Tom Sutcliffe: This disease is a cultural epidemic

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Cancer has become one of the great fictional resources of our age – even more important, I would guess, than tuberculosis was to the 19th-century novel and music drama. Regrettably it isn't, at present, a non-renewable resource. Screenwriters and novelists who rely on it have no immediate need to find alternative energy sources and there is no conservation issue at hand. But nonetheless, so potent a fuel for stories and plots deserves to be used with some respect for its origin and some consideration for the ecological consequences of careless usage. Narrative devices leave behind pollution too, invisible particulates which get into the system and affect how we think about our lives.

And it's pretty much impossible to breathe in – culturally speaking – without encountering cancer. In the last two weeks alone I've encountered it in three separate works: implied but unnamed in Paul Bailey's novel Chapman's Odyssey; explicitly identified in Linda Grant's latest book We Had It So Good; and in the American comedy series The Big C. It wouldn't be very hard, I'm guessing, to fill the rest of this article with other instances that have cropped up in the last year or so.

One of the reasons it's so prevalent is that it's so useful. We've moved a considerable way on from the time when Susan Sontag wrote Illness as Metaphor – a philippic against the literary employment of cancer in a way that, she argued, stigmatised patients as the unwitting origin of their own disease. These days cancer is far more likely to perform an instantaneous ennoblement, not because we're better informed about the true origins of the disease but because our favoured cliché for the patient has become that of the "brave battler", a tabloid conscription into a war that nobody wants to fight. Any decent writer steers clear of such simplifications, of course, more often using cancer as a kind of disclosing agent, which will peel away the trivialities of daily life to reveal the inherent character inside. More often, cancer is employed as a simple memento mori, the monosodium glutamate of imminent extinction which is supposed to add savour to even the most banal pleasures. Cancer patients in fiction are often rendered instantly more philosophical – not in the sense of a stoical acceptance of fate, but in the truer meaning of interrogating it. Cancer, for its fictional sufferers, sharpens to a cruelly immediate point the sense that a final addition will be possible on the sum of their life, and often persuades them (and us by proxy) to start the totting up.

Cancer is also a ticking timer, always useful for a constructor of plots. In the real world it can sometimes seem (very unfairly in truth) that what oncologists know better than anything else is how long you have left. We're all casually used to the notion that we will die, but defer it to a later date which somehow exists outside of time altogether. In fiction, as in real life, cancer sets a date. "I could be hit by a bus tomorrow," we say, trying to acknowledge the uncertainties of life. Cancer shows you the bus timetable, and tells you with unsettling clarity when the next one will be along.

That's how it's employed in The Big C, in which Laura Linney's middle-aged mom discovers that her melanoma has left her with just a year to get her life in order and simultaneously supplied a powerful disincentive to procrastination. If she wants to do it – whether it's getting closer to her son or putting a swimming pool in the backyard – she's going to have to do it right away. Which is conventional enough, except that The Big C is played for rueful laughs, a departure from the conventional piety that surrounds this subject. That isn't what leaves a bad taste in the mouth, to my mind. It's the fact that Linney's character hugs her diagnosis to herself, so that her eccentricities are inexplicable to her immediate family. Why? Well I guess because it's the only way the writers can ensure that her breeziness of spirit isn't made impossible by the grief of those around her. It's as if she's taking cancer as an enlivening drug, but one that will only work if she tells no one. And I doubt that's really what it feels like, even for the most larkily stoical of sufferers. They're burning fuel recklessly.

Rough around the edges – and better for it

I visited the Arcola Theatre in Dalston, east London, the other night for Rebecca Lenkiewicz's play The Painter, about Turner's troubled relationship with the women in his life. The fact that Turner himself uses the phrase "love-life" in the play may offer one clue as to why it didn't quite work – though there was also a sense that Lenkiewicz had assembled a set of preparatory sketches for a drama, but never quite got round to the thing itself. If the play wasn't a finished triumph, though, the theatre was, despite being only a few notches above a building site. Arcola only moved in three days before the opening of The Painter and on the night I went it was clear that the work of conversion was far from complete. Naked light bulbs dangled from plaster-spattered cables and the space itself was a palimpsest of ancient brickwork and raw concrete. And the odd thing was that it was theatrically exciting to be in this space. A bit of that might have been self-congratulation, I suppose (look how fringe I've got), but it also had something to do with the interaction of the ephemeral component of theatre – this particular performance – and all the solid bits that surround it. In an expensively finished theatre it's hard not to feel that the building outweighs the performance. Here there was absolutely no question that the play was the thing – and the surroundings just the price we'd pay to watch it.

Writers deserve the last word

Martin Amis once wrote an alternative-reality short story called "Career Moves", in which poets and screenplay writers swapped places. The screenwriters scraped a living, desperately trying to publish their work in small magazines, while the poets had rapacious agents and flew first class to LA to work on rewrites of their latest villanelle. I occasionally fantasise about a more modest (and credible) reversal, in which actors and actresses trade status place with screenwriters. One understands, of course, why every newspaper leads off with the news of actor and actress nominations and prizes – and why the awards ceremonies themselves put films and directors and cast high up the pecking order. Newspapers like glamorous faces. And I know that complaining about a star system that has been pretty much unchallenged for around 100 years is as close to pointless as makes no difference. But still. One can dream of waking up to find that the names in the headlines are Aaron Sorkin (winner of Best Screenplay for The Social Network) or David Seidler (Golden Globe and Bafta nominated for The King's Speech). Both films, I'd suggest, owe their success more to the script than the casting (good as the acting is), and yet the writer's contribution is an afterthought.