Wednesday, December 8, 2010

The "non-survivors" in the dance of cancer

Elizabeth Edwards died in her home, at the age of 61, on December 7th, after a six year battle with advanced breast cancer.  It was 2006, when on Senator John Edward's presidential campaign trail, with her cancer in remission, she was being hailed as a survivor.  With a glow in her skin, her hair showing no sign of chemo/radiation tox and with her seemingly unlimited enthusiasm and energy, she inspired fellow cancer patients, she met on the campaign trail and all over the country.  That was the time when she was one of the "celebrity cancer survivors" who often are celebrated by the media.[read here, here, here]

 Je suis un "Survivor".
"But in March 2007, during her husband’s campaign for the presidency, Ms. Edwards announced at a news conference that the breast cancer had recurred, certainly in a rib and possibly her lung. What she did next was rare for celebrity patients: She announced that the cancer was terminal. Yes, Elizabeth Edwards was a breast cancer survivor, according to the lingo. But she would not survive the disease." - Lessons From Elizabeth Edwards.  By Barron H. Lerner, M.D., December 7, 2010, Well Blog NYTimes
Today, her death tells the story of thousands of ordinary cancer patients,
who eventually slide into terminal state - and, these very thousands, with the help of old and new drugs wish to gain a few more months or years, with the hope of giving quality time and leaving lasting memories for their family and friends.  This emotional and psychological benefit to the family and friends, is another argument in support of the new drugs that often seemingly extend life of patients by only a few months compared to the standard of care.  In the follow-up post on NYTimes's Well blog, several comments capture these sentiments:  Andy writes, "I was never and have never been happy with the way someone’s cancer diagnosis has always been framed by the media as a 'battle' and those whose cancer has gone into remission as 'survivors.' Many cancer patients themselves simply do not feel that way. Also using the term 'survivor' makes it seem like the cancer is gone from the body, but it is simply impossible to rid the body of all cancer cells."

In the November 8, 2010, issue of New Yorker, Steven Shapin, writes:
"And Carla? She’s fine. Five years after Mukherjee confirmed her first remission, he drives to her house, bringing her flowers and good news. Her latest bone-marrow biopsy is negative. Oncologists are sparing with the word, but she has his permission to count herself as cured: five years in total remission is as good as good news gets."  [Read more: Cancer World: The making of a modern disease. By Steven Shapin.  New Yorker,  November 8, 2010]

Resources:
Steven Shapin's New Yorker article is review of Siddhartha Mukherjee's new book, “The Emperor of All Maladies: A Biography of Cancer” (Scribner; $30) | WorldCat | [see Mukherjee's interview at New York Public Library here |

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