‘There was no point in prolonging pain’

He said no (to chemotherapy)... He was the one who decided how much pain medication he needed. We respected his wish to not go for chemotherapy.

ROHINI SINGH, sister of Chandraveer Singh

NEWDELHI: Chandraveer Singh, 25, fractured his hip as he sat down in bed last January. He was stunned when the diagnosis showed he had a rare cancer: giant cell tumour of the bone, which in most cases is usually benign.

For the young hotel management intern, the pain however had begun three weeks before in the form of an unbearable knee pain, which the doctors initially misdiagnosed as a football injury. “Even though he was on very high pain medication, he could not get off the bed or even move,” said his sister Rohini Singh, a lawyer based in New Delhi, with whom he was staying while he did his internship.

“We chose the All India Institute of Medical Sciences (AIIMS) in New Delhi for treatment because we thought that is the only place where they might have experience in treating a tumour like this,” said Singh.

A surgery and five rounds of chemotherapy over four months led the family to believe that he was on his way to recovery. “But within two months of the chemotherapy ending, the cancer was back in several bones across the body. The doctors said that there was a very slim chance, less than 1%, that chemotherapy would help,” she said.

Based on this, Chandraveer decided he would not pursue chemotherapy treatment, which was also making him sick.

“He said no (to chemotherapy) in December last year. He was very strong throughout and hardly let on about how much pain he was in. He asked the doctors to tell him his prognosis. He was the one who decided how much pain medication he needed. We respected his wish to not go for chemotherapy,” said Singh.

When Chandraveer started having breathing difficulties, his doctors found that the cancer had spread to the lungs. “A day before he died, he went into deep sleep. The doctors told us that they could put him on ventilator, but we took the decision not to. We thought that if he was not going to recover from this, what was the point of prolonging his pain?” said Singh.

The family decided to let him go and Chandraveer breathed his last on 22 February. “That is what he would have wanted. He also wanted to do something for the patients at AIIMS and since we couldn’t donate other organs, we donated his eyes,” said Singh.

These decisions would have been easier for the family if there were a provision to make a living will. “In this case, the family understood that there was no point in stalling the inevitable. But it is difficult for the family of every patient to understand this. The role of good palliative care is to help patients and their families understand which treatment will or won’t help,” said a resident doctor at AIIMS.