Oncology. Is one of those words which in later life strikes fear at the dinner table as you reveal you have an appointment to see an oncologist later in the month. As with most of the medical industry the industry is divided into specialists, of which the treatment of cancer is the oncologist speciality.
Cancer that word which stokes apprehension in most of us, the silent killer, the disease which unlike most other diseases, we can take some measures to protect ourselves, cancer creeps up from behind, unseen, an out of control mutation of cells set in amongst the normal mutations which have been a part of our growth since we were conceived.
What causes the rogue mutation is unclear but the normal multiplication of cells, essential to life's process, is, like an unruly child in the playground, disruptive to all around, causing mayhem and eventually creating the complete breakdown of any sense of cell cohesion.
Untreated cancer leads to death. Initially the patient knows nothing of his or her condition, the problem is often picked up by a random blood test for something else and it's this hidden aspect which makes cancer so feared and especially the treatment, which is often so radical that the cure seems is as bad as the disease itself.
Embarking on a cure for something you can not feel, of which there are few if any symptoms, but knowing that the side effects of a cure are so dramatic they can change your life for the worse seems counter intuitive especially when there is no apparent substance to the medical prognosis.
Death at a certain stage in our lives reveals itself in many forms and the inevitability of death only dawns as one grows older. Like a passage from Methuselah, it won't go on for ever no matter how rapped up we are in our own lives, our stay on earth is time limited.
It's one of life's conundrums of course how narcissistic we are in our assumptions, how special we view ourselves when in reality our lives set against the totality of what is going on is but a tiny blip in time and our importance, minuscule in the cause of the thing we call evolution.
Cancer rarely appears on the death certificate, death is usually described as a result of a major organ failure but cancer is often at the root of the cause of other organs ceasing to work, that delicate balance which goes on in our bodies each day, each second of each day, the trials of the immune systems fight with the germs and the viruses is a marvel of ingenuity which we take for granted.
A fever, a headache, a cough, a pain, are all the outward indicators that the bodies immune system is at work finding a cure but the cure for cancer is beyond it, since in some ways, it is one and the same thing the elemental cell replacement system that has gone AWOL.
The oncologist has the unappealing job of trying to manage this breakdown of one of the fundamental aspects of life. They fight an up hill battle to stem the tide, like Canute, watching the tide roll in and willing it to stop is not enough.
Years ago I was working in Leicester Hospital on the Oncology Ward and asked one of the nurses how they dealt with the strain of watching patients, patients who one had talked to the previous day but who had died in the night. There was nothing to reveal their plight and I wondered how the nurses could be so bright and supportive each day knowing that the outcome was often negative. "It's we the living who must carry on" was the answer, "we carry the hope for the ones we care for and provide the optimism, even amongst the dying".
And so we are faced with a dilemma those of us diagnosed with cancer. To be optimistic and let the medical profession do what they think best, often only palliative until a cure or a new technology is developed to keep the scourge at bay. In the meantime our stoicism keeps reminding us that death, as unpleasant as it is is, unrelenting in its clear out, is natures way of providing the optimism that youth and new life brings with it, new hope, that fundamental aspect of the homosapien.
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