Anand (1971) and an Obsolete Cancer Name

Dr Bhaskar Banerjee, an oncologist in Bombay, is sick of his own profession: he sees poverty and preventable death and writes it all down in a diary. Into his care comes Anand Sehgal, a patient with lymphosarcoma of the intestine and about six months left. Anand declines to behave like a dying man. He renames Bhaskar 'Babumoshai', befriends nurses, neighbours, a theatre troupe and strangers in the street, refuses to stay confined to a hospital bed, and quietly manoeuvres the withdrawn doctor towards Renu, the woman he loves. Bhaskar, who deals in prognoses, finds himself unable to bear the one in front of him, and it is Anand who does the consoling. Anand's pain worsens; he keeps up the performance for everyone around him, and records himself on tape, laughing and reciting poetry with his friend. He dies with the people he has collected around him. The tape plays afterwards, his voice filling the room, and the film closes on balloons rising.

Spoilers throughout. Discussing the cancer storyline means discussing how this ends.

Anand endures because it is really about the people around the patient. The doctor's helplessness - trained to intervene, with nothing to intervene with - is drawn with unusual accuracy, as is his anger at a system that hands him incurable disease and no tools. The film understands that terminally ill people frequently protect their families by performing cheerfulness, and that this performance is exhausting. It shows a patient choosing life outside the hospital over medicalised time inside it, which is essentially the argument for palliative and home-based care, decades before that language was common in Indian cinema. It is also candid that the prognosis was disclosed and that Anand knew, at a time when withholding diagnoses from patients was routine.

'Lymphosarcoma of the intestine' is a period term and is used in the film as an incantation rather than a diagnosis; no staging, biopsy, chemotherapy or radiotherapy is meaningfully depicted. Anand is mobile, singing, travelling and socially inexhaustible almost to the final scene, with pain appearing only in brief spasms - real advanced bowel lymphoma more often brings obstruction, vomiting, wasting, drenching night sweats and long periods of debility. His death is quick, dignified and painless. The film also implies that spirit alone determines the quality of a dying person's days, which quietly puts the burden on patients who cannot manage that.

What the film calls lymphosarcoma of the intestine is now classified as non-Hodgkin lymphoma of the gastrointestinal tract - the lymph system's cells growing in the wall of the stomach or bowel. The National Cancer Institute describes several forms that behave in this way, including gastric MALT lymphoma, enteropathy-type intestinal T-cell lymphoma, which arises in the small bowel of people with untreated coeliac disease, and diffuse large B-cell lymphoma, which can involve the bowel. Early signs of non-Hodgkin lymphoma generally include painless swelling of lymph nodes in the neck, armpit, groin or abdomen; fever with no clear cause; drenching night sweats; unexplained weight loss; marked fatigue; itchy skin or rash; and pain in the chest, abdomen or bones. Fever, night sweats and weight loss together are known as B symptoms and are specifically worth reporting. Where the bowel is involved, people may also have persistent abdominal pain or swelling, nausea, a change in bowel habit, bleeding, or the symptoms of an obstruction. There is no screening test for lymphoma of any type in people without symptoms, and none is recommended. Diagnosis depends on someone acting on symptoms, followed by a biopsy of the affected tissue, imaging and blood tests.

A film is not a diagnosis, and a dramatised illness is not a guide to your own. What a story like this is genuinely good for is lowering the barrier to a conversation you might otherwise put off.

If something in your body has changed and stayed changed for a few weeks, that is worth raising with a doctor — not because it is likely to be cancer, but because most of the time it will not be, and finding that out is the point. Where screening exists for a cancer, it is the one thing you can do before anything is wrong at all. See screening and possible warning signs.

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Anand is worth watching as a film. It is not a guide to the disease it portrays. The gap between the two is what this page is for — and the thing worth carrying away is that a change which persists is worth a conversation, whatever a story led you to expect.

This page describes a work of film or television for education. It is not medical advice, and nothing here is a judgement of anyone's real medical care. Spotted an error? Please email [email protected].