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CANCER CONTROL INTERVIEW

7 CANCER CONTROL 2021

And, within this framework, we can understand where each

of us fits and what we can do. In the prevention realm, for

example, we can advocate for tobacco control through policies,

regulation, taxation, counselling, knowledge sharing and more.

Everyone has a role. And, as we consider the broader context

of cancer prevention, we must remain vigilant to better

understand carcinogens and to act on emerging risks such as

air pollution using levers throughout the halls of government.

Health professionals and advocates are core to this dialogue.

But, we must act in solidarity. There is not one button, there is

no superior voice. We move as a unified, inclusive community.

Can you talk about some of the other challenges facing us in

the cancer community?

We are at risk of losing our guiding beacon, losing steam

and losing cohesion. What are we trying to achieve? What

motivates our work?

It has been nearly 50 years since the war on cancer was

declared. There have surely been major advancements, and we

needed to be challenged as a global community to respond to

this devastating disease.

But, perhaps it is time to focus on solidarity with a more personcentred understanding of how cancer affects individuals and

communities. Let's be more attentive to the care requirements

for people living with cancer and their families.

To start, investments in cancer should be more focused on

improving access for all populations, driving forward universal

health coverage and ensuring financial protection. There is

a strong economic argument for doing so. But, even more

important is the human justification.

Can we accept a world where, for decades, millions of people

are dying unnecessarily from cancer because of where they

live or how much money they have? This tears at the fabric

of our souls and our bonds as a community. And, it is not a

high-income versus low-income country phenomenon. This

happens within zip codes, within neighbourhoods.

We also need to shift our language in how people with cancer

experience care. There are a lot of questions that get triggered

after a cancer diagnosis: why did this happen?, what are the

options of treatment?, why has the cancer come back?. Cancer

is a life-defining event that ultimately changes the trajectory

of life - but it does not have to be something that you should

wake up every day and think 'This cancer defines me. This cancer

is going to dictate every decision I make'.

People with cancer have shared with me that a philosophical

shift towards cancer as part of life helps, that we begin to

experience it as a chronic disease like diabetes or heart disease.

Discussions on cancer care should be informed by a vision for

tomorrow, not dictated by fears of death from today and the

disappointment of losing a "war" against cancer.

So you are not signed up to The War on Cancer and the

Moonshot?

That is a great question. There are dimensions of the War on

Cancer that have saved countless lives. I am not advocating for

less investments in cancer research and innovation.

But, for many in the cancer community, the bellicose language

or survival at all costs has had unintended consequence. People

living with cancer - the people we care for - are experiencing

fear, poverty, isolation. Providers are feeling burnt out,

exhausted. Inequities are rampant. Vulnerable populations are

being ignored. This cannot continue.

What if the social context of cancer changes? What if we

create a social context, based on equipoise, that addresses the

harsh physical realities but balances it with systems designed

to meet the broader needs of people with cancer - mental,

social, spiritual and economic.

There would be great value in changing the narrative, but it

is not easy to produce. Our investments reflect our priorities.

It is time to ask if we are investing enough in the broader care

needs of our communities and if we are ready to protect the

social fabric of our communities by promoting equity and

solidarity.

It is time to shift are understanding of cancer. Of all the

things that I remember, from the hospital and all the people

I talked to, I remember you encouraging me and telling me

that it's okay, 'You can deal with this', in the same way that I'm

dealing with my own high blood pressure, my own obesity, and

it's not necessarily going to be a perfect solution around the

corner. But it shouldn't make me live in fear."

There is a third option: that we maintain this fictional war

on cancer while at the same time supporting people to come

to terms with their diagnosis? It is close to double think.

Exactly. This is why it is so challenging. If you and I, people

who have lived and breathed these questions for decades,

feel the double speak in our internal thoughts how can we

communicate to others? How can we help the patient who's

sitting in a cancer ward focus on the future, on survival but

also live each day abundantly. It is a paradox, and that does

complicate how cancer is framed.

Cancer as a death sentence is still so real for so many people.

And that fear does influence everything. Sometimes it's has

positive consequences to motivate advocate, drive political

decision making. And in that regard, how do we support people

experience fear?

It is horrific to see someone suffer and die from cancer,

especially when palliative care isn't available. But that goes

back to where we can also spend more time as a community.

How do we create an environment where the needs of cancer

patients are being met in all domains of their life? The inability

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