Tuesday, August 11, 2009

What Cancer Has Taught Me (Part 1)

The following is the first in a series of periodic posts discussing some of the facts and insights I have gained from having cancer. I want to capture this learning as a reminder to me that I have gained something from this experience that has been positive and life changing, and as a way to share with others some of the learning that has taken place within me over time.


"Are we doing anything on the 22nd?" I asked Linda.

She thought for a moment. Well we have the memorial for my mother the following weekend, but nothing I can think of on the 22nd. Why?"

I looked up from my laptop. "The Lovin' Spoonful are putting on a free concert in Peterborough on August 22nd. Part of the Festival of Lights celebration down by the lake. Since we're not getting a vacation this year, I wondered about going to Peterborough, staying over night and taking in the concert?"

"That would be a great idea," said Linda. "I haven't even thought of the Lovin' Spoonful in years."

"Not since we were young, the whole world was becoming a more loving place and we were all going to live forever...."


Not cancer, but death itself has taught me the falsity of that notion over the past thirty years. I think of the friends and family I have lost to various diseases over the decades. But none of them to cancer. Most of them to strokes or heart attacks. I am the first member of our immediate family to have cancer.

Cancer was a disease that ran rampant in other families, not my own. It was not a disease I had particularly thought about. I would donate to the Cancer Society periodically on behalf of friends who were fighting the disease and Linda and I would take part her school's contingent in the 5K Walk For The Cure.

I knew cancer was out there. It just wasn't coming for me.

I had a lot to learn.

The first thing I learned about cancer, which surprised me greatly, is that there is no such disease. Cancer isn't a disease. Instead, as oncologist Dr. Robert Buckman points out, cancer is a process shared by a number of very different diseases.

We routinely talk as if cancer is a singular definable disease ("He has cancer!" "OMG, when's the funeral?"), when it fact it is series of over 200 diseases, all very different from each other.

Basal cell and squamous cell skin cancers have more in common with warts than, say, pancreatic cancer. In fact, when cancer statistics are collected and we are told that 150,000 Canadians (or 1,200,000 Americans) will develop cancer this year, basal and squamous cell cancers aren't even counted in the mix.

We should, instead, be talking about the "cancers", not "cancer".

As Dr. Buckman points out, "When you lump all cancers together as a singular mysterious disease that you then call by one name cancer, the predictability of the various cancers is lost. And there is a tendency to dread any of the cancers with the same fear and doom as the most serious of them.

"When predictability is lost, fear and panic rush in to fill the vacuum."

What the cancers have in common is their process. It is a three part process:

1) A particular group of cells, instead of reproducing normally, starts rapidly growing in a disorderly and uncontrollable way, in a specific area of the body.

2) The growing cells invade into neighbouring areas.

3) Worst of all, the cells then begin metastasizing to distant areas of the body, for example to the liver or the lungs, and it is these secondary cancers that are the gravest threat to life and health.

Science has reached the point of being able to make reasonably good predictions about the general likelihood of primary cancers metastasizing to other areas of the body.

But they are not good a making reliable predictions in specific individual cases. At the moment no one knows how well general predictions will apply to you. Or me.

I predict getting away to Peterborough for a day or two and taking in a concert in the park will be good for both Linda and I. But the concert could get rained out, the car could break down on the way, the hotel could be filled with kids at a baseball tournament yelling and screaming down the halls.

Life, you can only make your best guess and go with that, otherwise, nothing gets done.

This I've learned.