Tuesday, August 09, 2005

August 2005 cancer tests

Blood Tests:
AFP 2.8 (normal is less than 10)
betaHCG 0 (normal is less than 5)

Chest X-Ray:
Findings:
Heart: Normal
Mediastinum and Hila: Normal, No hilar enlargement
Lungs: Normal
Pleural Spaces: Normal
Bones: Mild spondylosis
Impression:
No radiographic evidence of acute cardiopulmonary or metastatic disease.

The spondylosis is new, had to look that one up. According to the google search it is "degeneration of the disc spaces between the vertebrae", so it's always some damn thing. Apparently some of this is normal due to advancing age and I can't find any link to it and cancer. The main thing is that I need to lose weight, but I knew that already.

Monday, August 01, 2005

Lance Armstrong

Finally, an article that breaks through the hype, from the Chicago Tribune:

After taking home his seventh consecutive Tour de France title July 24, Lance Armstrong is being hailed, justifiably, as a sports legend. Scores of American fans who've scarcely watched and barely understand the sport of cycling will utter his name in reverent tones and don the ubiquitous yellow bracelets in a show of adoration for their idol.

Of course, Lance mania has everything to do with his iconic status as cancer survivor, and little to do with his tenacious competitiveness, brilliance as a tactician, or staggering athletic ability. If Levi Leipheimer were returning with the yellow jersey, there'd be hardly a ripple in the public consciousness. Beyond serving as crusading voice on cancer issues, Armstrong has become a symbolic emblem of hope to millions, a figure one newspaper referred to as "St. Lance."

Yet Armstrong's public persona as cancer vanquisher may, paradoxically, prove a far more questionable component of his legacy than common wisdom would have it. As someone who, like Armstrong, received a diagnosis of testicular cancer in my early adulthood and was treated at the same facility and by many of the same doctors, I am sensitive to the enormous waves of goodwill toward him that sweep through the world of cancer survivors and beyond. But I also harbor a number of serious reservations--not regarding Armstrong himself, but the myth that has risen around him.

The fundamental message conveyed by the Armstrong image machine--in pharmaceutical and automobile ads, in media coverage, in the work of Armstrong's non-profit foundation--is that if you will it, you can do it. Whether it's beating cancer or winning the Tour de France, the right attitude, the proper measure of confidence, will make you victorious. When it comes to cancer, however, this philosophy is dubious and misleading.

It's worth pointing out first that Armstrong's very history as a cancer patient is an object lesson in how not to behave. As he painfully details in his best-selling autobiography, "It's Not About the Bike: My Journey Back to Life," his tough-guy athletic ethos caused him to ignore all the warning signs that there was something seriously wrong with him. He was spitting blood, with a testicle the size of an orange, before he finally turned to someone for help. A healthy dose of humility, rather than an I-am-the-king-of-the-world mentality, is in some ways a far more sensible prescription for someone facing cancer. When I go into Chicago-area high schools for a program to teach teenage boys about warning signs and prevention techniques for testicular cancer, one of the first things I tell them is, "Don't be like Lance."

Other details of Armstrong's story further undermine his representative status. To begin with, testicular cancer is one of the most curable of cancers, typically achieving cure rates of higher than 95 percent, even for Stage II patients. Other cancers do far worse. Comparably staged cancers of the cervix and lung carry five-year survival rates of only 53 percent and 16 percent, respectively, according to the American Cancer Society. In other words, Armstrong was "fortunate" in contracting one of the most treatable forms of cancer. Entering treatment with the physiology of a world-class athlete was a further advantage that few other cancer patients possess.

If Armstrong's situation was in fact quite unique, his story has been spun into a morality tale for everyone. Armstrong has seemingly ushered in a reversal of the image of the cancer victim: from the disgraced, concealed figure that Susan Sontag wrote about nearly 30 years ago in her classic "Illness as Metaphor" to the image of the heroic survivor, of which Armstrong is the leading icon. Yes, I'll take being identified with a jock over being viewed as a leper any day, but there are complications that accompany this cultural transformation.

First, most of us who live with cancer and its aftermath aren't heroes, or champions of anything. We just want to get back to our ordinary lives as students, workers or parents. The heroic ideal sets standards that few of us can meet. The model of the heroic cancer fighter sits even more uneasily in light of the millions of Americans suffering from terminal forms of cancer: Are they deficient in resolve, resilience or courage because their disease ultimately conquers them? Is it their own fault that they die?

In short, there is a disturbing undercurrent to the valorization of the cancer victim that leads us actually to avert our glances from the fact of death that lies at the heart of the disease. Is this new cultural figure merely a recasting of the metaphorical shunning of cancer that Sontag exposed, a way for Americans to avoid dealing with darkness, disfigurement and death? Take note of the medical-pharmaceutical industry's emphasis on the theme of hope. Do we see in this trend another version of the current administration's policy of trying to prevent Americans from witnessing the coffins and bodies of their country's war dead?

The yellow Livestrong wristbands, sold by the Lance Armstrong Foundation, epitomize this phenomenon of deflection. Ostensibly signifying support for cancer survivors, the real meaning of these bracelets is establishing a certain hip credibility. As Rob Walker wrote in The New York Times Magazine last year, the bracelets associate their wearer with "a heroic athlete at the height of his popularity." The supposedly inspirational credo for cancer victims to live with determination becomes a weakened, generalized shout-out to everyone to work out a little harder in your next spinning session.

I've never worn the yellow band, or marched in a walk for cancer survivors, or joined a cancer survivors' support group. What I do wear proudly is a thick, pinkish scar that descends about 8 inches starting at my mid-abdomen. It's been on display recently at my local pool, where I engage in the everyday act of being a dad to my two young kids.

If I could be so bold as to offer a suggestion to the reigning Tour de France champion, I would say to Armstrong: Take off the superhero mantle, and learn how glorious ordinary life can be. That kind of normalcy is the true goal for most of us living in the aftermath of cancer.