My Life (1993) and Advanced Kidney Cancer

Bob Jones is a Los Angeles public relations executive who has spent his adult life editing away his origins. He was born Bob Ivanovich to Ukrainian immigrant parents in Detroit, and he has barely spoken to his family in years.

He is told he has advanced kidney cancer and has months. It happens just as his wife Gail becomes pregnant with their first child. Rather than tell anyone, he buys a video camera and starts recording tapes for a son he does not expect to meet. How to shave. How to dribble a basketball. How to cook.

Gail discovers the illness and forces it into the open. Bob turns to an unlicensed healer, Mr Ho. The sessions do nothing to the tumors but crack open a lifetime of buried rage. He goes back to Detroit for the fight and then the reconciliation, and rides the roller coaster he was too frightened to ride as a boy. The baby, Brian, is born. The cancer reaches Bob's brain and he dies at home. The film closes on Gail and Brian watching the tapes.

Spoilers throughout. This page says how My Life ends.

Bob arrives already advanced, which is common enough to be worth explaining rather than assuming.

NCI is explicit that renal cell cancer may cause no signs or symptoms in its early stages, and that signs appear as the tumor grows. The list it gives is short:

• Blood in the urine.
• A lump in the abdomen.
• A pain in the side that does not go away.
• Loss of appetite.
• Weight loss for no known reason.
• Anemia.

None of these is specific to the kidney. Blood in the urine has many causes, most of them not cancer, which is exactly why it gets investigated rather than watched.

There is no screening program to fall back on here. NCI's kidney cancer page states that it does not have PDQ evidence-based information about screening for kidney cancer.

That is not the same as saying nobody is scanned. Some people are followed with imaging because of an inherited condition, and NCI names two: von Hippel-Lindau disease and hereditary papillary renal cancer. The other risk factors it lists are smoking tobacco, misusing certain pain medicines over a long period, excess body weight, high blood pressure, and a family history of renal cell cancer.

For where population screening genuinely exists, see cancer screening.

SEER's stage distribution explains why Bob's story is a possible one. The survival figures here track people diagnosed from 2016 through 2022. Sixty-six percent of kidney and renal pelvis cancers are found while confined to the kidney, and 5-year relative survival at that stage is 93.6%. Seventeen percent are regional, at 77.6%. Fifteen percent are already distant, at 20.3%.

Bob is in that last group. The film never says so, because it never says anything numerical at all.

There is no oncologist of substance in this film, no operation, no drug and no palliative team. NCI's summary describes a different landscape.

Surgery is the accepted and often curative treatment for earlier renal cell cancer. In appropriately selected patients, partial nephrectomy gives cancer outcomes comparable to radical nephrectomy while preserving more kidney function, and some studies report lower mortality. Radical resection removes the kidney, the adrenal gland, the surrounding fat and Gerota's fascia, with or without regional lymph nodes. For high-risk disease after surgery, NCI notes that postoperative pembrolizumab has been shown to prolong disease-free survival, though not overall survival.

Bob is diagnosed with widely advanced kidney cancer, then travels, argues, drives, rides a roller coaster and stays photogenic almost to the last scene.

The film's own plot supplies the contradiction. It sends the cancer to his brain. Headaches and seizures are the symptoms NCI's central nervous system summary names first for tumors there, and seizures are a presenting symptom in roughly 20% of people with tumors above the tentorium. Among people with metastatic brain tumors, 40% develop seizures at some point. A video project of the kind Bob is running would not survive that intact.

Brain metastases also come with their own daily management, none of which the film shows. NCI's summary names dexamethasone, mannitol and furosemide as the drugs used against the swelling that surrounds a brain tumor, and states that anticonvulsants are mandatory once someone has had a seizure. Bob has no steroids, no seizure medicine and no scans of his head.

The healer subplot is treated more generously, and deserves it. Turning to unproven treatment once conventional medicine has run out is extremely common, and the film shows it without mockery. What it does not show is anyone asking whether those sessions could interact with anything Bob was already taking, which is the question an oncology pharmacist would ask first.

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My Life is honest about anger, about the pull toward unproven healers, and about the dying being made to manage everyone else's feelings. It is not a picture of kidney cancer care. The fact worth carrying out of it is smaller and more useful: blood in the urine gets investigated, even once, even painless, even if it never comes back.

• NCI — Renal Cell Cancer Treatment (PDQ®), Patient Version
• NCI — Renal Cell Cancer Treatment (PDQ®), Health Professional Version
• NCI — Kidney (Renal Cell) Cancer, Patient Version overview
• NCI — Adult Central Nervous System Tumors Treatment (PDQ®), Health Professional Version
• SEER Cancer Stat Facts: Kidney and Renal Pelvis Cancer

This page discusses My Life for education. It is not medical advice, and nothing here is a judgement of anyone's real medical care. Spotted an error? Please email [email protected].