Читать книгу Cancer is a Word, Not a Sentence - Miriam Stoppard - Страница 8

The cancer process is shared by over two hundred very different diseases—such as cancer of the breast, cancer of the lung, cancer of the bowel and so on —which together make up a widely disparate group that we should really call the cancers. The central point—and this is important—is that most cancers have very little in common with each other, apart from sharing the fundamental cancer process.

Let’s take a couple of examples to illustrate the very wide range of conditions that make up the cancers. (This may sound a bit simplistic, but stay with me: it’s a very important point.)

If you have had one of the common types of skin cancer—basal cell cancer, or the other common type, squamous cell cancer—once the lesion has been removed, it is highly unlikely that the cancer will ever cause you any trouble again. You may later develop other skin cancers on other parts of your body, and occasionally the cancer can come back in its original place, but it is exceptionally rare for anyone to be seriously affected by one of these types of skin cancer. These particular cancers never spread to distant or important parts of your body, and so they never pose a threat to your life. It’s that simple.

In fact, from the point of view of endangering your health or life, it would almost be possible, as a patient once put it so neatly, to think of these types of cancer in the same way we think of warts—which are themselves benign tumours, growths that do not invade or spread.

For that very reason these types of skin cancer—as opposed to the much rarer melanoma, which may in some circumstances recur or spread—are not included in the cancer statistics. So when we are told that 276,678 new cases of all types of cancer were diagnosed in the UK in 2003, those numbers do not include the common skin cancers, which in themselves probably number several thousand cases. In many respects, then, the common skin cancers represent one end of the spectrum: they are cancers, but once they are removed the chance of their causing you serious trouble is zero.

On the other hand, if you happen to have, let’s say, advanced cancer of the pancreas, the chance of it being cured is very low. Pancreatic cancer is always very serious, and it has a high probability of threatening your life.

These two examples—skin and pancreas—in many ways represent the two ends of the spectrum. They behave in totally different ways and have nothing in common with each other, apart from the cancer process itself. They are not the same disease in any way.

This issue is not just a matter of semantics or grammar. The language that we use and the way we use it deeply affects the way we think. And that changes the way we feel—and how worried or afraid we may be when any topic is raised. That effect is particularly evident—and very powerful—with the cancers. The way we think and talk about this group of diseases greatly affects the impact that we usually feel when we hear a diagnosis including the word cancer.

The general view that cancer is a single terrible disease is now so ingrained into our way of thinking that it’s quite difficult for us to think differently. But it is so important for you to get rid of the old cancer-is-a-single-disease idea that I would like to use another analogy to illustrate the point. So let’s look at what would happen if you took another large group of diseases, the infectious diseases, and lumped them all together, as if they were one single disease.