Kathmandu, 17 June: Sometimes, a single word can shake the very foundation of life. The same happened in the life of 62-year-old Bal Prasad Khanal from Jorpati.
Living a simple life in the chilly air of Kathmandu, one day last Mangsir (mid-November to mid-December) turned out to be an extraordinary one for Bal Prasad.
In the third week of Mangsir, a tumor was detected in his gallbladder, and preparations for surgery were underway. The words he heard while sitting in the doctor’s office were enough to shake him.
The doctor had said, “There are signs that it could be cancer. But only the biopsy report can confirm it.”
Cancer? Bal Prasad had always heard that cancer was another name for death. A chilling fear crept deep inside him—“Will I not survive now?” he wondered. Though he appeared calm on the outside, the days leading up to the report felt like an eternity for him. Conversations at home revolved solely around the upcoming report. He couldn’t sleep at night. He had lost his appetite.
“May nothing be wrong, dear God,” his wife prayed at the temple every day. His son, Ramnath, would call the hospital daily.
“The report hasn’t come yet,” the response would come, leaving him disheartened. Yet, deep down, a faint glimmer of hope lingered.
28th Mangsir, it had been 22 days since the surgery was performed by a team led by gastro surgeon Dr. Ramesh Singh Bhandari at Tribhuvan University Teaching Hospital. The report that finally arrived that day shattered all the hopes of the Khanal family in an instant.
Stage-four cancer had already spread from Bal Prasad’s gallbladder to his liver through the blood vessels.
“When I held that report in my hand after 22 days, my whole body went numb,” recalls Ramnath, describing that terrifying moment. “It felt like the sky had fallen when we learned that our father had cancer—something none of our ancestors had ever faced.”
As the news spread, relatives began arriving. But instead of offering comfort, their words only deepened the family’s despair.
“There’s no need to pursue aggressive treatment now,” they said. “People in this condition usually have only a few days left—today or maybe tomorrow.”
But as long as there is breath, there is hope—and the Khanal family held onto that fragile thread. With that sliver of hope, treatment began at the Oncology Department in Maharajgunj.
After surgery, Bal Prasad developed complications as his surgical wound became infected. Since the wound hadn’t healed, chemotherapy had to be delayed. Meanwhile, a genetic sequencing report sent to India arrived, prompting the oncology team at Tribhuvan University to initiate oral medication—but the expected improvement didn’t come.
Disheartened, Ramnath decided to seek a second opinion at the Patan Academy of Health Sciences. There, he met cancer specialist Dr. Arun Shahi.
Dr. Shahi’s team carefully studied Bal Prasad’s case and developed a three-month treatment plan. The schedule included chemotherapy twice a month, followed by a 14-day rest period.
For the first time, the Khanal family saw a glimmer of hope. They trusted the doctors’ approach. The chemotherapy went on regularly for three months. Though the side effects were tough—nausea and weakness—Bal Prasad never gave up. His family remained strong by his side.
After three months, a follow-up CT scan brought astonishing news: the cancer cells throughout his body had disappeared.
“We never imagined such improvement was possible at stage four,” Ramnath said, tears of joy streaming down his face. “It felt like a divine miracle.”
Today, Bal Prasad is physically fit. He actively participates in household rituals and even attends religious ceremonies in the community.
“My father’s inner strength has always been incredible,” Ramnath shared. “If a person’s willpower stays intact during treatment, it seems even cancer can be defeated to a great extent.”
A New Turn Brought by Illness
In Kartik 2080 (October–November 2023), Bal Prasad had traveled to Australia to visit his younger son’s family. What began as a joyful trip soon turned into a journey of discovering a serious health issue.
Even while in Nepal, he had experienced abdominal pain and bloating, but dismissed it as simple gastric trouble. He relied on medication from local pharmacies and home remedies.
He never imagined that such ordinary symptoms were masking a serious disease.
Even in Australia, the discomfort persisted. He also started experiencing pain in his limbs.
Treatment from his nephew Rajan Sharma, an expert in yoga and natural therapies, gave him some temporary relief.
Hope returned to Bal Prasad’s heart: “I must be getting better. It’s nothing serious.”
When he returned to Nepal in Baisakh 2081 (April 2024), he got back to farming. For a few months, everything seemed normal.
But as Dashain approached, the abdominal pain returned—this time unbearable.
Taking advantage of the health facilities and insurance offered by the Jorpati Municipality, he visited Gokarna Nagar Hospital in the first week of Mangsir (November).
An ultrasound, recommended by the attending doctor, revealed a tumor in his gallbladder.
What must that moment have felt like for him? The issue he had assumed was mere gastritis had suddenly taken a terrifying, serious turn.
Since Gokarna Hospital didn’t have surgical facilities, Bal Prasad requested a referral to Tribhuvan University Teaching Hospital in Maharajgunj. There, the gastroenterology team led by Dr. Ramesh Singh Bhandari recommended further tests including a CT scan.
After analyzing the ultrasound and CT scan reports, doctors suspected the presence of cancer cells in the gallbladder and immediately recommended surgery.
However, due to a high patient load and other complications, Bal Prasad had to wait two weeks before undergoing surgery. On 28th Mangsir, Dr. Bhandari and his team performed surgery to remove the gallbladder along with part of the liver.
