Tag Archives: cancer

Letters to the Editor: 4/02/2021

Dear India Currents,

Biden Can’t End Cancer

Some politicians like to take credit for everything.  During a speech in Houston on February 26, 2021, President Joe Biden said, “I’ve said it before and I’ll say it again:  There’s just one thing—one thing—I could be known for as president.  It would be the end—the president who during his era ended cancer as we know it.”  There are three major problems with this statement.

First, scientific researchers, not politicians, will end cancer.  Second, there are over 100 types of cancer.  They won’t all be cured at once.  Third, the president cannot single-handedly allocate more taxpayer money for cancer research.  The House of Representatives and Senate are involved in determining how taxpayer money is spent.  Biden can’t end cancer.

Ashu M. G. Solo

Wilmington, Delaware

If you would like your opinion or perspective expressed at India Currents, do not hesitate to contact editor@indiacurrents.com with a submission or note. 

My Bones Just Lit Up Says Indira Ahluwalia About Her Battle With Cancer

Indira Ahluwalia is tall and graceful with a warm, welcoming smile. She’s the picture of wellness and good health, or so you’d think.  Her story, however, is about an illness that inspires dread, but it’s a remarkable and inspiring one.

In 2007 Indira was told she had metastatic breast cancer which had spread to her bones. She did not have long to live. But since that devastating diagnosis 13 years ago, Indira has beaten the odds and has not simply lived, but thrived.

Her  forthcoming book, Fast Forward to Hope, describes the tortuous, but ultimately awe inspiring journey through the dark crevices of her disease, and the toolkits for survival she developed which she firmly believes, contributed to her recovery.

“I remember the day I went to my gynecologist’s office so well,” Indira says. “I had coped with a terrible back pain for weeks and was walking around with a cane. I had an appointment with an orthopedic doctor but then a new symptom appeared. I felt this awful shaft of pain from the underside of my right nipple all the way up my arm; it was a live, electric wire thing, and it prompted me to make an appointment with Dr. Maser, my obstetrician-gynecologist, immediately.”

That trip led to an immediate mammogram which diagnosed her breast cancer and her doctor insisted she get a PET scan.

“I had already been through an MRI for my back pain, but without contrast, and it didn’t show anything. But when I had the PET scan, my bones just lit up,” Indira recalls. “Dr. Maser, an incredibly supportive doctor, came out and held my hand and said to me “promise me you’re going to fight.”

The full meaning of what it meant to have the cancer in your bones didn’t hit Indira till later.

“I visualized a tiny, pinkie size spot somewhere, and was horrified when I saw the spread.”

The process of getting the right diagnosis is one of the first lessons in Indira’s book.

“My father had colon cancer and we were very conscious of taking care of our health and testing on time. I began having colonoscopies when I was 35. But I was 38 and had never had a mammogram. I simply didn’t see the connection or imagined it was a risk at my age. I didn’t know at the time that there is a genetic connection between colon cancer and breast cancer. It’s important not to underestimate your risk in any area, was the first lesson I learned. It’s also important to get every technologically advanced current diagnostic test done. My MRI without contrast hadn’t picked up the cancer in my bones.

Her second lesson was about the will to survive. At the time, her children were young: her son was 3, her daughter had just turned 5. After going through every stage of grief – denial, shock, anger and finally, acceptance, – Indira came to the conclusion that dying before she raised her children was simply not an option.

“You have to believe in what you want the outcome of your illness to be,” Indira says. “I had a simple choice – living or dying – and I was determined not to die. You also have to commit yourself to healing and not let a feeling of powerlessness or helplessness overtake you. I had some very low points in my treatment, when I had to actively cultivate my faith in the positive outcome I wanted – beating back the cancer. There is an enormous capacity all of us carry within us for self-healing and we need to believe in it, with gratitude and humility.”

 Indira’s strong conviction about the healing power of positive thinking is borne out by recent research that supports the power of optimism and faith in changing the course of serious illness.  She also found that being open about one’s suffering and disease brought enormous rewards.

“The first thing that comes to my mind from my ordeal is the goodness of people,” Indira declares. “I knew there was a stigma associated with cancer, but I was open about my illness and I was overwhelmed by the response I got from all sorts of people – friends, family, staff, clients, my children’s Montessori teachers, unknown strangers. She believes that given and opportunity, even random strangers offer unconditional kindness and compassion.”

