A yearlong odyssey into the world of cancer a while ago made me reluctant to devote much time to reading about the illnesses of others.
But George Johnson’s “The Cancer Chronicles: Unlocking Medicine’s Deepest Mystery” drew me back into the chaotic realm of homicidal cells, starting with his drive along the Dinosaur Diamond Prehistoric Highway in western Colorado.
Once this area was filled with frolicking saurians who ate each other and then died out, leaving only the tiniest traces for the paleo-oncologist.
Tissue decomposes, bones disintegrate. Even so, evidence is mounting that cancer has been around since the early days. The Hadrosaurus, for instance, seems to have had a genetic disposition for tumors near the end of its spine.
Why? Was it a plant the creature dined on? Or perhaps X-rays from outer space that damaged its DNA? (This might support a theory that cosmic rays killed off the dinosaurs.)
A science writer for the New York Times and other publications and the author of several books including “In the Palaces of Memory,” an intriguing road map through the brain, Johnson writes with imaginative flair about the whole range of the cancer experience, from nutritional puzzles, clinical trials and wounds that do not heal to the endlessly complex ways a cell can create “something alien inside you.”
A teratoma, perhaps, a monstrous clump of cysts that on occasion might feature a single eye.
For several years, Johnson immersed himself in everything ever published or uttered at symposia where scientists, doctors and paleontologists ponder the mysteries of malignant cells.
He was prompted not by a cancer of his own but that of his wife, Nancy, who was 43 at the time she felt a lump on the right side of her groin.
“She lived to tell the tale,” he writes, “but ever since, I have been wondering how a single cell minding its own business can transmogrify into a science fiction alien, a monster growing within.”
An eight-hour surgery -- a modified radical hysterectomy -- removed fallopian tubes, ovaries and uterus, where a tumor had eaten three millimeters deep into the endometrial lining and started spreading.
To the usual question Why me? there wasn’t a single answer. Nancy wasn’t too tall at 5’3,” ate a lot of greens and exercised. Taller people have a higher rate of cancer. Diet, environment, geography play roles, though how much is uncertain. Pulling out his calculator, Johnson runs some surprising numbers for risky behavior.
What to Do?
Chance ultimately determines whether you end up hooked to a poison drip for hours on end at Christmas. With good luck and good doctors you might choose the right radiation treatment when oncologists present you with alternatives. In Nancy’s case, the two of them decided on the most ferocious counterattack possible: total pelvic radiation, which might however weaken her for future treatment.
It doesn’t seem she will require any. She beat the odds and after five years felt confident enough to indulge her childhood dream of having a horse and small property outside Santa Fe. The place turned out to be infested with tumbleweed, a plant with a nightmarish ability to survive hacking, poisoning, burning.
A metastasizing plant! They dragged huge garbage bags filled with roots to the dump, only to see surviving seedlings lurking by fence posts and rocks.
Apparently the little freaks are still popping up all over, though Johnson isn’t around to witness their triumph. There’s a surprise toward the end of the chronicle: His wife has departed. Johnson writes calmly about her decision to separate, though it was clearly a blow to which many will relate.
More than 60 percent of all couples drift apart when one partner becomes sick. The stress of the treatment, the confrontation with mortality, unpleasant physical changes and the fear of lingering too long (or watching someone who is) make people retreat in different ways.
My own partner of 20 years, a Christian Scientist, disappeared via e-mail the week I had another scary work-up at Memorial Sloan-Kettering Cancer Center (which ultimately turned out well).
In talking to doctors and friends who have returned to health missing body parts and partners, I realized how easily the narcissistic impulse can overcome any moral scruples. You learn a lot about people.
Like Nancy, I too ended up buying a horse and expanding a small farm with friends, rescuing some 50 creatures, including pigs, goats, a mule, a turkey and chickens. Riding is amazingly therapeutic: You’re in a landscape that cares little about you, but still offers soothing beauty if you really look outside yourself.
“The Cancer Chronicles” continues with a phone call from Johnson’s youngest brother, Joe. A squamous cell carcinoma about an inch long was growing inside his mouth and causing intense pain. By the time doctors cut it out, the tumor had more than doubled in size and seemed to have a life of its own.
Joe’s story ends with doctors futilely chasing new tumors around his jaw and neck. Johnson, pensive but never maudlin, is left pondering his own body and its 10 trillion secretive cells.
“It is eerie to think that inside each one -- invisible to the eye -- so much is happening,” he writes.
“The Cancer Chronicles” is published by Knopf (284 pages, $27.95). To buy this book in North America, click here.
(Manuela Hoelterhoff is executive editor of Muse, the arts and leisure section of Bloomberg News. All opinions are her own.)
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