Skip to Main Content
Have library access? Log in through your library

Malignant: How Cancer Becomes Us

S. Lochlann Jain
Copyright Date: 2013
Edition: 1
Pages: 309
  • Cite this Item
  • Book Info
    Book Description:

    Nearly half of all Americans will be diagnosed with an invasive cancer-an all-too ordinary aspect of daily life. Through a powerful combination of cultural analysis and memoir, this stunningly original book explores why cancer remains so confounding, despite the billions of dollars spent in the search for a cure. Amidst furious debates over its causes and treatments, scientists generate reams of data-information that ultimately obscures as much as it clarifies. Award-winning anthropologist Lochlann Jain deftly unscrambles the high stakes of the resulting confusion. Expertly reading across a range of material that includes history, oncology, law, economics, and literature, Jain explains how a national culture that simultaneously aims to deny, profit from, and cure cancer entraps us in a state of paradox-one that makes the world of cancer virtually impossible to navigate for doctors, patients, caretakers, and policy makers alike. This chronicle, burning with urgency and substance leavened with brio and wit, offers a lucid guide to understanding and navigating the quicksand of uncertainty at the heart of cancer. Malignant vitally shifts the terms of an epic battle we have been losing for decades: the war on cancer.

    eISBN: 978-0-520-95682-7
    Subjects: Anthropology

Table of Contents

  1. Front Matter
    (pp. [i]-[viii])
  2. Table of Contents
    (pp. [ix]-[x])
  3. Introduction: We Just Don’t Know It Yet
    (pp. 1-26)

    I knew a woman who went to medical school because she wanted to be with people at critical, life-changing moments; she imagined that sharing dire information would create an intense mutual experience.

    My own decidedly undramatic life-changing moment took place in a tiny, somewhat battered office. The doctor flipped back and forth and back again among the three pages of the report she had received from my radiologist. As she fidgeted, I surveyed the posters on her office wall of Banff National Park, in the Canadian Rockies, where I had been hiking the previous day as I wound up a...

  4. CHAPTER 1 Living in Prognosis: The Firing Squad of Statistics
    (pp. 27-45)

    After receiving my pathology report and full diagnosis, I found a set of prognostic charts in my burgeoning cancer library. Each listed the survival chances for a variety of subtypes of cancer. The left column specified tumor size (<1 cm, 2–3 cm, 3–5 cm, >5 cm), and the horizontal lined up the number of positive lymph nodes. Each box in the chart contained a number, such that the reader could correlate the characteristics of his cancer to the likelihood that he would be around in five, ten, fifteen, and twenty years. Ironically, no matter how hard I stared...

  5. CHAPTER 2 Poker Face: Gaming a Lifespan
    (pp. 46-66)

    When my partner’s sister showed up at our house all bald after her chemotherapy, I demonstrated my unvarnished social aptitude with the ridiculous joke, “Hey, you could totally be a lesbian!” I had picked up the culture of stigma, and this prevented me from genuinely recognizing her, even a few years later as she sat in a wheelchair shortly before her death. When my cousin Elise was undergoing chemotherapy treatment while in her early thirties, I couldn’t even mention cancer, couldn’t (wouldn’t, didn’t) say I was sorry or ask her how she was doing—even though it was so obviously...

  6. CHAPTER 3 Cancer Butch: Trip Up the Fast Lane
    (pp. 67-87)

    I didn’t set out to test-drive a sports car. Commuting one morning in my work-a-day Honda Civic, I noticed rows of BMWs and a huge banner inviting me to Come and drive one! Raise money for breast cancer! I screeched into a U-turn: I had always wanted to try out a BMW roadster. The showroom, decked out with pink roses, ribbons, helium balloons, and a huge array of finger foods donated by Whole Foods, reminded me of a movie star’s funeral, only the centerpiece was a BMW 3 Series instead of a coffin. That car would spend the summer purring...

