May 16, 2010

• Cancer Doesn't Care: An essay

  Paraphrased conversation from a scene in a televised drama program on ABC:
  Guy and gal are seated in a hospital chemotherapy room. The guy is hooked up to an IV. Guy: "You don't have to stay with me." Gal: "I care for you. That's why I stay." Guy: "Thank you. I just don't want you to see me like this." (He looks pretty hunky to me.) Gal: "Isn't this your last treatment? Want to go celebrate?" Guy: "Sure. Let's go out for dinner afterwards." They have a great time at dinner.

  One thing that really irks me about the portrayal of cancer on televsion, and especially on ABC's shows, is the wanton disregard for the facts of the disease, or it's many treatments. I listened to the above exchange about a month ago on the show "FlashForward." The show deals with science fiction in it's main plot, and when I heard the characters talking about going out to dinner following a chemo treatment, I figure there isn't really any allusion to real life in the sections which don't deal with scifi either. There have been cancer story arcs on quite a few ABC shows that I watch. Desperate Housewives, Grey's Anatomy and Brothers and Sisters have all had storylines where main characters develop the disease, and then are miraculously cured when their cancer goes into remission, usually during a sweeps season or on the season finale.

  My friend Joel passed away in the summer of 2008 following a nearly 5 year bout with cancer. It started as a ball in his large intestine, grew untreated for ten years, and was surgically removed, along with most of his intestine. After the surgery, he underwent five separate chemotherapies. The cancer eventually metasasized, spread to his liver, and killed him. I owed him a dinner from an old bet years ago,. and it took forever for us to find a time when he wasn't too sick to eat. Right after a chemotherapy, one doesn't feel like eating. In point of fact, the poison which is acting as a "treatment" is formulated to allow the patient to at least get home before he begins heaving. When chemotherapy treatments are in their early stages, the patient might feel better than after he undergoes a few of them, but the guy in the TV show has had cancer for a while, and is supposedly ending a treatment cycle, so I really don't think he and his lady friend would immediately want to go out. He'd most likely want to go to bed.

  ABC isn't stingy about killing off the main characters in their TV shows, either. Last week, a guy on Private Practice bit the bullet. Only 5 of the original cast of 14 on Lost are still around. Tonight, I believe characters on both Desperate Housewives and Brothers and Sisters are going to meet their maker. It won't even be the first time for Housewives, which has killed off two of the cast members in seasons past.

  I happen to watch quite a few ABC shows, but I suspect they aren't the only media outlet which seems to shy away from accurately portraying cancer and it's treatments. Although many characters die from murder and sudden brain hemmorages, cancer is a long drawn out disease, which eats at the victim from the inside out, and usually after a couple of episodes showing the character bald from chemo treatments, the cancer miraculously goes into remission, and in subsequent episodes, it's rarely even mentioned again. If only real life were so simple.

  What bothers me is the message this gives to those who don't know that much about the disease. Thankfully, I've never been diagnosed with cancer, and the one time I've had biopsy done of a polyp found in me, the prognosis was negative, and no cancer was found. I'll never forget when I drove Joel back from his colonoscopy, and in his inebriated state from the anaesthesia, he told me about how the doctor started explaining chemotherapy to him. My poor roommate didn't even realize what was happening until the anaesthesia wore off a couple of hours later. This began a brutal five year war with the disease, much longer than a 13 episode television story arc, and he didn't even lose his hair till after three chemotherapies.

  Not only was he not hungry after one of them, but in the end stages, he hardly ate at all, and even though he was six feet tall, he wasted away to about 130 pounds.

  Cancer is a disease in which unhealthy cells multiply throughout the body, invade healthy cells, and spread the disease. Anyone can get it. Over a million people a year are diagnosed with some kind of cancer. It can start anywhere, and is usually named for the place in which it starts. For instance if cancer begins in the breast, it is called breast cancer even if it eventually spreads to the liver. Cancer doesn't care what ethnic group or sex it invades. When the disease spreads to a part of the body that cannot be treated, the patient usually dies. And this death is not quick and easy, but incredibly painful and protracted.

