Why Is Cancer Always the Drama Queen?

It's probably happened to you ten or twenty times over the last decade. You've entered the realm of fictional cancer and cancer survival through media. You've witnessed the hero or heroine battling cancer from your perch in the fictional trenches. It's on the big screen in your local movie theater. It's in the TV special that has you glued to your sofa. It's in that bestseller you bought at the bookstore. It's in that short story in your favorite magazine. By the time you finish living through the cancer experience vicariously with the main character, you're emotionally exhausted.

But here are two questions for you. Why do fictional cancer tales always seem to stick with the same script? And why is cancer always the star of the show?

Oh, I understand all about the perils of cancer management. And you won't ever find me dismissing the cancer experience as "minor" or "a blip on the radar". But why do we always seem to put cancer up on a pedestal in fiction, whether it's movies, TV, books, or short stories? Does the plot always have to be about the disease? Frankly, I'm far more interested in the people, real and fictional, who survive the experience.

Some of the funniest, sweetest, feistiest, smartest, most compassionate people I know in the real world of cancer survivors would make fabulous characters in amazing tales. It's not because they have cancer, but because of who they are as human beings.

These people have lives beyond their disease. They are lawyers who happen to be talented musicians, journalists who live to box, social media experts who love their dogs...mothers and fathers, sisters and brothers, friends and neighbors who nurture fellow cancer survivors with some amazing outreach programs, -- ordinary people who do some very ordinary things, even while they navigate cancer experiences as varied and as unique as they are.

If you were lucky enough to meet them, as I have been, the one thing you would not take away with you is the sense that life is a constant edge-of-your-seat drama. These are not hysterical, desperate people living terror-filled lives. Sure, it happens sometimes that things go wrong and inevitably another beautiful soul loses the battle. But for the most part, the cancer survivors I know are not afraid to speak up, to speak out, to take charge of their world. They make the effort to infuse their lives with laughter and love.

How I wish we could capture that spirit, that wonderful sizzle of spunk that often drives so many of these cancer survivors to live their lives out loud. How many times have I heard them say, "(BLEEP) cancer! I'm going to do what I'm going to do despite it! I'm going for it!" And that's where the real stories of cancer can be found. Because so many choose to get around the obstacles cancer creates and achieve amazing things. So, why can't our fictional heroes do the same?

One of the saddest personal stories I ever read was from a real breast cancer patient, whose treatment totally disrupted her marriage to a man she thought would be there forever. Like watching a train wreck in slow motion, I followed her tale and thought, "If only this doofus had some idea of what to expect from his wife's cancer situation. If only he had heroes who had walked in his shoes and successfully managed to learn what to do and what not to do."

To me, movies, television, and stories are the perfect place for us to find inspiration on how to live with cancer, but if we only see the terrifying tales of gloom and doom, we become conditioned to expect cancer to be a death sentence, a downer, a disaster. The truth is that for every life destroyed by cancer, there are many more that were saved by treatments. Shouldn't our fictional characters share those experiences?

I was recently doing some research for a project I am working on as a mystery writer and I stumbled across something curious. Many of the writers who create cozy mysteries announce in their biographies that they are cancer survivors. Why is this? I have a theory. Cozy mysteries are all about people. We don't like lots of blood and gore in our stories. We don't like horrid characters who give us nightmares and do vicious things to our fellow human beings. In some ways, the cozy mystery genre is the perfect place to find comfort and happy endings for weary cancer survivors. Maybe that's what attracts writers and readers to the genre. We want to believe that life can be good. We need to believe it, because we will take that inspiration and use it in our own lives, when we or our loved ones are diagnosed with cancer.

But it's not only short stories and books that make a great platform for characters with cancer. Television and movies would be well served to utilize them. Why? Think about the people you know who have cancer. Think about the often profound changes they have experienced as they go through life after diagnosis. The truth is cancer changes everything. It's that unexpected wake-up call no one wants to get, and yet when it comes, it often seems to shake us up in ways that are often unpredictable and unexpected. It's not the cancer that makes people amazing. It's what they do in spite of the cancer.

As for interesting characters, I can attest to the fact that many of the cancer survivors I have had the pleasure of meeting are inspirational and memorable. If you can keep your sense of humor after a cancer diagnosis, if you can maintain a sense of hope in the face of such terrifying news, if you can carry on despite the uncertainty of having too many lemons and not enough sugar to make lemonade, you're probably going to have some great throw-away lines for any script.

