Saturday, May 30, 2015

Not a Victim, Not a Survivor


In my three year acquaintance with cancer, I’ve come to terms with some realizations. For one, I’ve learned this isn’t a fight. A fight implies a winner and a loser. If I were to compare the experience to a military action, I’d say this has been closer to securing endangered perimeters rather than trying to wipe out the adversary. I’ve been through nine surgeries and twice that many cystoscopies, where a tube is inserted up my urethrae and a tiny camera takes stock of the enemy positions. The surgeries remove cancerous cells, but these, so far, always come back. At best, I’m in a holding action.

Also, I’ve decided I really don’t like the term survivor. That makes it sound as if I’ve been the victim of something, and that simply isn’t true. I’ve been the recalcitrant and unhappy host to a guest that doesn’t want to leave, but I am most definitely not a victim. I’ve encountered people who, learning of my cancer, have nodded wisely (and a bit sadly), and told me, “I’m a survivor too…” When I answered, “Really? I’m not,” they looked at me askance, as if I hadn’t yet learned the vocabulary of cancer.

I don’t like defining my life in terms of the disease or, for that matter, any single issue. I’ve met people who do that, men and women who insist on wrapping their lives around a lone concern—work, health, family, alcohol; golf or tennis or coin collections. They have tunnel vision and are inestimably boring. Their conversation and scope of knowledge is sadly limited and I never quite know what to say after the ten minutes they’ve taken to tell me about their single-minded lives.

I have little faith in cancer research. Most people seem to think there will be a silver bullet, a magic pill or treatment that will be a cure-all. That’s not going to happen.

Cancer, basically, is the uncontrolled growth of abnormal cells. It develops when the body’s normal control mechanism stops working. Old cells don’t die as they should, and new, abnormal cells, are formed.

The problem is there are about 200 hundred different types of cells in the body, and within these cells are about 20 different types of structures, called organelles. Each type of cell may require a different sort of treatment when it ceases to act as it should.

Right now, surgery, radiation therapy and chemotherapy are how we treat most cancers. These are aggressive methods, nuclear bomb attacks on the system that often endanger healthy cells. Essentially, these are “kill them all and let God sort it out” treatments.

Nor do I believe that, even if a cure were to be found, it would be immediately made available. A proliferation of research means nothing if the research is not shared with others. The pharmaceutical giants are not likely to share the fruits of their studies; far too much money is at stake. If and when cures are found for particular types of cancers—leukemia, say—you can be sure they will be outrageously expensive. Look for a replay of the marketing of Harvoni, the Hep C drug, which costs almost $100,000 for a 12-week course.

Most cancer patients won’t be able to pay such amounts, and insurance companies probably won’t offer coverage.

Lastly, the battle against cancer is discouraging. I think it is fought with the wrong weapons. A thousand labs across the world are working not in concert but in competition. What we need is a Manhattan Project, and we’ll never get one. Other, more pressing issues, command more attention than does a cell-altering disease.

And yet there has been progress. Fewer people are succumbing, and what was once an almost assured death sentence no longer is. That’s something for which I can be thankful.  


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