and had done everything right. I had already beat the cancer. How could it be back? I tried to trace my habits, searching for clues in my lifestyle. I needed answers to find logic in my illness. I came up blank. I began to blame myself at this point. Not just for this complication but for getting the cancer in the first place. Was it an unhealthy diet? Was it bad luck? Or perhaps a neighbor’s evil eye? I felt responsible, convinced that I might’ve prevented it if I had done something differently. But the truth is that nobody can control or predict cancer. It took me a long while and much heartache before I realized this, but when I finally did, it became easier to modify my action plan and move on to the next phase of treatment.
I returned in February 2020 for another round of high-dose radioactive iodine treatment. This would help eradicate the cancerous tissue migrating to my lymph nodes. As standard protocol, they had asked me to stop taking my thyroxine medication in the weeks leading up to the therapy, so I was constantly fatigued and in pain. The pills they gave me for my symptoms only replaced my lethargy and pain with overwhelming nausea. My hormones were all up and down; some days, I would be shivering, while other days, I would be sweating so much that I would have to take up to three showers. These were the most difficult times of my cancer journey. My life became bland, and it had little to do with the low-salt diet that was prescribed to me. I expected that the radioactive therapy must have felt agonizing, like my insides were burning. But I don’t specifically recall that pain. Thinking back, I wonder where I drew the strength to endure a treatment that felt like being nuclear bombed. I suspect that perhaps it was because I had no choice. I didn’t have time to dwell on the details of my discomfort as I just needed to be done with it to proceed to the next phase of the plan.
After the radioiodine therapy in February, I was in one-month isolation. The radiation that I was emitting would harm anybody in my vicinity. Those few weeks where I was entirely on my own reinforced my sense of alienation; my physical isolation reflected the mental isolation of my cancer diagnosis. But there was light at the end of the tunnel. Soon after this period, my doctor gave me the good news. I had cleared the last hurdle: I was once again cancer-free.
From then on, I was wary during my follow-up appointments. I was careful not to be overconfident about the status of my cancer this time, cognizant that my papillary cancer had already spread to my lymph nodes before and that it could happen again. Like clockwork, a couple of months later, they found more cancer sprinkled in my lymph nodes. With every encounter, my cancer grew more robust and more persistent, but I was unfazed; I was evolving alongside my cancer and felt prepared for it this time. No longer naïve, I was ready to attack the next course of treatment.
The treatment was the same radioactive iodine ablation therapy that was used against my cancer the last time. However, I was advised to seek a higher dosage, as opposed to the standard dosage that was previously administered. The higher dosage would almost guarantee that cancer wouldn’t come back, at least not for a while: a new battlefield, the same old enemy. Where I had been supported financially and emotionally by the Qatar Cancer Society (QCS) in Doha, I would have to look for new solace wherever I decided to seek treatment. I decided to continue my treatments back home in Sri Lanka so that my family and friends could surround me; it seemed like a fair enough trade-off.
Before I left, QCS gave me a booklet called Story of Hope, which detailed the experiences of many cancer survivors. While reading through the stories, I was filled with the strangest feeling. Although the individuals in the stories differed from me—their backgrounds, types of cancers, and individual experiences — I still could relate to bits and pieces of their journeys. Until now, I remained strong because I felt I had no choice. I had to go on. But reading through the stories in the booklet filled me with extraordinary hope and inspiration. It helped me realize there is no cookie-cutter cancer experience, only a rich variety unique to every patient. Finally, I could make sense of my experience and take control of my narrative. It was hard to constantly hear that I had the “good” or “easy” type of cancer because while I respect that many others have had more difficult journeys, it undermined the fact that my experience was far from good or easy. Cancer is still Cancer. It was now as straightforward as the doctors would tell me, as the websites reassured me. I constantly had to modify my action plan; I had to be determined yet flexible, hopeful but not naïve. Reading the QCS booklet helped me realize that cancer is not the monolithic disease that the label suggests. Instead, it is a continuum experienced differently by every cancer patient. Suddenly, I felt liberated from any expectation of how this process was supposed to go and drew strength from the fact that cancer could be beaten even in all its different forms. I began to see the unpredictability of cancer as predictable and felt comforted that no matter how the cancer presented itself, I would be able to overcome it. Now that I have finished my treatment, I hope that my story can similarly inspire other cancer patients who felt as lost as I did. I hope they can find clarity and see themselves in my story. But I would expect even more for them to be able to create their own story on their terms.