Author Archives: Neeraj Shah

Why is the Threat of Cancer Not Enough to Stop People Smoking?

Cancer, a word the majority of the human race fears. If you smoke, the chances of developing Cancer is a lot higher than if you didn’t. Why then, do smokers still smoke?

In 2005 I had the misfortune of losing a very close aunt to Lung Cancer. I had reached the grand old age of 40 and had been lucky enough to never have experienced a death in the family.

My aunt had smoked since she was 17. Was she naive? No. Did she not understand the possible consequences of smoking? Hardly, she had been a nurse for over 35 years. So why then, did she continue to smoke, especially as she worked in a field where she came face to face with cancer patients on a day to day basis?

When she was first diagnosed with cancer it came as a big shock to all of us, as I expect it is to most people that get given this devastating news. The year previously she had been very ill with TB, and we all thought that her deteriorating health was down to a reappearance of that, how wrong we were. She gave up smoking straight away, and as she went through the grueling process of doctors, tests, scans and specialists, the rest of us smokers in the family continued to smoke. Oh not around my aunt of course, but continue we did. We had been dealt a terrible blow, we had up close and personal proof that smoking can lead to cancer. It’s not that we didn’t know that anyway, but when it never affects you directly it’s easy to shrug off the threat with excuses.

My aunts cancer was diagnosed as too far gone to be treatable, nothing could be done. She started smoking again. Three months later she was gone. Her funeral was the first one I had ever attended, I hoped is was my last.

And still we smoked.

Towards the end of that terrible year, November to be precise, we where yet again given bad news. My father had prostate cancer, and even though, he too was a smoker, we still managed to make excuses for the reasons he developed this disease, excuses like “a lot of men his age get prostate cancer, it’s quite common and easily treatable.”

Luckily, his cancer was treatable and he was cured. My father gave up smoking.

We, did not.

Three months later, after a routine blood test, my father was told he needed more tests, that something was wrong with his blood. A visit to the hospital revealed that the prostate cancer was back, but if that was not bad enough it had spread, he now had bowel cancer as well. I think for a brief period we all went into a state of shock followed by denial. This couldn’t be right, he doesn’t smoke anymore. It’s amazing how stupid you act when given bad news. A week later he’s in the hospital having an operation to remove his prostate and part of his bowl. My father had always looked young for his age, at 65 he looked more like 50, now, he looked awful, he lost over 2 stone in weight within a matter of weeks, he went from looking 50 to looking 90. He now looked like a little wizened old man, not my father at all. And during this terrible time, we still smoked.

A week after surgery the consultant met with both my parents to give them the news that not only did my father have cancer of the prostate and bowel, but that it had spread to his lungs and liver. The only thing that they could do for him now was to offer him chemotherapy, not as a means to a cure, but a way of giving him some more time, how much time, they couldn’t or wouldn’t say.

It’s now 2007 and luckily for us, my father is still here. He has his good days where you would never believe that there was anything wrong with him, then he has his bad days and you wished it was all over, just so he wouldn’t suffer anymore.

My father still doesn’t smoke.

We still do.

So why is it, even after two very painful experiences of the consequences of smoking, do we still smoke? What will it take to prove to myself and the other members of my family who smoke, that we need to quit. We have witnessed at firsthand the horror and pain cancer causes, we have felt the devastation and loss, but still it is not enough. Do we all believe that it will never happen to us, if so, why do we believe that. Why is it that certain members of the human race, a species that has evolved, adapted and developed into what it is today, simply refuse to believe what is in front of their eyes.

I’ve read all the warnings. I’ve seen all the advertising. I’ve been advised by doctors. I know all the dangers, an yet I still smoke.

I Have Thyroid Cancer

It’s a fairly rare cancer, or so I am told. But I have it. I didn’t know anything was wrong. I had no idea anything was going wrong in my body. I felt great. I still do. But I have thyroid cancer. My story started at my yearly physical exam with my doctor. I love my doctor. I have always liked her, but I have an entirely new admiration for her now. She found my cancer. We were chatting like we usually do about kids and summer and life. She was feeling of my throat with her fingers when she said, “Hush and swallow”. I did both. “What?” I asked. “Hush and swallow again”, she said.

