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It's too early to tell whether Lance Armstrong's yellow wristband craze is a fleeting fashion statement or whether the rubber bracelets - a symbol of cancer survivorship - will endure.
Regardless, the trendy $1 bands, inscribed with the command "Live Strong" and modeled by Olympians, presidential candidates, movie stars and Armstrong himself, represent the rapidly changing landscape in the fight against cancer.
Once a near-certain death sentence, cancer now also can be an endurance event. The Lance Armstrong Foundation, the group behind the "Wear Yellow Live Strong" fundraising campaign, is specifically geared to help those commonly known as "survivors."
The number of Americans living with the disease, or under the threat of its recurrence, has tripled to almost 10 million during the last three decades, according to last month's study by the National Cancer Institute and Centers for Disease Control and Prevention.
Consequently, the long-term emotional, physical and financial needs of cancer patients have increased too. This burgeoning population struggles with issues ranging from follow-up care, guilt, stigma, depression and fear of recurrence to negative side effects from medication over time.
The cancer group's growth and the unexpected sale of more than 8 million "Live Strong" bands has not only drawn national attention to the long-ignored survivorship issue, but it also has fueled the fiery debate over what people diagnosed with cancer should call themselves.
Armstrong, for one, is quite comfortable with "survivor," perhaps because as the world's best cyclist, he epitomizes channeled, fierce energy. Diagnosed in 1996 with testicular cancer that had spread to his lungs and brain, Armstrong underwent aggressive treatment at age 25. He not only beat the disease but won a record six Tour de France titles after the diagnosis. Along the way, he created the Lance Armstrong Foundation, now the largest national organization dedicated to survivorship.
Although not perfect, "survivor" is certainly hopeful, empowering and positive and can instill courage before, during or after treatment. Five years used to be a crucial survival mark, but Armstrong's foundation says survivorship begins the minute a person is diagnosed. A survivor, meanwhile, can be anyone touched by the ubiquitous disease.
"It's critical to understand that there is hope for survival and a return to a healthy life," said architect Michael Siegel, an Evanston father of five who proudly calls himself a leukemia survivor after two bouts with the disease. "Patients with hope can remain focused on the solution and not be dragged down by the problem."
But critics of the term, who have no better alternative, say "survivor" implies that cancer has been beaten when it could attack again at any time and that those who are still alive are somehow better than those who died. For some, "survivor" evokes images of prison camps and the Holocaust. Others feel unqualified to be a survivor or think using the term tempts fate.
When do you become a survivor? When is cancer something that belongs in your past?
The questions are impossible to answer. Everyone has an individual timetable. Meanwhile, most people acknowledge that even if the cancer has deserted the body, it still has a grasp on one's life.
"In some fundamental, philosophical sense, the power to name things is a way of taking control," said Barbara Brenner, executive director of Breast Cancer Action, who prefers the term "living with cancer" to "survivor." "If survivor works for people, they'll use it. It doesn't work for me, so I don't use it."
We will never find the perfect noun, and maybe we don't need one. The important thing is what people bring to the fight and that agencies like the CDC recognize that in addition to research, prevention, early detection and screening, people need help regaining control of their life after a cancer diagnosis.
That could mean anything from assistance when dealing with hospitals and insurance companies to practical information on finding clinical trials, organizing finances or preserving a woman's fertility, all survivorship goals of Armstrong's foundation.
At the very least, the energizing mantra "Live Strong" and the logo - two interlocking C's that form an "S" for survivor - are generating discussion. But Brenner, whose group offers "Cancer Sucks" buttons to get people talking, warns it shouldn't overshadow the real problem: "The great benefit from the (Live Strong) campaign would be to communicate to the whole world that there are way too many people in the cancer mill in the first place."
(Julie Deardorff writes for the Chicago Tribune. Write to her at: the Chicago Tribune, 435 N. Michigan Ave., Chicago, Ill. 60611.)
(c) 2004, Chicago Tribune. Distributed by Knight Ridder/Tribune News Service.