Cancer is Social

Cancer is the best death, apparently. As a medical practitioner and former editor of the British Medical Journal, one supposes Dr Richard Smith knows what he's talking about. His argument is almost philosophical, making the case that a long descent into the grave allows for the wrapping up of one's personal affairs and prepares friends and family for life after you. Considered in isolation from the traumatic experiences this disease causes millions of people every year, I suppose there's a certain logic to it. Though I'm not too sure about "wasting" billions on curing cancer. The pharmaceutical industry and its doings are far from unproblematic, but the war against disease is a good war. It should be up to individuals when to call it a day after all.

Published simultaneously was a study claiming that the majority (two thirds) of adult cancers are the results of bad luck. You have wonky genes, or one of your stem cells might slip up somewhere. It is, however, worth noting that we're talking *types of cancer* here, not cancers in total.

As Owen points out, cancer - like a great deal of disease - has been individuated. The rise of lifestylism and the markets that feed it are constantly reinforcing the message that health is a matter of personal responsibility. If you don't want cancer, then eat well, do your exercise, and avoid smoking, boozing, and fatty foods. Treat your body like a holy shrine, not a drip tray catching the run off from a revolving hunk of doner meat. That's the hegemonic set of ideas washing about health policy, public health discourses and the common sense of lifestyle gurus. Contrasting the biologically random chance of cancer puts paid to some of the guilt tripping this industry, for that is what it is, thrives on. That, however, only goes so far. Cancer is social.

Take Stoke-on-Trent, for example. According to the 2012 Public Health Report for the city, it is the 16th most deprived local authority area in England (out of a possible 326). 60.3% of people live in areas among the top 25% most impoverished areas in the country. About half of that (31.3% of total Stokies) lived in the top ten per cent of most deprived communities. In 2008-10, the life expectancy for men in Stoke was 76.2 and women 80.2, whereas for England as a whole it was 78.8 and 82.6 respectively. Of the main causes of death in 2011, 72.9% was made up of respiratory disease, circulatory disease, and the biggest was ... cancer. It accounted for 31.7% of total mortality across the city. The equivalent figure for England is 28.1%. Among the under-75s, the average cancer mortality rate per 100,000 was 141.6. A historic low, but significantly greater than the same statistic for the country as a whole (112.5). There's considerable variation within the city too. In Meir Park ward the rate was 78.4 whereas Bentilee and Ubberley returned a figure 0f 191.8. The difference? Wealth. If you live in a wealthier area, you're a third more likely to survive a cancer diagnosis.

As befits the age, the story our culture tells about cancer is one of individuals battling against the disease, as per Stephen Sutton, or folks rallying around to to raise awareness. What it refuses to talk about the bigger picture, how diagnosis and survival is very much linked to one's material circumstances. The danger is talk of cancer being entirely random disappears the awful truth: that regardless of type it is mediated by social conditions. That makes the war on cancer more than just a medical matter. It's a political question too.