A recent article by Bill Keller in The New York Times told the story of a woman fighting advanced cancer in New York. Bill raised the question of whether we cancer patients should see ourselves in a war with constant or recurring battles or see it differently. He wondered if, when cancer appears to be getting the best of us, we should step back, recognize our mortality and not always make the most aggressive choice. This is all part of a shift. Are we fighting a “war on cancer” or are we chipping away at its ravages, as a society and personally? I think it’s the latter, from my conversations with many experts.
My friend Dr. James Berenson, a leading expert in the treatment of multiple myeloma from Los Angeles, has been training for a marathon. He hopes to run 10-minute miles – not fast – and simply finish. He sees many of today’s cancer patients on a long journey like that. Not at all a sprint. New research for many cancers – certainly many blood related cancers – is producing new medicine and new hope, not yet for cures, but for living well longer. Yes, taking medicine; yes, always considering new clinical trials; yes, tamping down side effects, but living pretty well. Is cancer an enemy (warlike) or a serious illness? Certainly it is still a struggle at times, or even a sustained struggle for many. But my opinion is this war analogy no longer works. Do we still need to take the napalm for many cancers (chemotherapy)? In some cancers, the answer is more often “no.” In selected cancers it’s changing from a war to “chronic cancer.” It makes the marathon of life harder, scarier, and more uncertain. But with many cancers now – certainly too few – we are living with them and living longer.
Am I fighting my cancers – CLL and myelofibrosis? No. Fortunately, my immune system seems to be keeping my CLL at low levels and a relatively new medicine controls the symptoms and may well increase my longevity with myelofibrosis. I go about my business not in a war, but with two conditions. I recognize that I am luckier than many. Some people have times of much more intense treatment. I’ve had that too. But then, hopefully, you move on. Not a solider in a “war” but just another person with a health concern, like so many others. Again, I recognize it can still be a daily struggle for many. My high quality of life living with cancer is not everybody’s story. But it is for more and more. Progress. Yet we still have far to go.
I know some of you won’t agree with me. Please comment. I just think it’s time in many cancers for us to focus on living with whatever time we have.
Wishing you and your family the best of health!