“You have a nodule on your thyroid,” she told me. “No I don’t.” I said.

She put my fingers to the spot and told me to swallow again. Yes I did. I did have a nodule. Even I could feel it. She asked me if I had been having trouble swallowing. I had not. I asked her what this meant. I asked if I had a goiter. “Yuck”, I thought. She told me I had better hope it was a goiter, because the alternative was cancer. Ouch. The thyroid is a gland at the base of your neck that has sort of a butterfly shape to it. It makes thyroid hormone which regulates your metabolism.

She booked me an appointment for an ultrasound of the suspicious nodule. That was easy and painless. Yes I had a nodule. As a matter of fact I had several. I have since found out that women over 40 commonly have nodules on their thyroids. Great. Just turned forty and my parts are wearing out. Okay, so the ultrasound confirmed what my doctor already knew. What now? She wanted me to have the nodule biopsied.

“Correct me if I am wrong, but I believe that means a needle in my neck?” I asked.

I was right. Back to the radiology department at the hospital for me. They had me to lie down on a table with a rolled up towel behind my neck. The doctor came in and located the nodule in question with another ultrasound. Then he used some medication to numb the lower middle part of m neck. Okay, it burned some. Well quite a bit, but only for a few seconds and then the burning was gone. Next he stuck a really small needle into the same area and thanks to the numbing medication I felt no pain. It did, however, feel like someone was standing on my throat. I could breath just fine, but still that feeling was there.

He did this two times and decided he had enough cells to make a determination for me. He said I should know something in two or three days, but that most of the time these things are nothing. Great. I liked that. They placed a band aid over my neck and off I went.

Three or four days later I receive a call from my doctor. Confident she was calling with good news, I did not ask my son to leave the room. A decision I would soon regret. She read me the pathology report and told me it meant that I had thyroid cancer. Unfortunately they were not able to differentiate what kind of thyroid cancer it was from the tissue they had. She kept asking me if I was all right and if I had any questions. To be quite honest the entire conversation is a bit of a blur. I do remember her telling me that if I had to have cancer this would be the kind to pick because with surgery this was a curable cancer. She referred me to a surgeon in town who specializes in thyroid surgery. My doctor was going to let this surgeon make the decision for my next step.

I hung up the phone in a bit of shock. I had done my homework on thyroid nodules and discovered that only 5% of them are cancerous. I had conveniently placed myself in that larger, 95% group. I had fully expected my doctor to be calling with news to confirm this. But rational thinking would later remind me that your doctor rarely calls with good news. Usually the office staff has this privilege. Only when the news is not so good do they feel the need to call themselves.

My son had been sitting in the room and hearing the entire conversation. When I got off the phone he asked me what was wrong with me. I lost it then. Right in front of him. Not good. I called my husband who was thankfully on his way home anyway.

I was scheduled to see the surgeon a week later. By then I had gotten myself together and realized that this truly was a curable cancer when treated. The surgeon shared lots of information with my husband and me that day. I learned that she planned to take out my entire thyroid through a small incision on my neck. I learned that she would not know until the surgery just what kind of cancer I had. There are a few different kinds of thyroid cancer. I learned that depending on the kind of thyroid cancer she found, she may need to remove some lymph nodes in my neck, too.

I also learned that there was a possibility that I would need to take a few radiation pills if the kind of cancer warranted it. These pills are radioactive iodine or I-131. The thyroid gland is the only part of your body that uses iodine. It needs it to make the thyroid hormone that helps to regulate your body’s metabolism. So the radiation in the pill goes right to any thyroid tissue that’s left after surgery and destroys it. The only snafu with this treatment is that for the duration of the treatment (4-5 days) the patient is not allowed close contact with children (Due to the shedding of radiation), is not able to prepare food for or eat with others, and must sleep alone.

Following the surgery the surgeon told me I could expect to have a sore throat from the breathing tube that would be placed during surgery, and a moderate amount of pain at the surgery site. I would need to take one or two weeks off from work, and I would not be allowed any housework for at least six weeks. This was said tongue in cheek for my husband’s benefit. I like this surgeon.

