Hierarchy

Stages. Grades. TNMs.

Doctors love categorising stuff, and nothing more so than cancer.
Their first mission, on finding a little mass of cells dividing like billyo, is to find out just how enthusiastic it is. So they slice up a little piece of the flesh into microscopic slivers and peer at the nuclei and make a pronouncement about how differentiated, or not, the whole sorry mess is. And then they scurry around the body with probes and CTs and PET scans trying to find another part of you which has gone off script, and they nod sagely and rub their chins and pump dye into your lymph nodes and whip them out and slice them up and peer at them, and then a load of them sit around together, rubbing their chins and nodding sagely, and decide how f*%^ed you REALLY are.
And then they tell you what it all means, and what they're going to do about it.

And you find out your place in the hierarchy of cancerheads.

Minimally invasive types just have surgery and go home. Very dull.

Something a bit more adventurous-looking, but still in the one spot, might need a touch of chemo or radiotherapy afterwards, just to be sure to be sure, and that elevates you to the next level. You get chemo side effects (your hair might even fall out) and you have a really good excuse to skip work. But you will probably never be bothered by that particular brand of cancer again in your lifetime.

Stage 3 is where it really hots up, where every new ache or twinge or pimple could herald the long-anticipated Recurrence. Everyone (including the doctors) suspects it will happen, and you're really pretty lucky if it doesn't.

Stage 4 is when the horse has already bolted. There's almost an air of resigned contentment in the oncologist's room. He can justifiably "throw everything at it". Or not. You're toast sooner rather than later anyway.

As Johnny Sack says, "There is no Stage 5."

[There was a bit of a misconception around my place that "secondary cancer" meant Stage 2. I felt bad disillusioning that one.]

So cancerheads are always pretty keen to tell you where they are at on the scale. Loads and loads and loads of them (the ones that go on about it like) have Stage 2 breast cancer, and have to go through surgery +/- radiation +/- chemotherapy. That is about as much of the cancer "experience" as anyone could ever possibly want. You can call yourself a Survivor, write a book, get a slot on Oprah, win a TV talent show. Sorted.

But this has sparked a new phenomenon. The Cancer Lifer. A person who has metastatic cancer, stage 4, secondary spread. This bird did herself a nice viral video and coined the phrase. She is also coining it in, to the tune of $15k and counting.

So there's a one-up-manship thing going on. There's a sense that to be truly worthy of admiration/pity/sympathy/cold hard cash, you have to be really truly rightly up the cancer creek.


Human nature is bloody hilarious. Even cancer has its cliques.