She recounts a particularly moving incident. On a cab ride from her office in Ballston, the cab driver surprised Indira with a, “Oh, my God, it’s you!”  He explained he’d driven her home some months ago, “…. you were talking to your doctor and you’ve been in my prayers ever since.”

“It was the simple humanity of his words which really touched me,” Indira says.

“Another of my primary anchors was my faith,” affirms Indira. “I believe in the Sikh tenet of Chardi Kala which is, essentially, cultivating a state of eternal optimism as one goes into battle. And I was going into battle with my cancer, with all the resources I could muster, including my state of mind.”

Her doctor told Indira he had used her first diagnostic scan from thirteen years ago and her most recent scan, to teach a class of medical students. He presented them as scans for separate individuals. His students diagnosed the thirteen year old scan as that of a patient unlikely to live, but gave the latest scan a great prognosis. His students were astonished when they heard that both scans belonged to the same person.

“My doctor told me that they needed to bottle the magical elixir I’ve used to beat back my cancer and distribute it to all his cancer patients,” Indira recalls.

 “I’ve tried to share what I learned about my magical elixir in the book,” Indira says.” Writing it was a cathartic process and it lays out the essentials in terms of harnessing the science of your disease along with your faith and your social network, and creating your personal anti-cancer army. I really hope I can help others who may be going through a similar trauma. My advice to them: choose yourself and visualize your cure with all your heart.”

Indira’s book, Fast Forward to Hope, will be out in late April 2021 and will be available on Amazon and in Barnes and Noble and local bookstores.

Jyoti Minocha is an DC-based educator and writer who holds a Masters in Creative Writing from Johns Hopkins, and is working on a novel about the Partition.

Edited by Meera Kymal, contributing editor at India Currents

 

It’s Just a Little Cancer. No Need to Make a Fuss.

Monday, December 1, 1967, 4:21 AM. Bombayites were rudely awoken from their slumbers as the world around them shook.

It was the devastating Koyna earthquake.

My mother recalled being panicked at the steel “Godrej” cupboards rattling together.  “Aiyayo, what is happening?”, she screamed (I am guessing that is what she said since I was not born yet). My father (without opening his eyes), replied, “It is just an earthquake. Go back to sleep.”  

I have heard this anecdote repeated with a mix of mirth and pride by my mother when she wanted to poke fun at my father.

Living in the San Francisco Bay Area, I know that one is not supposed to roll over and sleep if an earthquake were to hit. Having said that, I have to admit feeling awe at my father’s stoicism. I cannot recall a single instance in my life when I have seen my father panic about anything. He faced family, medical, career, and financial challenges (with my mother’s firm support) without alarming his family. I wonder what it was about my father, he always made life look so easy.

Was it his disciplined lifestyle?

Was it his matter-of-fact attitude to life?

Was it his firm belief in God and his daily prayers?

I do not know where he draws his strength. But, I know his family draws strength from him. On Wednesday, October 9th, 2013, when his wife of 56 years passed away, he walked into the hospital room, stroked her head, turned around to his children, and calmly instructed them to start making phone calls to get “the body” home and make arrangements for the funeral. I remember that day being one of extreme sadness.  However, there was no panic about how we would get through it. If a man who had lost his beloved partner could think clearly and behave with dignity, it automatically meant that his family could as well.  

My version of the Koyna earthquake moment came on January 2015, when my father’s prostate cancer, that had been slow-growing until then, entered Stage 3, and the doctor, in a very worried tone, told my father that it was time to start treatment. I was scared. My father told the doctor calmly, “It is only a little bit of cancer, there is no need to make such a fuss”.

Author’s father during his cancer treatment.

The look of disbelief on the doctor’s face was amusing. I knew my dad well and would not have expected any other reaction from him. My father underwent radiation treatment for 9 weeks, 5 days a week. The radiation center was a good 20 minutes away from our home. We would drive back and forth listening to my father’s favorite old Hindi songs. The weeks flew by and as we reached the final stretch of the treatment, my father wistfully talked about how much he enjoyed the drives, the music, and the company of the lovely nurses who took quite a liking to my father. On his suggestion, we gave a cake as a thank you gesture to the medical staff on the last day of radiation. My father posed for photos with them, and I felt like a proud parent of a high school graduate. We got through it.

