Chronicles from Cancer Land by Val

“Uncertainty is an uncomfortable position. 

But certainty is an absurd one.” 

Voltaire

I recently learned that the old adage “when life gives you lemons, make lemonade” has a new meaning:  lemon juice is a cure for cancer. A friend of mine promised a well-meaning individual that she would tell me about this fantastic cure. Apparently, all I have to do is drink a glass of lemon juice a day and I can be certain that my cancer will go away.

Being a skeptical sort, I Googled it and discovered that the lemon juice cure has many important elements of a good scam. They are:

• The proponents (whoever they are) fake an e-mail communication allegedly arising from a credible health institution, the Institute of Health Sciences in Baltimore, MD, as touting the dramatic curative effects of lemons.
• They erroneously assume that credible research showing cancer cell killing properties of citrus fruit extracts in lab cultures can be generalized to human beings. This is not true. Many chemicals—natural and synthetic—have been shown to kill cancer cells in lab cultures but have shown no efficacy as actual cancer treatments.
• The proponents prominently state that pharmaceutical companies are conspiring to keep this information secret while they develop a synthetic substance or drug with the same properties so that they can make millions off its sale.

The only thing that didn’t pop up in my Google search was the usual anecdotal claim by Aunt Millie about miraculously curing her cancer by drinking lemon juice. But, I’m sure that a deeper search would reveal such anecdotes.

I have received other suggestions, including a package of information on a Mexican Clinic touting CAM (Complementary and Alternative Medicine) treatment by doctors. While I acknowledge that the material was given to me by a very kind and well- meaning friend, I have a lot of difficulty with these types of clinics. I actually have a lot of concern and skepticism about CAM in general. I used to think that it was OK because, at the very least, it “couldn’t hurt”. But then, one of my students from the yoga class I taught for cancer patients came back from a Mexican clinic with severe kidney failure. She was in hospital for a long time and I found out that one of the herbs she was on in Mexico is widely known to cause kidney failure. The kidney failure contributed to poorer quality of life and, likely, to a shortening of her life. I have since learned of many problems and deaths associated with CAM. When these facts are set alongside the certainty expressed by CAM practitioners that their treatments will work, an important distinction between modern medicine and CAM emerges. Modern medicine admits its uncertainties and unknowns and tends to self-correct. CAM does not.

I have been reading Siddhartha Mukerjee’s book, The Emperor of All Maladies: A Biography of Cancer. Mukerjee won a Pulitzer Prize for it, and no wonder. This is a fascinating and beautifully written book and, while I’ll have more to say about it in another post, there is one thing from the book I’d like to share now that is relevant to the self-correction attribute of modern medicine. In the 1980’s, an oncologist in South Africa falsified his data concerning the efficacy of a particular breast cancer treatment. This treatment consisted of mega-dose chemotherapy followed by autologous bone marrow transplant. He presented data showing that the treatment offered 80% chance of remission. As a result, patients demanded this treatment, oncologists all over the world began using it, insurance companies were persuaded to pay for it and the patients died. After a short time, suspicious oncologists and researchers demanded to see the South African’s clinical data. He was exposed and those oncologists who had not already ceased using the treatment stopped immediately.

Modern medicine is not immune to the fallibility of human beings. Mistakes are made. But it has the capacity for self-correction, growth and the development of new knowledge.

Despite the fact that clinical trials and other research studies have been done on various CAM treatments and have shown no efficacy and even harm, CAM clings to them on the basis that they are holistic and natural. Their certainty is absurd.

I haven’t always been so skeptical. In the past, I have been persuaded to do various CAM therapies. The lemon juice hoax mentions avoiding the difficulties and sickness of chemotherapy. When my first cancer diagnosis occurred, I was definitely afraid of chemotherapy and, in my fear, accepted some naturopathic ideas that I should have known, given my scientific background, were suspect or just could not be true. Playing on the fear of chemo and other modern medical cancer treatments is a CAM tactic.

Fear was not the only thing that drove me to CAM. Mine was a complex situation. But, in my fear, I failed to carry out due diligence on understanding the state of cancer treatment at the time. Therefore, fear combined with ignorance, were big factors in my decision- making. I have resolved not to be as ignorant this time round. That is the reason I am reading The Emperor of All Maladies.

Besides fear and ignorance, another factor needs to be acknowledged—how we respond to certainty and uncertainty.

As well as being self-correcting, modern medicine is pretty honest about the chances of cure and remission. Oncologists don’t say, “just do this, and you will be cured” unless it is warranted. And, in the world of cancer, this does not happen very often. My oncologist said that with the treatment regime he was suggesting, I had a chance at longevity. This is pretty positive but it is hardly a statement of certainty. CAM practitioners, on the other hand, are sure that their treatments will work or at least that is what they tell their patients. Whether they do it deliberately or not, they tend to play on our fears of uncertainty.

Reflecting on the quote from Voltaire – “Uncertainty is an uncomfortable position. But certainty is an absurd one.” – we need to ask ourselves how can we deal with the discomfort of uncertainty? This is our deep, existential question and mostly we just ignore it partly because it is so uncomfortable: We tend to accept the absurd rather than deal with the uncomfortable. Rife in our society, for example, are absurd notions about happiness as something we all deserve and have a right to, and about health and ageing that make it sound as if illness and degeneration were moral failures.

We are quick to take any good sign or test result as something that will eliminate uncertainty. But it won’t. It may be good news for now but only if we live as fully and with as much self-reflection, thoughtfulness and learning as we can everyday while not forgetting the reality of our transience.

One of my ways of dealing with uncertainty is to be skeptical of things that presume to be so certain. There are many categories of “certain” things. Many religious beliefs, New Age beliefs, UFOs and alien invasions, libertarianism, many philosophical ideas, humans cannot possibly alter the earth’s atmosphere, studies that supposedly  prove that girls and boys should be separately schooled, and on and on it goes. On and on…I better stop now before this turns from a blog post into a rant!!!