The truth is cancer survivors are people who learn to live with the disease. They learn to manage it over time, to know when it's time to get a "tune-up", and even to expect that it might return at some point down the road. But as more and more cancer survivors go through multiple bouts of the disease and live to tell about it, our fictional tales should reflect this fact.

My hope is that one day, authors, publishers, scriptwriters, producers, and directors will come to understand that cancer shouldn't always be the drama queen of a story. Sometimes cancer can be the fictional challenge that teaches a tenacious survivor how to get past even bigger obstacles. Or, better still, we can begin to treat cancer as the occasional footnote in our lives. For those whose cancer is caught quickly and wrestled to the ground, we might find fictional characters who use perspective and common sense to put cancer in its place.

Oddly enough, I think if William Shakespeare lived today, he would have done just that. Cancer would have been just one more challenge that his characters faced, some bravely, some cowardly, some with humor, but never without something interesting to share. I long for the day when cancer is not the lead player on the stage, but merely an act or two in a lengthy production:

All the world's a stage,
And all the men and women merely players:
They have their exits and their entrances;
And one man in his time plays many parts,
His acts being seven ages. At first, the infant,
Mewling and puking in the nurse's arms.
And then the whining school-boy, with his satchel
And shining morning face, creeping like snail
Unwillingly to school. And then the lover,
Sighing like furnace, with a woeful ballad
Made to his mistress' eyebrow. Then a soldier,
Full of strange oaths and bearded like the pard,
Jealous in honour, sudden and quick in quarrel,
Seeking the bubble reputation
Even in the cannon's mouth. And then the justice,
In fair round belly with good capon lined,
With eyes severe and beard of formal cut,
Full of wise saws and modern instances;
And so he plays his part. The sixth age shifts
Into the lean and slipper'd pantaloon,
With spectacles on nose and pouch on side,
His youthful hose, well saved, a world too wide
For his shrunk shank; and his big manly voice,
Turning again toward childish treble, pipes
And whistles in his sound. Last scene of all,
That ends this strange eventful history,
Is second childishness and mere oblivion,
Sans teeth, sans eyes, sans taste, sans everything.

From "As You Like It", monologue of Jaques, Act II, Scene VII

No Such Thing as a Good Kind of Cancer

Recently, there was great controversy stirred up by a UK pancreatic cancer charity, which launched a promotional campaign in which people spoke of wishing they had a different kind of cancer, because their outcome would be better. I was dismayed. Not only is this a misguided effort, it's downright dangerous. It leaves viewers with the idea that there is some "good cancer" out there, and that if one gets it, "no problem".

Such an unfortunate campaign sadly misinforms the public about the real face of cancer. In all my years, I've never known anyone to get a "good kind of cancer". Cancer is cancer -- a generic name for thousands of different kinds of biological reactions in the body that often attack organs and blood, creating tumors, autoimmune issues, and other maddening, life-changing, life-challenging issues.

In all my decades of life, I've seen so many things happen. People who had good prognoses died and people who had bad prognoses lived. You can't always predict how cancer will affect the body, and the idea that having a "good cancer" means you will survive is just wrong.

Don't believe me? Answer this question. Which vehicle would you prefer to be struck down in the street by at ninety miles an hour:

A. a 7-ton double-decker bus
B. a 2-ton Mercedes Benz
C. a  half-ton Fiat 500

Did you say the tiny, "cute" little Fiat? Did you perceive that because of its public aura, its marketing campaign, its ability to navigate through tight spots that you would be safer being struck by one? At ninety miles an hour, does it really matter what type of vehicle strikes you? I think not. Impact on the body is a critical factor in a traffic accident. The same is true of cancer's impact on the body. How much cancer is there? That's what helps to determine outcome. If doctors have to treat a body riddled with cancer, the chances of survival are about equal to being hit by any type of motor vehicle at ninety miles an hour.

