A Multiplicity of Needs: Prevent, Detect Early, Support, Cure

When we examine campaigns focused on breast cancer ‘awareness’ or ‘raising funds for the cure,’ we also need to acknowledge the complex set of needs involved when it comes to talking about campaigns surrounding cancer. I fear that some of these campaigns only focus on one facet, ignoring others, and as a result, they are sometimes alienating or not very productive.

In an ideal world, we would simply prevent all cases of cancer. If cancer doesn’t happen, then anything else isn’t really necessary. Full cancer prevention may never be possible. While we know a lot about contributing factors to cancer and can address issues like hazardous pollution, sometimes cancer just happens. Or it’s the result of an unrelated medical treatment someone needed to live. This doesn’t mean we should give up on prevention efforts, but it does mean prevention can’t be our sole focus. By all means, we should continue to research causes of cancer and to address obvious issues, known contributors to cancer in the population.

The next step in the logical progression is early detection. The earlier a cancer is found, the easier it is to treat, and the better the prognosis for the patient. Early detection is something a lot of organisations are working on, from providing low-cost and free screening services in low income communities to establishing protocols to get at-risk populations screened regularly to catch cancers early. These efforts, based on the idea that complete prevention is impossible, are a realistic approach to fighting cancer. You can’t stop it from happening, but you can attack it before it becomes monstrous.

Providing support for early detection of cancers requires a lot of funding as well as community outreach and education. What works in one community will not necessarily be as effective in another, and populations have varying levels of comfort with programs for early detection. Designing programs tailored to specific populations is critical, as is addressing factors that hinder access to such programs, like geography, poverty, race.

Cancer treatment is a complex and multifaceted topic, but one thing that does not get nearly enough attention is the support needed by cancer patients in treatment. People with cancer need help. This can range from help paying for treatments to the need for assistance with completing daily tasks. And cancer patients themselves are often left out of cancer ‘awareness’ campaigns. There’s a heavy focus on prevention, a heavy focus on ‘doing something for the cure,’ and on survivors, but people actually in need right now, people who have been diagnosed with cancer, often get left out of the dynamics.

I’ve harped on it in this series because it’s important. People with cancer do not get enough support, which is saying something when you consider the fact that cancer is a very media-friendly disease and people with other types of chronic illnesses and disabilities get no support at all. Friends and family tend to rally around them initially, but then they drift away over the course of the long haul. Attitudes about how cancer treatment works means that people are asked when their treatment will be ‘done,’ why it isn’t ‘over yet,’ why, even though they are not in treatment, they still aren’t capable of working or maintaining friendships or doing other things society expects of them.

Support for cancer patients can take a lot of forms, and every patient has different needs. Centring patients in these conversations would be a good way to start. If we are interested in fighting cancer, why not talk to the people on the front lines? Creating support networks for people is something that tends to happen on a community level, which is natural, but I don’t see a lot of these big ‘do something about cancer’ organisations telling people to find such networks in their communities and offer assistance. Some campaigns do help cancer patients with everything from housing to accessing clinical trials, which is excellent, but it’s often hard to find information about these programs, almost as though they want to hide them.

There’s a certain aspect of competition here, it feels like. These groups want your money and they say they will use it in the best and most effective way, but that might not always be the case, and there might be community-based things that would have a more immediate impact. Whether that’s a cancer resource centre or a research study or a program for early diagnosis and treatment.

And, of course, the eternal quest for the ‘cure,’ complicated by the fact that cancer is not something simple, it’s a moving, constantly shifting target and there is no way to develop a single method for attacking it. We can develop methods of chipping away at it, of targeting specific cancers, but there will always be more, always be something else. The focus on the ‘cure’ as the holy grail seems, to me, a little bit misguided. Targeting cancer as something that can be treated, something we need better treatments for, seems more realistic than demanding a ‘cure’ we can never actually achieve, especially when the lobbying for the ‘cure’ comes at the cost of providing support to people with cancer right now.

No one organisation can be all things to all people. I don’t think it would be reasonable to expect organisations working on cancer to address every single issue related to cancer, it’s simply not possible. But I do think we can ask for a more interconnected network of organisations, each focusing on different facets of the issue and each supporting the other rather than regarding it as competition. As it is now, it seems like a handful of big names compete for huge amounts of money and it’s not really clear, necessarily, where that money goes and what it does and how it will be used. Creating different organisations to target different topics and explicitly interconnecting those groups might be a better and less adversarial way to approach the problem.