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SAMJ: South African Medical Journal

versão On-line ISSN 2078-5135
versão impressa ISSN 0256-9574

SAMJ, S. Afr. med. j. vol.105 no.4 Pretoria Abr. 2015

 

IZINDABA
BOOK REVIEW

 

Malignant: How Cancer Becomes Us By S Lochlann Jain. Berkeley, CA: University of California Press, 2013. ISBN 9708520276574

 

 

 

Lochlann Jain is a cancer survivor. She is also an anthropologist living in the USA. Malignant is in part the personal story of what she aptly terms 'living in prognosis' after an ordeal of misdiagnosis and subsequent treatment for breast cancer. The book is also her detailed investigation of our profoundly diseased society.

Nearly half of all Americans will be diagnosed with an invasive cancer. The time lag between exposure to carcinogens and diagnosis makes pinpointing exact causes difficult, other than overt instances such as smoking and lung cancer, or asbestos exposure and mesothelioma. Many known and unregulated carcinogens are in our food, plastics, dyes and water. Fallout from war, even from medical treatments, adds to risk. Modern life evolves in a soup of hormones and chemicals, driven by our quest for youth, fertility, fast food, easy travel, gizmos and wealth. There is a massive price to pay, and the cost is often borne by those who do not benefit.

Jain unearths disturbing information, e.g. companies that make both carcinogen-containing products and chemotherapy drugs. Stating that she doesn't believe there is evil intent, she remarks that the way to make a fortune is to give cancer to someone who has health insurance, and then test, monitor and treat her for the rest of her life.

Jain's personal narrative informs and enhances her research. Her ability to present her emotional turmoil, vulnerability and even humour, as she finds herself ensnared by the big machine of what she terms 'the medical industry', is a thread that holds together an appalling story of the cover-ups and collusion between capital fearful of mass claims, the legal system that is too costly for individuals to seek redress, the health professionals who ask too few questions about causation, and the government agencies that are unwilling to regulate hazards.

There are no easy answers to the questions she poses. Malignant lifts the lid off cancer, showing it to be largely uncontrollable, unknowable, endemic to our culture, and metastasising into every aspect of life on earth, from our economic system to traces of lead found in Arctic ice. We are paying too high a price for our way of life, and we need to know this.

Malignant is essential reading for anyone involved in cancer care, who is affected by cancer, or who might contract the illness. Going by the stats, that's pretty much everyone.

Dawn Garisch
GP and author of Eloquent Body (Modjaji, 2012) and Dance With Suitcase (Tiber Tree Press, 2013), Cape Town, South Africa dawn.garisch@gmail.com

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