Wearing only a muslin loincloth, I lie on a hardwood table stained the color of mahogany from years of oil massages. A warm breeze flutters a sun-bleached crimson sari mounted lengthwise on the wire-screen wall that separates the treatment room from the garden and coconut palms outside. Krishna Dasan, the Ayurvedic therapist working on me, glides an oily satchel filled with freshly cut leaves, garlic, and lemon in long strokes from my chest to my legs. Sometimes along the way, detecting a stubborn area of muscular tightness, he stops and rubs back and forth over the stuck area for a number of staccato strokes before resuming longer ones.
When the bag cools, Krishna hands it to his assistant, Shashi, who puts it back in turmeric-infused oil bubbling on a single-burner gas flame and hands Krishna a hot one. After pounding the satchel once or twice on the table to cool it and remove excess oil, Krishna traces firm circles on either side of my chest. The air is fragrant with a smell more like food than medicine, vaguely reminiscent of homemade pea soup.
Because he is worried that the hot oil might cause the metastatic cancer cells in the lymph nodes of my neck to spread, Krishna massages that area only lightly. A few days before we’d begun these treatments, his guru, Chandukutty Vaidyar, an elderly Ayurvedic physician, had warned him to be careful.
Normally, Vaidyar, whose name is the Malayalam word for “doctor,” refuses to treat cancer patients, but since I have been his student for years, he’s made an exception.
“I’m not expecting Ayurveda to cure my cancer,” I tell Krishna. He seems relieved. “I just want to get as rested and balanced as I can be before I undergo the heavy-duty treatments.”
I figure the massages and herbal remedies, which had helped me so much in the past, would at least give me a better shot at getting through what was to come. And although there is zero scientific evidence to support the idea, I suspect they may even increase my odds of getting cured.
Helpful Ayurvedic Treatments Before Chemotherapy
A few days after beginning this round of Ayurvedic treatments, I notice that my tonsil is no longer covered with a grayish film but is shiny pink and looks smaller in the mirror. When I move my fingers across the lymph nodes in my neck, as I’ve done thousands of times on patients, it feels like they are also shrinking. Krishna agrees. Over the next couple of weeks, this trend continues, with a progressive, slight decrease in the size of the tumors. I’m not thinking this is going to be sufficient to eradicate the cancer, so I’m still planning conventional care, but it feels like confirmation that what I’m doing is already making a difference.
In deciding to go to India for Ayurvedic treatments before commencing chemoradiation, I remember something that I learned in medical school: Cancer is potentially life-threatening, but in most circumstances, it’s not an emergency. That’s why I shudder when people hurry into treatments before they’ve had a chance to carefully consider their options. By the time a cancer is diagnosed, it has often hidden in the body for years, sometimes for a decade or more. This is why a few weeks delay—unless there is a critical situation, such as a tumor obstructing a breathing tube or compromising another vital structure—usually won’t matter much. What is crucial to me is to get the best care possible, not, as I’ve heard patients say, to “get the cancer out of me as soon as possible.” I have the luxury of not being in an emergency, so I am able to do extensive research, talk with loved ones, consult colleagues, and get second opinions from other health-care professionals.
Yoga and Ayurveda During Chemotherapy
Less than a month after India, I arrive at a major medical center in the southeastern United States for cancer treatments. The air conditioning in the hospital is freezing. I’m wearing a maroon stocking cap, one of several that my sister-in-law, Madelyn, bought for me. Before the chemotherapy drug Cisplatin is infused, the nurse brings a paper cup with two anti-nausea pills. One is a powerful corticosteroid called Decadron. The other pill is a popular new anti-nausea agent that is said to be much more effective than the drugs that came before it.
Just in case, though, to help prevent nausea, I’ve drunk nothing but warm water for the past two days. I made the decision to forgo food after reading a report in an oncology journal that found patients who fasted during their chemo treatments reported little or no nausea. Sitting in the infusion center, I chew on slices of fresh ginger I’ve brought from home—an Ayurvedic remedy for nausea.