Today, in the era of the pandemic and political, social, and economic uncertainty, I realize that my children are probably looking to me to get hints about how to react. I do not possess my father’s courage. But, I simply recall all the incidents in my life when my father must have been concerned but did not show it. Just like my father did through his actions, I try to convey to my children that this will also pass and I hope that they will remember to pass on that message to their children.

Shailaja Venkatsubramanyan has taught information systems at San Jose State. She volunteers with the Plant-Based Advocates of Los Gatos. 

St. Jude Children’s Hospital Named Official Charity Partner for 2020 South Asian Spelling Bee’s Regional Competitions

is the official charity partner of the South Asian Spelling Bee’s (SASB) virtual regional events on Sunday, Aug. 23, in Seattle, Washington, and on Sunday, Aug. 30, in Fremont, California. 

SASB is an annual spelling bee in the United States for children of South Asian descent. Founded in 2008, the event has become the essential gateway for success at the popular Scripps National Spelling Bee. In fact, 11 of the 15 Scripps champions are alumni of the SASB since 2008. This year’s installment of the SASB will be held virtually across six regions, whose winners will get a chance to compete at the finals in September.

Just like SASB, St. Jude has a deeply held commitment to education not only as a research institution, but also as a children’s hospital responsible for providing long-term care to childhood cancer patients. For children undergoing treatment, the St. Jude School Program by Chili’s not only offers a familiar routine with St. Jude teachers offering one-on-one instruction for K-12 students, but also provides patients with a feeling of being in lockstep with the outside world.  In addition to K-12, students from around the world also have an opportunity to attend the St. Jude Graduate School of Biomedical Sciences, further displaying the importance of education within the core values of St. Jude.

 Because of generous donors, families never receive a bill from St. Jude for treatment, travel, housing or food – so they can focus on helping their child live. St. Jude also freely shares the breakthroughs it makes, so every child saved at St. Jude means doctors and scientists worldwide can use that knowledge to save thousands more children.

This is what makes a difference for patients like Smyrna and her family. At St. Jude, Smyrna’s treatment for medulloblastoma, a type of brain cancer, included radiation therapy and chemotherapy. Smyrna celebrated the end of her treatment with a No More Chemo party, surrounded by her care team, friends and family.

St. Jude Children’s Research Hospital is a humanitarian effort supported by millions of Americans of all faiths and backgrounds united in their desire to help St. Jude continue its mission: Finding cures. Saving children.® Because together, nothing is impossible.

Donor support for the patients of St. Jude Children’s Research Hospital brings hope and comfort to their lives. Share a sweet message today by sending a patient art-inspired card to fill their day with happiness.  

St. Jude Children’s Research Hospital®

St. Jude Children’s Research Hospital is leading the way the world understands, treats and defeats childhood cancer and other life-threatening diseases. Its purpose is clear: Finding cures. Saving children.® It is the only National Cancer Institute-designated Comprehensive Cancer Center devoted solely to children. Treatments invented at St. Jude have helped push the overall childhood cancer survival rate from 20 percent to more than 80 percent since the hospital opened more than 50 years ago. St. Jude won’t stop until no child dies from cancer. St. Jude freely shares the discoveries it makes, and every child saved at St. Jude means doctors and scientists worldwide can use that knowledge to save thousands more children. Families never receive a bill from St. Jude for treatment, travel, housing or food – because all a family should worry about is helping their child live. Join the St. Jude mission by visiting stjude.org, liking St. Jude on Facebook, following St. Jude on Twitter, Instagram and TikTok, and subscribing to its YouTube channel.

# # # #

Fighting Cancer, Choosing Hope

In 2012, Munira Premji was an active woman filled with the joy of life. Her career was satisfying, her marriage was wonderful, and her grown children’s successes filled her with happiness. On February 3 that year, however, her life changed dramatically with a diagnosis of Stage 4 non-Hodgkin lymphoma coupled with Stage 3 multiple myeloma. She fought both cancers fiercely, understanding that there is no current cure for multiple myeloma. Then in 2015, just when she felt ready to live the life she had to put on hold, she was diagnosed with Stage 3 breast cancer. Now, in her book Choosing Hope: One Woman 3 Cancers, Premji shares her journey as not a victim but as a champion.

