ESTOY CANSADA DE “LUCHAR” CONTRA EL CÁNCER

Actualidad Salud / Cuidado personal

Por Susan Gubar (Tomado de New York Time)

El cáncer de ovario comenzó su ataque silencioso antes de que yo me diera cuenta. Él es el agresor evidente; yo, la parte afectada. Sin embargo, conforme mis médicos usan sus armas para contratacar, se acumulan los daños colaterales. La fatiga me envuelve.

En ocasiones, el arsenal utilizado contra el cáncer recurrente parece excesivamente violento. A menudo me pregunto qué pasará cuando (si sucede) el medicamento del estudio clínico en el que participo deje de tener efecto sobre mi cáncer. ¿Contaré con los recursos para someterme de nuevo a una operación o a la quimioterapia?

Paradójicamente, los protocolos médicos pueden robarnos algo del tiempo que nos otorgan. Es posible obtener un poco de tiempo extra a costa de una calidad a veces degradada de vida. Hay que hacer un enorme gasto de energía para ir al hospital, llenar el papeles, esperar a que tomen los signos vitales, los exámenes de sangre y que llegue el oncólogo, prepararse para las tomografías o la radiación, someterse a infusiones o transfusiones, formarse en la farmacia, lidiar con los trámites para la aprobación del seguro. Periódicamente, los procedimientos quirúrgicos debilitan todavía más a los pacientes que envían a casa con un arsenal de medicamentos para atacar los terribles efectos secundarios, principalmente dolor, náuseas y debilidad.

ESTOY CANSADA DE “LUCHAR” CONTRA EL CÁNCER - www.tvnoticias.com.co (2)

Consideren que esta situación ocurre durante años, sin una fecha final establecida, y comprenderán por qué los pacientes sitiados sufren fatiga por el tratamiento. ¿La fatiga de tratamiento es igual a la fatiga de combate? La manera en que nos enervan la quimioterapia y la radiación —ambas derivadas de tecnología armamentista, por cierto— nos desmoraliza conforme los regímenes de tratamiento se multiplican y, a veces, parece imposible continuar. ¿La fatiga de tratamiento explica la retórica entusiasta que bombardea a los pacientes de cáncer y que muchos de ellos despliegan?

En una conferencia para sobrevivientes de cáncer de ovario a la que asistí, cada una de las “guerreras turquesa” —el turquesa es el color asociado con el cáncer de ovario— se daba valor a sí misma para mantener una “actitud positiva” y aplaudía a otras por “luchar y vencer valientemente” al cáncer. Estas mujeres han soportado una violencia extrema hacia su cuerpo con una dignidad extraordinaria.

Sin embargo, su compromiso militante con la victoria parece no coincidir con sus probabilidades estadísticas de supervivencia (cerca del 45 por ciento de las pacientes con cáncer de ovario sobreviven cinco años; mucho menos tiempo si están en etapa 4). ¿Será que sus doctores no les informaron, o que reprimieron su pronóstico? Algunas tratadas por enfermedad en etapa terminal creían que estaban o pronto estarían “libres de cáncer”.

Cuando me dieron el diagnóstico de cáncer de ovario avanzado, la única persona en mi familia que creyó que alguna vez yo estaría “libre de cáncer” fue mi anciana madre. Los demás atribuimos su optimismo a unas ganas desesperadas de hacerse ilusiones. A veces, negarse a reconocer la gravedad de una enfermedad puede hacer que el paciente se sienta obligado a combatirla. En lugar de corregir a mi madre, me coludí con ella en esa fantasía reconfortante. Estaba decidida a no arrancarle ese consuelo.

ESTOY CANSADA DE “LUCHAR” CONTRA EL CÁNCER - www.tvnoticias.com.co

Para algunas personas la negación funciona como un conservador de la vida. Algunos pueden canalizar su determinación apasionada de vencer al cáncer en trabajo para ayudar a otros. Un lector me escribió sobre una experiencia así: creó una organización para ayudar a los pacientes de escasos recursos a lidiar con problemas de salud costosos y complicados. Respeto ese tipo de activismo, pero durante la conferencia me preguntaba en silencio: “¿Acaso las participantes habían sido engañadas por una especie de individualismo estadounidense tipo ‘Puedes lograrlo a pesar de tus mínimas probabilidades’?”. O quizá es casi imposible continuar sometiéndose a procedimientos debilitantes sin una esperanza exagerada en sus poderes de restauración triunfante.

Los títulos de muchos libros sobre el cáncer conservan el optimista lenguaje marcial de las participantes de la conferencia: Nocaut, Vence al cáncer a través de la alimentación, Plan de batalla contra el cáncer, Puedes combatir al cáncer y salir victorioso, Derrota al cáncer, Combate al cáncer con conocimientos y esperanza. Ese discurso puede funcionar con los tipos de cáncer curable. No obstante, incluso en esos casos, los generales que manejan las poderosas armas quirúrgicas, químicas y radiológicas son los doctores, no los pacientes. Pero mis dudas sobre el lenguaje de guerra van más allá de esa objeción.

¿A los pacientes se les ordena derrotar a su esclerosis múltiple? ¿Se les alienta a derrotar su enfisema, esclerosis lateral amiotrófica, artritis reumatoide o la degeneración macular de sus ojos? ¿Por qué esta belicosidad es tan importante en relación con el cáncer?

Tal vez una razón que explique el lenguaje militar con respecto al cáncer tenga que ver con la fatiga de tratamiento. Se necesita firmeza de carácter para someterse a esos nocivos rayos x, toxinas y procedimientos, en especial cuando lastiman una existencia que es alargada por solo un tiempo limitado. La repetición tediosa de intervenciones sucesivas cansa a los agotados pacientes. Los médicos y familiares seguramente sienten la necesidad de animar al desmoralizado soldado raso. Cuanto peor el prospecto, más fuerte resuenan los tambores. Considera la otra opción, se les advierte periódicamente a los pacientes con enfermedad recurrente.

Al lidiar con una enfermedad crónica o terminal, sin embargo, algunas personas deciden rechazar las alternativas médicas que dañan la vida que les queda para vivir. Quienes se detienen y desisten no deben considerarse cobardes, desertores, perdedores ni derrotistas. Como objetores de conciencia, han firmado su propio tratado de paz: si no con el cáncer, sí con su vida y su muerte. Rechazan el tratamiento de manera consciente, quieren que los días o meses que les quedan sean más que una guerra contra el cáncer. Quieren considerar la otra opción.

Todavía no estoy en ese punto. Pero honro a quienes deciden deponer las armas. Deborah Cumming, quien murió de cáncer pulmonar, escribió que creía que “el cáncer es una oportunidad insistente de aprender que al morir estamos vivos y al vivir estamos muriendo”. Pensaba que “una buena actitud” no consiste en “pelear, conquistar, ganar. Consiste en la gratitud cotidiana. Y en la paz, no la guerra”.

De cara a su cáncer de mama metastásico, mi amiga, la pionera en estudios de género Eve Kosofsky Sedgwick reconoció que anhelaba escuchar tres simples palabras: “Puedes detenerte ahora”.

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