- Email: [email protected]
Growing Up with Cancer
Cancer and Society
mementos included in the book, she has a natural urge to chronicle the family history. To her siblings, Jessica and Matt, she writes, “this is our story…I hope that this book acts as a
reference over the course of your lives, as I know it will for me.” I sense that The Family Imprint will come to define the Borowicks for generations to come, to perpetuate the clan identity,
and, above all, to set a high watermark for how members of families can cherish one another.
Catherine Lucas
Documentary Growing Up with Cancer Growing Up with Cancer 2017, 30 min
1304
Growing Up with Cancer is an episode from BBC One’s Our Lives series broadcasted in June, 2017, and documents the lives and experiences of three ordinary teenagers battling cancer at the Royal Hospital for Children in Glasgow, UK. Filmed over a period of several months in a specially designed teenonly ward set up by the Teenage Cancer Trust, the documentary highlights the effects of cancer on the already-painful juncture of adolescence. The purpose of the unit—which “feels more like a youth club than a hospital” according to Natasha (aged 15 years), equipped with a hangout zone, pool table, and jukebox—is to bring young people together who are dealing with cancer so they do not have to face it alone. Onsite youth support coordinator Rónán Kelly, whose role is to support the teenagers and offer activities to relieve their boredom, says this environment helps to create a sense of normality for the patients, encouraging them to relax, have fun, and socialise, while supporting one another. Brightened by the youth club feel, the opening scenes of the docu mentary are surprisingly upbeat— with an emphasis on recovery and the cultivation of peer support. Each patient introduces themselves by name, age, illness, and what they want to be when they are older. Natasha explains confidently that she has Hodgkin’s lymphoma and wants to study law. An outpatient who visits the unit for chemotherapy treatment up to five times per week,
she admits it was not until her hair started to fall out that the reality of her illness sank in, but now she faces the disease with positivity and defiance. Another patient, Declan (aged 14 years) appears remarkably buoyant despite having acute lymphoblastic leukaemia and no idea what he wants to be when he is older. His aggressive form of cancer has not responded to chemotherapy, and viewers learn that a high-risk stem cell transplant is his only hope of cure. Declan admits the experience has forced him to grow up quickly, although he remains cheerful and is determined to get through the requisite isolation period in record time. Finally, we are introduced to Nairn (aged 14 years) who began feeling unwell a few months ago. He explains he thought it was a chest infection at first, until he became increasingly fatigued and emotional. When Nairn is diagnosed with Hodgkin’s lymphoma, his immediate concern is how it will disrupt his school life and exams. Beyond this pragmatic knee-jerk reaction, he is commendably self-possessed: reminding himself that other young people are going through worse, and smiling bravely for his parents’ sakes. Away from the bright lights and board games of the unit, we are reminded intermittently of the bleak side-effects of treatment, which drag on for months. As outpatients, both Natasha and Nairn are given cameras to help document their symptoms from home. These raw video seg ments expose the mood swings and lulls, and the gruelling
physical side-effects brought on by chemotherapy treatment. In one clip, Natasha is singing along to music, yet subsequently she appears deflated and depressed. Likewise, Nairn seems cheerful in his first home video but miserable in the next, listing a slew of symptoms including broken-out skin, dry sore lips, headaches, and an aching jaw. For Declan, although his stem-cell transplant is a success, the psychological impact of his time spent in isolation is easily discerned. “It’s difficult to smile now”, he says. “I think I’ve been in hospital too long: getting a bit depressed.” Identity is a central preoccupation for the teenagers in the documentary, and recovery is incentivised by an overwhelming desire to be normal— or at least, to return to their normal lives. “My name isn’t cancer”, explains Natasha, refusing to let herself feel compromised by the disease, while Nairn hopes he will not be treated differently or judged because he is ill. Declan remembers that during the depressive period of his isolation, it was only the thought of going home and being normal that got him through. Although such responses are characteristic of their age group, Growing Up with Cancer does not patronise or label them as teenage specific. Instead it presents an in-depth, honest reflection of the thoughts and feelings of these young people with cancer, which is unique and deeply moving. Not all patient outcomes are resolved by the end of the documentary: Nairn is feeling positive about his recovery but is still having chemotherapy treatment, www.thelancet.com/oncology Vol 18 October 2017
Cancer and Society
while two additional patients, Connor (aged 19 years) and Nikki (aged 15 years), are not introduced until the closing scenes and their stories
never fully develop. But for Declan and Natasha, news of their remission and discharge is a substantial victory, both for the specialist unit and for these
individuals who faced cancer with such inspiring optimism and resilience.