Here's another question:

If you fell overboard without a life jacket, where would you have the best chance of surviving:

A. In the middle of the Atlantic Ocean
B. In the middle of Lake Superior
C. In the middle of the Amazon River

Three different bodies of water. Three different types of challenges and risks. You might think that the ocean is the most dangerous. After all, if there are sharks and other predators in the water, and the waves are rough, your survivability rate will be sharply curtailed. We know that the Amazon has piranhas, those nasty little fish that work themselves into a feeding frenzy, not to mention black caimans, those alligator relatives, and any number of other critters, so that's probably not a great option. If you said Lake Superior, did you consider things like the shipping traffic? Or the ongoing risk of hypothermia? Or the dangerous rip currents?

Whether you're about to be struck by a vehicle going ninety miles an hour or you're dropped into the middle of a huge body of treacherous water, the end result is the same. It probably won't end well.

The same is true for any advanced cancer. In this past two weeks, I have read the posts by friends who lamented the passing of this person and that person. They were all individuals with different kinds of cancer and they died.

I have also read wonderful things by people who survived their battles. Everywhere I go, in public, online, people share their stories with me. Never have I found that one kind of cancer is better than another when it comes to survivability. What matters is the stage, the treatment options, and the cancer patient's ability to sustain the effort. There are so many variables, so many ways things can go, no one is ever promised complete cure or extended life, except perhaps in Stage One, where it's easy to be optimistic.

Understanding the broad spectrum of diseases with the generic title of "cancer" is more complicated than most people appreciate. While the pancreatic cancer organization in the UK erred by their promotional campaign's suggestion that there are better kinds of cancers to have, I've seen people make the opposite mistake. I once had a conversation with a cancer caregiver who actually thought her husband's taking a pill once every couple of months was the same experience as my mother's being at the cancer center five days a week for months of treatment. It wasn't the difference between prostate cancer and lung cancer that was the problem. My mother was dying of the disease. She had no treatment options, other than to keep her comfortable. To have her cancer dismissed as the equivalent of an active man with managed prostate cancer fully engaged in life was hurtful. Four years after my mother's death, the same man is still going strong, still enjoying life. Do I begrudge him that time? Absolutely not. I'm glad he made it. I wish everyone did.

But I also wish his cancer caregiver understood the difference between a well-managed cancer and one that is out of control -- not through a failure by patient, caregiver or doctor, but because cancer is what it is. When it overtakes the body, options are fewer and the toll is much greater. We need to support cancer families in crisis with real action. We need to be there for them through thick and thin. These are the cancer patients who have the greatest hardships. These are the cancer caregivers who need a hand in providing care.

I wish everyone survived their bouts with cancer. That's really the bottom line. Many more do now than did forty years ago. Some people manage their cancers for a while, thanks to new treatments and better diagnoses. But there are still some people whose cancers are so aggressive, it's impossible for oncologists to do much other than try this or that. Cancer is still a mystery to figure out.

While it's tempting to attack with an "Occupy Cancer!" attitude, as if we can sit in and force cancer researchers to cure this type of cancer or that type, the fact is the developments in disease treatment are often made in unusual ways. Just recently, there was an announcement that doctors think a new acid bath for cancer cells might be an amazing weapon in the fight against cancer. Acid bath? It sounds so much better than a cancer drug that knocks patients on their fannies and sometimes even coldcocks them. In reality, it's not always the cancer that kills the patient. It's the rigors of the treatments, with the dangerous side effects. Many chemotherapy patients find their organs permanently damaged by the very treatments that keep them alive.

Getting hit by a Fiat going five miles an hour is probably a survivable event -- the impact on the body helps to determine the extent of the injuries. Getting hit by one going ninety miles an hour is probably not. Perspective is important when assessing cancer survivability, and the better able we are to see what is in front of us means we will act in good faith and to the best of our ability when meeting the cancer challenge.

Let's stop assuming that the happy face social media slaps on cancer is the real story. Let's stop thinking of the disease in terms of "good cancer" and "bad cancer". Let's stop thinking that some people are "lucky to have the good kind of cancer" and others are "unlucky". We need to join together in supporting every cancer patient, every cancer family, without the rancor or bitterness. Cancer is cancer. It doesn't care who you are or what you do or how much money you have in the bank. It doesn't care if you're a worthwhile person or the vilest of the vile. Cancer can't be dreamed up or wished away. It's a challenge that can only be met with a positive attitude, a realistic perspective, and a gritty determination to learn as much as we can to insure quality of life, not just quantity. Cancer is what it is, but life with cancer is what you make it. Choose wisely.

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