Premji is an engaging writer whose job as an HR rep worked in her favor when she was able to acquire a new cancer drug she needed at no cost through her employer. Still, her anxieties about the cost of treatments, medications, procedures, and care are never withheld as she and her family navigate the Canadian health system. She makes it clear that cancer is a costly disease on many levels.

At her daughter’s urging, Premji began chronicling her journey by blogging, keeping family and friends updated, expressing her emotions and drive to survive while documenting the processes she endured. The entries—included in the book—also reveal a courageous and resilient woman. Her anecdotes are set in the chemotherapy clinic, the hospital rooms, and her home with an extraordinary mix of humor, appreciation, and seriousness. Some are amusing, others are painful or introspective, and others celebrate the bonds between cancer patients during treatments, while in the hospital, and at support group meetings.

Although she doesn’t recount every chemo session, drug, healthcare worker, or needle stick, she gives the reader plenty to absorb. Premji is a realist, yet she remains positive when discussing foggy “chemo brain,” recalling each time her hair fell out, or reliving her struggle to produce enough stem cells to warrant surgery. To her credit, she always moves forward, even when her world looks bleaker than the day before.

Choosing hope merged with her faith when one of Premji’s chemotherapy nurses presented her with a bracelet that read, “Once you choose hope, anything is possible.” 

Premji embraced the concept, which strengthened her resolve during countless chemo sessions, hospital stays due to febrile neutropenia, the long wait to have stem cell transplantation, and the days in between chemo when she’d feel anything from energized to simply unable to move out of bed.

She’s an inspiration not only to other cancer patients and survivors but also the rest of us to stop, breathe, and embrace life. 

Premji continues to maintain her blog, has a YouTube channel, and in June of this year, she happily checked off a bucket list item by launching a podcast, Choosing Hope: Ordinary People Doing Extraordinary Things.

Jeanne E. Fredriksen lives in both Carolinas where she is a Books for Youth reviewer for Booklist magazine/American Library Association and a member of WCPE-FM The Classical Station’s Music Education Fund committee. This review is dedicated to her brother, Ron, who has been battling multiple myeloma.

Dil Bechara: From Reel to Real

Sushant Singh Rajput’s posthumous film Dil Bechara recently released on Disney+ Hotstar. Clearly dedicated to him, the film begins with a smiling SSR playing the guitar while a quote of his flashes in the background: “Perhaps, the difference between what is miserable, and that, which is spectacular, lies in the leap of faith…#selfmusing.” Inspired by John Green’s novel The Fault in Our Stars, the film is set in Jamshedpur and its opening dialogues are what most bedtime stories start with: “Ëk tha raja, ek thi rani; dono mar gaye, khatam kahani.”   

Kizie Basu (Sanjana Sanghi) is a young girl suffering from thyroid cancer. An oxygen mask is attached to her person, which she carries with her at all times. Due to her disease, she has a largely boring life and feels like a reality TV show contestant who can be eliminated from the game of life anytime. She often attends funerals of strangers and sympathizes with their loss. More than anything else, she longs to be just like any other normal girl her age. 

Enter Manny (SSR), who she meets at a cancer counseling group. Though ill too, he is fun-loving and likes to sing, dance and act. SSR is sadly so energetic and full of life in this—his last film—with expressions that remind one of Shah Rukh Khan from the DDLJ days. He also spins magic with some promising dance moves in the film’s dreamy title song. Watching it one can’t help but lament with a heavy heart about such a talented life tragically wasted. 

The film has its share of clichés too—like the fact that Kizie and Manny’s taste in music doesn’t match. While she likes to hear soppy, mellow songs, he prefers the likes of Honey Singh. Along with Manny’s friend, the two of them start shooting a comical film together, and he shows her how to enjoy life. In turn, Kizie gets him to hear an incomplete soulful song by a singer whom she admires, and he begins to love the tune too. They write to the singer to conclude his song and request to meet him. Kizie can barely believe it when the singer invites them to Paris. Since her immune system is weak, it’s risky for her to travel, but with some coaxing, she goes to Paris along with Manny and her mother—who agree to fulfill her long-cherished dream. Though meeting the crazy singer (Saif Ali Khan) is a bit anticlimactic, the three of them have a great time in the city. 

