Dr. Sachin Kulkarni took a good look at his life when he turned 40 in 2022. The anesthesiologist from Sea Cliff, New York, was doing well. He was married to a woman he admires, he had two children, and he maintained a pretty good lifestyle by eating well, running and using his Peloton. Health-wise things were looking fine, but a checkup would probably be a good call, he decided.
“You turned 40,” Sachin Kulkarni said to himself. “Maybe you should think about seeing a doctor, given that you are one yourself.”
For the past year, Kulkarni had noticed some gastrointestinal issues, but he suspected it was nothing more than irritable bowel syndrome, or IBS. A visit to his primary care physician found that his vitals looked great, but the GI discomfort persisted.
“Right about the (time of the) new year of 2023, I started feeling a little bit worse,” Kulkarni recalls.
“I noticed I was having changes in bowel habits, some bloody stools. Just more discomfort after eating, and just even after not eating, just day to day. And so, I actually went to see a gastroenterologist that I work with.”
In February 2023, the gastroenterologist sent Kulkarni home with antacids for gastritis and told him to return in a few months for a colonoscopy and endoscopy.
“So, June 2, 2023, was a Friday. Beautiful day outside,” Kulkarni says. “I go in for this colonoscopy, and it turns out to be the worst day of my life. And the rest is history.”
The diagnosis
Things were hazy when Kulkarni woke up after the procedure. As anesthesia was wearing off, the doctor was holding up a photo of his colon and speaking to him and his wife. “I was just taken aback because I knew exactly what it was. There was no question in my mind, just seeing that image, what that was.”
The doctor had found something in his colon, and it appeared to be cancerous.
“I remember him asking me, ‘Who do you want your surgeon to be?’” Kulkarni says. But he was in a daze. “I couldn’t wrap my head around what was happening, let alone that next step.”
The next step was a CAT scan at the hospital where he worked. “As I walk by the cafeteria to the radiology suite, I see my partners in the cafeteria. I’m just trying not to make eye contact,” he says.
On the car ride home, his doctor called to confirm his diagnosis. In addition to the lesion on his colon, there were two on his liver, and they’d spotted a cancerous lymph node, too. Kulkarni's colorectal cancer was Stage 4.
“That’s when the ground fell out from beneath me, basically. And I will never forget that feeling. But I will tell you that was the one day that I felt that way. And every day after that was better.”
Plan of action
Kulkarni was going to treat cancer like a job, he decided. “I took it on like I take on a lot of things in my life.”
“I collected myself,” says Kulkarni. “I thought about what I was going to be fighting for, who I was going to be fighting for. And then it became pretty clear that we’re going to take this one step at a time. We’re going to do what we have to do. And we’re going to move forward."
He was going to attend all his appointments; do exactly as he was told and stay organized. “Most doctors are awful patients,” he quips. But he was determined to be different.
His treatment was to start at Memorial Sloan Kettering Cancer Center that same June. It began with a chemo port, which was implanted on the right side of his chest. The small device, connected to a vein, would administer chemotherapy into his body.
Then came five cycles of systemic chemotherapy, which allows the drug to travel throughout the body, per the Cleveland Clinic. And in September, he underwent surgery to remove a large part of Kulkarni’s colon, the cancerous lymph node, and two lesions on his liver. Doctors also removed his gallbladder and implanted a hepatic artery infusion pump, which administers chemotherapy.
“In doing it this way, they were able to deliver a more concentrated dose of chemotherapy to my liver without having any of these systemic side effects,” Kulkarni explains.
He still has both the port and pump today and expects to have them for at least another year.
Kulkarni says he’s now in the most critical window of treatment. While there’s no evidence of disease, doctors plan to monitor him for two years following his surgery. He has one more to go.
The support of all supports
At the time of Kulkarni’s diagnosis, things for his family were finally stabilizing. He and his wife, Sapana Kulkarni, have two children — their oldest, who has autism, was settling into an education and therapy program, and the youngest was finally in preschool and thriving. Sapana Kulkarni was planning on returning to work after having taken time off to look after their children.
When those plans were scrambled due to Sachin Kulkarni's diagnosis, their community stepped up.
As Sapana Kulkarni stepped into the role of both parent and caregiver, her sister organized a meal train and created a website where people in family’s town could volunteer to babysit and deliver meals. Plus, Sachin Kulkarni’s parents came by nearly every other day to look after the children.
Growing up, Sachin Kulkarni learned illness and death were things you suffered in silence. It’s a cultural phenomenon, he suspects, among South Asians. “I think we tend to sort of isolate ourselves when something like this happens,” he explains. But sharing their story brought the family more support than they could've imagined.
“To this day, I couldn’t really tell you why a certain relative passed, other than they just got old, you know?” Sachin Kulkarni says of the disinclination to talk about health problems in his family.
“More tragically, I had a very good friend growing up who passed away of adrenal cancer in 2012 at the age of 30,” he adds. “To this day, I feel so guilty for not being more present and reaching out to him and his family in those days. So, thinking about those things ... I had to just share the burden with anyone that was willing to share it with me.”
Among all the support, his wife and his oldest son have been his biggest strengths in this fight. “You have this whole plan in your mind of what life is going to be like. And then all of a sudden it just takes a sharp turn,” says Sachin Kulkarni.
Another time this happened for his family was when his oldest son, Zian, received his autism diagnosis. “He is the bravest guy that I know. And so, I look to him all the time,” he adds.
Sachin Kulkarni also says his wife is unwavering: “I knew that she was going through it like I was going through it. But she wasn’t going to let it stop her.” She went from doing the job of four people, he adds, to doing the job of six. “I will never forget that.”
“Just knowing that I had the ability to take care of myself for the past 10 months, focusing on myself, and knowing that it was OK for me to be selfish, to watch out for my own body and mind, knowing that she was going take care of all the rest —it was everything,” he adds.
Paying it forward
Just as his community and his family stepped up for him, Sachin Kulkarni is aiming to show his thanks by offering support to others who need it.
“I was talking to a couple of other survivors of cancer that live in town,” he says. “And we decided that we need to share our experiences in a constructive way with others in the community that are going through something like this to help them with their trauma as we’ve experienced our own trauma, to be an advocate, or to just listen to their story because, as I’ve mentioned, it’s a very isolating experience, cancer is.”
While it’s still in the early stages, he, his wife and others in his community are considering a meal train service, or a service offering financial and emotional support to those with cancer and their caregivers that they’ll call the Sea Cliff Cancer Alliance.
Where things stand
These days, Sachin Kulkarni feels amazing —“maybe even better than I did before even having this diagnosis.”
He’s transformed his lifestyle. “I’ve always been reasonably healthy and active, but I’ve definitely become more physically active.” He works out six days per week before work, his meals are 80% vegetarian, and he estimates he only eats red meat about once per quarter. Plus, he's reduced his alcohol intake by about 90%.
“I think all those things together definitely improved my energy levels, my sleep and mentally and emotionally feeling more present and being more appreciative of my kids, my family, my wife, and my career,” he says.
“No matter what, I think nothing will be normal again — whatever normal was. It’s a new normal,” Sachin Kulkarni says. Sometimes it feels like he must take half a step back to take a few steps forward, but he’s hopeful.
“There’s always going to be a little hiccup here and there, and nothing’s going to be just easy and smooth, but given what we’ve already been through, I think it’s definitely moving in the right direction.”
Aryelle Siclait
Health Reporter/Editor