Sunday, January 1, 2012

the war on cancer.

They're common enough phrases: "She's battling cancer." "He beat cancer." There's no one that hasn't heard that phrase from a friend, family member, or the media. Or patients in my case. I'm trying to remember when it first started to bother me. I suppose it was around the time when I realized that not everyone does 'beat cancer.' I don't know why we choose to use this phraseology for cancer. If a diabetic patient "beats" diabetes (which few actually do), it's because they strictly maintained their medication regimen, started exercising daily, lost 100 pounds, and are exactly compliant with their diet. Diabetes is something that is actively fought by lifestyle changes. Beating diabetes can be done. (I should clarify that I mean adult onset, or non-insulin dependent diabetes in this description). Diabetic patients can DO something about their diabetes. This is not the case with most kinds of cancer.

The vast majority of times cancer is something that we can't prevent. It's unsuspecting. It hits people with no warning. Twice this month in the emergency room we found "suspicious masses" randomly when we scanned the patient. Often times patients won't know they're sick until the cancer has spread so far that it is beyond cure. When a loved one survives cancer, it is truly a miracle and a gift. I have taken care of enough cancer patients at this early stage in my career to understand that there is a resilience that comes into play in the treatment, therapy and survival of cancer. I'm not trying to minimize that struggle and challenge. What irks me about the phrase "They beat cancer" diminishes the same struggles and strength that were present in the patients that die from cancer. Is beating cancer about survival or is it about endurance?

Although this is a topic that has always chafed me, I was fighting back tears one day in the ER last month as it triggered a whole new frustration at the culture of cancer. A woman with stage 4 lung cancer with metastasis (spread) to the bone and brain (probably one of the worst cancer prognosis possible--very aggressive and at the point where little can be done to cure). The kicker? She had never smoked. She had only been diagnosed 4 months ago and had undergone persistent radiation and chemotherapy since that time. She came in to see us when she stopped being able to walk. Her husband explained her medical history to me, and I turned sympathetically and put my hand on her shoulder. She had tears in her eyes "I'm so ashamed... I'm so ashamed that i can't beat this..." An anger surged up as I realized how unjust our system is to this woman. Here she was with no strength, completely wiped out, and we as a society have robbed her of her peace. Why is she in a position where she feels like she's failed herself and her family by having cancer? Why are we so afraid of death?