The time has come to rephrase the adage ‘there is no cure for cancer’ by putting an end to the fear of being diagnosed by this dreadful disease. A 67-year-old resident of South Delhi, Mr N K Choudhary, proved that with hope and courage even the deadliest battles can be won by beating cancer – not once or twice – but as many as six times in a period of 13 years. Mr Choudhary was first diagnosed with oral cancer in 2005, followed by recurrence in 2007, 2010, 2014 and twice in 2018.
He approached Dr Dinesh Singh when his oral cancer was detected for the third time in 2010 and started his treatment under the team. Mr Choudhary, visited hospital for his radiotherapy treatment for the 5th time.
In 2005, the paitient was diagnosed for the first time with tongue cancer for which he had undergone laser excision (removal of tumor using laser) and with few lifestyle modifications, he was cancer free for two years and then he developed recurrence in the neck again in the year 2007. Later on, he was cured and was cancer-free for the next three years.
However, in 2010 he again developed a new primary cancer in his right tonsil which was treated with concurrent chemo radiotherapy or in this case, re irradiation as he had undergone radiotherapy earlier as well. Through this procedure he led a cancer free life for the next four years. In 2014, unfortunately again, he was diagnosed with carcinoma of left last end of the tooth plate and hence, had to undergo a surgery followed by an adjuvant radiation, making it his third time of an effective radiotherapy.
In February 2018, he again developed a small nodule in his face, lower lip with pus-like discharge.
Post six months, the patient had recurrence in tongue again for the sixth time. This made the case complex and multifaceted as radiotherapy for the fifth time involved a high risk of tissues getting dissolved or burning out. The tumor was removed and sent to the lab to ascertain that all the margins are negative. This procedure alone took place for 20-30 minutes. The rest of the procedure took place for 5 hours and went successfully and he was free from cancer.
Through his whole journey which was filled with hardships, challenges and bleakness, one person who constantly supported him and stood still through thick and thin, was his wife, Ganga Choudhary.
Cancer is a disease that not only affects one person but an entire community surrounding that person, especially the partner.
Speaking on the complexity of the case, Dr Dinesh Singh, Director – Radiation Oncology, Max Hospital, Vaishali, says, “This case is unique from a clinical point of view, administering radiotherapy even for the second time at the same geographical area is a big challenge because the normal surrounding, tissues are at a risk of undergoing radiation necrosis. However, those patients who successfully are able to undergo re irradiation get good results. In this particular case, the patient was able to overcome radiotherapy successfully for the 5th time which is extremely rare.”
“It was a very big challenge both for surgical oncology team and radiation oncology team.
I could not find any previous reference or case study in which re-radiation was done for 5th time,” he concluded.
Six months post radiotherapy, the brave survivor is doing well and there are no signs and symptoms of tissue necrosis. His recent PET CT scan has also shown complete resolution with no evidence of disease.