Patient with cervical and breast cancers foxes doctors

MUMBAI: Hearing a diagnosis of cancer is tough for most, but Chandrakala Agarwal (63) is among the few patients in whom the task is doubly tough as they have two forms of cancer at a time. Her case is more unusual as she had the rarest combination of cancers-in the cervix and breast.
While it is common to hear pf metastatic cancer that spread from the main cancer site to other organs, dual cancers -or synchronous cancers as they are called-are relatively rare with few studies done so far.
"Primary cancers arising from multiple organs occurring in the same individual usually have some common factor,'' said breast cancer surgeon Dr Archana Shetty who operated on Agarwal at Kokilaben Dhirubhai Ambani Hospital in Andheri. So, it is likely for women to have breast cancer with ovarian cancer or men to have salivary gland tumours with lung cancers.
"But synchronous occurrence of breast cancer with cervical cancer is rare, mainly because of the contrasting predisposing factors," she said.
For Agarwal, health problems began in December 2017 when she had white discharge. "We went to a hospital in Bilaspur where we got a diagnosis of cervical cancer," said her son Nitin, a businessman from Bhatapara, a town between Raipur and Bilaspur.
The family wanted to get treatment in Mumbai and underwent multiple tests and scans when the second cancer was found. "A PET scan showed a spot of worry in the breast," said radio-oncologist Dr Pranav Chadha.
The main issue with synchronous cancers is coming up with a treatment plan, said Dr Kumar Prabash, professor at Tata Memorial Hospital, Parel. "As these cancers need different treatment or medicines, doctors from various oncology specialities have to sit down together and work out a common treatment plan,'' he said. The premier cancer hospital roughly sees 12 synchronous cases a year, added Dr Prabash.
In Agarwal's case too, Kokilaben Hospital doctors held meetings to decide which one be treated first -the breast or the cervix. "As the breast cancer was in the initial stage, we thought it would be best to remove it surgically. No other treatment would be needed for it," said Dr Shetty. The patient underwent a left breast mastectomy/removal in January and a fortnight later started simultaneous chemotherapy and radiation for cervical cancer.
A recent meeting with doctors showed Agarwal is recovering well.