The fifty shades of pain : Indian Journal of Cancer

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The fifty shades of pain

Jain, Ankur

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Indian Journal of Cancer 59(4):p 571-572, Oct–Dec 2022. | DOI: 10.4103/ijc.ijc_74_22
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When I began my career in hemato-oncology, I was thrilled to witness a multitude of malignancies. The inherent challenges of diagnosis, treatment, and rewarding outcomes for certain cancer types gave me an impetus to sustain myself and grow further. Gradually, the management of cancers and complications of their treatment became a part and parcel of my life. One day, I gathered all that I saw over the past several years in hemato-oncology. My face lighted when I remembered the fond memories of curing a patient with acute promyelocytic leukemia, diffuse large B-cell lymphoma, and chronic myeloid leukemia. However, when I looked back at the journey of a few of my patients with acute lymphoblastic leukemia (ALL), the excitement turned a little bitter. Although few of the patients with ALL got cured with therapy, and others died. Moreover, those who survived suffered a lot of “trauma” during their entire 3-year-long treatment journey. As a physician, we are delighted to see the final outcome, that is, being alive or cured. However, do we really see the coin from the other side? In other words, have we ever wondered what “pain” these patients go-through to reach the final outcome? In my poetry, I narrate the perspective of a patient with ALL and highlight the different “types of pain” such patients bear. The idea of describing the “pains” in different scenarios is to mention the turmoil of patients with malignancies to help build empathy among the treating oncologists. While I have chosen ALL as an example, the idea remains applicable to a broad range of oncological neoplasms. Patient X, a 14-year old boy, narrates:

Happiness is transient which seldom rains,

My life halted when I woke up with intense bone pains.

The pathologist found abnormal cells in my peripheral smear,

The doctor said- ‘you will need a bone marrow aspiration, my dear!’

Pain from marrow aspiration was dull aching and minimal,

But the diagnosis of acute lymphoblastic leukemia was dismal.

Life seemed gloomy with a dark end,

The family gave me strength and the doctor became my friend.

Finally, I began the induction phase of the Berlin-Frankfurt-Munster (BFM)-95 protocol,

That was the only way towards cure after all.

Chemotherapy caused a burning sensation along the veins,

Weekly vincristine resulted in marked neuropathicpain.

We traveled daily to the hospital daycare Centre via train,

My mother used to smile, but I could see her hidden agonizing pain.

Treatment and traveling led to financial drain,

Social workers provided us a shelter near the hospital lane.

One day, I experienced a headache with throbbing pain,

MRI brain revealed a clot in the cerebral veins.

L-asparaginase seemed to be the culprit,

But these hurdles did not affect my fighting spirit.

Lumbar puncture caused sharp shooting pain along my spine,

I had to bear it to prevent Central nervous system (CNS) relapse at a later time.

I accepted my destiny and learned to live with my disease,

I hoped that today’s troubles might bring my future to ease.

Mobility became difficult and caused crippling pain in the right hip,

‘Avascular necrosis of the femur head’ was another demon in the ship.

My body turned into a beating heart with a wounded soul,

It became difficult for me to picture life as a whole.

After one month, repeat marrow aspiration showed disease in remission,

But, whether to proceed with a stem cell transplant was the next decision.

After an extensive search, there was no suitable Human leucocyte antigen (HLA) match,

To proceed with chemotherapy was now the only best catch.

I had mucositis pain due to cranial irradiation,

But for CNS prophylaxis, it was the standard tradition.

Gradually, my body healed and I began building my dreams,

I would go to the school and celebrate my birthday at fifteen.

My fantasies broke and I experienced a bubble burst at last,

When my cerebrospinal fluid (CSF) showed the presence of the blast.

I realised that I now have only a few days to spend,

I prayed- ‘Dear God! After all this turmoil, please give me a painless end’.


The author declare that a written consent was obtained from the patient’s father prior to publication of any material.

Financial support and sponsorship


Conflicts of interest

There are no conflicts of interest.


I would like to thank my patients who showed immense strength and patience while undergoing treatment for malignancies. I thank them for sharing their experiences with me that I narrated in this poetry.

© 2022 Indian Journal of Cancer | Published by Wolters Kluwer – Medknow