Breaking the silence over cancer can help patients and their families

THERE is a colloquial word in Tamil that indicates something that you do not want to make direct reference to. My mother would use this word, palanthu, when in fact she meant to say “cancer”. That was at least 50 years ago.

During those days people in conversation would first look around in case there were eavesdroppers before whispering that somebody had cancer.

Times have changed since then. Man has been to the moon and back. The Berlin Wall has been torn down. South Africa has had successive black presidents. The transplantation of the heart and other vital organs is now an everyday occurrence. Society has made sickness a share-all topic. Yet cancer is often shrouded in secrecy.

With thousands of new cases of cancer being diagnosed in South Africa each day, cancer has become a word that’s hard to avoid. Yet, there are many people who want to keep their terminal illness only within a close circle.

With recurring frequency, I am finding that when I join friends and relatives in the shade of the trees at the Clare Estate Crematorium in Durban after the funeral service of a dearly departed, the discussion is often about how well the deceased had concealed the disease and, therefore, the unexpected death had come as a shock.

Worse than cancer itself has got to be secret cancer. I am certain that hiding the disease must, in many ways, be a bigger burden than the disease itself.

I concede that it is purely a personal choice whether a patient wants to share details about a life-threatening illness. Often with limited energy and a need to maintain normal routines, the patient may not know how to go about deciding when, how and how much to disclose.

The thing to remember though is that someone’s going to know. Sooner or later, word is going to get out.

You cannot rely 100% on your nearest and dearest keeping their traps shut.When I consider my circle of relatives and friends, I so easily recognise that cancer is now more commonplace than it ever was.

According to researchers, one in five men and one in six women will develop the disease in their lifetime. And as countries become wealthier, more people get cancers related to lifestyle rather than those linked to poverty. Lung cancer, breast cancer and bowel cancer are responsible for a third of all cancer cases and deaths worldwide.

Our diets have changed dramatically over the years. No longer are vegetables being grown in home gardens. When last did you eat a Zulu fowl – the free-range traditional chickens that used to roost in the mango trees?

Poultry, cattle and sheep are often given hormones to promote rapid weight gain.

Hormone residues in meats significantly increase the risk of humans getting cancer by disrupting the ordered growth of cells.

Cancer is an unwelcome house guest. You don’t want to wish it upon your worst enemy. Yet it is looming large and in such profusion.

Every patient reacts differently to their cancer diagnosis. I have had friends who wasted no time in sharing the terrible news.

When Ron Moodley, the boss of Indian television channel East Net, learnt he had bone cancer, he immediately faxed me the oncologist’s report which pointed to eventual death.

During numerous visits to his house when we reminisced about happier days and laughed until our sides ached, I somewhat helped him come to terms with his own mortality.

So too, it was with Charles Pillai, the Pension Funds adjudicator, lawyer, actor and a dear friend, who succumbed to cancer within a few months of diagnosis.

Despite his grave illness, we would engage in hilarious conversations which helped us both accept the impermanence of his life.

Then there have been relatives who, aided and abetted by spouses, children and other close relatives, have kept their diagnosis under wraps.

One aunt probably could have been helped to live longer had she spoken about her breast cancer which she had kept a secret.

Even her children did not know she had had a mastectomy. They only found out when it was too late and she was dying of lung cancer.

Another relative was not seen in public for months on end.

Every other sickness but cancer was proffered as the reason for absence. Cancer was only mentioned when the funeral message came through. A friend’s daughter did not speak to him for several months because he did not tell her about the cancer which caused her mother’s death.

It is believed the main reason given by people wanting to keep their diagnosis a secret is because they want their lives to remain as normal as possible and they cannot face having the conversation with close friends.

Some people do not spill their cancer beans because they are very personal – like a case of “this is my body, and what goes on inside it is my business”. Yet there are fun runs, cup-cake sales and Cansa shavathons dedicated to publicly fighting the disease, sending the message that you don’t have to suffer alone.

Another common concern for patients is that if fellow workers or bosses find out about their true health, it may harm their job status.

Even if they never touched a cigarette throughout life, lung cancer patients have to field questions about smoking.

In many communities, cancer is seen as the result of witchcraft. In others it can be attributed to stress or to having a negative mindset.

Fears that the disease may be infectious can result in people being shunned by friends.

Fears that it is hereditary can ruin the marriage chances of those with a parent known to have had cancer.

But there are drawbacks of not telling anyone. Nobody should have to deal with cancer alone. Disclosure will bring a warm outpouring of encouragement and concern.

Don’t assume that you’re burdening others; you may be depriving friends and family of an intimate relationship with you, and you may deprive yourself of support.

Facebook is where many share their cancer diagnosis these days. They only have to tell the basic cancer story once and there will be immediate social support – from prayers to volunteered meals to practical advice from others who’ve been there.

Let’s hope secret cancer is a choice made less frequently by individuals as communication regarding various cancer types and treatments grows more prevalent in the media, in everyday conversations and through social media.

Breaking the silence will not only make life easier for people with cancer, but can also change public attitudes towards prevention and early detection.