We can say the word "cancer" out loud nowadays. But how much does the general public understand about it? And why?
Brenda Denzler is a writer and editor living in North Carolina. She received her doctorate from Duke University and worked as an editor at UNC-Chapel Hill before she was diagnosed with inflammatory breast cancer in 2009. Since then, she has devoted a great deal of her time and energy to understanding and writing about cancer, cancer treatment and the impact of pre-existing PTSD on the ability of doctors to give and patients to receive medical treatment.
"Did you see combat?"
The answer to this question makes a world of difference in understanding the experiences of those who have served in the military. While the general rigors of being a soldier are shared by all who enlist, the specific experiences of those who see combat are very different from the experiences of someone who served in a desk job in the rear echelons.
It's the same with cancer survivors. We are not all alike, because the circumstances of our cancers were not all alike. This can be a minor distinction sometimes. A fellow survivor is a fellow survivor, after all. We have all felt the fear that receiving a cancer diagnosis brings. But in other ways, the differences in our cancers can be a defining difference between us. The magnitude of the threat to our lives that we have faced, the harshness of the treatments we have had to endure, and the after-effects we have been left with can be very different.
One of my friends was going through grueling treatment for an aggressive form of cancer that could easily have ended his life in very short order. He was laid off when he was well into his chemo, from which he was suffering multiple nasty side effects. Thus, he was in no condition to look for another job. Reflecting on the financial and practical daily problems that this man's treatment was creating for him, a mutual friend remarked, "I didn't need a handout when I had cancer. I worked the whole time. If I could do it, he can do it."
This mutual friend identifies himself as a cancer survivor, but when I asked him for details it was clear that it was nothing like what our friend is going through. He had had a pre-cancer many years ago - not an aggressive, invasive, full-blown, life-threatening cancer. It had been treated with a simple surgical procedure – not massive amounts of chemo and radiation. Thus, he fails to appreciate how debilitating it can be to undergo more extensive treatment. He fails to appreciate that our friend is not able to work and really does need a hand-out right now. He's not just malingering!
Another friend recently contacted me to say she had just published an article about how she had beat cancer and others can, too. I didn't realize she had a past with the beast, so I asked for more details. Turns out, decades ago LaRae's doctors had chanced to find cancerous cells in a supposedly benign lump they removed from her thyroid, so they went back and removed the entire gland.
What amazes me is that LaRae doesn't attribute her decades of health since then to the fact that she had one of the (usually) most easily treated, easily cured forms of cancer there is. She seems not to even know this. Nor does she attribute her subsequent health to the fact that she had the definitive treatment for it: surgical removal of the gland. Instead, she says she was cured by the series of spiritual practices and mind-body techniques she adopted after that, and she exhorts other cancer patients – without regard to the kind or severity of their disease – to use those same techniques if they wish to be cured.
The truth of the matter is that not all cancer is created equal. There are about 200 distinct diseases that share certain features qualifying them all as "cancer." The range of severity of these diseases goes from easily curable to almost hopeless; from truly "chronic" (for a very, very, very few types) and not likely to take your life any time soon, to horrifyingly aggressive and likely to end your life within weeks or months – and everything in between.
In other words, some people were poised to be lucky survivors from the start, simply because of the circumstances of their cancer. But they don't realize that fact. Others have had to work hard for their chance to live. It's frustrating that the first group of survivors too often fails to appreciate that about the second group.
I have come to believe that there needs to be a concerted effort to teach Americans more about cancer. After all, it's the second leading cause of death in the United States, according to the Centers for Disease Control and Prevention (CDC). Although heart disease is the No. 1 killer, it inspires far less dread. I mean, it's not the words "heart attack" that used to be whispered in polite company when I was a child. It was the word "cancer."
Why have this first-rate fear of the second leading cause of death? I think it's because cancer isn't like things that are "easier" to understand, like heart disease or infections. When I think of my heart, I think of a big pump. Like the pump that draws up water from my well or the fuel pump in my car, the pump that is in my chest can be damaged. That's easy to understand. Infections are easy to understand, too. A germ is a foreign invader. Again, easy to understand in very simple terms. But cancer? What is a tumor like? Where is the mental image that can make cancer easy to conceptualize and open the door for a more thorough understanding?
Nowadays, cancer has come out of our societal closet. We can say the word out loud and in public. But we still don't know how to think about it or how to talk about it, including many of us who are current or former cancer patients.
Nor are we encouraged to learn how to do so. Those currently in treatment who try to learn all they can about their malady are often accused of focusing too much attention on it.
"Just do what the doctors tell you," they're advised by well-meaning others. "Don't think so much about it. It's too negative to think about cancer. If you do that, you might not get well. You have to be positive to get well." Those who have survived cancer and try to learn all they can about it are often accused of being unwilling to move on. "It's over, now. Quit dwelling on the past," they're warned. "You're going to make yourself sick again if you keep focusing on all that negativity."
It's as if we think that knowing and understanding cancer too well might draw it to us in some benighted, magical, mystical fashion.
We may be able to say the word "cancer" out loud, now, but we still don't want to know much about it.