Stage Eight: The Final Battle

The second surgery was performed on the 13th of December, 2024. We prayed through every minute of it. The surgeon had agreed reluctantly, but he had given his word—and for that, I’ll always be grateful.

Two days later, the pathology report came back. I remember holding the papers in my hands, the black-and-white print full of words that most people would never want to learn. Recurrent leiomyosarcoma of thyroid.

The report described it clinically: a well-defined swelling just above the hyoid bone. The tumor measured roughly 4.3 by 3.5 centimeters—grey, yellowish, firm. Under the microscope, it was a battlefield: spindle-shaped cells, abnormal nuclei, scattered necrosis, inflammatory cells, and muscle fibers the tumor had invaded. The doctors counted nine to ten mitotic figures in every high-power field—too many for comfort.

The margins were mixed. The superior and inferior were clear, but the anterior and 9 o’clock margins weren’t. Meaning—there was still a chance that microscopic bits of the tumor remained.

The immunohistochemistry sealed the truth.

TTF: Negative.

PAX8: Negative.

CK: Negative.

SMA: Negative.

Desmin: Positive.

CD34: Positive.

Ki-67: 15%.

In the simplest terms, it was sarcoma. Again. This time it had reached the hyoid bone—the part just above where the thyroid once was. The pathologist’s note was short but heavy: Features are of sarcoma—swelling over hyoid bone. Differential diagnosis: leiomyosarcoma / rhabdomyosarcoma / anaplastic carcinoma of thyroid.

The surgeon didn’t need to say much. His silence said it all. He had done everything humanly possible, but leiomyosarcoma was relentless.

Still, my grandma lived those days with a strange, quiet strength. She could feel it coming back again, but she didn’t speak of it much. What mattered to her was that she had been given another chance—not to survive, but to understand. To stop wondering if she had done something wrong to deserve it.

After the second surgery, my grandma was fragile but steady. The doctors put her on antibiotics, painkillers, and a strict schedule of thyroid-stimulating hormone replacements. She took them religiously. Every pill was measured, every dose recorded, and the women in my family made sure she never missed a single one.

The tumor samples that had been removed during surgery were preserved and handed back to her, sealed in formalin bottles. She kept them carefully in her wardrobe—like an odd, unspoken symbol of what she’d survived. Every time she had a follow-up, she carried them with her to the hospital, her trembling hands holding the proof of her own endurance.

For a few weeks, she seemed to stabilize. The wound healed, her appetite returned, her voice came back faintly. But the real fight was still ahead. About a month later, the ESI hospital finally arranged for her to begin radiation therapy—something that should have been done after her first surgery. They referred her to Ramaiah Institute of Oncology and Memorial Hospital, where the sessions would take place.

This time, I was there through the entire process. I watched her sit quietly in the waiting rooms, her sari draped carefully over the scar that curved around her throat like a pale necklace. The fear she’d once had before surgery was replaced by a calm I still don’t know how to describe—it wasn’t hope exactly, but it wasn’t despair either. It was acceptance, maybe. A kind of quiet courage that doesn’t need to announce itself.

Each session took its toll. The treatments made her weak, tired, and nauseous. Some days, she could barely keep food down. But she never complained. She said, “I’ve already faced the knife twice. This light, this machine—it doesn’t scare me.”

And for once, everything seemed to go according to plan. The doctors were coordinated, the follow-ups regular, the treatments structured. For the first time since this nightmare began, there was no confusion—only routine, discipline, and a small, steady faith that maybe, just maybe, the worst had passed.