Cancer, we now know, is a disease caused by the uncontrolled growth of a single cell. This growth is unleashed by mutations - changes in DNA that specifically affect genes that incite unlimited cell growth. In a normal cell, powerful genetic circuits regulate cell division and cell death. In a cancer cell, these circuits have been broken, unleashing a cell that cannot stop growing.
to live at the cost of our living. Cancer cells grow faster, adapt better. They are more perfect version of ourselves.
It was usually a matter of watching the tumor get bigger, and the patient, progressively smaller.
-John Laszlo-
To cure cancer (if it could be cured at all), doctors had only tow strategies: excising the tumor surgically or incinerating it with radiation - a choice between the hot ray and the cold knife.
In the airy ward of the Children's Hospital, doctors and patients fought their private battles against cancer. In the tunnels downstairs, Farber fought an even more private battle with his chemicals and experiments.
Now it is cancer's turn to be the disease that doesn't knock before it enters.
-Susan Sontag-
It is a disease of overproduction, of fulminant growth - growth unstoppable, growth tipped into the abyss of no control.
To confront cancer is to encounter a parallel species, one perhaps more adapted to survival than even we are.
invade, survive, and mestastasize. Every generation of cancer cells creates a small number of cells that is genetically different from its parents. When a chemotherapeutic drug or the immune system attacks cancer, mutant clones that can resist the attack grow out.
The genetic instability, like a perfect madness, only provides more impetus to generate mutant clones.
Imhotep, a great Egyptian physician who lived around 2625BC. (중략) "Therapy," he offered only a single sentence; "There is none."
karkinos, from the Greek word for "crab". The tumor, with its clutch of swollen blood vessels around it, reminded Hippocrates of a crab dug in the sand with its legs spread in a circle.
onkos, a mass or a load, or more commonly a burden.
The human body, Hippocrates proposed, was composed of four cardinal fluids called humors: blood, black bile, yellow bile, and phlegm. Each of these fluids had a unique color (red, black, yellow, and white), viscosity, and essential character. In the normal body, these four fluids were held in perfect, if somewhat precarious, balance. In illness, this balance was upset by the excess of one fluid.
For cancer, Galen reserved the most malevolent and disquieting of the four humors: black bile. (중략) You could cut cancer out, but the bile would flow right back, like sap seeping through the limbs of a tree.
In the winter of 1533, (중략) Without a map of human organs to guide them, surgeons were left to hack their way through the body like sailors sent to sea without a map - the blind leading the ill.
Pasteur had made a bold claim: the turbidity was caused by the growth of invisible microorganisms - bacteria.
using the word radical in the original Latin sense to mean "root"; he was uprooting cancer from its very source.
(재미있는 것은 화학에서 'radical'은 전자를 잃어 쌍을 이루지 못한 전자를 가지고 있어 반응성이 높은 매우 불완전한 원자나 분자를 일컫는다. 일반적을 라디칼은 발암물질이다. 같은 언어가 한 면에서는 치유를 목적으로 사용되고, 한 면에서는 병의 원인으로 사용되는 것이 흥미롭다.)
Marie Curie called the new element radium, from the Greek word for "light".
radiation produced cancers. The very effect of X-rays killing rapidly dividing cells - DNA damage - also created cancer-causing mutation in genes.
Cancer chemotherapy, consumed by its fiery obsession to obliterate the cancer cell, found its roots in the obverse logic: every poison might be a drug in disguise.
It was a snake-pit - only of cancer, a seething, immersed box coiled with illness, hope, and desperation.
Cancer, he insisted, was a total disease - an illness that gripped patients not just physically, but psychically, socially, and emotionally.
vincristine, amethopterin, mercaptopurine, and prednisone. VAMP.
Doctors are men who prescribe medicines of which they know little, to cure diseases of which they know less, in human beings of whom they know nothing.
-Voltaire-
Carl Sternberg, was looking through a microscope at a patient's glands when he found a peculiar series of cells staring back at him: giant, disorganized cells with cleaved, bilobed nuclei - "owl's eyes," as he described them, glaring sullenly out from the forests of lymph. (중략) These owl's eye cells were malignant lymphocytes,
As with radiation, cytotoxic chemotherapy would thus turn out to be a double-edges sword: cancer-curing on one hand, and cancer-causing on the other.
I am not opposed to optimism, but I am fearful of the kind that comes from self-delusion.
-Marvin Davis-
cancer chemotherapy
But the basic purpose is not to save that patient's particular life but to find means of saving the lives of others.
"When doctors say that the side effects are tolerable or acceptable, they are talking about life-threatening things."
I would rather be ashes than dust.
-Jack London-
Palliative care, the branch of medicine that focuses on symptom relief and comfort, had been perceived as the antimatter of cancer therapy, the negative to its positive, an admission of failure to its rhetoric of success. (중략)
Cecily Saunders. In the late 1940s, Saunders had tended to a Jewish refugee from warsaw dying of cancer in London. The man had left Saunders his life savings -L500- with a desire to be "a window in [her] home." As Saunders entered and explored the forsaken cancer wards of London's East End in the fifties, she began to decipher that cryptic request in a more visceral sense: she encountered terminally ill patients denied dignity, pain relief, and often even basic medical care - their lives confined, sometimes literally, to rooms without windows. These "hopeless" cases, Saunders found, had become the pariahs of oncology, unable to find any place in its rhetoric of battle and victory, and thus pushed, like useless, wounded soldiers, out of sight and mind. (중략)
If oncologists could not bring themselves to provide care for their terminally ill patients, she would leverage other specialists - psychiatrists, anesthesiologists, geriatricians, physical therapists, and neurologists - to help patients die painlessly and gracefully. (중략)
doctors were allergic to the smell of death. Death meant failure, defeat - their death, the death of medicine, the death of oncology.