Elizabeth Gourd
Theatre Edinburgh Festival Fringe Roundup Cancer is not one disease but hun dreds—not one emperor of maladies but an empire of related conditions sprawling through the human body. Perhaps reflecting that fact, most Edinburgh Fringe Festivals see a glut of shows about cancers of various stripes. Each Fringe exhibits several medically themed shows, dealing with a diversity of conditions from Alzheimer’s (2015’s It’s Dark Outside) to organ donation (Jarlath Regan’s impeccably-named Organ Freeman). Nonetheless, shows about other ailments come as single spies; theatrical examinations of cancer come in battalions. Three shows at this year’s Fringe— one discussion panel and two plays—dealt not just with cancer but with cancer in Scotland. For any readers wondering what makes it necessary to deal specifically with the Scottish experience of cancer, a graph shown to the audience at the start of Dr Data: The Answer to Cancer makes things clear. The graph consisted of three stark lines: the mortality rate of cancer in Europe; that in the UK, this mortality rate lingered just above the European line; and, substantially higher up the graph, the mortality in Scotland. All three lines are gradually decreasing over time, which is the good news—but the gap between Scotland and the rest remains, the decline stubbornly gradual. Hence, then, Dr Data, part of the Cabaret of Dangerous Ideas series, which proposed that huge amounts of data—specifically genomic data—can help tackle cancer. The event teamed Professor Aileen Keel (Scottish Cancer Task Force, Edinburgh, UK) in her capacity as director of Scotland’s www.thelancet.com/oncology Vol 18 October 2017
Innovative Healthcare Delivery Programme, with a computer scientist, Dave Robertson (University of Edinburgh, Edinburgh, UK), to present their “Dangerous Idea” and answer questions from the audience. Keel and Robertson’s proposition is that data—massive amounts of it, sifted and shuffled at the genetic level—will be far more important in the fight against cancer than any new drug. A small but growing number of patients with cancer are having their genomes sequenced, and this effect, the pair contends, is where the greatest advances against cancer will be made in the decades to come. Taking questions from an audience by turns enthusiastic and sceptical, Robertson and Keel explained further. The current system, targeting different drugs to particular cancers, is a blunt instrument. With genetic data, doctors might discover that only patients with a particular genetic mutation need, or could benefit from, particular drugs. Without it, we are left with the bludgeon, perhaps exposing patients to side-effects with no benefits to their condition. In the past decade or so, the cost of sequencing a particular genome has tumbled from US$1 billion to US$1000. Each of us is worth about one gigabyte of data—multiplied across Scotland’s population, that is 5 million gigabytes, a vast amount. The problem to solve is not paucity of data but in the construction of systems to understand it, to filter out noise or correlation wearing the mask of causation. Robertson’s team are still engaged in the process of pulling all the data together from various
different silos, marshalling it so that it can be constructively mined. The structure of the event—mostly questions from the audience—allowed a proper debate about the claims on offer. Can we afford to do this? Keel maintained that we can not afford not to: new cancer treatments are so expensive that we need to make sure they are properly targeted. Will Brexit affect the data-sharing situation? In summary: the jury is out. And most importantly, what are the pitfalls? The possibilities for mischief are broad and discomfiting—information might leak into the public sphere or into the hands of private firms, although there are currently legal safeguards against data-selling. Flawlessly hosted by the sparky Susan Morrison—here needling the panellists, there teasing the audience— Dr Data proved a fascinating guide to data’s forthcoming role in cancer treatment, dealing with difficult topics, and only seldom tipping into wonkishness.
