When cancer is in all of us

When I went for my annual screening mammogram last week, I had to fill out a new online form with all sorts of questions. I was asked about my family history of cancer, age of menopause, HRT use, etc. When I got to the last question, I hesitated. 

"Have you had cancer?". The options were YES and NO. I thankfully was able to choose NO but thought there should be a better option than that. How about NOT YET?

Now don't get all freaked out on me about this. I'm not a fatalist, I'm not a hypochondriac and I don't harbor a death wish.

I did read a great book recently called The Emperor of All Maladies: A Biography of Cancer by Siddhartha Mukherjee who wrote this during his internship at Dana Farber Cancer Institute in Boston. 

This book changed my perspective on cancer. The reason I even know about this book is because my PCP and I share favorite books with each other and this was one she had recently read. I thought it might be over my head but it was written so well that it really did read like a biography.

It's a huge book with tons of science and research but also has personal stories about the author's patients. 

I found as I read it that cancer is not this new epidemic as some of us think. It's been around and recorded since the early days of medicine (early as in, Hippocrates). There have been many treatment philosophies, some with more success than others.

With all the studies being published (eating bran prevents colon cancer - oh wait, no it doesn't) there have only been two cancer causing agents that have been absolutely proven: radiation and smoking. That's it. And even then, not all people who smoke get cancer. The rest of the studies cannot be reproduced in a manner that can confirm other hypotheses. 

So, how much of this can we really control? Not much, I read. Researchers have discovered that cancer cells are normal cells gone haywire. (I am really really oversimplifying for the sake of this short column.) We all have normal cells, right? So that means we all have potential cancer cells. In our bodies. Right now.

Besides radiation and smoking, researchers truly have no idea what causes these normal cells to suddenly flip a DNA switch and cause the out-of-control growth of cells. Cancer cells do what "normal" cells can't do like travel to other organs and fend off antibodies. And researchers have no idea why it happens or how to stop it. They can play with chemo agents, radiation (to a point), and conduct radical surgery to try to control it with mixed results. But they can't ever guarantee that it is completely erradicated. 

I read this book because I've always felt that knowing the enemy helps my chances of survival. I'm also a bit of a science geek and thought I could learn something about an amazing biological phenomenon. I was right on the latter but not the former.

This is surprisingly not depressing to me. Instead of worrying about "getting cancer" I have accepted that my body will always harbor the potential. It was a "We have met the enemy and he is us" moment for me when I finished this book.

The stats say that more people are living with cancer than ever before. Does that mean that cancer is on the rise? No, I think it means that science has found remedial solutions so that we don't die from cancer as quickly as our ancestors. 

Mukherjee concludes in his book that we will likely never be able to find an absolute cure for cancer or even come to a total understanding of why cancer cells occur.

Cancer is still a scary disease to have and, to me, an even scarier one to watch a loved one bear. But there is relief in acceptance. Not of the inevitability of cancer so much as the reality of biology.