Cancer is often depicted as some insidious evil, worming its way inside, unseen. Like a horror film, the monster that crawls inside in the dead of night to burst out when least expected for shock value. Cancer, however, comes from within.
So what is cancer? Cancer is a vast collection of diseases that get put under the same umbrella because they all stem from the same root cause - some cells in the body go wrong.
You have a multitude of different cells in your body, and the majority multiply by splitting into two perfect copies of the original. The scope for this simple, taken for granted act to go wrong is enormous - one wrong protein in your nucleus and you've got something your body didn't plan for. Most of the time you, immune system will spot the error and kill the imposter. These irregular splits happen thousands of times a day and you're none the wiser.
Unless. Unless. Unless.
Mutations, for that is what they are called, build up over time. A slightly irregular cell doesn't get blasted by your immune system, it splits into two more slightly irregular cells, and so on and so on. This is why cancer becomes far more common with age - mutations have been building one on top of the other for years and years, and one day, something shifts and it goes from unusual cell patterns to a tumour.
Some substances make these mutations more likely. Smoking, drinking a lot, eating too much red meat, eating insufficent fibre, asbestos, etc etc. You've heard of everything causing cancer, I'm sure, and in some cases they're justified.
Some people have a genetic susceptibility to cancer. They have a gene fault that makes either the irregular cells as standard or that makes the irregular cells multiply far faster than normal. This is why people who have never smoked get lung cancer, and why people who have always smoked don't. This is why young people suddenly get cancer for no apparent reason. Genetic mutations in your DNA can be inherited (like the BRCA gene for breast and ovarian cancer) or you can develop them in utero. Perhaps cancer is simply stamped on our genetic template long before we are people.
There are only three treatments for cancer, and they're both simple and terribly complicated. You can cut a cancer out, provided it hasn't spread. You can burn a cancerous tumour away. You can poison your body, to kill the cancerous cells. A tumour removal can be a ten minute minor operation for a skin cancer, or it can be an intricate hours-long operation on your brain. There are as many types of chemotherapy as there are cancers, and some are designed to cure and some merely to buy time, and chemotherapy in itself is dangerous and often difficult. Radiotherapy is most useful in tumours that are difficult to get to, to burn away what couldn't be cut away. There are other treatments, particularly in reproductive cancers that are heavily influenced by hormones, but these are the big three.
We speak of curing cancer. We talk of wanting a day where nobody dies of cancer, where everyone can be treated and live forever. Cancer has existed as long as life has. It is the paradox, that what gives us life, this constant replication of cells, can kill us. The longer lifespan our species has, the more likely cancer becomes. We speak of hope, of treatment, of cure.
But we don't speak of what happens when there is no cure. We speak of those who have died, but not those who are dying. It hurts too much. It is difficult to admit there is nothing to be done. Cancer is always framed as this eternal battle between the darkness and the light, and when no cure or treatment is available, it is concealed, somehow wrong. Failing. Losing. Giving up. There must be SOMETHING that can be done? Surely, in this day and age, there is SOMETHING?
The nature of medical intervention changes. There are no treatment plans made, only plans for comfort. Suddenly home is a hospital - a hospital bed in the dining room, Class A drugs through the arm, syringe drivers under the stairs, medication that would fell an ox when previously she wouldn't take paracetamol for a headache.
My mum hasn't given up, even though we have known there would be very limited scope for treatment from the very start. She is doing everything she can to stay well, to recover from setbacks and to live properly through this. Our family cluster around. Those who can't ask for updates, but there are no updates people want to hear. It becomes harder to talk about, because we can't put the discourse in terms of What's Next treatment-wise. Sometimes, I wish she could have chemo just so I had something to tell people when they ask how she is. She's planned her funeral to the last detail, but what happens after that is the Mordor in the distance. We, her children, are attacked by grief at unpredictable times. Grief and rage and unfocused pain, but love and laughter, black humour and togetherness. Dying isn't the same as death. We can't imagine her absence while she is still so alive. We live in stasis, a bizarre limbo where there is no hope, only now. Only today.