There seems to be a trend towards using cartoons for health education: In just the past few months, we've posted on children's books, depression blogs, global-health videos, and art-based clinical skills, all using non-realist art to convey information and qualitative experience. A new blog by Andrew Howard, MD, radiation oncologist at the University of Chicago and the University of Illinois at Chicago, fits right in with this innovative bunch. His blog, Cancer Ninja, aims to use cartoons to convey both how cancer works and what it's like to be diagnosed and treated for it. Howard started it just one month ago, so his project was fresh from the creative oven when I spoke with him on the phone last week.
What motivated you to start Cancer Ninja?
I'd been frustrated for a while with how little my patients know about cancer. They come in with all these confusions; they don’t understand the difference between chemotherapy and radiation (and from a doctor’s perspective, there’s a huge difference). They don’t understand our rationale for choosing one treatment or another or a combination. One patient was convinced that hot sauce caused cancer and was really upset that she had gotten cancer because she had gone out of her way to avoid hot sauce all of her life. I realized there is a lot of misinformation out there, and that was the purpose for starting this blog.
My wife and I have two little girls, and in the evenings sometimes they say, ‘Draw dinosaurs with me, Daddy!’ So I started drawing with them, and I enjoyed it so much that I would sometimes stay up at night after they had gone to bed, still working on my dinosaur. My wife saw me enjoying that a lot, and thought maybe I could combine this with educating people about cancer.
Your website is targeted to be generally informative about cancer; why did you start with breast cancer?
Breast cancer is really common in this country, unfortunately, and it’s also very well studied, so we understand a lot about it, which makes it a nice model. There's a pretty clear algorithm for the proper way to treat a patient with such and such stage breast cancer, so it makes it easy to follow along.
How many characters or episodes are you hoping to do? So far, there's just "Jane."
I’m kind of experimenting. I envision that I’m going to follow Jane though her diagnosis and treatment, but my wife told me that Jane can’t die; she really likes Jane. But 40 percent of people with cancer will ultimately die of their disease, so I want to draw and write about what it’s like to be confronting one’s death, at least as I have witnessed it. What can medicine offer those people, and what can’t it? So I want to introduce a character who dies. I feel like there’s so much that’s already happened in Jane's story, and I could go back and fill in the details. The mutation steps that turn a cell into a cancer cell, that’s actually a really complicated transformation that I could explore in greater depth.
What reader feedback have you received, and where do you see this going?
I’ve had a number of patients tell me that they really like it and have already found it helpful. I’m trying to update every Tuesday, but I've got to speed up my drawing process!
My department chair is eager for me to do research, and it occurred to me that it would be really interesting to research the best way to educate patients. This hasn’t been well studied, so I was thinking of drawing specifically about one topic in cancer and then seeing how well it communicates to patients, as opposed to sitting in a room and talking to them.
Another thing about having kids is you start reading all these picture books to them, and I’m so impressed with some of these artists who can communicate so much with these really simple line drawings. It makes me feel like I have a lot more to learn about art.
Speaking of your daughters: What do they think of it?
They think it’s pretty boring! They’re five and two, so neither of them can really read yet and from their perspective there are too many words. But we will sometimes draw together; I’ll be working on Cancer Ninja and they’ll be working on their own projects and we’ll admire each other’s work. It’s pretty fun.
Initially, Howard wanted to write a book; the introduction he started is an engaging and compelling description of what an informed patient's care could be like.
Previously: Educating cancer patients in Africa and beyond, Prescribing a story? Medicine meets literature in "narrative medicine", Fruit-filled manga comics may increase kids' consumption of healthy food, Stanford nurse's whiteboard artistry brings cheer to patients, co-workers and Boing Boing co-editor tweets, blogs about her breast cancer diagnosis
Graphic by Andrew Howard