Cancerism and the harms of our negative cancer bias

As a practicing gynecologic oncologist, I have spoken the words, “I’m sorry, you have cancer,” or some version of that sentence thousands of times. And although my delivery is fairly consistent, modified only slightly to improve understanding, my patients’ responses vary from stunned silence to uncontrollable, overwhelming cataplexy. The stalwart emphatically reply “I’m gonna beat this thing,” but the vast majority tentatively wonder “How long do I have?” and retreat into a jumbled dark world of fear and the expectation of horrific treatment followed only by painful death.

We’ve all seen it, right? We all know someone who has been through this. Or perhaps been there ourselves. We’ve cried the tears. We felt the anguish. We’ve heard the stories. We’ve seen it on TV — those pictures, those terrible heart wrenching photos of bald sick kids. It’s real. We know what we know.

Or do we?

More recent data tell a different story. Are you aware that nearly 70 percent of patients diagnosed with cancer in the United States live over 5 years? That most childhood cancer cure rates are over 85 percent? That even the most stubborn cancers like melanoma are seeing stunning responses to newer immune modulations treatments. Furthermore newer classes of agents, targeted directly at the abnormal processes within cancerous cells show tremendous promise of well tolerated long term treatment. We still have a ways to go, but there is definite improvement.

So in this brave new world of improved cancer treatments with better quality of prolonged life, why do we maintain our negative biases. Our stereotypes? Our Cancerism? Perhaps it’s a knowledge deficit. Perhaps folks just haven’t seen the improvements yet. Or perhaps, as in my case, we reflexively go back into that dark place of cancer stereotype when we hear … well, when we hear “that sentence.”

Seven years ago, my family and I retreated into the fearful jumbled world of cancerism when my wife and mother of our young daughters, at the age of 44, was diagnosed with leukemia.  Leukemia is not a disease I treat, yet I know it well. My uncle died horribly of leukemia after three years of nonstop torturous treatment at the age of 47 … in 1987. This experience colored, better said, totally biased my expectation on our future. I began to mentally explore how we would get through the next 3 awful years, and then how I would manage as a single father, alone at our daughter’s graduations and weddings.  I gave away all the hopes and dreams of my family’s future. I caved from my cancerism.

Yet the last seven years, as a result of a new biologic leukemia treatment called Imatinib, brought us one valedictorian graduation speech, one acceptance to medical school, multiple concerts and performances as well as the daily squibbles and squabbles of an intact young family. My wife, aside from the daily reminder of taking her medication, leads a full and active lifestyle.

Within my practice, I still see the corruption of cancerism daily. As I had given away my hopes and dreams, I see others give away their precious days and even their very lives. It is time now to change our expectations. There are many reasons to hope, 15 million in fact, the number of those cancer survivors in the U.S. today. For more discussion of this topic please see my TEDx talk, “Cancerism: Confronting the biases we share.

Rick Boulay is a gynecologic oncologist who blogs at Journey Through Cancer.

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