Lanes
by Berg
Image text: Each quarter of the lanes from left to right correspond loosely to breast cancer stages one through four (at diagnosis).
In the comments on wednesday it was pointed out that xkcd is a webcomic of romance, sarcasm, math, and language- humor isn't necessarily guaranteed. Today's comic, depressing as fuck and just as poignant, underscores that point.
The comic is built around a dialogue between two friends about cancer, presumably cancer that cueball number two's (hereafter Twoball) wife has been diagnosed with. The conversation itself is about as straightforward as a conversation can be. It details the maturation of Twoball's understanding of cancer diagnoses, knowledge which we can presume he has gained, reluctantly, by watching a loved one suffer. It is probably safe to say that either Randall or somebody close to him is currently in Twoball's position, and we, the readers, are the beneficiaries of this new understanding of cancer diagnoses without having to watch somebody close to us suffer. So... thanks, I guess?
The comic's title, Lanes, comes from the two panels which illustrate either end of the spectrum of Twoball's mental representation of how cancer treatment proceeds. In that there are many possible outcomes for cancer treatment, the image of a multi-lane freeway seems an apt metaphor to represent this understanding visually.
In the first freeway diagram, there are several paths, but the system is very simple, and easy to take in. Only a few lanes lead off into the oblivion which surrounds the freeway, a single offramp circles back from the path to survival to treatment, and survival is a visible endpoint.
In the second freeway diagram, however, things are much, much more complex, and much more bleak. Even six years out, survival isn't visible, and many lanes end in oblivion, sometimes not veering off for years after treatment. The image text informs us that this is meant to be loosely representative of breast cancer stages one through four, proceeding by quarters from left to right. It's a grim outlook, hence cueball number one's understated but completely fitting reaction to this plethora of new knowledge:
Fuck cancer.
July 29th, 2011
randalls fiancee has breast cancer. the “family illness”-message was also related to that.
knowing that, todays comic is very depressing
July 29th, 2011
Man this comic is depressing.
My mental model of breast cancer treatment used to be exactly that first image above. It got adjusted to the “correct” model when my cousin some years after her latest treatment suddenly died overnight.
Fuck cancer indeed.
July 29th, 2011
I may have phrased this badly, enligsh isn’t my mother tongue so I’m not sure. This is now half a year ago, by “overnight” I meant she was healthy the day – or even just hours – before death.
July 29th, 2011
No you phrased it correctly. Suddenly died overnight doesn’t mean she died recently, just that she died quickly. And we could assume that meant she seemed healthy immediately prior.
And I’m sorry.
July 29th, 2011
Note how graphically the final panel shows that as you pass from left to right through “breast cancer stages one through four”, the chance of an early bad outcome increases dramatically. Hence the importance of early diagnosis, to catch it while still in stage 1.
July 29th, 2011
Indeed. With 52 lanes in this graph, the first quarter (12.5 lanes) has one lane leading to death, versus the last quarter has all but two leading to death.
July 29th, 2011
Renal Cell Carcinoma has the exact same sort of treatment/relapse/survival model as this, and going through it myself right now, I was only beginning to understand the first model was inaccurate. Today’s comic taught me something that dozens of doctors and nurses have not been able to convey.
July 29th, 2011
Perhaps you should print it out for your doctor to use with other patients. I suspect Randall would approve.
July 29th, 2011
As much as I love Randall, that one word would prevent my oncologist from appreciating the comic.
It turns me off a little too (for explanation’s sake: my love for Randall drops (on a scale from 1-11) from 11 to 10 when he uses the “F” word.)
July 30th, 2011
Weird. I can understand people resenting childish overuse of the word fuck, but I think the use here is perfectly apt. There is nothing decent about people dying and thus indecent words are completely appropriate.
Fuck cancer. Seriously.
July 29th, 2011
Since it’s currently uncategorized, I’d probably categorize this one under “Illness” and “Death”
August 1st, 2011
I’d go one further. Based on Randall’s comments from the Blag, Bob may as well start a cancer tag.
July 29th, 2011
The ability to scan for individual cancer cells is the reason why thyroid cancer is the “good” cancer. You have to go on a no-sodium diet for weeks, and then you get injected with a radioactive dye that attaches to any thyroid cancer cell anywhere in your body. If some cells had gotten away, then they can be discovered right then, without waiting for that cough or ache.
I’ve had a few family members survive thyroid cancer for years. It will be wonderful when we can do the same for other cancers.
August 11th, 2011
I was diagnosed and treated for thyroid cancer, and I’m cancer free today.
However, this comic is a vivid reminder of the reality of recurrence rates, even for more treatable cancers like papillary and follicular thyroid cancer.
I teared up when I read this a week ago, and I teared up again today. Very poignant, and very depressing.
July 29th, 2011
Heads up:
“and we, the readers, are the beneficiaries of this KNEW understanding of cancer diagnoses”
Just found this site- not a deal breaker, but it didn’t make the best first impression.
July 29th, 2011
Welcome… And likewise, you have not made the best first impression…
July 30th, 2011
My dad’s stepmother is close to the 10 yr mark. Thanks, Randall, for helping me see what she’s really been going through.
July 30th, 2011
According to what Randall posted on his blag some months ago, his fiance was diagnosed with Stage III breast cancer.
I hope that this graph has percent error.
November 18th, 2011
Truth is, it doesn’t. We’s all like to imagine that the people we care about are the exceptions, but they aren’t. I only wish that knowledge was helpful somehow. For some cancers the treatment is horrible, a living death, is it better to hope and suffer, or enjoy a shorter time completely. I don’t know and I hate the question. Fuck cancer indeed.
August 20th, 2011
I was recently treated for Stage II endometrial (uterine) cancer. They’re pretty sure that the surgery got it all, but I had to have radiation treatments afterwards anyway, Just In Case; the oncologist explained that it raised my odds of long-term survival from “50 to 60 percent” to “85% or better”. (And in my case, the symptoms of a recurrence would be gynecological, and a bit more obvious.) But, yeah, definitely, FUCK CANCER.
This strip really hit home for me – so much so that I linked to it in my Dreamwidth and LiveJournal journals. I also printed it out, because it appeared just hours before my follow-up visit (six weeks since my last radiation treatment), and I was going to show it to the staff at the cancer clinic. I didn’t, though, because I realized that a couple of them would be offended by the presence of the word “fuck”. Instead, I hung the printout over my computer, but first I added a mark indicating that I was closer to the left-hand lanes… to remind me, whenever I start feeling sorry for myself, that I’m doing okay…