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My story today your story Tomorrow - Anil Agarwal (November 30, 1996)

As an environmental activist and writer, I have tried for years to promote nationwide concern about the deteriorating state of our environment. The idea of writing about my own travails as an environmental victim had, however, never crossed my mind. But obviously, I could not have escaped what was and is happening all around me.

Facing a Silent Spring

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A young patient of cancer at New Delhi’s All India Institute of Medical Sciences

Cancer is a frightening word. It means a terminal disease with periods of excruciating pain. And the treatment, full of poisons, is often as horrific as the disease itself. So how would you feel if you are told that you are suffering not just from cancer, but from such an extremely rare form of it that there is hardly any treatment available? That it has already invaded both your eyes, formed a small tumour in the centre of your brain so that it cannot even be surgically removed without cutting up the brain completely and has even reached your spinal cord? And that as the cancer grows in the eyes, the mass of cancerous cells will pull out the retina in both your eyes and make you go permanently blind; the tumour in the brain will grow to put pressure on the brain and cause strokes, among other things; and the malignant cells in the spinal cord could affect the various nerve endings attached to the cord any time and cause you acute pain and/or irreversibly paralyse parts of your body? The end of all this suffering will, of course, be death. Maybe not more than a year later, but a large part of that year could be spent in bed groping in darkness and pain.

What’re lymphomas?
Lymphomas are cancers that develop in the lymphatic system. They are parts of what are called lymphoid malignancies — lymphomas and leukaemias. The most common type is called Hodgkin’s disease; the rest are Non-Hodgkin’s Lymphomas. The lymphatic system is part of the body’s immune system, consisting of lymphatic vessels carrying lymph, a watery fluid that contains infection-fighting white blood cells or lymphocytes.
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Terrifying prospects, as you will agree. These were the prospects I faced in early
1994. And they were enough to make me think how merciful was God to those whom he let die peacefully in their sleep.

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Fluorescin angiogram of left eye before treatment (left): a cloud over the retina — sheet of cancer cells — hides it and makes the author blind in the left eye. Following chemotheropy, vitrectomy and radiation treatment, retina can be seen again, making vision possible

In early 1994, I faced the prospects of blindness, neurological disorders and death

Failing to find even a diagnosis for the symptoms in my eyes — black lines inside my left eye so that I could hardly see from it — in India, I was finally referred to the National Eye Institute in usa, whose scientists after diagnosing ocular and central nervous system Non-Hodgkin’s Lymphoma (nhl), referred me to their prestigious sister institution, the National Cancer Institute (nci). I learnt that the black lines in my eyes were cancer cells which had formed a sheet in front of the retina.

Table 1 Placing Cancer
Age-adjusted cancer incidence rates (per 100,000 persons)

Urban centres

Rural centres

Year Bangalore Mumbai Madras Delhi Bhopal Barsi
  M F M F M F M F M F M F
1982 100.2 129.0 119.9 111.2 81.6 108.1            
1983 92.5 116.2 116.5 106.3 88.7 121.9            
1984 90.6 116.3 123.9 113.8 87.6 120.0            
1985 98.7 108.7 129.5 122.9 92.2 128.3            
1986 97.0 115.9 128.5 120.9 101.3 135.7            
1987 110.7 129.5 130.4 118.8 104.4 133.4            
1988 114.6 132.3 129.6 122.7 125.2 129.7 116.8 133.5 98.1 98.7 55.4 52.2
1989 112.2 124.7 130.4 120.4 118.5 135.0 118.8 140.7 106.2 100.1 57.6 52.2
1990 113.9 139.8 138.9 124.9 116.5 136.2 125.1 143.6 107.5 101.2 56.2 58.3
1991 115.7 144.6 132.9 130.8 121.11 131.4 119.1 137.1     55.5 67.3
M: Males F:Females
Living in polluted cities more than doubles the chances of developing cancer, as compared to living in rural areas

Fortunately, doctors at NCI had an experimental chemotherapy for the disease. They first pumped in fatal doses of a cancer drug so that it could break past the blood-brain barrier and enter the otherwise well-protected central nervous system and eyes in quantities sufficient to kill the cancer cells. They had to immediately follow up with an antidote to save me from dying. The treatment gave me an year’s blissful ‘remission’ (a period without measurable cancer). After an year, in late 1995, the cancer cells returned. I was faced once again with the prospect of blindness, neurological disorders and death.   

Table 2 Placing NHL
Age-adjusted NHL incidence in India (per 100,000 people)

Urban centres

Rural centres

Year Bangalore Mumbai Madras Delhi Bhopal Barsi
  M F M F M F M F M F M F
1982 3.1 1.4 2.6 1.8 2.3 1.0            
1983 3.1 1.6 3.4 2.0 1.8 1.2            
1984 3.4 1.7 3.3 2.4 2.0 0.8            
1985 2.9 1.0 4.1 2.0 3.2 1.3            
1986 3.2 2.5 3.6 2.3 2.7 1.8            
1987 1.7 2.0 4.4 2.8 3.4 0.9            
1988 4.2 1.3 3.1 2.6 3.5 1.7 5.0 2.3 0.5 1.1 0.0 0.0
1989 3.1 2.1 4.0 3.0 3.9 1.8 5.1 2.4 0.5 0.5 1.9 2.0
1990 5.0 2.4 4.4 2.4 4.2 2.1 4.5 3.3 2.1 1.7 0.6 0.0
1991 3.7 0.5 4.0 3.1 3.6 2.2 4.8 3.3     1.1 1.2
M: Males F:Females
Delhi has the highest incidence of Non-Hodgkin’s Lymphoma (NHL), followed by Mumbai




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