With the stars of young love in her eyes, Kizie soon finds a raison détre in Manny, but filled with emotion, she frequently gets breathless and her heart beats faster when around him. Manny later tells Kizie that an ache had led him to discover sometime back that he too is going to die very soon. In a poignant scene, his family hugs him and cries, as his condition steadily deteriorates. He also attends a mock funeral for himself where his best friend and girlfriend read weepy vows to him, while he sits across and hears them out. Predictably the end of the film is melodramatic, made more true to life by the fact that SSR is no more in reality too. There are several dialogues that seem ironic now—and while they were being shot, no one probably had a clue about what the future holds. In one instance, Kizie tells Manny, “One doesn’t need to be popular to be a hero. You can be one in real life too.” 

The film’s subtle message is in the letter that Manny leaves behind before dying: “We don’t decide when we are born and when we die, but we decide how we live.” As Kizie tearfully watches visuals of the completed film that they had shot together, it could very well be Sanghi herself watching the completed Dil Bechara in real life now. In a sense, the film and SSR’s life remind you of the fleeting nature of existence itself, making you almost want to hug your loved ones a little tighter, laugh a little louder, and just live life a little more fully…

_____

Neha Kirpal is a freelance writer based in New Delhi. She is the author of Wanderlust for the Soul, an e-book collection of short stories based on travel in different parts of the world.

Mahesh’s Life in the Balance


Alameda, CA –  Mahesh, a 68-year-old man, is a loving husband and father of two. In May 2019, he was diagnosed with Acute Myeloid Leukemia (a type of blood cancer), the day after celebrating his son’s marriage. A stem cell transplant is Mahesh’s only chance of beating this disease. Before a transplant takes place, a matching stem cell donor must be found.

Mahesh has spent four months in the hospital and his need for a match is urgent. Initially, five matches were found on the registry in India. But, these donors declined to move forward or were ineligible to donate their stem cells. No donor has been found on the Be The Match® national registry.

Matching is based on your human leukocyte antigen (HLA) tissue type. Your HLA is part of what makes you ‘you’ – your individual genetic characteristics. So, HLA matches are closely based upon a patient’s ethnicity.

Mahesh is South Asian/Indian. So, his perfect stem cell match will most likely be someone who is Indian or someone with Indian ancestry. You have a 30 percent chance of being a match with a sibling. But, Mahesh’s siblings are not the best match for him.

Mahesh family is from Central/Eastern India. His parents hail from Orissa. Today South Asians make up one percent of the bone marrow registry.

“My father’s health is rapidly declining and he needs a stem cell match right away,” says Amrut, Mahesh’s son. “If you are South Asian/Indian then signing up might save our Dad’s life or, if you are not a match for him, you might also save the life of another South Asian looking for a match. We need your help!”

More about Mahesh

Mahesh is a father, a husband, and a friend. He is also a leukemia patient. His heritage, Indian American, is preventing him from finding a matching donor because there aren’t enough Indians registered as potential donors.

Mahesh with his family

“I am completely dependent upon the registry to find a match, as my leukemia is aggressive,” Mahesh says. “There are zero matches for me. Being of Indian-American heritage, the population is severely under-represented as donors. If you have just five minutes, I ask you to register.”

Join the registry by texting MAHESH to 61474

What’s the Solution?

People of color are more likely to die of leukemia and other blood cancers because there is a shortage of diverse HLA types on the Be The Match® national registry. It is vital to build a more diverse registry so everyone has an equal opportunity to survive blood cancers.

Encouraging more people of ethnically diverse backgrounds and those of mixed heritage to be committed and join the Registry, potentially saving a life.  Each of us can “Be The One to Save a Life!”

The Asian American Donor Program (AADP, www.aadp.org) is a 30-year-old community based nonprofit 501 (c) 3 organization, based in Alameda, CA, that works to educate community members about marrow donation and the importance of joining the Be The Match® national registry. It is the oldest nonprofit of its kind in the country. AADP staff is dedicated to increasing the availability of potential stem cell donors for patients with life threatening diseases curable by a blood stem cell or marrow transplant. AADP is an official recruitment center for Be The Match®.

“For thousands of severely ill blood cancer patients, there is a cure,” says Carol Gillespie, AADP executive director. “You could be the cure. Those whose marrow/stem cells are not a match for a patient in need now may be a match for someone else down the road, anywhere in the world. I encourage all individuals to commit to registering. It is simple to register – just a swab of the inside of your cheek.”

