The Big 'C'
(Published in the August Edition of Works In Progress - 2017

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Be wary of those who say they’re on your side when it comes to the war on cancer 

Cancer seems to be on everyone’s radar these days.  The struggle against the disease is discussed openly in everyday conversation and constantly referenced in the media.  But that’s a good thing, right? I’m old enough to remember when “the big C” was a dark secret, discussed in hushed tones by folks who shuddered and shook their heads sadly upon hearing the news about a relative or friend.  Cancer used to be a hopeless topic and the subject of short conversations for good reason: the proverbial death sentence diagnosis and the ultimate negative lottery. 

 

But today the topic of cancer no longer lives in the shadows.  Now, nearly all of us know somebody battling the disease and many who are ‘winning’, surviving what was once a death sentence, or at least living with it for years longer than before.  We are told that cancer rates are improving and that we as a society may just whip cancer all together if we raise enough research dollars.  We have the best minds and the most money America can offer to fight this scourge; it’s the “moon shot” for our generation. 

And this noble fight against cancer has become a part of business in America.  Everywhere you look some hospital is touting their team as the most adept at fighting a cancer diagnosis.  It’s more than just out in the open now; cancer care advertising is in your face every day, hawked at a fever pitch, right up there with beer, cars and cell phones. 

 

But should we all be cheering along with the health care industry?  Yes, cancer survival rates are perhaps improving but what about cancer diagnosis rates? 

 

It is a matter of fact that the incidence of cancer has increased dramatically over the last century.  And the rates have not slowed in the last half century with the highest rates being in the most industrialized nations.  (Are We Winning or Losing the War on Cancer? Howe & Clapp 2004; World Cancer Research Fund: Data for Cancer Frequency by Country 2012).  There’s convincing evidence that over the course of that time our diet, habits and environment have all changed in ways that make us more likely to develop cancer.  (CDC Recommendations for Cancer Prevention 2016; NCI Cancer Causing Substances in the Environment 2015; WHO – Environmental & Occupational Cancers 2011; WHO Fact Sheet 2017).  An emphasis on treatments, survival rates and cures does not help to shed light on why individuals are getting sick in the first place.  Is it because a focus on survival and cures is just a more upbeat and positive message?  Or is it because focusing on prevention offers little in terms of a business model. 

 

Healthcare has become big business in America.  Our nation spends nearly one fifth of our gross domestic product on healthcare.  That’s more than $3 trillion annually, about the same as the entire economy of France.  As with the health industry, cancer too has become big business.  Cancer treatment alone has grown globally to a $100+ billion-dollar market (IMS Institute for Healthcare Informatics June 2016) and is forecast to increase 50% in the next four years (Forbes May 2015). 

It makes sense then that today’s medical industrial complex would design ad campaigns that target rich growth opportunities.  But there’s more at play here than just aggressive cancer care promotion.  Let’s consider some of the recent slogans for cancer advertising:  

 

“Make Cancer the Victim” (Oregon Health & Science University)  

 

“It’s Cancer’s Turn to Be Afraid” (Cancer Research UK) 

 

“We Won’t Give Up ‘til Cancer Does” (Irish Cancer Society) 

 

“Where Cancer Meets Its Match” – (University of Kansas Cancer Center) 

 

“Cancer Destroyers” – (MD Anderson Cancer Centers) 

 

“Cancer Picked a Fight with the Wrong Team” - (St. Francis Health SCL Health Colorado) 

 

“You Wanna Fight?” - (University of Colorado Hospital) 

 

Sense a theme here?  At first glance, these may seem simple words of empowerment for a boomer generation. But we should consider their sponsor and ask why they seem designed to appeal to one’s fighting spirit.  To be sure it is a theme that resonates with those no longer wishing to be hapless victims living in fear of cancer. But just as we should be wary when our government vilifies a convenient demon in support of military engagement, so should we be circumspect when the medical industry issues such a hyperbolic call to arms against a disease.  These slogans cheer the victims of cancer and paint their sponsors as vanquishers in a holy war waged against the terrorist disease.  Might these ads be crafted instead to distract the consumer away from the larger issue?  How we perceive and approach cancer as a society is important in and of itself.  To what degree is cancer merely a symptom of the modern condition of our own making with the help and blessings of those very same corporate interests who tout its cure? 

