and the meaning of cancer
the fortieth anniversary of the publication of Illness as
Susan Sontag’s extended essay comparing and contrasting the meanings
carried by tuberculosis, in the 19th century, and cancer, in the late
20th and the ways I which they are discursively deployed for political
then we have made some progress in the understanding and treatment of
cancer, but perhaps not as much as Sontag hoped. She envisaged a time
when science, as it had with tuberculosis, identifies a single cause
that could be dealt with efficiently, lessening our fear.
we have the Daily
Mail’s obsession with blaming everything from broccoli to
bubble-baths (I’ve only looked at the Bs). The condition for this
nonsense is medicine’s failure to come up with a convincing
course, we know some things. Everyone can name someone close who has
smoked heavily for many years and has contracted lung cancer. On top of
what the science says, you can see a connection.
isn’t the same for alcohol. That there might be a link only struck me
when a colleague of mine, a prodigious consumer of gin and soda water,
died of throat cancer. For the rest of the heavy drinkers I’ve known,
it’s been liver disease that’s got them.
subjective impressions conform with most of the rest of the population
who, to the shock and dismay of some public health campaigners, don’t
realise drinking is a major cause of cancer. They also conform to the
statistics. According to one paper “alcohol-attributable cancers at
these sites make up 5.8% of all cancer deaths world-wide”.
this point, someone is going to ask me how many deaths I would find
acceptable. This is not a serious question as there is no possible
that lack of awareness is now being addressed by a vigorous campaign.
The previously mentioned paper, authored by New Zealand-based Jennie
Connor and titled simply ‘Alcohol consumption as a cause of cancer’,
in 2016 enjoyed more than 56,000 downloads from the Addiction
was more than six times its closest competitor, a paper on e-cigs –
not exactly an unsexy subject.
is clearly something going on here, and this surge in interest in
alcohol-as-carcinogen has already achieved a significant policy success.
The new alcohol guidelines announced last year say that because of the
cancer risk there is no
safe level of drinking.
was, of course, crystallised in the remarks of the chief medical officer
herself, Dame Sally Davies, who exhorted the common people to do as she
did and think of cancer every time a glass of wine approached her lips.
has since admitted she “could have put it better”, but it conveys
the ‘no safe level of drinking’ message pretty accurately I think
– as utterly ridiculous. Even if it were true that the merest sip
somehow gets those cancer cells going, it’s not a credible public
health message – or is it?
research in Australia suggests that advertising invoking the link
between alcohol and cancer is most effective at getting
people to think about their drinking.
ad in question, angrily described as ‘immoral’ by my Twitter
correspondent @ProfByron*, is really quite bizarre in that it shows a
trickle of red wine coursing through the bloodstream and triggering
cancer all over the place.
as Jennie Connor herself admits, we have scant understanding of the
mechanisms by which ethanol might act on the body to produce cancer
cells. With the exception of certain mouth and throat cancers the
evidence is purely epidemiological, mathematical.
would have recognised what’s happening here. Even 40 years on, cancer
remains mysterious and dangerous enough to stir deep fears. It is
scarier than liver disease, which is a risk we can better grasp.
laden with otherness, cancer is also able to blame the host for its
presence. Like the vampire, we must have invited it in.It is a uniquely
powerful weapon and its aggressive deployment in the public health
armoury against alcohol is a political act.
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