Women's health

Breast cancer: “I am a stronger person today”

Simran Sethi from India shares her experiences after her breast cancer diagnosis and how self-realization and her family helped her.
Swati Prasad
Published on 11. Oktober 2021

Three women, three countries, three individual breast cancer stories. In the second part of this three-part series, Simran Sethi talks about her journey of self-realization after being diagnosed with cancer amid the pandemic. Simran (49) loves to shop, and she arranged to meet our journalist and photographer at the Dilli Haat market in Pitampura, north Delhi, on a hot and humid afternoon.

<p>Seeing us at the entrance, Simran’s face lights up. “I am coming here after a very long time,” she says.</p>
But Dilli Haat isn’t quite the same — only a few stalls offering snacks and cold drinks are open. Some youngsters are hanging around, taking selfies and shooting dance videos to upload on social media. They are not interested in handicrafts, which is what this village-style, open market is all about. Little wonder the artisans aren’t back. Things haven’t gone back to normal.
<p><p>Last summer, when India was lifting the world’s most stringent lockdown in a phased manner, Simran noticed a lump in her right breast while taking a shower. For this middle-class housewife, a lot changed in that moment.</p></p>
Simran Sethi stands against a wall at Dilli Haat market in Delhi, India, her favorite place to recharge power after her breast cancer diagnosis.
<p>In India, most women go for a breast screening only when they notice a lump, and Simran’s case was no different. When she consulted her gynecologist, she was advised to go for an ultrasound. It didn’t reveal anything alarming. Days went by, and the lump grew bigger, causing discomfort. She went back to the gynecologist. This time, the doctor advised Simran to get more tests done, and from a good radiological laboratory. Simran visited a private hospital in south Delhi with the reports. But her friends insisted she visit government-run <a href="All India Institute of Medical Sciences (AIIMS)" data-ste-link-id="1490137041.on/cp-text-image-30961535:3692948510. Medical Sciences (AIIMS):1324667756">All India Institute of Medical Sciences (AIIMS)</a> in south Delhi, which has one of the largest tertiary-care cancer centers in the country.<br></p><p>Dr Ajay Gogia, Associate Professor, Department of Medical Oncology at the <a href="https://www.aiims.edu/en/departments-and-centers/specialty-centers.html?id=415" target="_blank">Dr B.R.A Institute-Rotary Cancer Hospital at AIIMS</a> asked her to repeat the biopsy, which was undertaken at the institute. The biopsy report showed the presence of an invasive carcinoma in her breast.&nbsp;</p>

India has 15 such AIIMS offering medical education and free treatment.

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<p>Simran’s was a typical case of <a href="HER2-positive, fast-growing breast cancer" data-ste-link-id="0000804804.on/cp-text-image-6affd90c:1368116846.ast-growing breast cancer:2967969077">HER2-positive, fast-growing breast cancer</a>. Between all those visits to her gynecologist and various radiological laboratories, her breast cancer had spread to the lymph nodes. By the time it was detected (November 2020), her breast cancer was at stage III<sup>1</sup> with a 50 percent chance of survival. “The survival rates are a lot higher for patients detected with stage I and II breast cancer – at 95 and 85 percent respectively,” says Gogia. The chances of survival dim to 20 percent for those detected with stage IV breast cancer.</p><p>Today, breast cancer is the most common cancer in India. “Fifteen years back, when I joined the profession, it was cervical cancer,” says Gogia.</p>

HER2-positive breast cancer is a cancer that tests positive for a protein called human epidermal growth factor receptor 2 (HER2).HER2 proteins promote the growth of cancer cells. Though such cancers are very aggressive, treatments that target HER2 are very effective.

