Depending on how we look at cancer, cancer can mean different things. We might think of cancer in biological terms (e.g. as cells that divide too quickly), or in population terms (e.g. statistics about incidence), or in personal terms (e.g. our symptoms and feelings, or part of our professional work), or with a focus on fund raising campaigns and television adverts, to mention a few examples. To some anthropologists and feminist theorists, however, cancer is also culture. The American anthropologist S. Lochlann Jain, for example, understands cancer in this way. But what does it mean to say that cancer is culture?
In their book Malignant: How Cancer Becomes Us, S. Lochlann Jain (2013) describes cancer as ‘a conglomeration of interests’. What they mean is that cancer is many things and can be known in different ways. Yet, they also observe that knowledge around cancer tends to be split between the ‘objective scientific’ knowledge of cancer and the ‘subjective experimental’ knowledge of cancer, e.g. a split is often made between studies in oncology vs. personal memoir or a split between doctors’ experiences of cancer vs. patients’ experiences of cancer.
Making such a split has consequences, Jain argues. It leads to blind spots in how the disease is understood and treated, and as a consequence, we are led to what they call ‘pseudo-questions’ such as ‘how much we as a society should spend on treatments’ or ‘whether we are winning the war on cancer’.
Instead, Jain explains that because knowledge is necessarily always incomplete – whether this concerns ‘objective scientific’ knowledge or ‘subjective experimental’ knowledge, it makes more sense to see the different forms of knowing cancer as shaping each other and working together. For example, how ‘health’ and ‘sickness’ is understood by the medical system may impact not only on how patients themselves experience cancer, but also on what kind of options are available for patients when it comes to treatment and support. Jain therefore argues that it is worth understanding better the notions of health, patienthood, sickness, economics, cause and so on that cancer science and research relies on, since they underwrite not just the social life of living with cancer, but also actual treatment options (Jain and Stacey 2015: 12).
Another example from Jain’s book of how different forms of knowing cancer become intertwined is the experience of time. While some cancer researchers tend to understand cancer as progressive and linear through their work on the aggregated, abstract and predictable bodies of statistics, patients may not experience cancer in this way. Rather patients may instead experience cancer as non-chronological and what Jain refers to as living in ‘prognostic time’ (Jain 2007). They describe this as ‘living in the folds of various representations of time’ (Jain 2007: 80), which means living in the past, present and future all at the same time. Experiencing time in this way is then very different to the focus on progress and the survivor figure present in survival statistics, offering instead ‘an uneasy alternative, one that inhabits contradiction, confusion and betrayal’ (Jain 2007: 90).
Yet, the dominant way of understanding time as linear and progressive carries with it certain ways of approaching cancer, Jain argues. For example, Jain writes that the focus on survival statistics tends to result in campaigns for early detection of cancer, e.g. the offering of screening or detection of biomarkers through blood tests. And while this is very well, it nonetheless tends to side-line, they argue, the equally as important concern of prevention. Consequently, other possible cancer causes (not just biomedical), e.g. chemical, environmental, or demographic tend to be obscured, they argue.
To challenge the ways in which cancer is represented and understood, Jain therefore turns their attention to what they call ‘the cancer complex’. Here, cancer is not only a biomedical disease or a personal tragedy, but so much more – it is made up of law, science, progress, profit, environment, time and lifespan to mention a few domains that on their own are unable to address ‘the multiple and constantly shifting uncertainties that we consolidate with the word ‘cancer’’ (Jain and Stacey 2015: 3).
Addressing the cancer complex, Jain argues, is a way to open up things rather than offering any clear answers. This might sit uncomfortably with some, but Jain’s point is exactly that it is important to recognise that cancer exists in a space of uncertainty. Cancer is complex and elusive. Not only may many people diagnosed with cancer feel that they are thrown into what the feminist cultural theorist Jackie Stacey calls ‘a place of ontological uncertainty’, where you enter a ‘confusing and unwelcome world’ (Jain and Stacey 2015), the ‘cancer complex’ is itself an uncertain terrain, where cancer ‘works for’ different interests in ways that can be difficult to grasp and make sense of.
Yet, by analysing this ‘cancer complex’ and understanding cancer as culture, we are offered a way to ‘demystify [cancer] as a way of understanding the work it does for different interests’ (Jain and Stacey 2015), e.g. what cancer does for law or medicine or the economy. By opening up the question of what cancer is and how we know it, Jain argues, is then to ‘address, interrogate and offer ways to bridge the vast chasm between modes of experience for doctors and patients and how these experiences situate knowledge claims’ (Jain and Stacey 2015: 12).
To take from Jain’s work is then the important insight that ‘cancer is a communal event as much as an individual disease’ (Jain and Stacey 2015: 6).
References:
- Lochlann Jain (2007), ‘Living in Prognosis: Toward an Elegiac Politics’ in Representations 98 (1): 77-92
- Lochlann Jain (2013) Malignant: How Cancer Becomes Us. London: University of California Press.
- Lochlann Jain and Jackie Stacey (2015), ‘Critical Perspectives: On Writing about Illness: A Dialogue with S. Lochlann Jain and Jackie Stacey on Cancer, STS, and Cultural Studies’ in Catalyst: Feminism, Theory and Technoscience 1 (1): 1-29