On the day of the surgery itself, doctors gave a preliminary conclusion indicating cancer, and awaited the biopsy report. The sample sent to the Oncology Department at Tribhuvan University revealed that the cancer had spread to the liver and reached the lymph nodes—classified as stage-four cancer. In medical terms, this is considered the terminal stage.
But the challenges didn’t end there. After the surgery, his wound became infected, causing further complications. Since the surgical wound wouldn’t heal properly and kept getting infected from time to time, starting chemotherapy immediately was not possible.
By the second week of Magh (late January), Bal Prasad’s surgical wound had started to heal. The doctors gave a new recommendation: “The extracted tissue from the surgery should be sent for next-generation genetic sequencing.”
In modern medical science, this kind of genetic testing is considered a new ray of hope. It helps identify the exact nature of the cancer and guides more precise treatment options.
Following the doctors’ advice, Bal Prasad’s family sent the tissue sample to India through a private laboratory for testing.
It took nearly a month for the report to arrive. Based on that report, the doctors prescribed a 500 mg oral medication.
However, the treatment did not seem reliable enough. Realizing this, his son Ramnath began seeking additional medical opinions.
They eventually decided to consult the Patan Academy of Health Sciences. Even before formally visiting, Ramnath had already met Dr. Arun Shahi. Based on Dr. Shahi’s recommendation, the Khanal family began the chemotherapy cycle.
Dr. Arun Shahi initially prepared a three-month treatment plan, followed by a four-month follow-up plan. Treatment began accordingly.
His warm tone and confident attitude helped the family tie their hopes to a new thread once again.
“We’ll begin with a three-month plan,” Dr. Shahi said. “Then we’ll see what the results show.”
“At that time, we had no other option. Hope itself became our medicine,” said his son Ramnath.
The journey with chemotherapy was not easy. Bal Prasad received chemotherapy twice a month, followed by 14 days of rest. After three such months, a CT scan was done. The report showed no trace of cancer cells in the body.
“When the cancer cells disappeared after just the first cycle of chemo, it felt like a divine miracle,” Ramnath shared. “It wasn’t just relief from unexpected suffering—we saw it as a medical miracle.”
Dr. Shahi then decided to pause chemotherapy and keep Bal Prasad under observation. Ramnath said the decision was based on “clinical observation.”
According to him, since the chemo holiday began, Bal Prasad’s wound has also been healing well. “He’s not doing heavy lifting yet, but he’s started blowing the conch again, taking part in daily worship, and even visiting religious ceremonies,” Ramnath said, describing his father’s current routine.
Even Stage-Four Cancer Can Be Treatable
Senior cancer specialist Dr. Arun Shahi expressed that Bal Prasad’s gallbladder cancer treatment had made encouraging progress.
According to Dr. Shahi, when cancer spreads from one organ to another, it is considered stage-four cancer.
“At this stage, the cancer cannot be completely cured, but it can be controlled,” he explained. “Cancers up to stage three can be treated and cured, but stage four cancer typically cannot be eradicated.”
However, he noted that in some hopeful cases, cancer cells can completely disappear from the body after chemotherapy, targeted therapy, or immunotherapy.
“But not everyone experiences such results,” Dr. Shahi emphasized. “Out of 5,000 cases, only one or two patients might have such a positive outcome.”
Dr. Shahi has encountered several such examples. According to him, cancers such as breast cancer, lung cancer, GIST, CML, and dermatofibrosarcoma can, in rare cases, be completely eliminated from the body—even at stage four—with proper treatment.
This condition is known in medical science as “remission.” Dr. Shahi explains, “In medical terms, we call it remission,” meaning that the cancer cells, which appear to have disappeared from the body, may reappear after some time.
Three months after treatment, a “response evaluation” is conducted to measure how effective the treatment has been. This evaluation assesses the current state of the disease—whether it has reduced, stabilized, or progressed.
In some very rare cases, cancer in stage four patients can completely disappear. This rare outcome is called “complete response” in medical terminology.
According to Dr. Shahi, gallbladder cancer is one of the most aggressive and difficult types of cancer to treat. Typically, patients diagnosed at stage four have a life expectancy of only 1.5 to 2 years. Some research even suggests that survival may be less than a year in many cases.
“In Bal Prasad’s case, the cancer that had spread throughout his body at stage four completely disappeared within three months of treatment. The CT scan and blood reports showed no signs of cancer cells,” says Dr. Shahi.
After receiving such promising results from the CT scan, Dr. Shahi decided to put Bal Prasad on a ‘chemotherapy holiday’ for a few months.
The next phase of treatment will depend on the results of the follow-up CT scan after a few months.
Even when cancer seems to have disappeared, continuing chemotherapy is important to prevent its recurrence in the future.
“Since the patient has gone into complete remission, we have placed him on a chemo holiday,” said Dr. Shahi. “Currently, no medication is being administered, and we have scheduled a follow-up after three months.”
According to Dr. Shahi, patients in such conditions generally have a life expectancy of only 1.5 to 2 years. However, some have managed to live for 5 to 7 years.
He described this case as extremely rare and noted that the chance of a complete cure remains very low.
“There are cases in Nepal where patients diagnosed at stages 1, 2, or 3 have lived for 8 to 20 years,” Dr. Shahi says. “Even among stage 4 patients, 4 to 5 individuals have survived 7–8 years and still visit regularly for follow-up.”
Source of Onlinekhabar