The Edinburgh Festival Fringe ran between August 4–28, 2017, in Edinburgh, UK
Steph Wright
Dr Data: The Answer to Cancer
Dr Data: The Answer to Cancer
1305
mementos included in the book, she has a natural urge to chronicle the family history. To her siblings, Jessica and Matt, she writes, “this is our story…I hope that this book acts as a
reference over the course of your lives, as I know it will for me.” I sense that The Family Imprint will come to define the Borowicks for generations to come, to perpetuate the clan identity,
and, above all, to set a high watermark for how members of families can cherish one another.
Catherine Lucas
Documentary Growing Up with Cancer Growing Up with Cancer 2017, 30 min
1304
Growing Up with Cancer is an episode from BBC One’s Our Lives series broadcasted in June, 2017, and documents the lives and experiences of three ordinary teenagers battling cancer at the Royal Hospital for Children in Glasgow, UK. Filmed over a period of several months in a specially designed teenonly ward set up by the Teenage Cancer Trust, the documentary highlights the effects of cancer on the already-painful juncture of adolescence. The purpose of the unit—which “feels more like a youth club than a hospital” according to Natasha (aged 15 years), equipped with a hangout zone, pool table, and jukebox—is to bring young people together who are dealing with cancer so they do not have to face it alone. Onsite youth support coordinator Rónán Kelly, whose role is to support the teenagers and offer activities to relieve their boredom, says this environment helps to create a sense of normality for the patients, encouraging them to relax, have fun, and socialise, while supporting one another. Brightened by the youth club feel, the opening scenes of the docu mentary are surprisingly upbeat— with an emphasis on recovery and the cultivation of peer support. Each patient introduces themselves by name, age, illness, and what they want to be when they are older. Natasha explains confidently that she has Hodgkin’s lymphoma and wants to study law. An outpatient who visits the unit for chemotherapy treatment up to five times per week,
she admits it was not until her hair started to fall out that the reality of her illness sank in, but now she faces the disease with positivity and defiance. Another patient, Declan (aged 14 years) appears remarkably buoyant despite having acute lymphoblastic leukaemia and no idea what he wants to be when he is older. His aggressive form of cancer has not responded to chemotherapy, and viewers learn that a high-risk stem cell transplant is his only hope of cure. Declan admits the experience has forced him to grow up quickly, although he remains cheerful and is determined to get through the requisite isolation period in record time. Finally, we are introduced to Nairn (aged 14 years) who began feeling unwell a few months ago. He explains he thought it was a chest infection at first, until he became increasingly fatigued and emotional. When Nairn is diagnosed with Hodgkin’s lymphoma, his immediate concern is how it will disrupt his school life and exams. Beyond this pragmatic knee-jerk reaction, he is commendably self-possessed: reminding himself that other young people are going through worse, and smiling bravely for his parents’ sakes. Away from the bright lights and board games of the unit, we are reminded intermittently of the bleak side-effects of treatment, which drag on for months. As outpatients, both Natasha and Nairn are given cameras to help document their symptoms from home. These raw video seg ments expose the mood swings and lulls, and the gruelling
physical side-effects brought on by chemotherapy treatment. In one clip, Natasha is singing along to music, yet subsequently she appears deflated and depressed. Likewise, Nairn seems cheerful in his first home video but miserable in the next, listing a slew of symptoms including broken-out skin, dry sore lips, headaches, and an aching jaw. For Declan, although his stem-cell transplant is a success, the psychological impact of his time spent in isolation is easily discerned. “It’s difficult to smile now”, he says. “I think I’ve been in hospital too long: getting a bit depressed.” Identity is a central preoccupation for the teenagers in the documentary, and recovery is incentivised by an overwhelming desire to be normal— or at least, to return to their normal lives. “My name isn’t cancer”, explains Natasha, refusing to let herself feel compromised by the disease, while Nairn hopes he will not be treated differently or judged because he is ill. Declan remembers that during the depressive period of his isolation, it was only the thought of going home and being normal that got him through. Although such responses are characteristic of their age group, Growing Up with Cancer does not patronise or label them as teenage specific. Instead it presents an in-depth, honest reflection of the thoughts and feelings of these young people with cancer, which is unique and deeply moving. Not all patient outcomes are resolved by the end of the documentary: Nairn is feeling positive about his recovery but is still having chemotherapy treatment, www.thelancet.com/oncology Vol 18 October 2017
Cancer and Society
while two additional patients, Connor (aged 19 years) and Nikki (aged 15 years), are not introduced until the closing scenes and their stories
never fully develop. But for Declan and Natasha, news of their remission and discharge is a substantial victory, both for the specialist unit and for these
individuals who faced cancer with such inspiring optimism and resilience.
