Opinion: I respect you, cancer, but you’re killing both of us
You and I’ve been locked in a life-and-death struggle for six years but have never talked.
It’s time we had a chat.
Speaking directly to cancer cells might strike some folks as loony. But studies of the placebo effect and its evil twin, the nocebo effect, show that our thoughts and beliefs can heal or harm our bodies. Mind-body connections are not well understood, but I hope you and I can find a way to have a frank conversation.
Let me start by admitting that it’s hard not to hate you. You’ve turned my golden years upside down. My relaxed cruise into retirement became a harrowing, pain-filled journey.
When the small lump on my neck was diagnosed as metastatic cancer with no known cure, fear stabbed me like an assassin’s blade. Gradually I came to understand that fear and dread could ruin what time I had left, maybe even shorten it. That encouraged me to make peace with the idea of dying while doing what I could to stay alive.
Because you’re an extremely rare form of apocrine cancer, I have no data on my life expectancy. You already had invaded more than three dozen lymph nodes in my neck by the time you were detected, though — not a good sign. Now you’ve grown into thickening bruise-like splotches on my face, neck and chest that remind me of my mortality every time I glance into a mirror.
My talented Stanford University Medical Center care team, led by Dr. Alexander Dimitrios Colevas and Dr. Anne Lynn Su Chang, has reached deep into its bags of tricks in search of a cure. I’ve undergone surgery, radiation and chemotherapy, as well as hormone therapy, immune therapy and photodynamic therapy. Each of those treatments had nasty side effects, none an enduring impact. Several knocked you back. You kept on coming.
Along with my fear and hatred of you, I developed a grudging respect. You’re tough and resilient, qualities I’ve sought in myself to survive you.
Motives of mutant cells
You constantly demand my attention, yet refuse to share your secrets. Why did you mutate? Could I have prevented that? More important, what can I do now to stop you?
I’m not even sure how to think about you. People talk about “fighting” you as if you were an invading alien force. You’re not. You’re a mutation of my own cells. Other than making use of available medical treatments, how do I fight? I can’t kick, punch, stab or shoot you and see no gain in simply adopting a belligerent attitude.
You act like you want to kill me. But can mutant cells have intent? Does any cell have intent? My body’s three-trillion cells are linked by intricate biochemical and electrical interactions. Are they also connected by some kind of consciousness?
Consciousness is sometimes compared to a CEO who barks orders from the brain that are carried out by the body. But nerve impulses can’t travel fast enough to allow the brain to guide the fingers of a concert violinist. To decide which notes to play, she must rely on the consciousness developed in her hands through training and practice.
You cancer cells also behave as if you have some kind of consciousness or intelligence. You recruit healthy cells to build blood vessels to nourish your tumors. You mask yourselves to hide from the killer T cells of the immune system.
What kind of communication takes place at your level? Is it a language I can ever learn to speak? I hope so because there’s something I urgently want to tell you.
It’s this: Please stop dividing and die.
Pleading for a deal
That’s a big ask, but hear me out. Healthy cells divide a fixed number of times, then expire. Your refusal to follow nature’s plan by recklessly reproducing is a misguided quest for immortality because if you kill me, you too will die.
Yes, by continuing to divide you can extend your life a bit. But if you have consciousness, you should consider sacrificing yourself for the greater good. I represent the whole of me, after all, while you are merely a part.
I’m not trying to guilt-trip you. I doubt you have hostile intent. You are the offspring of a healthy cell that led a normal life until something came along and altered it. Now, like all living things, you want to continue living, even if circumstances beyond your control have put your well-being in conflict with mine. And who knows, maybe I’m to blame for those circumstances.
While my doctors don’t know what made you mutate, I’ve exposed myself to numerous cancer risk factors. I smoked cigarettes for years and still drink alcohol. I’ve eaten my share of red meat and worked for decades in high-stress daily journalism. Maybe I made you what you are.
No doubt, I — more specifically, my immune system — failed to rid myself of you before you could do harm. Among my cancer risk factors is the biggest one of all — old age. I’m 75, a time in life when biological systems tend to weaken. If my T cells were still in their prime, you and I probably would not be having this conversation.
Yet here I am, standing at the gates of eternity, pleading for a deal.
If you won’t stop dividing, will you at least slow down? A cancer’s pace of cell division can change. Some grow so slowly they don’t kill their hosts. If you slow down, I’ll have more precious moments with loved ones and longer to marvel at the wonders and mysteries of life.
You and I will never be friends, but maybe we can co-exist.
What do you think?
Hello. Can you hear me?
Michael Dorgan was assistant business editor and a Pacific Rim correspondent for the San Jose Mercury News and Beijing bureau chief for Knight Ridder Newspapers. He also is author of the memoir “No Fight, No Blame, A Journalist’s Life in Martial Arts.” In a commentary last year, he wrote about how the national scarcity of front-line chemotherapy drugs was affecting his cancer treatment. That shortage was resolved, and he is now being treated with a different chemo drug. His cancer progresses, but slowly. He says he remains hopeful, at least hope-half-full.