Wednesday 28 September 2016

Not only is cancer a lot more treatable, we can talk about it

Published 18/01/2016 | 02:30

Jackie Collins did not reveal that she had been suffering from cancer until shortly before her death Photo: John Donegan/ABC
Jackie Collins did not reveal that she had been suffering from cancer until shortly before her death Photo: John Donegan/ABC

So, two high-profile deaths within the space of a week; the much-lamented David Bowie, and the widely mourned Alan Rickman (who, among other achievements, produced the best screen interpretation of Eamon de Valera, with a peerless Clare-Limerick accent, in 'Michael Collins').

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Both were 69 and both, it was announced, died from cancer: Bowie from liver cancer, Rickman from cancer of the pancreas.

changes in public attitudes to cancer have been striking over the course of my working life. It was once the great unmentionable.

When I was a young reporter in Fleet Street in the late 1960s, we were forbidden to print the word. It was believed to be indelicate, that it would upset readers, and some even thought, irrationally, that it was unlucky. Cancer wasn't stigmatised, as TB had been - since tuberculosis was so highly infectious - but it was feared, as 'the Big C'. So cause of death was often veiled.

When King George VI, father of the present Queen Elizabeth, died from lung cancer in 1952, it was not openly referred to at the time. When his brother, the abdicated Edward VIII, Duke of Windsor, died in 1972, also from cancer, neither was that made known.

We are much more open about discussing cancer today, partly because we are less private in general, and partly because so much progress has been made in the treatment of the illness that it is no longer an automatic death sentence. People make very good recoveries from cancer and can live in remission for many years. (One of my oldest friends had an aggressive form of breast cancer in 1993. She is today hale and hearty and enjoying life to the full.) Great strides have been made in the treatment of the malady.

There is more campaigning to detect cancer and get an early diagnosis and treatment. And the boffins who are doing medical research realise that public awareness is vital to raise funds - Daffodil Day, which is coming up, is a vital contribution to cancer research.

'Cancer diaries' help people understand the illness much better - Emily Hourican's weekly cancer diary in the 'Sunday Independent' has been brave, inspiring and empathetic. One in four of us will get cancer, so it is right that we should be informed about it and identify with cancer patients.

And yet, for all the openness about cancer now, some people prefer to keep their diagnosis private. David Bowie felt that he just wanted to focus fully on his creative work, without public fuss over his illness; and he made the opening of Enda Walsh's 'Lazarus' on December 7, just a month before he died.

By the same token, the author Jackie Collins chose to not to reveal until just before she died that she had been suffering from breast cancer for six years. She told her sister Joan that she had lost weight because of a new Californian diet.

Jackie said she really wanted to concentrate on her writing and discussing her cancer openly would have been a distraction. She got six books written over the course of her treatment.

By contrast, Clive James has been very public about his leukaemia (as well as having COPD, chronic obstructive pulmonary disease). Indeed, since announcing that the Grim Reaper was waiting for him in the wings, he has written and published some of the best poetry ever penned about saying goodbye to this world. And month after month, he produces more verse of beautiful reflections on life's passing.

The BBC's political editor, Nick Robinson, has also been completely open about his lung cancer - not only announcing it, but disclosing that it turned out to be worse than originally diagnosed. But he got the treatment and is now back on the airwaves.

For some people in the performing arts, there can be an anxiety about insurance; actors are insured against illness and emergency and a cancer diagnosis can affect the premiums - and the risks producers are willing to take.

The screen writer and director Nora Ephron feared that she would lose work in Hollywood if she spoke about her myeloid leukaemia. Dame Maggie Smith, however, was quite candid about taking a break from her career to have treatment for breast cancer; she bounced back and into 'Downton Abbey', a role in which she had more global success than ever before.

It is clearly up to each individual whether they want to make their illness public or keep it private. I thought it was honest, and responsible, of the late Brian Lenihan to speak about his diagnosis of pancreatic cancer - a Finance Minister's health may indeed be a matter of justified public interest. (It is disconcerting, however, to learn that in the United States patients survive pancreatic cancer five times longer than on this side of the Atlantic. Surely this is a cause for some medical investigation).

But cancer patients do have a choice now as to whether they wish to make their illness known or keep the matter private. Being open about an illness is admirable, but candour shouldn't mean that all personal privacy is abolished. Yet at least, people are not forced to conceal it from a sense of misplaced prudishness or fear of eliciting fear in others.

Irish Independent

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