Cancer gets you when nothing else can
- Ivo Vegter
- 06 Dec 2011 06:57 (South Africa)
It is a sign of our times that one can say of a man aged 72, “he died too young”.
Tony Nathan was a tough expatriate from London, who only 10 days ago still shrugged off questions about the cancer that was eating him alive. A little more pale and drawn than usual, and shorter of breath, he was down at the pub, telling a few last boisterous anecdotes of life as a bon vivant in the 1960s and 1970s, when he had a photographic studio in Soho. He didn't eat, but as always, his tales were tall, entertaining and quite possibly true.
Once, he claims he photographed a fellow who seemed interested in making records. Tony gave him some advice on getting published. “Don't bother. Nobody appreciates decent music and the record companies will chew you up and spit you out.”
An ordinary conversation ensued, like he'd always have with his subjects, about the commercialisation of arts like music and photography and the two parted on great terms.
After the customer left, Tony's wife saw the photographs. “Cor blimey,” she said. “That's Eric Clapton.”
I don't know if the story is true, but I'd like to think it is. Thinking about the death of a man like Tony puts a sharp edge on my distaste for people who exploit emotional subjects like cancer for political causes.
Tony may have died of cancer, but he defied the predictions of contemporaries like Paul Ehrlich, the man Life magazine once dubbed “ecology's angry lobbyist”. Infamous for his 1968 prediction that mass starvation in the 1970s or 1980s would claim 4 billion lives, Ehrlich also penned an article in 1970 entitled Eco-Catastrophe! In it, he foretold that the ecological consequences of persistent chemical insecticides and fertilisers would reduce Americans' life expectancy to a mere 42 by 1980.
Basing his environmental activism on little more than his own study of butterfly populations and Malthusian mathematical models, Ehrlich was a master of fanning the flames of our deepest fears.
Like much of the nascent environmental movement of the day, he was inspired by the dire warning of Rachel Carson's 1962 lament, Silent Spring, in which she told of a woman who came in contact with a chemical pesticide, contracted leukaemia and died within three months. Carson herself died of breast cancer not long after the book was published.
Ehrlich’s prophecy of doom, like most of his other predictions, proved to be wrong. Not just a little bit wrong, but spectacularly so. By 1980, life expectancy in the US had not plummeted, but had increased from 70.8 to 73.8. When Ehrlich made his prediction, 158 countries reported life expectancies higher than 42. By 1980, 171 exceeded Ehrlich's prediction for the US.
Much of the science and popular literature of the age repeated this alarmism. Dystopian fiction writers and magazine journalists vied to give colour to the dire predictions about a future blighted by environmental destruction and deathly disease.
Today, US life expectancy is an astonishing 78.2, and only Mozambique, Angola and Haiti rank below Ehrlich's dark prediction. To rub salt into the wound, the only major disease that has noticeably affected life expectancy anywhere since is Aids, which is clearly not caused by human economic development.
Despite being spectacularly wrong, the notion that we're getting more cancer because of chemicals in our agriculture, medicine, food preparation and general environment, is persistent. Mention the word “cancer” in general conversation, and someone will solemnly opine that instead of increasing quality of life and health, modern life actually causes cancer. They'll warn darkly about the dangers of antiperspirant spray, or mobile phones, or hair dye, or food preservatives, or milk.
It is true that some substances are known carcinogens, but none of these is among them. Carcinogens in the environment are a risk, but only one in 50 cancer deaths in the developed world can be attributed to environmental pollution caused by industrialisation.
Casting cancer as a symptom of modern society and using death as a rhetorical bludgeon to make people fear economic development is a reprehensible tactic. Yet, despite all the evidence that it's wrong, alarmist myths remain stubbornly persistent.
In truth, economic development and scientific advances have combined to make us all healthier. When friends and family die of cancer – apparently before their time – that is because they didn't die at a younger age of smallpox, polio, influenza or malaria. Because so many infectious diseases no longer kill us, we now succumb to degenerative diseases like cancer, heart disease and stroke. The simple problem is that we live long enough to get them.
Another reason cancer appears to be more prevalent today is not because modern life is more taxing on our bodies than the “natural” lives our ancestors lived, but because modern medicine is better at diagnosing it.
Back in the day, many cancers weren't diagnosed even if they turned out to be lethal. As recently as 1926, a Nobel Prize was awarded for the “discovery” that roundworm causes stomach cancer. They don't. Today, doctors know a lot more, use far better equipment, and run screening programmes designed to find cancers early which otherwise might have gone unreported. No wonder we see more cancer.
Even the data are no longer comparable to those of Ehrlich's day. They show higher incidence of cancer, but they're based on a “standard population” for the year 2000 which is considerably older than the 1970 standard population used by US health authorities for age-adjustment.
If you adjust for ageing, cancer incidence was no higher by the end of the 20th century than at its midpoint. If you also adjust for smoking, as Bjørn Lomborg did in The Skeptical Environmentalist, cancer mortality is down almost 30% in the developed world. Despite the fact that new cancer risks do exist, the catastrophic epidemic Ehrlich and Carson foretold is pure fear mongering.
Treatment has also improved dramatically. Many people now survive cancers that a few decades ago would have killed them, or live many more years of quality life than their parents could reasonably have expected with the same condition. My grandmother beat cancer three times before dying, eventually, of a stroke. In the US, the five-year survival rate of all cancers has increased from roughly a third in 1950 to almost two thirds 50 years later.
None of this is any consolation to the friends and family of someone who dies of cancer, of course. When I first heard Tony had cancer, I hoped he'd be among the two thirds. He seemed so full of vitality. He was bitterly unlucky, even at his age, to get an incurable form of cancer. Yet he was also lucky, to have lived long enough to die of cancer.
Whenever you greeted him, asking “How's life?”, he'd say, “Shit, actually,” and laugh mockingly. Few realised how serious he was. It only dawned on me a few months ago how bad the cancer had become, and that he'd known for a long time there was nothing they could do. His abrasive, witty, Cockney humour was his defence against the hand life had dealt him.
Almost to the end he refused to stop living. A gloomy sense of depression about cancer as a symptom of modern society would dishonour his memory. He lived life to the full, he was always gregarious, he worshipped his wife and was brazen in the face of adversity. The world needs more people like him.
His death was an exception. It was bad luck. It should be a reminder that he had a good life, in which he lived and loved with infectious enthusiasm. He will be missed and mourned. Rest in peace, Tony Nathan. DM