Cancer and grief: Part I
In his groundbreaking 2010 tome on cancer, Dr Siddhartha Mukherjee defined cancer as a ‘lethal shape-shifting entity imbued with such penetrating […] potency that [it] is often described as the defining plague of our generation’. Despite decades of research on the causes and course of cancers, this subset of disease encompassing over 110 distinct conditions continues to be largely an enigma that carries with it feelings of uncertainty, unpredictability, and unjustness. It affects people of all ages, fetuses in utero to supercentenarians, and ranges in severity from precancerous wait-and-watches to widely spread metastatic disease affecting multiple body systems, a stage responsible for 90% of cancer deaths. People may live for decades after diagnosis and treatment with no sequelae, or they could die within days or weeks following identification of the once normal but now duplicitous, unendingly duplicating cells.
For patients, cancer can be all-encompassing and can obscure any normalcy in their lives. Cancer is not relegated to one part of life: it affects the patients and their loved ones in many segments of their being leading to physical, emotional, and social changes that affect their self-identity. There are many excellent first-person cancer narratives available to better understand the depth of these illnesses from Dr Paul Kalanithi’s heart wrenching autobiography When Breath Becomes Air to Nina Riggs’ poetic memoir The Bright Hour.
In the 1860s, German monk Gregor Mendel began laying out the basics of genetics, but his work was quickly forgotten, and science did not progress until rediscovery of his work in 1900. Building from his research, modern biologists have discovered the function of cellular mutations in previously normal cells in the development of cancers. From this, they created the field of histology, a specialty that helps pinpoint from whence tumors have arisen. Thanks to this early and continued work, as well as the work of research scientists such as Wilhelm Röntgen, we can now both qualify and quantify cancer.
Until Stanley Farber’s pioneering research on chemotherapy beginning in the 1940s, the only interventions available for the treatment of cancer were surgical resection or radiation. Aside from this, only supportive care for the symptoms associated with disease progression were all that medicine had to offer sufferers. As Gabay said, cancer is ‘a threat to one’s belief in the prosperity of the righteous and to human existence’.