So now I’m waiting a month for my surgery. For something that’s supposed to be so rare, I have talked to many people who have known someone with thyroid cancer. I am happy to report that I have heard of only great outcomes. Although I suppose no one would tell me the bad stories, if there are any. But I am encouraged. I have had lots of hugs and lots of prayers said on my behalf.

If you are over 40, and especially if you are female, let me encourage you to have a yearly check up. Have your doctor check for nodules on your thyroid and then if anything shows up, have it checked out. Most likely it will be just fine, but untreated thyroid cancer can spread to the lymph nodes, lungs, and the bones. Like with everything else, early detection and early treatment is best.

Risk Factors and Causes of Liver Cancer

Liver cancer may not have as high a profile as some other forms of cancer but it is one of the most lethal forms of cancer. Most people do not survive beyond a year after being diagnosed with it. A peculiar fact about liver cancer is that its risk factors are mostly related to lifestyle choices and behavior such as alcohol use, sexual behavior, drug abuse, and occupation.

The most common risk factor/cause of liver cancer is spread from other cancer sites in the body (metastasis) but this causes Secondary liver cancer. The risk factors that are discussed here are those that result in Primary liver cancer which is cancer that originates in the liver.

Risk Factors for Liver Cancer

Sex: Liver cancer occurs more in males than females. This could be attributed to the fact that males are more likely to engage in behavior that predispose to developing liver cancer such as excessive alcoholic intake and use of anabolic steroids. (1) (2)


Cancer of the liver is more common in older people in developed regions of the world. In contrast, it occurs more in younger persons in developing areas like Africa and Asia. (2)


Chronic infection with hepatitis B virus (HBV) and hepatitis C virus (HCV) both lead to cirrhosis and consequently, liver cancer. HCV infection is more likely to become chronic and is the more common cause of liver cancer in developed areas like the United States. HBV is the more prevalent risk factor in developing regions. Both viruses are transmitted through such means as unprotected sex, sharing needles (drug abusers) and contaminated blood transfusions. (1) (2) (3) (4)

Excessive Alcohol Intake

Prolonged alcohol abuse leads to irreversible liver damage and consequently, liver cirrhosis and liver cancer. (2) (4)


These are substances produced by fungi which grow on food such as wheat, corn, rice, peanuts, etc. Eating food contaminated with aflatoxins over a long period of time increases the risk of liver cancer. (1) (2) (3) (4)

Prolonged Use of Anabolic Steroids

Anabolic steroids are hormones used to increase muscle bulk by athletes and body builders. Long-term use increases the risk of liver cancer. (1) (3) (4)

Non-Alcoholic Fatty Liver Disease

In this condition, fats called triglycerides accumulate in the liver. It is seen in diabetic patients and obese people and leads to cirrhosis. It is associated with an increased risk of liver cancer. (1) (2) (4)

Exposure to Chemical Compounds:

Certain chemical compounds greatly increase the risk of liver cancer. They include vinyl chloride which is used in making plastics and arsenic which is found in water from some wells. Prolonged exposure to these compounds increases the risk of developing liver cancer. (1) (3) (4)

Liver Cirrhosis

Liver cirrhosis is the end result of several types of insult to the liver and is one of the most important risk factors for liver cancer. In this condition, damaged liver cells are replaced by non-functioning scar tissue. Cirrhosis can be caused by obesity, alcohol abuse, hepatitis infection, non-alcoholic fatty liver disease, autoimmune diseases, and metabolic diseases of the liver. (1) (2) (3)


This has not been totally proven but some scientists say there is a link between smoking tobacco and an increased risk of liver cancer. The effect of smoking is seen to be more pronounced in people who have hepatitis or abuse alcohol. (1) (3) (4)


Depressed immunity such as in people who suffer from HIV/AIDS or in transplant patients who take immunosuppressive medication can lead to an increased risk of developing liver cancer. This may be because they are more likely to be infected with hepatitis viruses. (3)

Contraceptive Pills

That contraceptive pills increase the risk of developing liver cancer is still a controversial issue. Contraceptive pills have been found to cause benign liver tumors called hepatic adenomas but it is not clear if this increases the risk of liver cancer. (1) (3)


