My experience as a matchmaker : Cancer Research, Statistics, and Treatment

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Musings

My experience as a matchmaker

Chandrasekharan, Arun

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Cancer Research, Statistics, and Treatment: Jul–Sep 2022 - Volume 5 - Issue 3 - p 401-402
doi: 10.4103/crst.crst_210_22
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It was raining outside when a thin built lanky gentleman walked into my clinic, the last patient for the day. He walked in alone clutching a sheaf of loose papers and quietly sat down before me. I could tell he was probably from one of the small towns that surrounded the city that I practiced in, from his attire which was traditional and commonly worn by the menfolk while working in the fields. Looking as if something heavy weighed on his mind, he held my gaze with mild trepidation mixed with uneasiness. It was as though he dreaded speaking his mind, like an anxious relative dreading bad news outside an intensive care unit. He wished me good evening and hesitantly began to speak in a rural accent. “I’ve arranged a match for my son, 6 months ago, with a girl from our community. They have grown to like each other over time and are in regular contact with each other. However, fate had other plans in store for her. She was recently diagnosed with thyroid cancer, underwent surgery for it, and is currently cancer free. The girl’s family has given me all her reports and I’m here to ask your opinion regarding moving forward with the marriage.”

Although I have had years of training to become an oncologist, nothing in my prior experience had prepared me for a question like this. To attempt to prognosticate a patient I hadn’t met and to play a hand in deciding her future was something I was hesitant to do. Also, the patient herself had not given her permission in any sort of way for me to comment on her medical history. I could very well tell him that I could not possibly comment on the reports without the patient’s explicit consent and without examining her in person. But as soon as he walked out, I knew he would not be coming back and he might instead, rely on the opinion of some unqualified local quacks, who were a dime a dozen scattered across the countryside. However, as the girl’s relatives had shared her reports with her prospective father-in-law and since she was acquainted with him, she probably would have consented to this opinion. These moral and ethical dilemmas played a confusing game of tug of war in my head, but above all else, I wanted to do right by her. I asked him if he had spoken to the treating doctor of the patient first. But he replied that the cancer center was far away and owing to the COVID-19 lockdown, he could not travel so far.[1] Besides, there was no teleconsultation facility available. The onus was on me to help guide his decision. I had heard about the experiences of senior doctors being consulted regarding the marriage prospects of patients with cancer and most, if not all, had disappointing outcomes, with many of the alliances being called off hastily.

“Many of my relatives told me not to go forward with this alliance, once the diagnosis of cancer was made”, he continued. “But I see this girl as my own daughter, and one does not abandon one’s own. My son is also quite attached to her and will find it difficult to break things off at this complicated moment.” I stared at him with mild disbelief along with a sense of awe. Here was a man, who had the courage to go against the flow and battle deep-rooted misconceptions attached to cancer.

In most societies in India, rural as well as urban, the word “cancer” carries a stigma that is difficult to break free from.[2] Fears of incurability, pain, toxicity of treatment, and infertility affect patients, caregivers as well as the lay public[34] and have led society to shun such individuals, especially when it comes to marriage. Women, in general have more difficulty finding partners when compared to men. There is a feeling that treating cancers entails disfiguring surgery thus affecting the physical attractiveness and sexuality of women[5] There is also a belief that cancers cause permanent sterility and women carry a risk of transmission of cancer to their children. I remember a patient, who had a difficult time finding a suitable match as all families rejected her once they found out about her battle with cancer. She finally did find a through a non-governmental organization that paired her with another cancer survivor and is currently happily married.

I went through the reports and found that she had a thyroid malignancy which had been treated completely. My thoughts quickly ran through what I should disclose. I could tell him that everything was all right and there was no chance that the cancer would recur. This would have improved the chances of her marriage going ahead as planned and I would sleep easy knowing that I had done my best to safeguard her interests. But I would also be kept awake by the fact that I had not been truthful to the father-in-law who had won my respect, by at least coming to seek an opinion and not downright calling off the wedding. I knew that I would have to tread a middle path of cautious optimism and practicality—a narrow tight rope, stretched across a deep chasm. I explained the routine follow up and outcomes expected with this kind of tumor but did not give any false guarantees. I spoke in general about thyroid cancers, not specifically about the patient, respecting the ethical guidelines that bound me. He listened patiently and then thanked me profusely for my time. “God above has brought this alliance and my son is happy. Who are we to interrupt the flow of His command? Life will bring many more hurdles in the future and if we can get past this one, the next ones will be much easier. There is no surety that the next match will work out. I will be moving forward with the marriage and leave the rest in God’s hands.”

He took his leave, and I sat back with this mellow feeling building up inside me. It was a mixture of hope interspersed with respect for his actions. Hope, because I prayed that he would probably be the first of many who would take a well-informed stance against the misconceptions about cancer.[6] Respect, because he might have to face discord or resistance subsequently from his relatives. Even a decade ago, the outcome of this conversation would have been brutal and would have sentenced the girl to a life darkened by the dense shadow of cancer. However, my encounter with this gentleman was the metaphorical light bursting through the storm clouds that shroud the stigma that is cancer, bringing with it dazzling radiance and gentle warmth, much like the glowing face of a shy bride on her wedding day. An auspicious day, hopefully not too far away for the girl in question.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

REFERENCES

1. Dalal NV Social issues faced by cancer patients during the coronavirus (COVID-19) pandemic Cancer Res Stat Treat 2020 3 Suppl S1 141 4
2. Noronha JL Cancer stigma –Why don't we sit down and talk about it? Cancer Res Stat Treat 2020 3 167 8
3. Sahoo SS, Sahu DP, Verma M, Parija PP, Panda UK Cancer and stigma:Present situation and challenges in India Oncol J India 2019 3 51 3
4. Sahoo SS, Panda UK, Parija PP Cancer stigma:Are we asking the right questions? Cancer Res Stat Treat 2020 3 640 1
5. Talreja V Love in the time of cancer Cancer Res Stat Treat 2018 1 75 7
6. Padmanabhan M, Balasubramanian S, Sha EK, Malodan R Knowledge, perception, and attitude of the general population toward cancer and cancer care:A cross-sectional study Cancer Res Stat Treat 2021 4 251 5
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