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Random Acts of Cancer

I went to a memorial service today for my friend, Jeanne, who died two days before Christmas from brain cancer at the age of 58. Her sister spoke, as did her closest friends and her children, but it was something her husband said that stayed with me: “I used to think things happen for a reason. Now, I believe things just happen.”

To me, those words underscore the randomness of cancer. With the exception of people who practice risky behaviors that increase their chances of getting cancer, the rest of us can only hope that luck is on our side. Cancer strikes with ferocious democracy — it doesn’t care how young we are or whether we’re complete innocents or evil to the core.

I’m not the only one who thinks so. Many scientists believe in the randomness of cancer, too. Last year, researchers at Johns Hopkins University School of Medicine used a statistical model to determine that random mutations may account for two-thirds of the risk for getting many types of cancer, leaving heredity and environmental factors responsible for only one-third. That means there’s a large component of cancer we can’t do a thing about, a fact that may comfort some people and scare the hell out of others.

I’ve been thinking about the randomness of cancer for more than forty years. I was 14 when my mother was first diagnosed. From then on, this weird movie snippet started playing in my head day after day. In it, a giant red ball bounced from the roof of one house to the next as it traveled around the block. Bounce, bounce, bounce went the ball, a little slower and lower with every landing. Finally, it came to rest on one roof. My roof.

The radiologist arrived with my x-rays, illuminating them on a light box on the wall. “I see a shadow here,” he began as he pointed to a blurry spot and I braced for the remainder of his sentence.

I wouldn’t wish what my family went through on anyone, but in the awful years that followed, I often lay in bed staring at the ceiling, wondering why the big red ball didn’t land on my neighbor’s roof instead of mine. I still think of that damn ball whenever I hear of a new diagnosis, which I do with terrible regularity. And every time, I suspect the victim asks, “Why me?” just as I’m asking myself why her and not me?

Perhaps the fact that I’ve already suffered greatly at the hands of cancer has given me some sort of immunity, like a force field. After my mother’s long illness and death at age 49, I thought the worst thing that could happen had happened. “Bring it on,” I’d say, my belligerent chin tilted to the sky at whatever powers might live there. “I can take whatever you’ve got.” I wore that sorry suit of armor even after I became a wife and mother in an effort to convince myself that I was inured to loss.

Then a few years ago, I went for my annual mammogram, which had always been normal. This time, the technician left the room with my pictures, promising to be right back. The germ of fear she planted sprouted as in a time-lapse movie, growing from seedling to sapling to Sequoia in mere seconds. After what felt like forever, the technician returned to say that the doctor wanted to talk with me and would be in shortly. In an instant, my “bring it on” bravado was gone. I thought of my young sons and my husband, tears streaming as I ticked off the milestones I’d never see. I didn’t think about treatments or survival rates. I just thought about dying.

“So, this is how it starts,” I said to myself. “A random moment on a random day marks the divide between before I had cancer and after.”

The radiologist arrived with my x-rays, illuminating them on a light box on the wall. “I see a shadow here,” he began as he pointed to a blurry spot. I braced for the remainder of his sentence. “But after consulting with my colleagues, we think it’s actually nothing. You’re good to go.”

And just like that, I didn’t have cancer. I’d see my sons graduate and marry, and I’d meet my grandchildren someday. I wouldn’t die young like my beautiful mother.

When I think about people I know (and even those I don’t) whose doctors didn’t say, “You’re good to go,” I feel lucky and grateful and guilty. With one out of eight women facing breast cancer in their lifetime, I know I’ve dodged that particular bullet for now but possibly not forever. But even with that sobering statistic and the knowledge that cancer is lurking around my DNA, I try not to live in fear. The truth is that cancer has no definite direction, rule or method, no particular plan or pattern. With so much potential randomness in that realm, the best I can do is reduce the randomness in other parts of my life by living with purpose and loving my family and friends as best I can.

That’ll probably do me a lot more good than my imaginary force field.

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