'Two messages from old friends began 'What terrible news about your health' and 'Not good news!' and then switched subject in the next line'

I am now between therapies, so to speak. Eight cycles of accelerated chemotherapy have left me rather battered - waking every night with hot flushes - and I embark on six weeks of radiotherapy imminently.

I have tried to keep working as much as possible, but having treatment every two weeks has made that a struggle at times. And I have agreed to reduce my hours in order to recover sufficiently to resume my former punishing pace once treatment is over. I say agreed because although I am acting on the good advice of caring professionals, it doesn't feel entirely voluntary. My work has always defined me.

I wait impatiently for my hair to return. Not so much elderly Betty Boop as white maggot. A few people have failed to recognise me. I should be pleased that each day brings me closer to the world of the hirsute, but in the small, sweaty hours the prospect of post-treatment life is strange, and in my head I am trying to adapt to the label of my illness. This has led me to think about disease and how we perceive those with it.

I am humbled by the cards, letters, e-mails and texts I have received. All made me smile for their humour, warm encouragement and sage advice. Two messages from old friends began 'What terrible news about your health' and 'Not good news!' and then switched subject in the next line. Perhaps they were embarrassed, unable to find anything positive to say. Don't get me wrong, I don't blame my friends. Theirs is a rational response in a society ill-equipped to deal with sickness without turning away in discomfort.

Others have told me how brave I am. To quote the wonderful Jane Tomlinson: 'What's so brave about getting cancer?' Perhaps they mean I am brave to talk about it.

Our whole media culture - tabloids, TV, magazines like Heat and Hello - is geared towards a saccharine world populated by youth, celebrity and affluence. Even the illness stories are sanitised; Kylie Minogue given the 'all-clear', attending a fashion show where she can spend more on a dress than the average reader spends on a family holiday. Yet for a year she was off the radar. Would news of her treatment and recovery provide negative, feel-bad publicity?

Even the terminology is off-putting. I prefer illness to disease. At least it has a counterpart in wellness, whereas disease suggests that the alternative is ease. Perhaps it would be odd to celebrate something as burdensome as ill health, but surely there are powerful arguments for changing our binary approach to the subject, to enable people to be open about their health rather than expecting them to go underground or be 'brave' enough to speak out.

Thanks to the wonders of modern medicine many conditions, including cancer, are becoming increasingly chronic. If we cannot embrace those with long-term conditions how will we enable them to take the full part in society that they would want and should have?

The resulting ignorance can be exploited through a culture of fear. Western medicine has been accused of disease-mongering. It has been suggested that this may be promoted by the pharmaceutical industry, in conjunction with the medical profession and patient groups.

I recently met an American who was expecting to be screened for prostate cancer at 30. Are we losing our grip? Surely it's time to stop nannying people and to give them responsibility not only for their health but also to deal with a world in which most of us will have several conditions by the time we shuffle off this mortal coil.