War Games

Lot of cancer patients – sorry, “cancer survivors” – and patient advocates complain about the war metaphors used to describe the medical experience of cancer. Which I sort of agree with. Unlike, say, measles or HIV, there is no invading Other that your body treats as a hostile force. Cancer is simply oneself, through a glass darkly. It is difficult to destroy because treatments cannot differentiate between cancer cells and normal cells; it is difficult to eradicate because the immune system recognizes and protects it.

But the war language persists. The Susan G. Komen Foundation is “leading the fight” against breast cancer. So-and-so “lost their brave battle” with cancer. (The clichés associated with this disease are kind of the worst part. I am going to murder the next person who says “It is what it is,” tells me to live “one day at a time,” or describes a cancer diagnosis as coming “out of the blue.” [For the record, the best parts of cancer are $5 massages, and hanging out with nurses.])

I think of cancer as being more akin to guerilla revolution than an actual war. Bear with me for a minute on this one. Biologists believe that multicellular organisms arose as something like a collaborative process: Slightly different organisms formed symbiotic relationships that became permanent as individual cells specialized further. For an example, take lichen: There’s a plant component (algae) that photosynthesizes, and a fungus component that provides stability and shelter. Over billions of years, the cells formed chains, and then the chains became rafts, and the rafts formed digestive systems and rigid structures and, eventually, spinal columns and immensely complex brains.

Anthropomorphizing single-celled organisms in the primordial soup is ridiculous. But isn’t it tempting to think of that early evolution as the first formation of a republic? And now, we, the descendants of those primitive joinings, are republics of a few trillion members, carefully regulated by DNA, policed by amino acids, and governed by consciousness (or the soul, or the mind, or whatever).

And cancer is what happens when a single cell rejects the tyranny of life encoded in the DNA, rejects the amino acid commands for apoptosis, pursues its own life and reproduction to the detriment of all the other cells. A cancer death is a successful revolution.

I’m overthinking this. Whenever I start to expound on this theory, J---- from my support group finds a way to subtlely call me an asshole. If even the other cancer patients think I’m full of shit, I must be full of shit.

Tomorrow would be the first day of the sixth cycle of docetaxel and Gemzar, except that I only had five cycles. So, chemo’s over! A couple of people have told me that it’ll be six months before I feel like I did before I started. It might be longer for me, even, because I had more cycles than usual.

I get new scans next week, and see Dr. C-----. I’m sure everything’s fine, but sometimes when I take a deep breath I get this strange tickling ache. One gets you ten it’s just allergies, or a reaction to the dry air here, but of course I’m imagining metastasis. I’ll probably spend the next four and a half years imagining metastasis every time I get a headache or a sprained ankle; stupid five year waiting period.