Moral struggles of young adults with cancers

June 24, 2015

By Chad Hammond

Today I am here in this compact online space to address something intensely sensitive and controversial: the morality of cancer. In my research with young adults across the country, every one of them raised questions about their nomination to join the cancer club—Why me? Why did I get cancer? What did I do to deserve this?

Thinking about other younger people who died of their cancers, a fair minority also asked—Why not me? Why didn’t I die? What makes me so different?

These existential questions are the bedrock of distress for many young adults with cancer as they hunt their pasts for answers—Did I do something wrong? Could I have seen this coming? Could I have done anything differently? These journeys are part of the deeply personal quests and the outraged public inquiries into where their cancers come from.

Controversies lay in how people come to terms with these questions, for they can sometimes attribute responsibility and blame. As a severe example, there was once a time when it was widely believed a “cancer personality” existed: a type of person who represses turbulent emotions, which in turn slowly corrodes their body from the inside. Oncologists these days tend to shy away from such claims and, depending on the type of cancer, are often sparing in their suspicions of cause, particularly with younger people. Nevertheless, many people want to know, they seek a play-by-play, an account of the precipitating events, an origin story of sorts…for good reason: cancer grows within and by means of our own bodies. It is no outrageous thought to wonder what among our local environments, or daily habits, or personal struggles may be a favourable habitat for cancer.

I would like to share some of the major origin stories provided in a single, modest study with 21 young adults. Take note: these often go beyond the basic biomedical story of how one renegade cell begins a movement, recruiting other cells to join forces and gather into a tumour. Moral explorations can be helpful when trying to situate cancer within one’s own life, but can be less helpful when they are used to police or accuse others of some personal failure. My effort here is to lay judgments low and, instead, honour the many different ways young adults try to make sense of their cancers. Sharing these stories may—I hope—help facilitate explorations that are personally relevant and meaningful to others who live among the uncertainties of cancer.

Power of the mind

While nobody talked about having a “cancer personality,” some young adults provided a “psychological” origin story, suggesting that living a high-stress life, or holding in emotional turmoil, can come out as physical illnesses like cancer. People saw a strong connection between their minds and bodies, in terms of both possible causes and ways of recovering from cancer. Mending mental distress was seen, then, as a personal responsibility and part of the journey of recovering from cancer.

Carrying conflict within

A few young adults traced their cancers, in part, to conflicts in their relationships. Enduring distress from another was described as a contributor to mental, emotional, and physical suffering, making cancer a by-product of social tensions. A strong sense of injustice and abuse came with these origin stories. Recovering from cancer often included severing these ties and/or healing from the harm done by these relationships.

Conspiring bodies

Another type of explanation stayed within the cellular level of people’s bodies. With people who had a long family history of cancer, they suspected cancer was passed down genetically and it was just a matter of time before these dormant cancer cells popped up. A couple women wondered if these cells were enacted by other bodily changes going on, like pregnancy. Unlike those who talked about psychological origins, their suspicions often put their own bodies at a distance, seen as complicit in the development of cancer and not to be trusted. People placed hope in medical surveillance and intervention to get a handle on their bodies’ shifting alliances.

Forces of the heavens

Shifting from the micro to the macro, several young adults referred to a more cosmic source of cancer: sometimes it was a divinity, sometimes the impersonal universe, but always with an intention. People said that their cancers “happened for a reason,” initiated by some larger force in the cosmos, but left up to them to discover the reasons behind it. In fact, coming to understand the reasons was seen as part of the healing process; people meditated, prayed, and reflected on their lives in search of understanding and acceptance.

Toxic surroundings

Then, there were origin stories placed within the local environment. Some young adults talked about the possible role pollution played. Some offered general comments on the health effects of contemporary industrial life—the quality of food, the exploitation of natural resources, the stress of hectic urban spaces, and the unknown impact of new technologies—while others spoke of toxic exposures at their workplaces or homes. Responsibility for cancer under these terms was more disperse—placed within a call to humanity for better stewardship of the earth.

Unsolved miseries

Interwoven with the above origin stories was the uncertainty of them all. Most of the young adults I spoke to entertained the possibility that their cancers were entirely random, or at least had no clear source, maybe even a handful of sources with synergistic effect. They believed much about cancer is an unsolved and untraceable mystery. Having cancer violated how they imagined themselves as young adults: healthy, hardworking, aware of their bodies, and knowledgeable about the risks to avoid. Not knowing means not being able to predict or control, and, in turn, few moral judgments can be made. Across the board, however, one of the responsibilities the young adults saw for themselves was accepting their limits and finding appreciation for what hasn’t been lost.

When something disruptive happens in life, the work of mourning our losses often involves building causal links around the disruption—it’s not an outright scientific endeavour, but it is often grounded in rich, personal experiences and observations. Consider the above as just a few of the many ways young adults may explain the sources of and solutions to their cancers.

Chad Hammond is a Postdoctoral Fellow with the University of Ottawa School of Rehabilitation Sciences/École des sciences de la réadaptation Université d’Ottawa who studied young adult cancer experiences for his dissertation. As some of you may have participated, or may find the information interesting and useful, Chad has offered to share his findings with us through a series of blog posts. Young Adult Cancer Canada is not responsible for the information presented.

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