Part of any game of deception is to direct the subject’s attention away from where their focus should be.  Note that the above campaigns bear down on the cancer battle post-disease, where the biggest potential for treatment profits exists as opposed to prevention. True, there’s no profit motive for the medical industry to emphasize prevention - and I’m talking true prevention as opposed to early detection which still involves expensive tests and procedures – but that only goes so far in explaining the themes at play.  Perhaps the bigger message from all four corners of the corporate world is that what is being laid before us to live with and consume is fine and grand and should not be questioned. 

Part and parcel to this propaganda is the subtler underlying message that cancer is inevitable: just part of the cost of living in this modern world and enjoying the benefits of greater life expectancy.  This rests on the assumption that adults are actually living longer than their ancestors which is not necessarily the case     (Common Misconceptions about Science: Life Expectancy, Psychology Today November 2008).  Worse yet, the excuse that cancer is just a natural response to modern medicine increasing our lifespans only makes us more complacent with a situation we should be outraged about.  It seems like the more health care becomes a high stakes business model, the more the emphasis is on the message that implies you can’t really do anything about cancer until you get it.  And when you do, then have no fear: we’re winning the war so send your cancer business our way.  The more compelling narrative is drowned out: that modern society’s choices are putting us in harm’s way and what can we do to lessen our chances of getting cancer in the first place.  One message supports the medical industry, and industry as a whole, while the other does not serve to make anyone rich.  Don’t expect Wall Street or Madison Avenue to tell you to eat fewer processed foods and cut down on your use of toxic household products.  Those items alone represent half the shelves of the modern grocery store; there’s no profit in that message. 

The passion displayed in the above advertising by the cancer industry is misplaced.  We should be afraid, angry and ready to fight but not just about getting cancer and the battle ahead post-diagnosis.  We should be afraid of what’s happening to our world and that’s where we should be directing our anger and fighting spirit.   

I say all this with no interest in adding stress for those who are already dealing with their own or a love one’s struggle with this affliction.  I know their world.  I lost my first wife when she was struck down in her early ‘30’s and left two small kids alone with a dazed father.  But we cannot let this increasingly more common and everyday struggle distract our society from facing the true realities of the situation.  There is something wrong with our situation and it is folly to turn our attention away from this reality in pursuit of a miracle cure.  Those who profit from the increased emphasis on treatment and research, instead of a broader more fundamental approach to prevention, will continue to distract us from our core responsibility to make this world safer for successive generations. 

 
Resources: 

Are We Winning or Losing the War on Cancer? Deciphering the Propaganda of NCI's 33-Year War 

Genevieve K. Howe, Richard W. Clapp.  (First Published August 1, 2004)   

http://journals.sagepub.com/doi/10.2190/4ERA-540H-7U7C-PB3V 

World Cancer Research Fund: Data for Cancer Frequency by Country – 2012 

http://www.wcrf.org/int/cancer-facts-figures/data-cancer-frequency-country 

CDC Recommendations for Cancer Prevention (September 2016) 

https://www.cdc.gov/cancer/dcpc/prevention/index.htm 

National Cancer Institute – Cancer Causing Substances in the Environment (2015) 

https://www.cancer.gov/about-cancer/causes-prevention/risk/substances 

World Health Organization Fact Sheet – Environmental & Occupational Cancers (March 2011) 

http://www.who.int/mediacentre/factsheets/fs350/en/ 

World Health Organization Fact Sheet (February 2017) 

http://www.who.int/mediacentre/factsheets/fs297/en/ 

An American Sickness – Elisabeth Rosenthal (Penguin Press 2017) 

The Financial Management of Hospitals – Howard Berman & Lewis Weeks (Health Administration Press, 1982) 

The Cancer Drug Market Just Hit $100 Billion And Could Jump 50% In Four Years - Matthew Herper (Forbes Magazine, 2015) 

https://www.forbes.com/sites/matthewherper/2015/05/05/cancer-drug-sales-approach-100-billion-and-could-increase-50-by-2018/#336819232dc6

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