When a marrow match is not readily available, patients have to wait longer than is ideal to find a match. Once a match has been found, their disease may have progressed to the point that they are no longer eligible for a transplant.

Importance of Diversifying the Registry

In 2019, an estimated combined total of 176,200 people in the US were expected to be diagnosed with leukemia, lymphoma or myeloma. New cases of leukemia, lymphoma and myeloma were expected to account for 10 percent of the estimated 1,762,450 new cancer cases diagnosed in the US in 2019. (From: https://www.lls.org/facts-and-statistics/facts-and-statistics-overview/facts-and-statistics

The Be The Match® registry recruits hundreds of thousands of donors each year through an extensive network of about 100 local and regional Community Engagement Representatives and organizations. You only need to join the Be The Match® registry once.

Marrow/stem cell matches are very different than blood type matches.  Just as we inherit our eyes, hair, and skin color, we inherit our marrow and stem cell tissue type.

How You Can Commit to Help

Or, text MAHESH to 61474

  • You must be 18 to 44 years old and meet general health requirements.
  • Complete the online consent form and a swab kit will be mailed to you.
  • Be committed. Be ready to donate to any patient in need.
  • Other ways to help – call AADP at 1-800-593-6667 or visit our website http://www.aadp.org

Please take a few minutes of your time to learn more about how you can help save a life and register as a marrow donor.

How to Build a Healthy Plate – Indian Style

Sukham Blog

My article  All That You Need to Know About Nutrition for South Asians introduced a framework to develop individualized, varied and nutritious meals that you would enjoy every day. This sequel provides suggestions to develop and sustain nutritious, healthy eating habits on a South Asian diet, distilled from conversations with Dr. Ranjita Misra, Editor of the 2nd edition of the AAPI Guide to Nutrition, Health and Diabetes, and Dr. Padmini Balagopal, Editor of its first edition. Dr. Balagopal – a Clinical Nutritionist with a commitment to community education in preventive health – is a Registered Dietitian and a Certified Diabetes Educator (CDE) who practices both in the United States and in India.

This is a practical guide to help you get from where you are to where you want to be.

Dr. Balagopal recommends the ABCD approach: use Anthropometric, Biochemical Clinical testing as the starting point to develop your Diet plan. Anthropometric measurements include height, weight, BMI, weight-to-height ratio, and waist-to-hip ratio. Biochemical includes metabolic, blood chemistry and other tests your physician would order, and Clinic stands for the examination he or she would perform – blood pressure, reflexes, heart and lungs etc. These measures, a customized interview and your physician’s guidance provide the basis to develop and sustain a nutritious, healthy diet optimized for you and your health condition.

Drs. Misra and Balagopal stress the role of a lifestyle change. “People would do better to focus on all aspects of their health – the whole chakra – and not just their particular health condition,” says Dr. Balagopal.” Physical activity, relaxation and mental health are also critical.  “No diet is complete without physical activity, and chronic stress can create a lot of damage.” Meditation, exercise, yoga are essential supplements to your dietary plan.

How you implement your new diet is also critical. Dr. Misra suggests you begin where you are and make a series of small, incremental and sustainable changes to your diet. She points to rice as an example. Most Indians are used to and like white rice. “If I asked my dad to switch to brown or red rice, he would throw a hissy fit,” she says. Instead, start with an equal-parts mixture of rice and quinoa or millets (available in India and in some stores in the US).  If you must, have just a little white rice at the end of your meal to satisfy your palate. “Cut your portion sizes and eat in moderation”, she advises. Allow yourself to indulge once in a while. “Food should be an enjoyable experience and you don’t have to give up everything you like.” Train yourself to take a balanced approach. A small cup of ice cream for comfort food after a bad day is okay if it makes you feel better and helps with your mental wellbeing, as long as you get back on track the next day. “Be aware of what you eat!”  A slice of pizza once a week is better than one every day.

