Mahesh Seshadri (60), a Bangalore-based engineer who owns a manufacturing facility in Mysuru, was always on the go. However, things took a turn for the worse in 2015 when he developed a stubborn cough and fatigue. “The symptoms persisted even after I took medication. Moreover, I was unable to concentrate on work as I was fatigued,” recalls Seshadri. Tests revealed a tumor in his kidneys, and he was eventually diagnosed with stage four renal cell carcinoma (kidney cancer).

Diagnosis of renal cell carcinoma

Seshadri experienced the symptoms while he was in Dubai, and they lingered even after he returned to India. “I visited my cardiologist and underwent blood tests, along with a chest X-ray, angiogram and CT scan. The results indicated that pneumonia and ulcers were to blame for my cough,” says Seshadri.

However, to rule out any other underlying issues, his cardiologist insisted on an ultrasound. “I was informed that a small tumor was noticed in my left kidney. Everything happened so fast that I couldn’t process the information. A biopsy finally revealed that I had renal cell carcinoma and a rhabdoid tumor [a highly aggressive soft tissue tumor],” shares Seshadri. He underwent a partial nephrectomy (a surgical procedure to remove part of a kidney) in March 2015.

One of Seshadri’s doctors, Dr Amit Rautan, HOD and consultant, oncology, Manipal Hospital, Bangalore, says renal cell carcinoma develops in the kidney tubules. Some signs that could indicate renal cell carcinoma include blood in the urine, pain or a lump in the abdomen, fatigue, fever and weight loss. “However, the condition can sometimes be asymptomatic, making it hard to detect, especially in the early stages,” he informs.

Treating renal cell carcinoma

After the diagnosis, Seshadri underwent CT scans every six months for the next two years. In September 2015, a PET scan revealed that the tumor was spreading to other parts of his body. “As a result, they had to remove my left kidney,” shares Seshadri. “After the nephrectomy, there was a lump in my back, and I was in excruciating pain. My oncologist then prescribed me oral chemotherapy tablets.”

While the first course of chemotherapy medication showed significant improvement, there were severe side effects with the second one. “The rectum developed a scaly texture, and ulcers appeared everywhere,” says Seshadri. “I had trouble swallowing. By the third cycle, I couldn’t even drink water. I gradually lost my appetite as well.”

Seshadri was hospitalized again in April 2016 as his condition deteriorated. “I wasn’t responding well to the treatment. My blood pressure dropped, and my heart couldn’t pump blood effectively; I was put on a ventilator,” he recalls.

His wife and son had lost all hope. However, he miraculously regained consciousness the next day. “After a few more tests, we found that the cancer had spread to nearly all the body parts, including the brain, lungs and liver,” he says.

His doctor then recommended immunotherapy as a last resort, which boosts one’s immune system to fight off cancerous cells. Immunotherapy wasn’t a very prominent cancer treatment in India back then. The hospital had to apply for a drug import license, import it from the UK and then administer it.

“Immunotherapy has become a widely used treatment modality for most forms of cancer; it doesn’t cause the side effects of chemotherapy like vomiting, infections and airway obstruction,” says Dr Rautan.

The road to recovery

Things started to look up for Seshadri, as the immunotherapy improved his condition over the coming months. “After the first dose of immunotherapy, which was an intravenous injection, I gained an additional 15 to 20 kilos due to the water retention. I needed help to walk and move around,” shares Seshadri. “Within two or three days of the second round, I started losing all the water in my body through urine. Even the PET scan started to show positive results and the tumor had also shrunk.”

Dr Rautan reviewed Seshadri’s progress every three weeks; he received 18 injections between April 2016 and July 2017. The tumor shrank further each year until he finally achieved remission in 2023.

Learning life lessons

Despite being under treatment, Seshadri resumed working on his factory operations in Mysuru in June 2017. “I was fortunate to have a full-time assistant who helped me with my medical needs and took me to physiotherapy,” he says.

The doctors advised Seshadri to return to a regular diet and exercise regularly. During the course of treatment, he developed diabetes and gut issues. “I restrict myself from eating sweets and processed foods to keep the diabetes under control,” he says, adding that he learned a big lesson to not ignore the warning signs. “If you face any unusual symptoms, get them checked immediately. The recovery journey has also taught me patience and to trust the process,” he shares.