Beyond Polarity

Donna’s Cancer Journey Post #4

Living with Cancer

Yahoo! I have a surgery date: August 3rd. The Alberta Health Services (AHS) machine is in motion and I’m being flooded with information & pre-admission logistics. The certainty is definitely comforting. But deep down, I know a lumpectomy isn’t the end of this journey. 

Cancer is now a regular feature of being human.

Research tells us one in two Albertans will be diagnosed with cancer in their lifetime and at least one in five will die of the disease. Gulp. My dad was diagnosed with lung cancer late in 2017 and died, untreated, about six weeks after the cancer was first detected. Eight months later, my mom found out she had stomach cancer and in spite of aggressive treatment, passed away in 2019. 

Rationally, it makes sense. Earth’s population has exploded; people live much longer; and tools for cancer diagnosis have dramatically changed. Twenty-five years ago, I would be blissfully unaware of cancer until it hit stage 3 or 4.

For many people, cancer is seen as the enemy. The disease that doesn’t knock before it enters; the ruthless, secret invader; a capricious, evil, invincible predator. Cancer has become a sci fi avatar–an alien mutant. We fight cancer by whatever means required to kill a lethal, insidious enemy…bombarding it with radiation and blasts of chemo. U.S. President Nixon famously declared a war on cancer in 1971.

But to my way of thinking, the war on cancer is over. Cancer won.

So…instead of talking about a war with cancer, what about a conversation on how we learn to live “with” cancer? Is that even possible?

Believe me, I get it! My fear of cancer is real. And some of the treatments feel primitive. Patients don’t just survive cancer, they have to survive the treatment too.

Yet we live in a time of revolutionary change. What we know about mRNA has been accelerated–because of COVID. Smart scientists are working on implanted devices that target cancer via electromagnetic waves (rather than a shotgun approach). And there’s a very real possibility that artificial intelligence (AI) can be deployed to crack cancer’s deepest codes.

Humans (including me) get caught in this story-telling collision: “I’m in a war against cancer” vs. a different story about modern tools for cancer care.

(And that’s not the only story-telling collision; some people believe AI can make our lives better and others believe it may turn on us and get us nuked.)

What could a new narrative sound like? Well, take a look at America’s recently recalibrated cancer moonshot that aims to not only cut the death rate from cancer by 50% in 25 years, it also seeks to improve the experience of people and their families living with and surviving cancer.

There is a compelling new narrative emerging.

The Future of Cancer Care

Diagnosing and treating cancer is a big ticket item in provincial healthcare budgets. In Calgary, finishing touches are being made to a $1.4 billion Calgary Cancer Centre scheduled to open early in 2024; it’s the largest government infrastructure project in the province and one that I’m proud to say I zealously advocated for as an MLA. But, how exactly do we redesign, rebuild and fund a healthcare system that equips us to live “with” cancer?  

Heads whipped when B.C. Health Minister Adrian Dix started to direct breast and prostate cancer patients to clinics in Bellingham, Washington for radiation treatment. At first blush, it sounds irresponsible for B.C.’s healthcare system not to be equipped to handle routine cancer care. But maybe B.C.’s choice is an honest one. In a way, Canadians already have a a two-tier healthcare system—the U.S. being the private option. Sending cancer patients to Washington for radiation may be fairer; paying your way in an American healthcare system isn’t a choice available to most Canadians. 

The sober reflection of my father—in the face of a late-stage lung cancer diagnosis—opens up another recourse.

In his 82 years of living, my dad never once spent a night in a hospital bed. That’s rare. Dad recognized his good fortune. He was happy to have paid far more into the system than he extracted. Although it made me cry at the time, I could not have been prouder of my father than when he asked his oncologists whether certain cancer treatments offered him were worth the expense. 

As difficult as this kind of self-reflection is, as brutal as it may sound, and counter to the whatever-it-takes desire we have to live or to keep our loved ones with us one moment more, we must ask ourselves these questions.

There is a disconnect between our expectations of the health-care system and our ability to sustainably fund future costs. Certainly, I’m not so hard-hearted as to condemn those with the misfortune to suffer. That’s not what I’m talking about. It’s the expectation of some that they are entitled to every available test, every available procedure, and every new medication. And there’s a demographic dimension here too–most notably, aging Boomers risk crashing the healthcare system.

Most of us are afraid to talk about this. My father wasn’t. What’s too much and what’s not enough? It’s an ages-old question and I don’t (yet) know the answer. 

What I do know is people can’t take much more. El Niño’s strange climate patterns make it feel like the sky really is falling; wildfire smoke across the country shows no sign of abatement; and the war in Ukraine is stuck in a stalemate. How do we tell people we’re going to be okay? That cancer is pervasive but modern treatments are moving forward.

My cancer surgery will be okay. It’s the story I want to believe.

Quite honestly, I can’t bear the thought of being embroiled in a war with cancer.

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