Cancer And Community

Commentary

One of the certainties of reaching a certain age today is that you can't help but feel stalked by cancer.

Cancer is the second leading cause of death in the United States, after heart disease. Medical science saves many lives that cancer would have certainly taken 25, 10 and five years ago — even one year ago.

Medicine also prolongs lives. We all know people who have been cured "for now," who are in remission or who are being treated aggressively with radiation, chemotherapy or something else. We all know people who have high odds of getting cancer because of their genes. We all know someone who is helping care for a cancer patient.

So it is not just death by cancer that stalks us; it is living with cancer in one way or another.

Sometimes we feel lucky and grateful simply to have a loved one alive no matter what. Sometimes it is harder. Sometimes medicine seems like salvation; sometimes, torture.

The length of time people are sick today, and the new ways we communicate and "stay in touch," are changing how we cope with illness and what we think of as community.

The NPR community lost Leroy Sievers to cancer Friday. He was a distinguished journalist at CBS News and ABC News who talked about his own condition on Morning Edition and wrote about it on the blog My Cancer here at NPR.org. Leroy's blog was wonderfully popular. It had all the qualities of the word "community" though few of the people in the My Cancer neighborhood ever met physically.

Earlier in the week, my father's wife died of lymphoma. She married my father many years after my mother died, of breast cancer. She took care of my father before he died six years ago, of multiple myeloma. She was well-known in Chicago, where I come from, and had a huge, inspiring personality. Many people felt close to her and wanted to know how she was doing since she was diagnosed one year earlier. They did this through a Web site that many cancer patients use called Caring Bridge.

I first learned about Caring Bridge when the son of two of my most beloved cousins fought leukemia with astounding guts before he died last year. The number of people who wanted and needed to keep track of this child was huge and always growing. Caring Bridge allowed this to happen in a way that didn't burden the family. Again, it provided what we think of as community.

Without getting all gooey and New Agey, it is clear to me in my dotage that intimate, enduring human relationships — community — are the most important medicine for patients in long struggles with cancer.

It is also clear that community is growing rarer in mobile America, at least physical community. Not surprisingly, social isolation is increasing. An important study, published in the American Sociological Review in June 2006, found that the number of people who reported they had no confidants with whom they discussed intimate matters tripled between 1985 and 2004. A quarter of the people surveyed in 2004 said they had no confidants in life.

Since I work in the business of online news, I am often asked if I think "virtual community" is as important or nourishing as "real community." Can technology bring people together in an authentic way, as direct conversation does?

My answer is no. And it is risky for society to think otherwise. If we allow organic community — neighborhoods, hometowns, living near family, having relationships across generations, lifelong friendships, and family-to-family friendships — to atrophy, there will be no way re-create it. In our lives, if we rely on the virtual too much, or instead of the old-fashioned, we will be at risk.

But can virtual community provide something profoundly meaningful? Yes. I have learned that from online communities that have served cancer patients.

Virtual communities have one other virtue: They are available to the isolated, to the marginalized and to the shut out. Are they replacements for organic community? No. Are they important, helpful new options? Yes.

Like the fountain pen and carrier pigeon, the new technologies of human communication are morally and sociologically neutral, neither good nor evil. Things digital tend to be time sinks — immersive, addictive and anonymous. They need not be, though, as they are merely tools.

Cancer is pervasive; as I said, it stalks us. Illness is always isolating. Unwanted isolation is unhealthy. Just as we have new medicines, we have new ways to communicate. Both can be used and abused.

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