“I want to call my next book ‘I Survived Cancer. But Can I Survive My Kids and My Grumpy Husband?’ ” quipped Lucas, 44, who on a recent Sunday was in the back of a New York City cab drinking chilled rosé with a group of girlfriends as we headed to a hipster Brooklyn parlor for celebratory tattoos.
Before such celebrities as Christina Applegate and Sheryl Crow helped take the edge off the C-word, Lucas was speaking out irreverently about the disease. Her 2004 memoir, “Why I Wore Lipstick to My Mastectomy,” became an international hit, as did the ensuing Emmy-nominated 2006 movie.
Now Lucas leads a growing number of Gen-X and younger cancer survivors who are changing attitudes toward a disease that was once a death sentence but now has more young survivors than at any point in history.
About 513,000 cancer survivors are ages 20 to 39, according to data from the American Cancer Society. Since 1999, cancer death rates for people in that age range decreased 19 percent in men and 15 percent in women. The declines in mortality rates are because of earlier detection and improvements in treatment, researchers from the society said.
“That data is completely shaking things up for young people,” said Lucas, whose jet-black hair and Jackie O sunglasses have made her the sassy face of cancer survival. “There’s a lot of real energy now with survivors.”
Lance Armstrong has his bike. Lucas has her lipstick — a metaphor for courage, for fighting back. Lucas was a quirky, female superhero during my own battle with cancer in 2006. I was a fan of her oncological brinkmanship and Bridget Jones-meets-breast-cancer mash-up memoir.
On TV, in movies
Lucas is not alone in her effort to subvert cancer’s stigma. Showtime’s “The Big C” stars Laura Linney as a woman who decides to live her life fully — having a steamy love affair, building a pool, and emptying her retirement account to buy a sports car — despite a bleak prognosis. This fall will see the release of “50/50,” starring Joseph Gordon-Levitt as a young radio reporter who has cancer diagnosed. The film co-stars Seth Rogen, who steals the show as the protagonist’s kindhearted and slightly overwhelmed BFF. (In one scene, he uses his bald, cancer-stricken friend as a wingman so he can play the sensitive male and earn the sympathy vote of women at a bar.)
The screenplay is based on real life. Rogen and Will Reiser were best friends as comedy writers for “Da Ali G Show.” Soon after, Reiser, who was 25 at the time, had a spinal tumor diagnosed. He survived and wrote a screenplay about how bizarre it was to have a life-threatening illness in the prime of life.
“Most movies depict cancer in a maudlin and very heavy-handed way,” said Reiser in a telephone interview. “I didn’t want to write a movie about me. Who cares about me? My hope is that it would be authentic and really capture what it’s like when you are so young and it’s such uncharted territory for you.”
“It totally captured how weird and [expletive] it was that this could happen to young people,” boomed Rogen in a telephone interview. “This movie is kind of like ‘Dr. Strangelove.’ Our hope is that it’s about a topic that no one wants to talk about, but it ends up ultimately being a great story — of friendship — that people want to watch anyway.”
Such pop-cultural touchstones as these signal a diminution of “cancer’s bugaboo,” said Matthew Zachary, head of the I’m Too Young for This! Cancer Foundation, the nation’s largest support organization for young adult survivors.
“We are not the dying Debra Winger anymore,” said Zachary, referring to the actress’s character in the 1983 tearjerker “Terms of Endearment.”
In March, Zachary will host the OMG! Cancer Summit in Las Vegas for 500 young adult survivors. “We are not your father’s cancer society,” says Zachary, who in 1995, at 21, was a concert pianist, composer and college senior who had pediatric brain cancer. He was told that he probably would not survive six months, much less perform again.
Not about ‘the cure’
Scientists working to find a cure at Bethesda’s National Cancer Institute recently released a white paper called “Changing the Conversation,” which addresses advances in detection, treatment and survival. According to Rick Borchelt, the institute’s special assistant for public affairs at the National Institutes of Health, it’s time for a new national dialogue about cancer, one that’s not focused on “the cure,” but on a future in which many cancers will be prevented, a slim few will have cures and the vast majority will be treated as chronic diseases much as diabetes and HIV are now.
