THE MIND, SOCIETY AND CANCERPeople are more than the sum of their chemical molecules and cells. They are social beings. As we have seen, the pattern of cancer varies from one society to another; and these different patterns reflect not only the different pool of genes in each society but also the environmental differences which may play a part in causing cancer. In this context, ‘environmental differences’ embrace the social, economic and political circumstances in which individuals find themselves. Such circumstances will determine many facets of their lives, including many of the physical features of their environment. Advanced industrial processes potentially expose people to more carcinogens (cancer-causing chemicals) but if the individuals who may in some way be affected by those processes happen to live in a country with a free press, pressure groups, ‘watchdog’ organizations and a government responsible to an electorate, there is a better chance of the necessary environmental safeguards being put in place. To take another example, prevailing social attitudes to smoking or being suntanned will have a direct influence on the extent to which individuals indulge in these risky habits. Variations in diet between countries, or between different groups within the same country, remain under investigation as a possible environmental explanation for different levels of cancer incidence. Such variations are the product of a complex web of social, economic and physical factors.*109\194\4*

Cancer tends to also weaken and suppress the body’s immune system. This means that infections are easily caught and tend to be more serious than they are in a person without cancer. Because of this, infection, which often takes the form of pneumonia, is a frequent cause of death in cancer patients.

There are also ways in which cancer can cause sudden death. One is through bleeding, which is often internal. Another is through blood clots on the lung. Blood clots form more easily in people with cancer than in people without cancer. Blood clots can travel to the lungs and lodge there. This can completely block the blood flow through the lungs, in which case death occurs within minutes. If the clots are not big enough to block the blood flow completely, the symptoms consist of shortness of breath, chest pain and coughing of blood.

With cancer we have seen that death is often due to failure of the liver, brain or lungs to do their normal job. In the case of the lungs this may be due to cancer itself, pneumonia or blood clots. In all these instances, it is unusual for the patient to remain fully alert and conscious up until the time of death. In fact, it is most unusual for patients with cancer to suddenly drop dead, whatever i he actual cause of death. A gradual drifting into sleep and unconsciousness, usually comes first. In most cases, especially if everyone is prepared for it, this is best for both patients and their loved ones.

If you’ve read right through this chapter to here, you’re a very brave person. Stick with it! Now that we know something about what cancer is and how it behaves, let’s find out what to do about it.

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