Cancer is a Prison

There are many types of prisons. Trapped in a physical building is just one example. You can be imprisoned in a travel experience that won’t end. You can be incarcerated in your own mind, being in a rhetorical prison. When I am in treatment centers, I always ask people sitting near me, “what are you in for?’ They always get where I am coming from. We don’t have to discuss anything else, just that we understand the position we are all in.

Let’s start with the types of physical prisons:

• Juvenile. …
• Minimum, Medium, and High Security. …
• Medium security prisons are the standard facilities used to house most criminals. …
• High security prisons are reserved for the most violent and dangerous offenders. …
• Psychiatric. …
• Military. …
• Federal v State. …
• Jail v Prison.

The law clearly defines what actions constitute going to prison. You may get a lengthy or life sentence depending on your crimes, attorney representations, and or jury and judges. There are three sentencing systems: those featuring determinate‐sentencing statutes; those using indeterminate‐sentencing statutes; and those applying sentencing guidelines. In all these types of concrete prisons, one can get, time off for good behavior, a reduced sentence for overcrowding, and occasionally a pardon can take place by a governor, or president. One may get paroled if they serve a certain amount of time and have been well behaved.

Here are the numerous types of punishments:

Capital Punishment • Imprisonment • Judicial Corporal Punishment • Fines • Compensation • Forfeiture & Confiscation • Costs • Security to Keep Peace • Suspended Sentence • Discharge • Probation • Community Service • Revocation of Rights

One common denominator in going to a physical prison is usually but not always free will and choices. There are many people in prison convicted unjustly and sentenced to ridiculous time for simple drug charges. So, there are nine types of concrete prisons to date. But one thing is for sure, the prison we that have; cancer is not by choice.

Yes, we have juvenile cancer & adult cancers, but numerous other types that truly are our virtual prisons:

Bladder Cancer • Kidney Cancer • Lung Cancer• Lymphoma/Blood Cancers • Mesothelioma • Myeloma/Blood Cancers • Breast Cancer • Cervical Cancer • Colorectal Cancer/Gynecologic Cancers • Ovarian Cancer • Prostate Cancer • Skin Cancer • Thyroid Cancer • Uterine/Vaginal Cancer • Head/Neck Cancer • Melanoma • Glioblastoma

Some of these can be prevented by not utilizing self-inflicted issues, such as smoking, better nutrition, consecutive preventative care, and screenings. But in the end, you can do everything correctly and still end up in this prison called Cancer!

We also have several levels of staging that could be called “sentencing”, basically what we are facing and how we got to this point. Our judges, attorneys, and juries are the healthcare teams that do not defend, judge, or advocate what happens to us long-term, but treat us and encourage our survival.

In the TNM system, our version of the three types of criminal sentencing, (our basic laws), the overall stage is determined after the cancer is assigned a letter or number to describe the primary tumor (T), lymph node (N), and metastasis (M) categories, spreading to other body. The T category can be assigned a letter or a number: TX means there’s no information about the primary tumor. Our lack of “testimony”. T0 means there is no evidence of a primary tumor. Our lack of “evidence” in our case. This means that the cancer cells are only growing in the layer of cells where they started. The lymph nodes (N category) Lymph nodes near the primary tumor are usually are checked to find out if cancer has spread into them. Many types of cancer often spread to nearby lymph nodes before they reach other parts of the body. The N category can be assigned a letter or a number: NX means there’s no information about the nearby lymph nodes, or they can’t be assessed. N0 means nearby lymph nodes do not contain cancer. Could be our version of a misdemeanor! A number after the N (such as N1, N2, or N3) might describe the size, location, and/or the number of nearby lymph nodes affected by cancer. The higher the N number, the greater the cancer can spread to nearby lymph nodes. This is our version of organized crimes and multiple felonies!

Metastasis (M category) Tumor has spread to other parts of the body. The M category is assigned a number: M0 means that no distant cancer spread has been found. M1 means that the cancer has been found to have spread to distant organs or tissues. This is truly our version of serious or basically our version of Life without Parole! There are so many more ways to stage our sentencing such as clinical and pathological testing, grades, differentiations, cell type, tumor location, tumor markers, person’s age, and access to care and treatment.