Studies have shown that liver cancer occurs more in overweight and obese people. This could be because obesity can lead to non-alcoholic fatty liver disease and liver cirrhosis which are both risk factors for liver cancer. It could also be related to diabetes as diabetic people are commonly overweight. (1) (2) (3) (4)

Family History

A history of liver cancer in other family members especially first-degree relatives like a parent or sibling increases the risk of a person developing liver cancer. Other forms of cancer e.g. prostate cancer in such a relative may also increase this risk. (3)


Research has shown that people who suffer from diabetes are more prone to developing liver cancer than those who do not. Diabetes increases the risk two- to threefold. Diabetes is also associated with non-alcoholic fatty liver disease and obesity. (1) (2) (3) (4)

Inherited Metabolic Diseases

These are rare diseases present at birth which cause an increased risk of liver cancer. An example is Hemochromatosis in which the body absorbs too much iron from food leading to liver cirrhosis. Other such conditions include Wilson’s disease, porphyria cutanea tarda, tyrosinemia, and glycogen storage diseases. (1) (2) (4)


1. What the Risk Factors for Liver Cancer?

2. Liver Cancer: Risk Factors

3. Risks and Causes of Liver Cancer

4. Liver Cancer: Risk Factors and Prevention

Dear Cancer

Dear Cancer:

This is to let you know that I hate you. No, hate is not the right word, it’s more like detest. Yes, I detest you and all you stand for and all you have done and all you will ever do. You have no conscience, you do not discriminate and you always press forward with malice aforethought. It’s all about you, isn’t it? It’s about how much you can destroy in record time. And once you have started, you just don’t stop until everything and everyone around you is destroyed, or at the very least, changed for life.

You started out in my life as a nasty thorn in my Mother-In-Law’s side. She thought she was over you, she thought all was forgotten and that you would never come back, but that of course is not your way. You waited for her to have a life, to have children and a career and then you snuck back in and took it all away. She did do a number on you, though, she fought you. She fought you with everything she had and every tool imaginable. She was even going to let others study what you had done to see if they could find a way to stop you. But you were too strong. You were too knowledgeable in the ways of destruction. You won.

Next time I met up with you it was my Uncle you decided to attack. He was strong, in his prime of life, 50 years old also with kids and a family. I know, you don’t care, it doesn’t affect you, I don’t know why I even bring it up. But you got him where it hurts. This time, you not only took a life but made your victim suffer first by nearly crippling him. He had to use a cane and was in much pain towards the end of his life. Just so you know, he may have gone too soon, but he went quietly with his wife by his side.

Then, as if that were not enough, you picked on two other uncles almost in the same way. They both had to have operations and one of them got their larynx removed. That was cute. He had to spend the rest of his life talking with a microphone on the outside of his throat. You thought that was pretty clever didn’t you? You thought you were pretty smooth. You got what you wanted and moved on to other areas so they could continue suffering until they died. You unrelenting pig!

Last, but not least, you decide to go after my best friend. How could you? You just couldn’t leave well enough alone, could you? No, you had to show me your truly ugly side. Good job. Well done. You took her way too young and you know it. You were coy this time. You didn’t show up until it was way too late to do anything about it. You were probably enjoying the fact that she already had something removed and thought she was in the clear. But no, you came back with a vengeance. You came back on top and didn’t give her a chance in hell. You wrapped yourself around so tightly, no one could get to you. I had to watch, you know, and I saw it all. I saw the way you took her hope away. I saw how you alienated her children with fear. I saw how you took away her speech. Oh, you’re good!

But I have news for you. Her family and I weren’t about to let her suffer by herself. We weren’t about to let you take over and destroy her slowly without a fight. Yes, we helped her cope, we comforted her, and we got her through the tough nights of no sleep and the rough days of no eating. We were right there by her side and we refused to let her face you alone. So you won, but you lost! We made sure everyone knew what you were doing and we fought you with love and understanding.

So, in the end, I want you to know that I still detest you, even more if that’s possible. I loathe the air in which you breathe and the cells in which you breed. I will celebrate the day they destroy you and if you ever dare to show your ugly face in my presence again, just be forewarned: I’ll be ready. I know what you did and I know where you live!

Your Sworn Enemy.