  7. CHAPTER 4 Lost Chance: Medical Mistakes
    (pp. 88-111)

    Mike sat at the bar telling me about the blow job he insisted on every two days from his partner, a Hollywood agent about whom he was also writing a book. Reading numerous textbooks on personal injury law for the book I’d written on the subject still left me ill-prepared for my experience that afternoon: my lawyer going into increasingly drunken detail about his life in bed and in elevators. Some people love sex stories, but by then I had already heard far too much. The timing was just off. Still, it didn’t feel right to prudishly cut off the...

  8. CHAPTER 5 The Mortality Effect: The Future in Cancer Trials
    (pp. 112-127)

    What happens if I get a placebo in the trial but later the medication is shown to work? This question appeared in a pamphlet designed to recruit people suffering from late-stage kidney cancer to participate in a trial. It echoes a key anxiety in the decision to join a trial: What if I don’t get the better treatment? The answer: “If the study shows TroVax® prolongs survival and you received the placebo, you will be given the opportunity to be treated with TroVax®, following regulatory approval.”¹

    The pamphlet doesn’t mention that regulatory approval may take years, even decades. A person...

  9. CHAPTER 6 Inconceivable: Where IVF Goes Bad
    (pp. 128-150)

    As I sat in my cancer group wondering if it would be rude to reach across the coffee table for yet another scone clumped with clotted cream and strawberry jam, one of the women began talking about egg donation. In our meetings we take turns speaking about anything that happens to come up—treatment options, relationships, children, drugs, side-effects. That week, an informal tally of our smaller-than-usual group revealed that two women had been egg donors and two others had taken fertility drugs. Granted, the tiny gathering skewed 100 percent toward those with cancer. But research of any kind starts...

  10. CHAPTER 7 Can Sir: What Screening Doesn’t Do
    (pp. 151-178)

    Grab your wellies: at least one guidebook recommends the large intestine as a pleasant, if mucky, place for an afternoon stroll. The Prevent Cancer Foundation’s “Prevent Cancer Super Colon™,” an eight-foot-high, twenty-foot-long replica of the human colon, slinks around the country with this inviting offer, while reducing the indignity of cancer symptoms by making the colon our friend. The Super Colon campaign aims to reduce the number of people who literally die of embarrassment, too ashamed to speak of the symptoms of “below the waist” cancers.¹ Another awkward one, testicular cancer, remains the largest cancer killer of guys between the...

  11. CHAPTER 8 Fallout: Minuets in the Key of Fear
    (pp. 179-201)

    Have you ever wondered why the phrase “You’re the bomb” offers a slangy compliment, whereas “You are the gas chamber” would not go over well in a romantic situation? (Clearly, I have.) This translation of nuclear imagery into benign, even sexy, language is not uncommon. When the word bikini crops up, most Americans think of the swimsuit rather than radiation sickness. Though perhaps not the intent in naming the bathing suit, it would be difficult to think of a better way to diminish the significance of the Bikini Atoll’s annihilation by the twenty-three nuclear tests carried out on the South...

  12. CHAPTER 9 Rubble: Bakelite Bodies
    (pp. 202-214)

    Whenever I move house, around midnight on the final day of the lease I end up with a little pile of things in the middle of my furnitureless place, things that don’t really belong in any of the labeled boxes and yet that don’t quite seem like trash: a jar of pennies, a Niagara Falls keychain, a sentimental Christmas ornament.

    After my cancer treatment, as I packed up to leave my parents’ home, the dreaded mound accumulated in my closet. In this case, I had bottles of pills I could sell on the street for hundreds of dollars. I had...

  13. Conclusion: Shameless
    (pp. 215-224)

    Several years ago, well before my diagnosis, my family visited the Commonweal Center in Bolinas, California. My mother, a physician, wanted to find out more about the cancer therapies used at the famous retreat center. My family commonly undertook such medical expeditions; years ago we visited the barracks in Hawaii where lepers had been sent until Hansen’s disease largely disappeared in the 1940s. There, too, we wandered amid the sheer natural beauty, though the cliffs and ocean had served as prison bars rather than comfort for those who had been sent there. I enjoyed the novelty and splendor of Bolinas...

  14. Acknowledgments
    (pp. 225-228)
  15. Notes
    (pp. 229-282)
  16. Index
    (pp. 283-290)