“This is not reflected in popular culture today,” Borchelt said. “It’s a much different world today for people diagnosed with cancer. Successfully surviving cancer with good quality of life is increasingly the story our research lets us tell.”
Harold Varmus, director of the cancer institute, is also dedicated to fostering — and directing research dollars toward — the reframed cancer discussion. “There’s a much greater level of awareness on the complexity of survivorship today,” Varmus said. “And there is a serious effort by NCI to address the medical and psycho-social problems that are faced, like questions about what happens after you survive — employment discrimination, fertility, dating.”
The most well-known voice in survivor advocacy is Armstrong, he of the yellow wristbands, whose LiveStrong Foundation partnered in November with the American Society of Clinical Oncology to start Focus Under Forty. It’s a curriculum designed to educate physicians about the unique challenges facing young adult patients.
“The best way we can end the stigma of cancer is to share our stories with one another,” Armstrong said in an e-mail interview. “One in three women and one in two men are affected by this disease. It’s all around us all the time and humor is a great coping mechanism. TV and film can help to de-stigmatize cancer.”
Humor in the situation
When Lucas began getting offers to turn her memoir into a movie, she realized the idea of a breast-cancer chick flick would be so jarring that it might work better somewhere other than Hollywood. So she signed a deal with Lifetime Television — choosing he cable network because it had a Stop Breast Cancer campaign that would provide on-air information — and she worked with Nancey Silvers to adapt her book for the small screen.
The film’s plot shares the book’s self-deprecating candor: A recent graduate of Columbia University’s journalism school is working her dream job as a television producer when she has breast cancer diagnosed. She visits a New York topless bar and contemplates the power of breasts. She tries to imagine life after a mastectomy. She deals with a withdrawn husband who takes off skiing during her final chemotherapy session because he feels left out. She gets sick, very sick, especially in cabs, where she blurts out her bad news to a cabbie who ends up confessing that he had testicular cancer.
Lucas sees herself as standing on the shoulders of such women as Betty Ford. The former first lady was one of the first public figures to talk openly about having a mastectomy — an issue that was, in the 1970s, still highly taboo.
For me, Lucas’s humor is comforting. Grandparents can talk about death because they and their friends are facing it. But my peer group would much rather go out for cocktails than talk about how it feels to know that cancer might kill you before you hit 40.
“It’s been such an evolution with this whole idea of humor being used while a person goes through the C-word,” Lucas said. “People didn’t know what to think [of the movie]. Was it a drama? Was it a comedy? We used to whisper about this disease. Now we can note the absurdity. But I think it’s important that with the humor you also honor the darkness.”
The secret of Lucas’s appeal might be that she’s not perfect. She admits to wearing Spanx under her cute jeans. Although she shares how lucky she is that chemotherapy didn’t destroy her fertility, she also confesses that raising children can be maddening. Lucas wishes there were an adult Make-a-Wish Foundation to foot the bill for her post-chemo shopping spree.
“The biggest compliment I ever got from a reader was, ‘You made me laugh when I thought I would have nothing to laugh about.’ ”
At one point in her book, Lucas recounts consulting with a cosmetic surgeon about having areolae tattooed onto her reconstructed breasts. (“Whoever thought you would be shopping for a nipple?”) A doctor tells her that she can create a pointillist effect with hues of creamy pink, soft white and maroon — a Monet!
Ultimately, Lucas decides impressionist nipples would seem inauthentic. Instead she ends up at a tattoo parlor in New York’s East Village. She called many places to ask about a tattoo and got many rejections because of where she wanted it inked. But a tattoo artist whose grandmother died of breast cancer agrees to ink her and designs a tasteful heart with wings for the lower end of her mastectomy scar.
“I was born into a certain body, but I have become this one,” she writes.
Now, 15 years later, she’s back at the artist’s new parlor in Brooklyn. Lucas orders a pizza, and her friends look through books of tattoos as the record player spins New Order and Madonna.
All of us, inspired by Lucas and perhaps the mood of hipster America, get tattoos. And every woman has her own reason.
Lucas gets one to honor 16 years of survival.
This time, it’s pain that she’s choosing.