Living strong with the Big ‘C’

The ‘C’ word is one that can have many repercussions. It can shock those who are on the receiving end of it. It can be used in a derogatory sense to describe someone not in favour. It can cause the deliverer of the statement to have second thoughts about what they are about to say, in case they hurt someone. Unfortunately, cancer is a reality that can affect anyone at any time.

It is quite likely that someone reading this article has had some sort of cancer, or has a cancer right now. Cancers can be insidious things – growing so slowly that you don’t even recognise the new ‘mole’ on the back of your neck, or they can be shockingly devastating, causing a reaction involving vomiting, headaches, paralysis, and passing out within a few hours. Equally variable, they can be easily treated with a quick slice, or they could spread so dispersedly that even the best surgeon and radioactive therapy would need to do more damage to the victim than the cancer itself to get rid of it.

The definition of a cancer, in the most basic of terms, is the uncontrolled growth of abnormal cells. In the healthy human, there are genes which promote cell maturity and growth. In order to stop the growth getting out of hand, there are antagonistic genes called tumour suppressor genes.

When these latter genes get stopped by something such as a toxin (from tobacco), a virus (such as the human papilloma virus), or some hereditary reason beyond the understanding of the medical sciences, the cell growth continues uninhibited. Too many cells lead to the development of big growths, or tumours, that start invading other structures and blocking normal bodily functions. But, like all dangerous things, it’s not size that matters.

A large golf-ball sized tumour in the colon might not cause any more problem than some mild constipation. A pea sized ectopic neuroendocrine tumour (like the one diagnosed in Steve Jobs) can release enough steroids or thyroid hormones into the blood to lead to excessive fatigue and coma. What we need to accept and understand is that cancer is not always a be all and end all, and that there is a spectrum of damage.

Indeed, most cancers have a good chance that the patient will live at least six years after diagnosis. Given that patients are often in the older age groups, this is quite comforting. But this is not to discount the possibility of an acute onset leukaemia killing an infant within a few days. Cancer is unpredictable, and society needs to come to grips with the fact that the definition is as variable as the disease itself.

Cancer comes from the Ancient Greek word for crab, based on the appearance of the veins that grow around large tumours looking like the claws of a crab, back when dissection was a novelty. But just as the violent grip of a crab’s claws can come down hard and hurt us, so can hermit crabs run away, harmlessly causing nothing more than a small fright.

True to its etymology, cancer can be just as heterogeneous, and the more we treat every case of it individually as opposed to the default apocalyptic doom status someone with cancer is normally given, the sooner we can get rid of the stigma and anxiety associated with what is a very wide spectrum of conditions.

Richard Withers

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