Most medical insurance policies in developed countries mandate routine screenings, such as a mammogram. Not so in India. “Unlike the West, where 70 percent of breast cancers are detected at stage I, in India it’s quite the opposite — over 63 percent of patients that come to AIIMS have stage III or IV <a href="Metastatic" data-ste-link-id="2486966216.on/cp-text-image-862cbb08:3777587411.Metastatic:1784122547">metastatic</a> breast cancer,” says Gogia.<p><br></p><p>According to a <a href="https://ascopubs.org/doi/abs/10.1200/JCO.2020.38.15_suppl.e12567" target="_blank">study </a>undertaken by AIIMS between January 2014 and December 2019 of 997 patients, only 40 patients (or 4.01 percent) had been detected with stage I breast cancer, 326 (32.7 percent) with stage II, 419 (42.02 percent) with stage III and 212 (21.26 percent) with stage IV breast cancer.</p>

In metastasis, cancer cells break away from the primary cancer and form new tumors.

<p>The diagnosis shook Simran and her husband Rajesh (51). They live in an extended family with Rajesh’s parents. Simran is the mother of 20-year-old Archa and 15-year-old Parth, and the anchor of her family. “It was difficult to believe this could happen to me,” says Simran.</p><p>In India, specialists like Gogia see hundreds of patients in a week and find it difficult to counsel each one. He told Simran and Rajesh about the lengthy treatment plan, a mix of mastectomy, chemotherapy and medications.</p>To begin with, she was to undergo six rounds of chemotherapy. Surgery — a <a href="mastectomy">mastectomy</a>— was to be performed on her in February 2021. This was to be followed by more rounds of chemotherapy and medication.
Removal of breast tissue, undertaken to treat and prevent breast cancer.
<p>Understanding the treatment plan and disease is one thing, dealing with emotions quite another.&nbsp;</p>
Simran Sethi stands pensively in Dilli Haat market: at first after her breast cancer diagnosis, she thought her life was over.
<p>“The diagnosis was devastating. My husband and I used to wake up at night and cry. It seemed like my life is over,” she says.</p><p>Simran drew sustenance from Gogia’s words. “He said in a couple of years you won’t even remember this phase. You can choose to face this bravely, or cry over it,” reminisces Simran. She also took inspiration from a neighbor who was diagnosed with breast cancer five years ago. “If she could have the strength to go through it, so could I.”</p>
<p><a href="Chemotherapy" data-ste-link-id="2316643912.on/cp-text-image-d0fa597c:3166022663.Chemotherapy:3001702375">Chemotherapy</a>&nbsp;tends to cause a lot of discomfort. For the first ten days, Simran would have nausea, vomiting and her hair would fall out. “Those were difficult days,” she says.</p><p>Simran had grown up in Delhi and was fortunate to have strong family support to see her through the crisis. Her biggest support was her husband, who owns an electronics shop in Delhi’s Bhagirath Palace. He stopped going to the shop.</p><p>“Rajesh said I will earn money later. First, I have to tend to you,” recalls Simran. Her son was a calming influence. “He also took care of my diet,” she says. Her daughter studies in the UK and wasn’t able to visit them due to the pandemic. But she was always just a video call away.</p><p>Her parents and siblings were a huge support too, as was her husband’s family. Her sister-in-law in the UK follows Buddhism and got her into chanting.</p>
Use of strong drugs to destroy cancer cells.
<p>Simran’s illness taught her to focus on herself, before looking after her loved ones. </p>
Simran Sethi sits on a wall and smiles confidently because she has learned how important it is to take care of yourself first, then others.
Today, she is grateful to her loving family that encouraged her to practice yoga, eat nutritious food and take good care of herself. Being a Punjabi, parathas (fried flatbreads) were part of her daily diet. The parathas have given way to quinoa, salads, fruits and double-toned milk. She practices yoga every day under a trainer. Praying and listening to positive talk is now part of her daily routine. “Post this experience, I am certainly a stronger person,” says Simran. So, does she have any dreams for herself? “All my dreams are for my kids. I want them to settle down well,” she says. For now, Simran is busy planning a holiday with her family. And as we know, family means the world to her.

By Swati Prasad
Swati Prasad is a freelance journalist based in Delhi, writing on business, economy, technology and healthcare. She reports from India for several publications overseas and has worked as a correspondent and editor for The Economic Times, Business Standard, The Indian Express, and Business Today.