Prevention is the Cure.
oral tabacco - could also cause lip, mouth, and throat cancer.
tar-stained bronchi and soot-blackened lungs.
Politicians were far more protective of the narrow interests of tobacco than of the broad interest of public health.
The lag time between tobacco exposure and lung cancer is nearly three decades, and the lung cancer epidemic in America will have an afterlife long after smoking incidence has dropped.
An ebullient, immaculately dressed young advertising executive who first started smoking to calm his nerves had to have his jaw bone sliced off to remove an invasive tongue cancer.
(과거의 담배의 유해성에 관한 논쟁에 있어서의 정치적 비호가 있었던 것처럼, 현대의 발암원인에 대한 정치적 침묵이 있는 것이 아닐까 의심한다. 암, 불임, 등에 전자파의 기여가 아직 확실히 규명되지 않은 상황에서 일상에 너무도 깊이 침투한 셀폰, 블루투스, 무선통신망, 컴퓨터 등의 사용과 그 기업의 거대함이 과거 담배 회사의 그것과 너무도 비슷하다. 아마도 백년 정도 지나 전자파의 유해가 확실히 밝혀지고 나서야 지금의 무지함/무관심함이 드러나지 않을까 싶다.
나노Nano-도 마찬가지이다. 표면적이 넓어진 나노 물질은 작은 양으로도 극대화된 효과를 갖는다. 그러다면 지금 밝혀지지 않는 유해성이 작용할 수 있는 가능성도 극대화하는 것이다. 또한, 나노 오염이 되었을 때, 흡입하거나 피부에 닿거나 환경으로 흘러들어갔을때, 이 물질을 회수하거나 정화하는 것은 거의 통제 불가능하다. 만약 나노로 사용하고 있는 물질중 몇가지가 발암물질이라면 인간 스스로 암을 극대화된 효과로 조장하고 있는 것이라는 생각.)
Cancer therapy is like beating the dong with a stick to get rid of his fleas.
-Anna Deavere Smith -
"Left to myself, I would not event try. I'm doing this because of the kids."
Hippocrates tells us, "and life is short; opportunity fleeting' the experiment perilous; judgement flawed."
A Distorted Version of Our Normal Selves.
These leukemia cells have come into my laboratory from the National Cancer Institute, where they were grown and studied for nearly three decades. (중략) The cells, technically speaking, are immortal. The woman from whose body they were once taken has been dead for thirty years.
Cancer was not disorganized chromosomal chaos. It was organized chromosomal chaos: specific and identical mutations existed in particular forms of cancer.
In his book Invisible Cities, Italo Calvino describes a fictional metropolis in which every relationship between one household and the next is denoted by a piece of colored string stretched between the two houses. As the metropolis grows, the mesh of strings thickens and the individual houses blur away. In the end, Calvino's city becomes no more than an interwoven network of colored strings.
"Survivors look back and see omens, messages they missed."
The landscape of carcinogens is not static either. We are chemical apes: having discovered the capacity to extract, purify, and react molecules to produce new and wondrous molecules, we have begun to spin a new chemical universe around ourselves. Our bodies, our cell, our genes are thus being immersed and reimmersed in a changing flux of molecules - pesticides, pharmaceutical drugs, plastics, cosmetics, estrogens, food products, hormones, even novel forms of physical impulses, such as radiation and magnetism. Some of these, inevitably, will be carcinogenic. We cannot wish this world away; our task, then, is to sift through it vigilantly to discriminate bona fide carcinogens from innocent and useful bystanders.
In 500 BC, in her own court, Atossa self-prescribes the most primitive form of a mastectomy, which is performed by her Greek slave. Tow hundred years later, in Thrace, Hippocrates identifies her tumor as a karkinos, thus giving her illness a name that will ring through its future. Claudius Galen, in AD 168, hypothesizes a universal cause: a systemic overdose of black bile - trapped melancholia boiling out as a tumor.
The Greeks used an evocative word to describe tumors, onkos, meaning "mass" and "burden".
But if one looks back even further behind the Greek to the ancestral Indo-European language, the etymology of the word onkos changes. Onkos arises from the ancient word nek. And nek, unlike the static onkos, is the active form of the world load. It means to carry, to move the burden from one place to the next, to bear something across a long distance and bring it to a new place.
"Cancer breaks some families and makes some," Germaine said. "In my case, it did both."
- 두달 반에 걸쳐서 정말 자세히 읽었다.
어쩔 수 없는 암. 미친 생명력을 자랑하는 암.
어찌 보면 암은 현대사회의 개인이나 사회와 너무도 닮아있다. 성장만을 강조하는 현대 사회처럼, 존재의 이유나 목적은 무시된 채, 그저 커져만 갈 것을 요구하는 사회에서 개인들이 몸 속에 성장을 멈추지 못하는 암을 키우는 것은 당연한 일인지도 모른다. 그래서 본문에서 여러번 되풀이되는 문장처럼 암은 우리자신과 너무도 닮아있는 광기의 자기복제판인지도 모르겠다.
개인에게 암을 진단받는 것은 단순히 병에 걸리는 것이 아니다. 그것은 저주받는 것이다. 암에 걸리기 이전과 이후는 확연히 다르다. 저주를 푸는 주문은 아직 과거 마녀의 주술과도 흡사하게 모호하다. 모호한 희망은 잔인하다. 초대도 없이 삶에 들어와 버린 저주를 안고 살다가 안고 죽어야 하는 것이다. 선택의 범위는 '어떻게'라는 문제만에 국한되어 있다.
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