The Curious Case of Cancer's Comic Timing

Oh, Cancer, sometimes you're so funny.

People seem to enjoy anthropomorphizing cancer and its effects. We hear terms like battling, fighting, surviving, as though cancer has an actual objective. We give cancer all these human traits, treat it like an actual villain, and yet fail to appreciate it's subtle sense of humor.

One might almost suggest that Mr. Cancer is a droll fellow, with quite a dry sensibility, though I might stop short of calling it farcical.

Exhibit One: The Diagnosis

More and more commonly, young, healthy people with no known risk factors are being diagnosed with advanced lung cancer. After decades of being sold the narrative that lung cancer is caused either by smoking or working with asbestos, it has come to light that there has been a huge uptick in patients with Stage IV disease who had no obvious exposure risk.

"Irony" is defined as a state of affairs that seems deliberately contrary to what one expects. As one of the most prevalent forms of literary humor, it translates well to stand-up when the audience is in on the joke. By now, I expect that most people have been indoctrinated into the idea that lung cancer is a smoker's disease. I have even had nurses express to me, upon learning my lack of a smoking history, about how tragic my diagnosis is (as though it would have been less tragic if I actually deserved it, which is its own special kind of joke).

Comedy is, as Mark Twain supposedly put it, simply Tragedy plus Time. Thus, as we move forward from the diagnosis and into treatment, the opportunities for humor continue to expand.

Exhibit Two: The Side-Effects

Cancer treatment can go on and on for a very long time. Sadly, there are many patients who do not benefit from this long slog into comic territory. With an average of 433 lung cancer patients dying every day in the United States, receiving another few months or years might seem like an amazing gift. For advanced, metastatic lung cancer, more and more patients are able to live with their disease as a managed condition. To do this, however, often means leapfrogging treatments over the years.

Skipping from one slippery stone to another, never quite sure if the footing will hold or for how long, makes this an endless balancing act over a choppy river. While the patient may feel like a clown with all the hoops that must be jumped through, the slapstick is outweighed by an underlying sardonic sensibility from some omniscient narrator.

It is dark humor, to be sure. Just as a patient adjusts to one set of side-effects, word comes down that the treatment is no longer working. Two years of stasis have turned into progression. No evidence of disease turns into recurrence just as the patient begins to relax. A previously placid tumor turns aggressive just when everyone was expecting remission.

Side effects replace other side effects replace other side effects. Just as one clears up a new one surfaces in its place. Medicine becomes a juggling act. The whole darn thing is at minimum a three-ring circus.

Cancer is a comedian

So you talk of cancer like it is an enemy force, like it is waging a war. But I see cancer as a comedian. Sometimes it might be smashing watermelons with a hammer, leaving much of the audience shaking their heads and wondering just what is supposed to be funny about that. I'm not saying that cancer is even a good comedian -- heck, it really does have to work on its timing. But if I am going to give a personality to something living inside of my body, I am going to give it the benefit of the doubt. It might bomb on opening night, but at least it's trying.

Now to get those overripe tomatoes ready to throw at the stage...

Editor’s Note: We are extremely saddened to say that on October 21, 2018, Jeffrey Poehlmann passed away. Jeffrey’s advocacy efforts and writing continue to reach many. He will be deeply missed.