Elizabeth Gourd
Theatre Edinburgh Festival Fringe Roundup Cancer is not one disease but hun dreds—not one emperor of maladies but an empire of related conditions sprawling through the human body. Perhaps reflecting that fact, most Edinburgh Fringe Festivals see a glut of shows about cancers of various stripes. Each Fringe exhibits several medically themed shows, dealing with a diversity of conditions from Alzheimer’s (2015’s It’s Dark Outside) to organ donation (Jarlath Regan’s impeccably-named Organ Freeman). Nonetheless, shows about other ailments come as single spies; theatrical examinations of cancer come in battalions. Three shows at this year’s Fringe— one discussion panel and two plays—dealt not just with cancer but with cancer in Scotland. For any readers wondering what makes it necessary to deal specifically with the Scottish experience of cancer, a graph shown to the audience at the start of Dr Data: The Answer to Cancer makes things clear. The graph consisted of three stark lines: the mortality rate of cancer in Europe; that in the UK, this mortality rate lingered just above the European line; and, substantially higher up the graph, the mortality in Scotland. All three lines are gradually decreasing over time, which is the good news—but the gap between Scotland and the rest remains, the decline stubbornly gradual. Hence, then, Dr Data, part of the Cabaret of Dangerous Ideas series, which proposed that huge amounts of data—specifically genomic data—can help tackle cancer. The event teamed Professor Aileen Keel (Scottish Cancer Task Force, Edinburgh, UK) in her capacity as director of Scotland’s www.thelancet.com/oncology Vol 18 October 2017
Innovative Healthcare Delivery Programme, with a computer scientist, Dave Robertson (University of Edinburgh, Edinburgh, UK), to present their “Dangerous Idea” and answer questions from the audience. Keel and Robertson’s proposition is that data—massive amounts of it, sifted and shuffled at the genetic level—will be far more important in the fight against cancer than any new drug. A small but growing number of patients with cancer are having their genomes sequenced, and this effect, the pair contends, is where the greatest advances against cancer will be made in the decades to come. Taking questions from an audience by turns enthusiastic and sceptical, Robertson and Keel explained further. The current system, targeting different drugs to particular cancers, is a blunt instrument. With genetic data, doctors might discover that only patients with a particular genetic mutation need, or could benefit from, particular drugs. Without it, we are left with the bludgeon, perhaps exposing patients to side-effects with no benefits to their condition. In the past decade or so, the cost of sequencing a particular genome has tumbled from US$1 billion to US$1000. Each of us is worth about one gigabyte of data—multiplied across Scotland’s population, that is 5 million gigabytes, a vast amount. The problem to solve is not paucity of data but in the construction of systems to understand it, to filter out noise or correlation wearing the mask of causation. Robertson’s team are still engaged in the process of pulling all the data together from various
different silos, marshalling it so that it can be constructively mined. The structure of the event—mostly questions from the audience—allowed a proper debate about the claims on offer. Can we afford to do this? Keel maintained that we can not afford not to: new cancer treatments are so expensive that we need to make sure they are properly targeted. Will Brexit affect the data-sharing situation? In summary: the jury is out. And most importantly, what are the pitfalls? The possibilities for mischief are broad and discomfiting—information might leak into the public sphere or into the hands of private firms, although there are currently legal safeguards against data-selling. Flawlessly hosted by the sparky Susan Morrison—here needling the panellists, there teasing the audience— Dr Data proved a fascinating guide to data’s forthcoming role in cancer treatment, dealing with difficult topics, and only seldom tipping into wonkishness.
The Edinburgh Festival Fringe ran between August 4–28, 2017, in Edinburgh, UK
Steph Wright
Dr Data: The Answer to Cancer
Dr Data: The Answer to Cancer
1305