  A cancer patient can live for many years, or just a few, after diagnosis, but no doctor will ever proclaim, like the ones in the TV shows do, that the cancer is completely gone. It goes into remission, and it can come back, and usually does. I used to really feel for Joel when he would go in for his post chemo appointments, and his oncologist would tell him that there were incredibly reduced rates of the disease in his system. This caused him a sense that he might be beating the disease, but the doctor never told him he was completely cured. There was always a chance that it would return, and it did,  almost like clockwork.

  Joel had different chemotherapies, including two experimental treatments, because he actually lived longer than his oncologist figured he would. For the first couple of years, one would hardly know he had the disease at all. He looked and acted the same as always, and he wasn't in that much pain. He did suffer from the chemo treatments, usually in the form of nausea in the hours immediately following them, but both of us were amazed that the disease, which began as a large single tumor, and eventually spread via his lymph system to his liver, didn't seem to act as a "disease" at all.

  Three years in, Joel began to appear more tired, and lost weight. His hair did fall out, and grew back. One of the chemo treatments caused him to lose feeling in the soles of his feet and the palms of his hands. Sometimes it seemed as if the treatments were even worse than the disease.

  Once the cancer really started to spread, the chemo didn't work at all, and his last chemotherapy series was cancelled only a couple of weeks before he died. At that point, anyone who met him knew the end was near.

  I did see one movie during Joel's slide which sort of prepared me for what he might finally have to go through. It's from 2006 titled "Two Weeks" and stars Sally Field as a woman going through the last two weeks of her life in hospice in her own home. Eventually, the pain became so great that she was hooked up to morphine all the time. At some point, either the cancer or the vast amounts of morphine cause the body to fail. Joel and I talked about this scenario. As it happened in his case, the last stages of the disease struck pretty quickly, and we were preparing for the hospice when he passed away in the hospice preparation center of the hospital. During the last weeks of his life, we didn't talk about his death either. Joel was pretty brave, and tried as much as he could to just be himself. Both his brother and I knew that he was in incredible pain, however.

  Cancer attacks a lot of folks after age 55, so it is very important to get consultation from your doctor, and to go through as many early screening tests as possible. Don't wait. One third of cancer deaths every year are related to nutrition, overweight or obesity, and physical inactivity. Some cancers are caused by drinking alcohol or smoking cigarettes. Some cancers are passed on in the DNA from generation to generation.

  Cancer is not specific. Cancer doesn't care. Cancer can strike at any time, and any one of us can be at risk. I've been lucky so far, but I have lived alongside the disease, and I read all the material Joel's oncologist supplied him. I constantly ask my doctor, during my yearly physical, about screening tests, and about signs that my body might be telling me.

  It's a shame that media, and somewhat popular television shows paint such a lenient picture of the dangers of the disease, and the terrible times victims suffer during the treatments. So far, there is no cure. And once the dominoes start to fall, they usually continue till the patient is gone. Fictional television series use cancer as just another story arc. I'm a writer. I understand conflict and conclusions. But the conclusions writers seem to come up with when presenting cancer in the media still bothers me. Becuase I know firsthand what the disease can and usually does do. Some people are lucky. A fellow workmate had breast cancer in her 20s, and is in her late 40s now, and the cancer has been in remission all this time. But sadly, this is the exception, and not the rule. The TV shows seem to give people a much more rosy picture in the name of drama.

  The American Cancer Society has a very detailed yet easy to maneuver website that answers almost any question you might have about cancer.

  EDIT: 5/17/10 6:51a.m. pdt. A new subscriber and commenter, Stephanie (they_call_me_steffyjean), has a "Relay for Life" page on the ACS site. HERE is her Xanga blog entry detailing the run and her reasons for doing so. You go girl.

  • 2:34 pm
  • 81 Comments