From Cancer Cure to HIV Cure

by Ni Gong, PhD Candidate, School of Sociology and Anthropology, Sun Yat-sen University, Guangzhou, China

and Qingyan Ma PhD, UNC Project-China

There has been more and more research on HIV cure recently. If HIV is cured, what change will it bring to individuals and the society? Will there be any ethical and social problems occurring? These are interesting yet difficult questions to answer, as only one person has been cured of HIV so far: the Berlin patient – Timothy Brown. It is hard to estimate the influence of curing HIV through only one case. Even the HIV infected individuals may feel it impossible to imagine the world free of HIV. As such, we would like to explore a relevant target – a disease that is also hard to cure but hopefully can be – cancer.

One of the authors, Ni Gong, is a PhD candidate in the School of Sociology and Anthropology at the Sun Yat-sen University in Guangzhou, China. He has been doing anthropological fieldwork in a cancer hospital for over a year. He conducted in-depth interviews and participant observation with hospital managers, doctors, nurses, patients and their family members, and the administrative staff of the hospitals. In his research, he placed emphasis on doctor-patient interaction, the physical experience of patients, the understanding of and fight against the diseases, and the role of traditional Chinese culture in this process.

In most cases, surgery can alleviate the sickness and it is critical to count on the after-operation recovery. In the process of recovery, some problems, like too narrow suture and intestinal fistula, are rare, however, the risk of these rare side effects considerably affects the recovery and psychological state of the patients. Meanwhile, a successful treatment requires long-term observation, which may last for five to even ten years. As long as the patients of intestinal cancer are willing to accept the surgery and the supporting chemotherapy, there is great possibility that their tumors can be removed. However, the price for recovery is that they may lose their anus and have to wear a stoma. For many patients, the negative impact of a stoma may be greater than that of cancer. According to Ni’s interviews, the majority of the patients with stomas complained about how inconvenient it is by wearing the stoma in their daily lives. Some of them became discontent with their bodies. Some even mocked themselves and isolated themselves from their social lives and networks.

From the perspective of social science, the lessons of cancer cures may provide lessons that would be useful as an HIV cure is under developing.

First, both cancer and HIV are considered chronic disease. With the medical advancement in modern times, great progress has been made in the treatment for cancer, such as surgery and chemotherapy, and the side effects of the treatment significantly declined. Except those suffering acute complications, many cancer patients can live and work as the healthy people after the treatment. Similarly, HIV infected individuals can also enjoy a normal life expectancy if they have good ARV adherence.

Next, both the status of cancer and HIV infection can remain confidential to the patients themselves. Unless the HIV infected individuals want to make their disease known, it is difficult to know their physical health from their appearance. Ni’s study shows that a large number of cancer patients are reluctant to make their disease known by others too. In a lot of cases, both patients choose to hide their disease from the public, with the fear that their physical condition will affect their work and the relationship with people around them.

Lastly, uncertainty for curing HIV or cancer is common for the patients and medical professionals of both diseases. For cancer patients, the doctors would say: “If you don’t get the surgery, you can live for 1.5 or 2 years; but if you do, you can live for another 20 years”. The doctors will never say there is a 100% cure to their patients. By the same token, uncertainty in curing HIV is represented in the current discussion of functional cure and remission. The cancer patients can live a normal life with the possibility of relapse of tumor in the following decades after the surgery. In fact, Ni found out that the cancer patients in different stages of cancer view their lives, bodies and the disease differently. Their attitudes would change from great expectation to the ambition for fighting against cancer and to a peaceful mind.

In conclusion, the studies on curing cancer may greatly facilitate the ones on the cure of HIV, but more in-depth study and more data are needed in the future. Lessons learned from the interventions to treat serious side-effect for some cancer patients after they were cured and to deal with the emotional turmoil of wearing stoma are meaningful to design possible interventional strategy after HIV is cured.