As the yellow contents of the small bag of Cisplatin drip into a larger bag of saline running into a vein in my arm, I do not think of it as a toxic drug, even though I know full well that it is. Instead, I imagine that it is a healing nectar flowing into me and circulating throughout my body. I lie back on the vinyl chair, look out the window at the few trees in this urban landscape, and silently chant mantras.
The yoga pose that is proving most helpful to me is a prone restorative twist. To come into it, I sit with my bent knees to the right side of my body with my right foot cradled in the arch of my left. As I bring my torso down toward a cylindrical bolster, I twist my spine and my head to the left. Just before my chest lands on the bolster, I turn my neck in the opposite direction, so that my knees and head face the same direction. My breath deepens as I sink in.
This is a beautiful stretch between the neck and the rib cage, helping me preserve movement threatened by the chemoradiation. And because this prone twist is a restorative pose, I can hold it for a long time. I’ve been tired and unable to do much yoga practice most days. Some mornings, just standing and lifting my arms overhead feels like too much. I stay 20 minutes in the twist, then come into the pose on the other side.
Yesterday, Madelyn caught me asleep in the pose. I might have been there 45 minutes. Normally that never happens.
An Integrative Approach to Cancer Treatment Shows Results
Three months post-chemoradiation treatment, I return to the hospital for another PET scan to evaluate my response. I’m told that the areas that lit up on my initial tests seven months ago, indicating cancer, have returned to normal. Neither of my doctors, both of whom examine me carefully, finds any evidence of cancer in my mouth or lymph nodes. I have what they call a “complete clinical response.”
In my experience practicing medicine, cancer treatments can be both overused and overly aggressive. For many malignancies, including mine, an integrative approach that includes the best of modern scientific medicine, but which also addresses the many areas of mind, body, and spirit that the field systematically neglects, appears to offer the best hope.
Holistic systems of medicine such as Ayurveda and traditional Chinese medicinework like an organic gardener who makes plants (in this case the body) hardier by strengthening the soil rather than simply pouring on pesticides. But sometimes you need both. One aspect of good holistic care is that it welcomes treatments such as drugs and surgery when they seem like the right tools for the job. You might say the integrative path I chose to deal with the pernicious invader that is cancer incorporated the toxic chemicals of chemotherapy along with the soil-enhancing effects of diet, stress reduction, and gentle herbal remedies.
I didn’t choose this cancer adventure. But I see clearly that my choices set the karma in motion that brought me to it. In trying to deal with it as skillfully as possible, given the imperfect collection of information I’d amassed by the time each decision needed to be made, I did the best I could. And overall, I’m happy with the choices I made.
All you can do is the best you can do at any given time and not second-guess yourself. That’s skill in action—the Bhagavad Gita’s definition of yoga. Is it also yoga to use your life and struggles to learn and grow, turning seemingly bad events into things that serve you. Yoga teaches that it’s possible, through your actions, to change some bad karma into good karma. I chose the path of holism, taking one small step at a time and trying to look at specific aspects of my situation in hopes of shifting the whole in a helpful direction. I addressed my structure, my breathing, my nervous system, and my mind. In addition to the Ayurvedic treatments, I had dozens of acupuncture treatments and regular visits to a physical therapist for bodywork called myofascial release. And I continued my journey of psychological excavation, jettisoning attitudes and behaviors that may have served me in my difficult childhood but which I no longer needed.
As hard as I’ve worked to get through the challenge of cancer, I have also surrendered the illusion that I can control it. After getting the news I’d been hoping for at my follow-up appointment, I learned that there is a 5 to 10 percent chance the cancer will recur in the first three years. Optimistic as I am, I’m aware that my efforts may not have been enough. Part of my hopefulness is that I know that if the cancer should recur, I have tools to help me get through it. To heal even if I cannot be cured. To live however much life I have left with joy and contentment and love. And the urgency the diagnosis has brought is to live life more fully, to bring even more passion and discipline to the work I feel like I’ve been put on the planet to do.