In September 2023, Sudhindra Aithal (43), a software director in a networking company, ticked off another item from his wish list — trekking the Mayali pass in Uttarakhand, which is at an altitude of over 17,300 feet. The previous year, he finished the Pin Bhaba trek located at a height of 16,000 feet in Himachal Pradesh. And in 2021, he completed the Malnad Ultra 50K, a trail marathon in Chikmagalur. What makes his feat extraordinary is that Aithal was diagnosed with stage 4 lung cancer in 2019.

Aithal shares, “I never thought I could complete the 50K trek. If you look at me, you may not even realize that I have lung cancer.” Aithal has no comorbidities like smoking. And despite the diagnosis, he considers himself lucky in several ways. Chief among these is the fact that he did not need chemotherapy and is on targeted therapy, which involves a pill taken once a day. He says that it is the result of his strong support system. “With their help, I have been able to maintain my lifestyle. There have been minimal changes to my daily routine since my diagnosis,” he adds.

For Aithal, one of the main motivations for staying fit is to continue running and participating in treks, marathons and other outdoor activities with his friends. “Running is something I don’t want to stop at any cost,” he says.

Learning about the diagnosis

In July 2019, Aithal was rushed to the emergency unit of a private hospital due to vomiting, disorientation and inability to walk properly. For a few months before this, he had been complaining of neck pain, headaches, nausea and dizziness.

A cranial CT scan found cancerous lesions in his neck and a PET scan confirmed malignancy.

“I was in a daze. It registered very slowly,” says Aithal, adding that the initial few weeks after the diagnosis were the hardest. His wife, Ramya R, recalls that both of them initially spent a lot of time thinking, “Why me? Why us?” Moreover, Aithal kept pondering over his family’s future and financial security despite dealing with the essentials in a practical manner. Recalling what he learned from those days, he shares, “Someone with stage IV cancer should ideally look for the best way to manage their condition and look for better treatment options.” 

Ramya, a senior scientist in the somatic cancer team with a Bangalore-based precision medicine company that does a lot of tumor molecular profiling, shares, “Even at work, I was going through lung cancer cases and thousands of publications regularly. I knew too much to be too scared or upset. At the same time, I knew there was hope.” She adds that she was aware that a long battle lay ahead. “Despite this, I knew of outliers — people who did not fall into the average category, who tried different options with good outcomes,” she says.

Finding support

The turning point, says Aithal, was meeting a family friend who was a blood cancer survivor. “He told me about someone with the same type of cancer as me, who was doing very well on the same drug I was on for the past two years. This seemed to be pretty long and it became a turning point for us.” So they focused on living in the present and held on to hope.

Aithal signed up for support groups, where he met many survivors and learned from their experiences. “This made everything a little easier,” he says.

Challenges of cancer in younger people

Dr Vijay Agarwal, lead and senior consultant, medical oncology, Apollo Cancer Centre, Bangalore, who has been treating Aithal, says that the standard cancer treatments used in most cases are not often a good fit for people like Aithal. He explains, “People in their thirties and forties are at the peak of their career. They want to continue leading an active life and contribute to society.” Considering his passion for running, doctors have tailor-made treatments that do not affect his routine. “We have modified the standard lung cancer treatment so that it does not affect his nerves, allowing him to retain his ability to run,” says Dr Agarwal.

Living with lung cancer

The cancer has progressed over the past year. Aithal shares that while his fitness levels have dipped, he is still able to run. He is keen on continuing his tradition of annual treks and marathons. “I have also been planning a family trek to the Himalayas with our 11-year-old daughter,” he says.

However, Aithal is aware of his circumstances and how rapidly they can change. “Fitness is only one aspect of it. I don’t know if I can plan for six or eight months ahead,” he adds.

Staying hopeful

Though the last year has been tough, the couple has been optimistic. Ramya shares her acceptance of the ever-changing nature of life. She says, “ I know that the cancer is not going to vanish. So, I pray for the next best thing — a stable disease.”

Aithal says that while everyone’s journey is unique, the one thing that helped him so far is having hope. “Wanting to spend time with my daughter and watch her grow is a major motivating factor for me,” he says.

Aithal tries to avoid negative thoughts. “I try to live as normally as possible. I continue doing what I love to do: being active.”