The first step in adapting the Dietary Guidelines for South-Asian cuisine is to address grains. Less processed is better. Use brown or red rice. Consider alternatives like quinoa, bulgur wheat, and millet as substitutes for rice, or use a combination; they provide more protein with less carbohydrates. Refined carbohydrates “end up in the belly area” as triglycerides. If you must, have a very small quantity of white rice at the end of the meal to soothe your palate.  Many South Asians have hypertriglyceridemia resulting from high refined carbohydrates – the white rice factor. Use whole wheat flour for chappatis and rotis.  Ensure you eat plenty of fruits and vegetables. Introduce more color in the diet. Fresh is best, frozen is the next alternative. Canned food should be a last resort.  Add non-fat or low-fat yogurt to your meal for probiotics that are good for digestion and gut bacteria. The DASH meal plan is a good model to follow, especially for low sodium diets. Eat at least three hours before going to bed to aid in digestion and keep your blood glucose in check.

A plant-based diet comprising fruits, vegetables, legumes, and whole grains is the ideal way to go. It is also consistent with the Sattvik diet described in the Bhagavad Gita and other Yoga Shatras.  Furthermore, studies have shown that the prescribed plant-based diet  diet can help prevent and treat diabetes, heart disease, some cancers, high blood pressure, and other long-term conditions. A recent article provides evidence that this kind of diet  also helps with Crohn’s’s disease,  and it’s not difficult to reach the Guidelines’ goal of nine servings of fruits and vegetables daily.

‘Tadka,’ or ‘Oggarane’ – tempering – is a fundamental step in South Asian cooking; it provides those mouth-watering flavors by liberating essential oils in spices and condiments. Drs. Misra and Balagopal encourage this – we must enjoy our food – but urge us to minimize the quantity of oil, and suggest that canola and olive oil are better than other options, since they have lower trans- and saturated-fat content. Avoid saturated fats and limit ghee to occasional use. Avoid deep-fried food.  Above all, never reuse oil left over from deep frying. “When you heat oil to a certain temperature, it generates acrylamides – chemicals known to be carcinogenic,” Dr. Balagopal warns.

Another  essential key is portion control.  “Set your tummy thermostat to half-full and get up when you get there,” Dr. Balagopal urges. A high-fiber, whole-grain diet, while good for other reasons, also makes you feel fuller, and helps in this context.

We’ve given you a plate-full of suggestions to get started.  Future articles will focus on the health benefits of certain spices and condiments, and eating with chronic illnesses.

With sincere thanks to Anna Pelzer at Unsplash for the use of her beautiful photograph.

Sukham Blog – This is a monthly column focused on health and wellbeing.  

Mukund Acharya is a co-founder of Sukham, an all-volunteer non-profit organization in the Bay Area established to advocate for healthy aging within the South Asian community.  Sukham provides information, and access to resources on matters related to health and well-being, aging, life’s transitions including serious illness, palliative and hospice care, death in the family and bereavement. If you feel overcome by a crisis and are overwhelmed by Google searches, Sukham can provide curated resource help. To find out more, visit https://www.sukham.org, or contact the author at sukhaminfo@gmail.com.  

 

Make Life an Option

Mindy Kaling, the famous actor-producer in the hit series – The Office – stated on Twitter “I just signed up! All my fellow South Asians, let’s make a difference here – it’s so easy, and one day it could be you or someone you love.” She was referring to the search for a marrow donor on behalf of Liyna Anwar, a podcast producer for The Los Angeles Times who is fighting an aggressive form of cancer. When certain cancers strike, a bone marrow transplant becomes a lifesaving option and South Asian representation is woefully negligible in registries.

An effective treatment option for several blood cancers, and one which often results in a cure, is hematopoietic stem cell transplantation (HSCT). In addition to blood cancers, this procedure is invoked in the treatment of other serious illnesses including lymphomas, immune-deficiencies, and anemias. In all these instances an allogeneic HSCT is required, in which a matched donor is the source of healthy HSCs.

‘Matching’ involves the identification of human leukocyte antigens (also called HLA), which are proteins present on the surface of the transplanted cells, and ensuring that those present on the donor cells are compatible with the patient receiving these cells. This is dependent on genetics, and it thus follows that a match will be procured from a donor of the same ethnic background. Unfortunately, at the present time the probability of an Indian finding a matched donor in an international registry is approximately 10% (compared with the 80% probability of a Caucasian finding a match). Thus, there is an urgent need for increased representation of donors of Indian and south-east Asian descent in international donor banks, including those right here in America.