Let’s compare punishments. Criminals’ punishments are handed out based on what type of crime they commit and then they decide which prison they will go to. Most of the time, they do not serve their complete sentence unless they are life without parole. The only way we get a lesser sentence is when our cancer goes away quickly and does not return ever. They all get the choice to plead innocent or guilty. They can cut a deal with the prosecution for a lesser sentence etc. We can see ourselves as innocent, but we are guilty and going to prison unless there is some mistake in our evidential medical findings. Regular offenders can get time off for good behavior. Hmm, can cancer patients get that? Some might say that if we do clean eating, and change our lifestyles, our cancer may go away faster. We cannot negotiate our punishment, only choose our poison. Let’s take a quick look at our punishment, otherwise known as treatment, and the side effects that everyone with cancer will eventually experience.

Radiation Surgery • Stem Cell Transplants • Chemotherapy • Immunotherapy • Targeted or Precision Medicine

The side effects of prison could be many, such as illness, injury due to fighting, PTSD, being abused, malnutrition, depression, restlessness, irritability, acute anxiety, etc. Also, recidivism, paranoia, rage, panic, and insomnia. Both effects do not necessarily end when your sentence is up, or your cancer goes into remission. Our side effects of our punishment in cancer are endless. Here are a few:

Nausea, vomiting, exhaustion, cataracts, lack of sleep due to steroids, shaking, weight gain, weight loss (I wanted this side effect), but of course, I got the opposite! Some more unfortunate effects are hair loss, dry skin/nail changes, mouth sores, trouble swallowing, bruising, anemia, heart attack, pulmonary/breathing issues, constipation, and diarrhea. Mood changes, (not sure how my people know the difference!), chemo brain, and lack of remembering (at least I have an excuse now). Chemo-induced neuropathy can lead to stabbing pain and numbness in limbs, and instability in walking or exercising. Infection from surgery, infections from lack of immune system in tack, urine, bladder changes, fertility problems can continue. Also, rash, fever, chills, intense headaches, and depression. Unfortunately, they pretty much stay with you if you still are in treatment, except for neuropathy which is a long-term gift that many of us have. Most of us will never get paroled from neuropathy.

In the end, I don’t think going to prison or being imprisoned with cancer is an equal experience. At least, as a patient, we do not live with physical bars, or ugly conditions and in fear of those around us. Our inmates are usually kind and sympathetic. Most prison sentences have a finite amount of time. Cancer does not. When you are in jail for a crime, you have the choice to be a repeat offender. With cancer, you really have no choice. You just wait around for the other Manolo to drop!

The rate of recidivism for juvenile criminals is currently around 38.4%, adult 28.5% with the most common being 62.7% for drug-related crimes, 74.2% for other felonies, and 66.4% for property crimes. Cancer recidivism or refractory cancer depends on what type of cancer you have, what stage you were diagnosed with, and what treatment you have. Some are higher than others like Glioblastoma is at 100%, Ovarian cancer, 85%, melanoma, which goes from 15%-87% depending on treatment and stage. Pancreatic after treatment is 46%, breast cancer around 30% after treatment, Blood cancers 10% to 43%, and soft tissue sarcoma about 50%. So, it is clearly a mixed bag.

Lastly, I say we pray for all prisoners, especially those who have no way out or family to support them. I am hopeful our criminal justice system changes. You most definitely do not want to get cancer while in prison. As inmates in cancer, we mostly have access to great care in this country. Although different minorities do not have the same access (see my blog on disparities in cancer). That must change. Just like most minority alleged offenders do not have access to equal representation. This must change! Our oncologologic systematic punishment continues to get improvements in new medicines to advance potential cures. I simply vote for no more cancer at all!

The only thing that would really thrill me is that we all could get a pardon and start over. Not sure how we go about that with the big guy?

Until the next time, please find something funny to share with someone.

Best,
Cathy