Tag Archives: Medical Treatment

Cancer as a battleground

I listened to a really interesting podcast of Radio National Australia 360 Documentaries entitled Cancer as a Battleground http://www.abc.net.au/radionational/programs/360/cancer-as-a-battleground/4156650

In the developed western world the dominant discourse of cancer is as a battleground. This was really started in US in 1971 with the appropriation of $100 mill to launch a war against cancer. There was a belief that cancer, a major burden of disease, could be defeated in much the same was as other major diseases like smallpox, polio etc. It only needed enough money to find the magic cure. So the war on cancer, like the war on drugs and the war on terrorism became an easy slogan to garner our attention and justify large amounts of public funds to create a voracious research machine.

The weapons of war, chemicals, radiation and biological are deployed against the bad cancerous cells inside our body. The focus is on ridding the body of these alien cells and thereby allowing the diseased person to survive.  Treatment is constructed as a battle of good versus evil with all the power of the artillery available to the modern medical system waged against this evil.

In this podcast it is pointed out that we don’t question the war on cancer as we question other wars and without this debate we are caught in an earlier more naïve view of war like World War 2; one which is seen as goodies versus baddies and can be won with the baddies being defeated.

“ We start to run, swim, bake, grow moustaches, wear pink, have afternoon teas etc to fight the war – like nationalist buying war bonds during war.”

We love war stories and admire war heroes. In the battle against cancer there is a whole machinery for the construction of suitable heroes. We particularly look to celebrities. The breast cancer industry has constructed a number of celebrity heroes such as Melissa Etherington, Farrah Fawcett and in Australia we have

Kylie Minogue, Olivia Newton John, Jane McGrath and Belinda Emmet. The thing that all these women have in common is that they are beautiful, blonde, famous and rich and all present a pretty, polite, packaged face of breast cancer.  In Britain Jane Gooding – Big Brother contestant went from being regarded as a loud mouthed racist bigot to a hero when she was diagnosed with cancer. Women living with breast cancer feel they can’t possible live up to these heroes, who make it public that you are not doing it right.

We like to hear about heroism but we don’t want to talk about defeat. The medical profession often finds it very difficult to talk about death. “Our doctor told us that Angela would be off the trial. I asked him what I should do now. He said well you should make an appointment in 4 weeks time but don’t make it yet, what do I do in the meantime well you should get your wife’s affairs in order.  Then it hit me he was trying to tell me that my wife was going to die. All this code I think why cant he just talk to me honestly one adult to another”

We create a hierarchy of heroes, with some types of cancer more sympathetic.

“Surrounded by breast cancer sea of pink, my aunt with lung cancer was envious of support, she felt guilty as people assume she smoked and therefore brought her own cancer on.”

Talk of battle turns inwards into the minds and bodies of patients. Patients go to all ends to win this war. Similar spirit of ANZAC, spirit of patriotism, brings people together to construct hope.Pick a fight with you cancer – game on – patients speak of their bodies as the enemy to be battled.

“Being positive can cause trouble because people can feel that if they are not perpetually positive then they are letting themselves, their families, their doctors down.”

“Language of battle makes it hard to accept defeat.”

“We talked about everything except that she would die. When she died she had a pile of books titled you can beat cancer next to her bed”

“Her battle meant that I could never say goodbye.”

We seem less prepared for death than ever. If we don’t battle what is left is just the uncertainty of death and is that too terrible to face.

There is also an additional narrative that people cause their own cancer by they way they live their life, they have drunk too much alcohol, smoked, not exercised enough or else as Louisa Hay has argued not managed their emotions properly; they have repressed their anger, been too stressed or anxious.

This simplistic, black and white view of cancer is imposed on all people with cancer. As a woman with breast cancer I found myself feeling guilty that I had caused my cancer, which left me feeling powerless and lacking confidence in my own body. In this frame of mind I had limited confidence to challenge the onslaught of the medical system as it deployed its weaponry against my body.

I have found that by engaging with my body through the use of a fusion of creative arts, movement, painting, poetry, and photography, I have been able to reconnect with the power and wisdom held within my body and my intuitive right brain. I have been able to tap into the many complex layers of my female body, which has assisted me to accept my cancer, to make sense of the cancer treatment, to accept my changed body and to live my life as I want to live. I have been liberated from the battleground.

Using creative arts I have been able to explore the messy, confusing side of cancer. The simplistic battleground narrative does not allow space for questioning motives, strategies or indecision. There is no time for delay and the pressure is placed upon you to jump on the medical conveyor belt and not get off until you are cured. To be cured of breast cancer means to look like you used to so the aesthetic decision of whether to have breast reconstruction is included in the treatment.

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After my first surgery – need to go in again.

A week after my surgery I visit my surgeon to get my pathology results. I’m confident everything will be okay. My surgeon blasts through my confident exterior when she says I’ll need more surgery. I don’t have clear margins. She’ll need to take a bit more. She draws me another diagram illustrating how she’ll just need to take a slightly larger incision.

The DCIS Booklet

I read the booklet on DCIS and am blown away by the presentation of the data on treatment outcomes, in which 🙂  symbol is used to represent survival and
😦 symbol to represent death. I think, well I guess you would be a bit sad if you die!

A week after my surgery I visit my surgeon to get my pathology results. I’m confident everything will be okay. My surgeon blasts through my confident exterior when she says I’ll need more surgery. I don’t have clear margins. She’ll need to take a bit more. She draws me another diagram illustrating how she’ll just need to take a slightly larger incision.

She operates two weeks later. It is frustrating knowing that my healing breast will be again be cut into. I know the nurses and the drill. Although I hate having an anaesthetic it all goes well and I’m back home that night tucking into a delicious dinner.

I attend my follow-up appointment curious to see whether I will need to have radiotherapy. My daughter insists on coming with me even though I told her I don’t need her as it will be just be a standard follow up. The nurse checks my wound and says its healing well. I still haven’t seen my scar as I have had dressings on it all the time. I’m curious to see how I will look. I guess I can get a false nipple to wear; I’d seen an episode of “Sex in the City” in which one of the characters had worn one to attract men.

We wait in the room for the surgeon, eventually she walks in her expression as inscrutable as ever. She sits down and says, “it is totally unexpected but we still didn’t get clear margins. We will need to take the whole breast off to ensure you are clear. It has been growing so stealthily without being picked up by any of our tests, we would never know what was happening.” You will have to have a mastectomy. I was in complete shock! Here I have been worrying so much about how I would be without a nipple and now I am going to have my breast cut off! Suddenly the aesthetics seem so less important than living or dying.

The day before my operation I have another appointment with my surgeon. The nurse shows me different prosthesis I could use and gives me a free Berlie mastectomy bra.  It finally hits me there in her office. By this time tomorrow I will no longer have my left breast. My surgeon asked me what sort of mastectomy I want. Whether a clean cut to the chest wall or one that entailed a smaller incision and retained some skin so that I could have a reconstruction later. I don’t know! Part of me would like to have a clean excision to my chest wall and proudly bear my scar. But another part of me would like to keep the option of having a breast reconstruction later. She then asks me whether I want to have the lymph nodes that the breast drains into removed. I DON”T KNOW! This is all too much.

For the first time she doesn’t sound so confident that the pathology will be clear after my breast is removed. I guess her confidence is dented as well. The prospect of me having invasive cancer now seems like an option. For the first time I am scared! I don’t want to die! Not yet! When is a right time to die? My previous concerns about losing a nipple seem less significant and my concerns about having slightly sagging breasts now appear truly trivial.  I walk out of the clinic with my nice pink Berlie gift bag. I feel others compassionate glances as they know this means I’m having a mastectomy.