Demystifying cancer is crucial, according to oncologist Dr Robert Buckman, and leads to a greater ability to cope. Sylvia Thompsonreports
So fearful were many people of cancer in the past that it was simply known as the Big C. The word itself was too frightening to utter. "Cancer is probably the most dreaded word in the English language," says Canadian medical oncologist, Dr Robert Buckman.
Buckman is the author of a new book entitled Cancer is a Word, Not a Sentence, in which he gives readers clear, calm and concise explanations of a range of cancers from diagnosis to treatment.
His aim is to help those with cancer understand better every aspect of their disease so that they can let go of some of their fears and face the facts.
"Cancer brings with it, universally, queasy feelings of fear and doom," writes Buckman. "Many people describe the sensation as chilling, or as a sense of helplessness, or even foggy feeling of mental paralysis. I wrote this book to help people get over that initial shock and to make sense of, and then cope with, the facts of their own situation."
The fact that around half of those diagnosed with cancer will be successfully treated and not troubled by cancer again is one piece of information that often gets ignored in the cauldron of feelings that cancer evokes. "Taking all cancers diagnosed this year, the chance of surviving it is 50 per cent and that figure has been increasing steadily over the last four decades," says Buckman.
The belief that cancer is a death sentence arose, according to Buckman, because the word cancer lumps together over 200 different diseases.
"Cancer is not a disease, it is a process in which many different diseases - the cancers - are created. Most cancers have very little in common with each other apart from sharing the fundamental cancer process," he explains.
By way of explaining further how cancers vary hugely - from benign skin cancers to advanced pancreatic cancer - Buckman compares them to infectious diseases.
He explains how viruses range from the common cold virus to the deadly Ebola virus, HIV/Aids virus or, indeed, avian flu. Yet we don't link the common cold with the more serious viruses.
"When you lump different diseases together and you include diseases of greatly different behaviours under the same label, you increase the fear and the dread that the label brings with it," he says.
"The real problem is that by linking them together, you remove the predictability of the individual disease and you create a myth of a single, unpredictable and changeable super-disease, which can mysteriously leap from one type of disease to another."
In his book, Buckman clearly explains the cancer process, which involves the disorderly and uncontrollable growth of cells. Significantly, this uncontrollable cell growth does not respect the normal boundaries between different types of tissue and invades nearby organs.
And more unusually, some cancers spread to distant areas of the body in a process called metastasising, creating what are commonly known as secondaries. It is this third step of the cancer process that represents most of the threat to health and life.
"We now believe that some cancer cells have a high tendency to metastasise, while others do not," he writes. The problem is that, currently, clinicians can only predict the range of probability of metastasising and then recommend treatment options to decrease the risk.
According to Buckman, nobody can yet say for definite whether an individual cancer will spread and, therefore, nobody can say whether the treatment is preventing recurrence or whether the cancer would not have recurred anyway.
Nowadays, people have a much greater knowledge about medical procedures but it is still difficult to get a firm grasp of different diagnostic tests and treatment options.
In his book, Buckman gives crisp, clear definitions of the range of different biopsies and blood tests and explains how the location of the cancer, the speed (or slowness) with which cancers grow and how common the symptoms all influence when a diagnosis is made.
"People often feel that any period of time that elapses during the process of diagnosis has somehow jeopardised them," he writes.
"In fact, that is very rare. Those feelings are part of the baggage that is brought in with all the reactions to the word cancer."
He also explains in considerable detail the four main types of cancer treatment - surgery, radiotherapy, chemotherapy and biological therapy (which includes hormone therapy).
He presents a risks/benefits analysis of treatmentsdepending on the type of cancer. And he discusses the short- and long-term side effects of each treatment.
For those interested in future directions in cancer research, the book gives what is possibly the clearest explanation of biological agents currently available to a non-scientist.
Biological agents (in the form of drugs) are to the forefront of cancer research because they attack the internal mechanisms within cancer cells, thus limiting the damage to normal cells which is an ongoing problem with chemotherapy.
And for those interested in using complementary therapies, Buckman has some cautionary tales of false claims and misinterpretation.
"The greater the fear, the greater the urge to believe that all cancers can be quickly and easily cured, without side effects, by alternative, complementary, folk or home remedies," he writes.
While acknowledging that many complementary therapists offer cancer patients a more supportive feeling in the consultation, he cautions against raising false hopes.
And finally, as a doctor who has been teaching communication skills to other doctors and medical students for the last 20 years, Buckman offers readers plenty of gentle advice on self care and the importance of keeping good communication channels open with family and friends.
He also acknowledges the steady advances in reversing some cancers, controlling others and improving treatment in others.
In conclusion, he writes: "We are generally doing fairly well and 'the search for a single cure' is an unreal yardstick by which we fail to appreciate the progress we are actually making."
CANCER DIAGNOSIS: THE DOS & DON'TS
DO try to get a reasonable, general overview of your type of cancer.
DO get a small amount of trustworthy current information from a few reputable cancer websites.
DO accept, which means admit and acknowledge to yourself any uncertainty about the diagnosis and/or treatment. Uncertainty is always unpleasant but easier to cope with if you acknowledge that fact.
DO ask your medical team a few specific questions once you understand the general overview of your situation.
DO get a second opinion if you really think you need it.
DO talk to your friends and family.
DO breathe. Do spend a little bit of time every day doing something you really enjoy and thus look forward to it.
DON'T respond simply to the word cancer as a universal and total signal of doom and gloom.
DON'T go to the internet and collect hundreds of different views, opinions, home remedies and fringe medications.
DON'T think that things won't change after your hear the first view of the diagnosis and treatment. Plans may well change as time goes on, so try to stay as flexible as possible.
DON'T or try not to ask the same questions too often. Asking over and over again usually means that it's difficult for you to accept the answers.
DON'T get a third opinion if the second opinion is the same as the first.
DON'T feel you have to hold all your concerns and worries in until you know all the answers.
DON'T panic. There is plenty of time to get informed and make decisions.
Adapted from Cancer is a Word, Not a Sentence by Dr Robert Buckman (Collins UK£9.99)