Language Effects

Cancer does weird things to the body -- it deforms tissue with tumors, twists DNA into bizarre mutations, establishes rowdy colonies far from the original tumor site. It can shut down organ function and stop the breath. The disease is both killer pirate and imperialist parasite. But it doesn't change just the body; it alters perception, perhaps in part because it alters language. Cancer gives us a new and strange vocabulary for talking about the disease and its treatment.

Because I think mostly in words, this new Cancerland dialect is sort of fucking with my reality. I mean, I LOVE acquiring new words, truly. I hoard them in synapses and work them into conversation or poems at every opportunity.  But cancer words...hmmm...well, it feels a little like my vocabulary is growing tumors.

Linguistic signifiers in Cancerland are mostly scientific. Some originate in Greek; some just look like Greek and Klingon got together and made compounds.  For instance, the polysyllabic names for our medicine might end with "nib" (meaning they are small molecule inhibitors) or "mab"(monoclonal antibodies), and they have big-pharma-invented prefixes attached to stems derived from chemical names, so they end up looking unpronounceable. Try saying pembrolizumab or ipilimumab five times fast. For ROS1+  cancer, we take crizotinib, lorlatinib, entrectinib. Sometimes, drugs can get a cute nickname we use for shorthand, like ippy for ipilimumab. Once these nibs and mabs go on the market with FDA approval, they get new brand names, like Xalkori, the medicine formerly known as crizotinib.

In Cancerland, we use acronyms and abbreviations as words. If you have mets (metastases), your cancer is colonialist. Our doctors are our Oncs. If you need radiation, you'll see a Rad Onc. When you have Stage IV disease, you wonder how long you'll have PFS (progression-free survival) on your TKI (tyrosine kinase inhibitor like crizotinib), or if you'll ever reach NED (No Evidence of Disease). For mets in the brain, you may have WBR (whole brain radiation) or SRS (stereotactic radiosurgery).  We can have DFS (disease-free survival) or a DFI (disease-free interval). Research studies consider OS (overall survival) rates. And of course have fun reading those scan reports, laced with abbreviations and names of body parts you might not have known you had.

But probably the most common word in the parlance of Cancerland isn't medical or scientific. We all use it -- doctors, patients, researchers -- a lot. It's a four-letter word that translates well into other dialects: hope.