KU Medical Center researcher and Fulbright Specialist made a difference for patients recovering from cancer in India
KU School of Health Professions professor introduced rehabilitation methods to area where number of head and neck cancer patients is among the highest in the world.
Those who apply for Fulbright awards usually wait months to find out if their application is approved. Last August, Linda D’Silva, Ph.D., assistant professor at the University of Kansas School of Health Professions, learned her destination almost immediately. Her background in neurologic physical therapy was a perfect match for a Fulbright Specialist they wanted to serve a hospital in India.
“It’s like the opportunity was just sitting there waiting for me,” said D’Silva. “I teach rehabilitation for head and neck cancer patients, and that’s exactly what they were interested in.” By November, she was on her way to spend a month at Kasturba Medical College in Mangalore, on the southwest coast of India.
D'Silva, who is originally from India, earned a bachelor's degree from King Edward Memorial Hospital, then earned a master's degree in physical therapy from the All India Institute of Physical Medicine and Rehabilitation, both in Mumbai. She arrived at KU Medical Center in 2010, where she completed her doctorate in rehabilitation science, and then joined the faculty in 2018.
D'Silva’s primary teaching responsibilities in the doctoral program in physical therapy in India included interventions and modalities used in physical therapy practice and ethics in physical therapy practice. “They put me up in the staff quarters, rather than a hotel,” D’Silva explained. “I ate my evening meals with other guests and faculty, and lunches with students — who always wanted to talk and learn.”
During her month in India, D’Silva spent her days working alongside faculty and advising students. Together they provided rehabilitation services to patients who were past the acute stages of their treatment for head and neck cancer.
In a special event for doctors throughout the region, she shared her experiences working with doctors in an interdisciplinary setting. The staff invited other doctors from miles around to hear her explain what the team at KU Medical Center looks like, and how to help patients with survivorship, from talking with families to working with oncologists, dentists and more.
Many barriers to overcome
D’Silva speaks Hindi, the national language of India, but she sometimes needed others to translate for her if a patient couldn’t understand her clearly. “Many patients travel a long way from the city, and there are so many languages in that region, so they may not speak Hindi,” D’Silva said. When they do come, she explained, they have no resources. While receiving treatment, they are likely to live on the street outside the hospital.
India has some of the highest rates of head and neck cancer in the world. D’Silva said that is mainly due to the centuries-old cultural tradition of chewing betel nut. Use of betel nut creates a euphoric feeling, offering temporary relief from the daily struggle to survive poverty and oppressive heat. But it is classified as a carcinogen and is addictive when used in high doses or for extended periods.
According to the Global Cancer Observatory, an agency of the World Health Organization, there will be 2.1 million new cancer cases in India by 2040, an increase of 57.5% from the year 2020. Thirty percent of cancer cases are head and neck cancers, compared to 4% of U.S. cases, according to the National Cancer Institute.
“It’s a very dramatic and painful disease,” D’Silva said. “Most patients treated at this hospital were men in their 50s, but they generally looked like they could be in their 80s.” Because parts of their faces have been removed, rehabilitation can ease the transition for people who live on the streets.
Cultural exchanges, now and in the future
Part of the Fulbright experience includes taking in cultural activities at each location. D’Silva arrived in time for the staff to host a Diwali celebration at the hospital. Also known as the "Festival of Lights," Diwali is India's biggest holiday.
“The food was incredible,” D’Silva said. “I cook Indian food at home, but I discovered new dishes.” Some of those dishes turned out to be too spicy for her family.
D’Silva continues to work with a doctoral student she met in India who is working on patient exercises to be done during cancer therapies. “I spent a lot of time with her and want them to know about the work being done in their field,” D’Silva said. “We have been corresponding, and I still feel like part of their team.”.
Back home at KU School of Health Professions, D’Silva continues to be engaged in and looking forward to a variety of scholarly endeavors. “I have an exciting job,” she said. “I want to continue to learn what people are doing around the world, particularly in the vestibular (inner ear) system,” she said. “Someday I might explore doing another Fulbright project in Germany … I know they have interests that match ours here at KU.”