Cancer’s Face

Cancer, although devastating, is a fascinating disease. It is characterized by the rapid, uncontrollable proliferation of cells. The disease has long been defined by symptoms rather than by a causative agent. We disguise our persisting inability to pinpoint a single culprit by substituting naming for explaining. We refer to an agent that causes cancer as a carcinogen. Carcinogens cause cancer. If something is associated with the onset of cancer, it is a carcinogen. This naming by explaining has entered a new stage during the past few years. Researchers now consider cancer not a disease but rather an evolving species, a “separate, brand new parasitic species that evolve from and prey upon their human hosts.”¹

No matter its cause, cancer has long had a public face. James T. Patterson in his classic The Dread Disease: Cancer and Modern American Culture (1987) has reminded us that Ulysses S. Grant purposefully made his battle with lip, mouth, and jaw cancer public. Newspapers carried the details.

Keith Wailoo’s stimulating How Cancer Crossed the Color Line is about cancer’s face in the twentieth-century United States. It accepts the old adage that, in history, you begin your story in the middle. Wailoo starts his analysis in the 1920s with what he sees as the onset of the cancer-awareness campaign. Cancer awareness—measured as the public articulations of social scientists, littérateurs, journalists, and especially doyens of the then–brand new American Society for Control of Cancer—framed the campaign in terms of a single stereotype: white middle-class women. That caricature was not to represent all victims of cancer but rather the targets of the awareness campaign; it was to be cancer’s public face. This campaign’s raison d’être was twofold. First, women seemed to get cancer in far greater proportions than others—and by others contemporaries meant men; they did not much consider persons of difference—and, second, that target audience was a most critical segment of society. Eugenic concerns as well as conceptions of motherhood as the bulwark of the family and of society animated the effort. That the mothers of America would be stricken by the malady in seemingly increasingly greater numbers inspired both the campaign and also public examinations of motherhood, femininity, and the consequences of the modern age.

Those examinations not only further defined the target group but also those peoples left out of the calculus. African Americans, both male and female, received an identity in direct contrast to the cherished group. Two particulars drew the most focus. Some spokespersons argued that African Americans suffered cancer in small numbers; they said African Americans possessed a biology different than Caucasians and therefore rarely got the disease. Others argued that African Americans lived differently than contemporary white Americans. (Wailoo treats white America as if it were a monolith—a curious choice given the extreme homogeneity of ethnic neighborhoods in major American cities at that time. In addition, the Army Alpha and Beta tests, and the passage in 1924 of the National Origins Act, were potent demonstrations that a vast swath of white America did not consider itself homogenous.) Rather than suffer the trials and tribulations of modernity, it was believed that African Americans lived a marginal rural existence—Wailoo calls it “primitivism”—and therefore escaped the cancer-producing stresses and strains of an urban, hypercaffeinated life.

The analysis continues almost to the present day, as Wailoo searches for the point at which images of cancer do, in fact, publicly include African Americans. In what was, in effect, a formulation and reformulation of public policy (even if government was not involved), campaigners unfailingly applied new versions of race, habit, or ethnicity to support the redrafting effort. The Great Migration from the American South in the 1920s and 1930s brought rural African Americans before the more highly trained physicians of Northern cities—but cancer’s face remained lily white and its gender female. That face did not change even as the rise of the Nazis brought discredit...