The quest for a suitable donor usually begins with finding a match with a sibling or a relative, but only an estimated 30% of matches are found from within relatives. More often than not an unrelated donor is sought and a wider net is cast that spreads over three source tissues, and the repositories which house them. Three sources of tissues may be used as starting material for a HSCT: (1) bone marrow harvested from the pelvic bone, (2) peripheral blood stem cells (PBSC) isolated from blood after being mobilized from marrow, and lastly (3) cord blood (CB) stem cells. The first two are harvested from adult donors (optimally 18-45 years of age), while the third one is harvested from the umbilical cord after childbirth. Of these, the bone marrow and peripheral blood derived stem cells are preferred as they pack a concentrated bolus of stem cells. Cord blood has advantages in that the requirements for a match is less stringent, but the number of stem cells per sample is limited and the time taken for engraftment is longer. Another significant difference lies in logistics and infrastructure. Registries exist for the adult-derived stem cells where a database is created to record HLA characteristics of registered samples. Once a match is identified the donor is contacted and tissue harvested, processed, and shipped to the recipient’s hospital. In contrast, physical samples of cord blood harvested at the time of childbirth are stored in tissue banks awaiting a request once a match is identified.

Prominent international stem cell banks and registries include the World Marrow Donor Association (WMDA) which is headquartered in the Netherlands, and the Anthony Nolan Trust based in the UK. The Be The Match registry (also the National Marrow Donor Program (NMDP)) is maintained by the Health Resources and Services Administration (HRSA) of the US Department of Health and Human Services (https://bloodcell.transplant.hrsa.gov/index.html), and in addition to the registry provides a trove of information about current research and options available to patients. As there is a widely acknowledged need for donors of non-Caucasian ethnicities in these international banks, the HRSA also provides information related to initiatives and funding for establishing registries focused on these populations. One such initiative is a California-based non-profit Mixed Marrow that is focused on finding bone marrow and blood cell donors of multi-ethnic descent. South Asian Marrow Association of Recruiters (SAMAR) is a community-based network partner and official recruitment center of the Be The Match Registry. Although they were initially focused on recruitment of the South Asian ethnic group, they now serve diverse racial groups. Information may be obtained for other registries including DKMS and Gift of Life.

Of specific interest to patients of Indian and South-east Asian ethnicities are stem cell registry and banking initiatives in India. Currently five registries exist, namely, Marrow Donor Registry India (Mumbai), Genebandhu (Delhi), Bangalore Medical Services Trust (Bangalore), Datri (Chennai), and Jeevan Stem Cell Foundation (Chennai). Jeevan also houses a cord-blood bank. In addition, there is an ongoing initiative of the Government of India to create a national registry. Dr. Srinivasan Periathiruvadi, Chairman of Jeevan, estimates that when the registry touches the million mark approximately 60% of patients of Indian origin will find a matching donor. Since 45% of the Indian population is between the ages of 18-45 which is optimal for a donor, he opines that reaching this goal should be possible in a year or two. HLA typing is performed on registered donors, and once matched, the requisite tissue sample may be shipped to national and international transplantation sites.

India Currents editor Nirupama Vaidhyanathan remembered a high-profile campaign in the South Asian community about 10 years ago in the Bay area, when there was a big push to include participation among Indian-Americans in bone marrow registries. “The registration process was very simple,” she said, “I went to the Hindu temple in Fremont – volunteers swabbed inside my mouth for a sample and then sent the details to the registry. I was contacted about five years later saying that there was a possible match with a patient. Then, they contacted me again saying that they had found a match that was even closer to the patient’s tissue structure. I am still registered and I encourage all to do so. I can only imagine the pain that family members go through when they try to hunt for a possible donor.”

Registering in a database is not difficult, and instructions for sample submission, along with the relevant form, is available on the respective websites. Data obtained from the HLA typing is stored in the database, and the donor will be contacted only when there is a potential match. Donations are usually performed by isolation of PBSCs, which is likened to a prolonged session of blood donation and is appreciably less intrusive than marrow extraction from the pelvic bone. Cord blood is collected from the umbilical cord which is usually discarded, and may be donated with little effort. Both these actions can save lives.

As a community we could contribute to the health of our generation and the next by creating robust registries and cord blood banks. Having this option to fall back upon in the face of a dreadful illness could indeed be a blessing for the international community of South Asian descent.

 L Iyengar has a Ph.D., and has been involved in researching the biology of stem cells for about two decades. She has been involved in research programs both in the USA and India.