The common saying is that “they come in threes.” We’re talking about celebrity deaths, of course, and although this is typically the sort of nonsense that can be justified simply by shifting the period of inclusion so it always appears to be accurate, there is something eerily unique about this past week. Within nine days, we have had three prominent people of the same age whose deaths are blamed on cancer.
First, we had Ellen Stovall, age 69 and president of the National Coalition for Cancer Survivorship. Technically, she died from complications related to cardiac disease, but the cause of her heart trouble is traced back to treatments she underwent 45 years ago for Hodgkin’s lymphoma. According to her obituary in the New York Times, she had a recurrence of the lymphoma in the 80s and then also discovered that she had breast cancer — about this time she also discovered a pamphlet from the organization she would later be president of, which introduced her to the term “survivor” as a replacement for the word that had been commonly used to describe cancer patients: victim. This subtle adjustment of language helped to give her drive and focus and to become a force in the next wave of cancer awareness. She died on January 5th.
Next came the news on January 10th that David Jones, better known as David Bowie, had died after an 18 month “battle” with an undisclosed cancer just two days after his 69th birthday. While his family declined to offer details, it was reported by the New York Times that the director of Lazarus, Bowie’s Broadway collaboration, mentioned liver cancer in an interview with Danish media. Whether this meant the cancer originated in the liver or had merely settled in that organ is not clear, keeping in tune with the varied enigmatic personas the performer was known for. However, not knowing the type of cancer adds not just to the mystique of David Bowie, but the general fear and uncertainty that the word “cancer” conjures on its own.
Alan Rickman, also 69, passed away on January 14th as the result of an undisclosed cancer. While the actor was best known for his scene-chewing villains, he displayed a very versatile range that made him impossible to pigeon-hole. And though well-known for his work, he managed to keep his private life mostly off the radar. Even his recent marriage had been mainly kept secret. As is the case with many prominent personalities, however, the details of his illness (including the length of, or even if he had undergone treatment) have not been revealed.
Certainly, the deaths of these three individuals will help to bring the discussion of cancer back to the forefront. And since President Obama mentioned how Vice-President Joseph Biden’s son had died of cancer (Beau Biden died of brain cancer in 2015 at age 46), pledging that the United States would once again be leading the way toward a “cure” for the disease, we should expect to see quite a bit of lip-service paid to cancer over the coming weeks. But will this discussion be as powerful and proactive as it could be? The answer to that question will depend heavily on the language used — and specifically on how the appropriate cancers themselves are named.
As addressed in my last post, language matters. It has the power to enlighten as well as to obfuscate. Declaring a “war on cancer” may sound great as a rallying call during a hot political season, but it is essentially meaningless in view of modern medical science. Not because there is a lack of passionate enthusiasm to stamp out the myriad of cancers we know about, but because we know so much about such a wide range of distinctly different cancers.
“Cancer” is merely a term for the uncontrolled growth of mutated cells. These are still our own cells, native to our own bodies. The type of cancer is generally referred to based on the organ in which the cancerous cells originated, such as lung cancer or pancreatic cancer. Some have much more intriguing names, like the Kaposi sarcoma. But the reality is, there are over 200 types of cancer . Rather than try and make them all be treated as their own disease, it makes more sense to break them down into categories.
The five basic types of cancer are:
- Carcinoma
- Sarcoma
- Leukemia
- Lymphoma and myeloma
- Cancers of the central nervous system
For a list of a wider range of cancers, click here , here, or here . The sheer number of cancers can be daunting to read. But it is important to consider, because it forces us to reframe the discussion of a cure. The mythical “Cure” for the mythical “Cancer” is something that makes for great dramatic oration, but no practical sense. Far from filling us with despair, however, the knowledge should be emboldening.
Because we recognized it as its own unique thing, science has changed the course of breast cancer. What was once appeared a certain death sentence, now is more commonly looked upon as a manageable condition that is often curable. Because we recognized it as its own unique thing, colon cancer is usually diagnosed and removed quite early, saving lives that would otherwise have been lost. By focusing on specific mutations, science makes dramatic progress.
By addressing the specific cancers that take the lives of notable people, such as the three luminaries we lost this month, we are able to be better advocates for all cancer patients, for all cancer research. It needs to be clear that this is not a one-size-fits-all situation. We do not have a simplistic and singular “war on cancer” to fight, but rather a complex web of similar yet distinct diseases to address. Finding cures — plural — will happen one mutation at a time, perhaps even several at a time as unifying mechanisms become more understood; but we must be ready and able to honor those patients who have not outlived their cancers by talking frankly about their conditions, learning from them, and realizing that one cancer death is not the same as another just as one cancer is not the same as another.
I don’t just have cancer, I have lung cancer. I don’t just have lung cancer, I have adenocarcinoma. This matters because it breaks the walls of misunderstanding, leaving digestible chunks of knowledge where before there was looming darkness. This matters because “cancer” has no unified approach, no sense of clear treatment, no easy path to trust, but adenocarcinoma has proven treatment options rooted in sound science that offer an optimistic plan for success.
Naming that which we fear can remove the fear. More than that, the power we gain by distinguishing one cancer from another may actually save lives by driving awareness and helping to streamline research and early detection.
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