Cancer incised
by
AJ Philip |
Pulitzer winner unveils the mysteries of the deadly diseases
Generally speaking, Indians recognise a person only after he is recognised by the West. Mother Teresa spent a lifetime serving the poor in Kolkata, but the nation honoured her with Bharat Ratna, only after she won the Nobel Prize. Amartya Sen did his pioneering study that earned him the sobriquet — welfare economist — long before the nation’s highest civilian award was conferred on him in 1999, months after he won the Nobel.
Now that Siddhartha Mukherjee, a young practising oncologist in the US, has won the Pulitzer Prize for his maiden book The Emperor of All Maladies: A Biography of Cancer, he would be feted and honoured with all kinds of prizes. Already, St Columba’s in New Delhi, his alma mater, remembers that he had won the ‘sword of honour’ in his final year at the school, a distinction he shares with film actor Shah Rukh Khan, who earned it seven years earlier.
Why blame others when I spent $17.07 on his book only after he won the Pulitzer, though he had been contemplating it. It would be an understatement to say that cancer is a much-misunderstood and much-feared disease. There are many autobiographical books in the genre of ‘how I fought cancer’, but none that looks at it from a historical and clinical perspective, and that too in a language a layman can appreciate.
Today cancer is a major killer. The author estimates that in 2010, about 600,000 Americans and more than seven million humans around the world would have died of cancer. “A quarter of all American deaths, and about 15 per cent of all deaths worldwide, will be attributed to cancer”. Pray, who has not been affected by this disease in one way or another?
Less than a year ago, I lost a close friend, who realised that he was in a terminal stage of abdominal cancer only when he consulted a general physician, who gave him a choice: you can spend a fortune on such treatment as chemotherapy in a ‘cancer ward’, or spend the rest of your life with your family availing yourself of palliative care. In both cases, life would remain short.
The very thought of ‘cancer ward’ would have reminded him of Aleksandr Solzhenitsyn’s novel by that title in which Pavel Nikolayevich Rusanov, who is in his mid-forties, discovers that he has a tumour in his neck and is immediately whisked away into a ‘cancer ward’ in some nameless hospital. “To be discovered with cancer, he discovers, is to enter a borderless medical gulag, a state even more invasive and paralysing than the one that he has left behind”.
A middle class man who could have afforded treatment in a cancer hospital only by selling his property, my friend chose the latter option and lived for six more months at his home. He did not allow his family to be pauperised. Incidentally, one of the primary causes of rural indebtedness is the exorbitant cost of healthcare. But doctors who give such honest advice are few.
Only a sensitive doctor like Mukherjee feels haunted by the thought: “Was it worthwhile continuing yet another round of chemotherapy on a sixty-six-year-old pharmacist with lung cancer who had failed all other drugs? Should a Spanish-speaking mother of three with colon cancer be enrolled in a new clinical trial when she can barely read the formal and inscrutable language of the consent forms?”
Most doctors prefer to give false hopes to their patients till they reach a stage when death becomes imminent. A friend’s father was advised to try ‘homoeopathy’ after the last penny was sucked out from him in the name of chemotherapy at a cancer hospital. “Cancer is a disease caused by the uncontrolled growth of a single cell. This growth is unleashed by mutations – changes in DNA that specifically affect genes that incite unlimited cell growth.” But this understanding didn’t exist earlier.
Several decades ago, scientists claimed that cancer would soon be ‘curable’, but that stage is still in the realm of speculation. There are, as of now, no clear answer to the question: what causes cancer? Smoking and passive smoking as a cause of cancer was publicised by the propagandists of Hitler, as well-known cancer specialist Sthabir Dasgupta argues in his book Environment and the Phenomenon of Cancer. “Those who smoke have a lower incidence of brain and bowel cancer as compared to those who despise Lady Nicotine”, he points out humorously.
Yet, myths abound about cancer. Much of the so-called studies that relate cancer to some causes have been misleading. There are over 100 types of cancer. What follows from it is that there is no sure-shot lifestyle remedy. Is cancer a new disease, as many seem to believe? “The Mesopotamians knew their migranes; the Egyptians had a word for seizures. A leprosy-like illness tsara’at is mentioned in the book of Leviticus. The Hindu Vedas have a medical term for dropsy and a goddess specifically dedicated to smallpox”.
But when it comes to cancer, such as breast, lung, and prostate, no such terms exist. “With a few notable exceptions, in the vast stretch of medical history, there is no book or god for cancer”. What is indisputable is that cancer is an age-related disease. The older a person is, the more likely he is to get it. In ancient societies people did not live long enough to get cancer. Instead, they died of many diseases like TB which are now curable. For instance, in India, life expectancy which was just 23 years in 1901 shot up to 62 in 1996. In other words, by extending life spans, ‘civilisation has unveiled cancer’.
If at the end of the book, cancer no longer remains the dreadful, inscrutable and enigmatic disease that it was at the beginning, it is a measure of the masterly narrative skills of the author, who upholds what the great discoverer Madam Curie had said, “Nothing in life is to be feared, it is only to be understood”.
The writer is a New Delhi-based senior journalist.
Oman Tribune
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