Cancer Is Stupid

December 18, 2009

A few days ago, I met a 49 year-old head and neck cancer survivor who was first diagnosed 10 years ago. Apparently, Tommy’s (not his real name) bout with the disease wasn’t pretty, but after some taxing treatment (including surgery that left him with a noticeable scar on his neck), he has been (his words) “disease free” for nearly 5 years. Ten years ago, Tommy was surprised, to say the least, to be diagnosed with cancer. He had never smoked (actually has always thought it was gross); he exercised every day; he is a high school teacher, so “other than annoying teenagers,” he isn’t “exposed to anything hazardous at work.” As far as he knew, he didn’t have any family history cancer except “some prostate cancer, which seems pretty normal.” Tommy didn’t understand then what he had done wrong, and he still doesn’t understand now. “I’ve been a teacher for nearly 30 years now. I’m not a psychologist, but my particular cancers don't seem to follow the philosophy of rewarding positive behavior. If I treated my students like cancer has treated me, they would be bouncing off the walls.”

Tommy isn’t exaggerating. From what he told me, he has done everything right - both before and after his diagnosis. In the five or so years since he has been “cured,” Tommy estimates that he checked in with his oncologist once per year, and he went for regular check ups with his primary care physician every 6 months. As soon as he could after treatment, he got back to exercising. About 2 months ago, he ran a marathon; it was his 9th. I will write that again, he ran a marathon; it was his 9th. He had been training all summer, and he felt great. But on race day, after just a few miles, he felt exhausted, and although he was properly trained, he was reduced to walking by halfway through the race. “I just couldn’t catch my breath; at one water station, I sat down for a few minutes, and felt like I was going to pass out.” This was not a normal feeling for Tommy; over the past five years, he has been running a lot, and recently he has been feeling like “superman.”

After the race, old feelings of fear crept back into his psyche. He thought maybe his cancer was back. He was worried that another tumor in his neck might be making it difficult to breathe – that seemed logical to him. Tommy made an appointment with his physician, and after a chest x-ray, it was clear that his old cancer wasn't back; it was a whole new cancer. Tommy now had lung cancer.

“This is stupid.”

Those were the first words Tommy said to me. That's what he said to me before he told me any of his story. I work in a major cancer center, and I was bustling through the waiting room of the outpatient clinic rushing to pick up some materials for a research project in which I am involved. I paused for a moment to grab a drink at the water cooler, which was next to the chair in which Tommy was sitting. I nodded at him, and he said, “This is stupid.” Obviously, at that point, I had to know more. We ended up talking for about 30 minutes, and I asked him if I could relay his story to the CT Challenge family, he said sure, but asked me to change his name. He hasn’t told everyone (including his students) about his new diagnosis yet.

“I just want to know what I’m up against before I start worrying everybody again.” He was oddly calm when he talked. I got the sense that this was a true calm; he wasn't faking or supressing his feelings (that's not an expert opinion, just my personal read on a man with whom I had a 20 minute conversation). He had traveled across a few states to get an opinion from the oncologist he was waiting to see. “In this cancer game, information is king. It doesn’t make any sense why I have it now…why I had it before…why it’s back. None of it makes sense. But I do know that since it is here, I need to know as much as I can, so I can fight it.” I asked him a question I ask almost every cancer survivor I meet: As an experienced survivor, do you have any advice for other survivors?

“Sure. Like I said – this is stupid. Cancer is stupid, so be smarter.” We both laughed when he said that. I thanked him, and moved on with my day. But I couldn’t stop thinking about “Cancer is stupid. Be smarter.” Great advice.

What does it mean for a cancer survivor to be smarter? We know that being smarter means making the lifestyle choices that lead to well-being. This includes many of the choices Tommy made – avoid risk factors like smoking or excessive sun exposure; exercise and strive to be lean; eat healthy foods; inform yourself about your cancer and what is healthy for you. You can do other things that I am sure Tommy did (but we didn’t discuss) like surround yourself with a good support system; take advantage of mental health care to reduce stress.

As Tommy unfortunately learned, cancer is not something over which we have complete control, but within the cancer survivorship experience, there are many many decisions which survivors are afforded. Tommy’s advice is sage – in each decision you are afforded as a survivor, be smarter than cancer.

Christian McEvoy, MPH

Director of Cancer Survivorship Information