The "C" Word

There is a "C" word that is incredibly profane and vile in American culture, though the British use it rather more freely and comfortably. I'm not talking about the one that offends sensibilities. Frankly, I think that word is an ugly one, but the one I'm going to talk about is a scary one, not one that causes virgin ears to suffer. The "C" word in this case is cancer. It feels like I've always known about and lived in fear of cancer, such is part of the dubious wonder of the modern world. It exists as an invader to be vanquished for some and, for nearly everyone, the imaginary monster under the bed for which we must keep checking.

Cancer was merely the monster under the bed for most of my adult life. In 2011, it assumed a more menacing position. My sister was walking around one day and passed out. After years of being told she was tired and dizzy because she was anemic, doctors finally figured out that she had uterine cancer. The tumor was about as big as a grapefruit and blood vessels from the uterine wall had grown attached to it such that immediate surgery would have resulted in her bleeding to death on the operating table.

People tend to think that cancer is this thing that you can detect early in all cases and that doctors are going to find it if it is there. The truth is that my sister had serious health issues for a very long time before anyone decided to poke around in her lady parts for potential causes. Eventually, they managed to irradiate her enough and fill her full of enough toxic chemicals to shrink the tumor to a sufficiently manageable size. They yanked out all of her reproductive organs and removed the cancer.

People also tend to believe that receiving treatment and surviving is a relatively nice clean deal and that surviving and remaining cancer-free for a certain number of years means you're in the clear. The monster has lost the war and gone home, or at least packed up his crap and headed for less hostile territory. The treatment my sister received decimated her immune system. The radiation killed all of the bone marrow in her pelvis so she has half as much white blood cell activity as she did before treatment. The post-surgery chemo was so toxic that she nearly died from it three times before they gave up and stopped trying to save her from future cancer recurrences by trying to kill her with medical assistance.

The chemo also caused her to have transient ischemic attacks (TIAs) - a sort of mini-stroke which damaged her brain such that she can no longer focus or do more than simple calculations. Multi-tasking is a thing of the past for her. She had mini-seizures for some time and couldn't reliably drive due to the risk of losing control of her body. Since my mother is blind and my father is disabled, this put her in quite a pickle when it came to getting to her doctor's appointments.

At present, two years after her treatment, she has serious issues breathing if exposed to any sort of chemical - even fairly common and innocuous ones. No medical professional can figure out why, but she can't walk in front of a display of scented candles, stand in line with a person wearing perfume, be in a recently cleaned room or a place with old or dirty carpeting without having her lungs struggle to work. She also catches any disease at the drop of a hat now. The cancer is gone (at least for now), but she has been disabled because of the way treatment decimated her body.

Cancer treatment isn't the same for everyone, and many people do much better than my sister. That being said, I read about a study recently which talked about how psychosocial treatment (and marketing) for cancer focuses largely on young, attractive, verbal, intelligent and successful (YAVIS) women when they are a very small portion of cancer survivors/sufferers. The beautiful, bald, bold, and strong woman who gets featured in articles and ads is not the norm. The norm is older, uglier, less resilient, and not likely to return to life as normal without some compromises. My sister may not be the norm, but neither are all of those vivacious women who smile back at you in magazines and talk about how they have bounced back fully from their illness.

In late 2011, while my sister was waiting for her treatment to start, I went to a doctor for a routine check-up and he saw what he believed to be a tumor in my neck. A few samples were taken of what ended up being my enlarged thyroid, but no one could tell me if it was benign (a goiter) or malignant (cancer) until they'd chopped it in half and tested the part they'd removed. The test results took nearly three weeks in which I pondered my mortality and the possible treatment that I'd have to endure. I knew chances were low that I had thyroid cancer, and even lower that it would kill me, but cancer became even less abstract for me. I was looking at having one of the most "treatable" cancers, but I was terrified at the thought of chemo or radiation treatment.

I was lucky. It was a benign tumor for me. There was no monster under my bed,  though people were sure checking to make certain. The long needles inserted into my neck and later the stapled gap across my slit throat were evidence of their careful efforts. My sister was not so lucky. It turns out that my father has been similarly hit by misfortune.

For some years, my father has had what he has concluded are "bladder infections". He'd drink cranberry juice, as that's the rumored natural substance that will clear such things up and gobble down Cystex for supposed urinary tract issues. Like many men, he hated going to doctors and rarely went to one unless he was on death's doorstep or it was required for some sort of paperwork for his disability benefits.

My sister told me that she saw blood on the toilet seat recently. Since my mother is long past menopause and my sister had her fun factory yanked out along with her enormous blood-sucking tumor, she knew there was a high likelihood that it related to my father. She told my mother and, knowing my dad's reluctance to see a physician, old mom tricked him into getting a check-up by saying that their insurance required it for paperwork.

My father reported the urination issues to the doctor and they figured it was an enlarged prostate issue and did some surgery to remove part of it. After the surgery, they found out that he has a very large tumor, about the size of an orange, in his bladder and that the cancer is at stage three. That means it has spread to surrounding tissue (as opposed to being contained in the tumor), but has not yet gotten into his blood stream or more distant organs - at least not as far as they know at this time.

I have little worry that my father will survive cancer. I have a great deal of concern that he won't survive the treatment. He's in his early 70's and has smoked all of his life with at least a half dozen short-term periods in which he has quit. He's an alcoholic and he has had intermittent paralysis and partial blindness during most of his adult life as a result of brain damage he suffered while working in a factory and getting wanged on the head several times by heavy machinery. Despite his many issues, he was actually in fairly decent health - or at least he was told he was by his doctor until they found the cancer.

An article in the Wall Street Journal wrote about how early detection and diagnosis of cancer may not necessarily be a good thing and I'm on the fence about this issue. I've hurtled over said fence and reached some conclusions about treatment in general for cancer though, particularly aggressive follow-up chemotherapy to prevent recurrence. It nearly killed my sister and I'm very, very afraid that it's going to kill my elderly father.

Sometimes I think the "C" word is the monster under the bed, but I think nuking the bed in order to make sure it can never come back may not always be the best solution. One of the reasons that people accept such lethal care is that they are so terrified of cancer that they will accept whatever doctors tell them about what it takes to make sure it doesn't return, but I think it may be time to stop reacting with fear of the monster and more carefully assess the weapons being used against it and the damage they can do.