Cancer and the arts: why we need works by long-term survivors

Correspondence to Dr Wolfgang Wagner; [email protected] The incidence of cancer is rising worldwide. In 2008 it happened to be some 12.7 million new cases (7.6 million cancer-related deaths), in 2030 it could be 20.3 million cases. Only the means of medicine could alter this trend with a concordantly increasing number of victims. A classical ‘conditio sine qua non’: There are also writers and poets among the ill, among the survivors, among those we lose. No wonder literature regularly offers works that present their readers the individual experience of authors confronted with disease, with cancer. One of the most famous examples— Alexander Solzhenitsyn’s ‘Cancer Ward’ of 1967. The Nobel Prize laureate of 1970 had been treated for cancer in a clinic in the Uzbekistan Soviet Republic in the 1950s. His novel describes relations and fates of a group of patients with cancer in a hospital at the end of the stalinist era. It’s a picture of politics and society (The Gulag Archipelago) in the USSR. Cancer treatment in its thoroughly dark age stays in the background. With quite another background the novel nevertheless shares similarities to Thomas Mann’s ‘The Magic Mountain’ of 1924. The grandmaster of German literature in the early 20th century also presents a group of persons in a medical institution. In Mann’s novel they are bourgeois tuberculosis (TB) patients in a clinic (sanatorium) in Switzerland. What TB happened to be around 1900 cancer is in the 21st century, no doubt about the demographic trends. Let us leave undiscussed this old trick of writers to show human nature by convening individuals under some existential threat (TB, cancer) in a confined space. Anyway, whereas Solzhenitsyn’s and Mann’s novels also never concentrate on TB care or oncology itself as main topics another book on cancer caused an uproar in 1975. At that time, 40 years ago, the German actress and singer Hildegard Knef (1925–2002; in the US also known as Hildegarde Neff) published the second part of her biographic works: ‘The Verdict’—Knef’s documentary as breast cancer patient a few years earlier (Figure 1). Knef described the crude treatment modalities and the crude ways she was treated by her doctors. The book was almost immediately a bestseller in the German speaking countries. It was a hype. One year later it came out in English and gained Knef the Mark Twain Prize (it stood second among the bestsellers in the USA in 1976). The book was translated into 15 languages. There was discussion everywhere in the media: Should a cancer patient thus describe his/ her experiences? Is such a piece of literature denouncing medicine or doctors? There was an outcry on all sides.