What My Experience With Cancer Helped Me Understand About ‘Annihilation’

A deeply personal story about the relentlessness of mutating cells and what Alex Garland's Annihilation gets right about cancer.
Annihilation Sci Fi

There was a small bump on my left flank. It was red and circular. I thought it was from a bug bite. Harmless. Nothing to fret over. Time passed. The bump grew in size. I poked and prodded, and tried to figure out what it was and why it was getting bigger. It eventually caused an intermittent pain in my side. I would later learn precisely what this growth was. I was eight. It was a melanoma.

A nineteenth-century surgeon once described cancer as “the emperor of all maladies, the king of terrors,” as related in physician and oncologist Siddartha Mukherjee’s book “The Emperor of All Maladies.” It’s an apt description of what we know today is an umbrella term for numerous types of diseases all unified under one central concept: unsuppressed growth. A normal cell has in its programming “apoptosis.” Once a cell reaches a certain point in its cycle, it dies. Cancer cells “rage” against their own mortality so to speak. Through mutations, these cancer cells can’t stop growing and do not follow their ingrained programming to die. Their propagation results in the eventual death of the body, as normal cells are inundated by the cancer cells and can no longer function. Cancer is our cells mutating and turning against us. Siddartha Mukherjee describes cancer as a “clonally evolving disease.” It’s an illness that takes advantage of our bodies on a fundamental level.

The film Annihilation — written and directed by Alex Garland, based on the novel of the same name by Jeff VanderMeer — centers upon Lena (Natalie Portman), a biologist and former U.S. Army soldier. Her husband, Kane a current U.S. Army soldier (Oscar Isaac), volunteered with a team to venture into the enigmatic and dangerous Area X. He returns a year later with no recollection of the expedition and falls into a coma. Both Lena and Kane are quarantined by a government agency in a research compound positioned near the border of Area X, also known as “The Shimmer.”

The perimeter of Area X is surrounded by a membrane that looks like an amalgamation of light and liquid filtered through a spectrum of iridescent colors — hence “The Shimmer.” It’s revealed by Dr. Ventress (Jennifer Jason Leigh), a psychologist aiding in the study of The Shimmer, that the area is expanding in size. Unsuppressed growth. Area X is encroaching on unaffected areas and will eventually engulf the entire planet. In essence, The Shimmer is a type of cancer that is spreading from a source, suspected to be the lighthouse, based on past expeditions. It’s not said how many expeditions were sent inside Area X before the events depicted in Annihilation.

Cancer itself can be traced back to ancient Egypt. Imhotep, an Egyptian physician (2625 BC), described a form of breast cancer in what’s believed to be a facsimile papyrus of his teachings riddled with errors by whoever copied it. As related by Siddhartha Mukherjee, Imhotep offered only this sentence for therapy: “There is none.” Many lives have been lost in studying the illness because, in order to treat diseases, one must first understand them. That is the very nature of the field of pathology.

Cancer has four stages, and each stage is more advanced and resilient than the preceding one. In the nascence of medicine, it was all too common for healthcare providers to watch their patients die, not just from cancer but from other illnesses. Today, the prognosis isn’t as grim, but the fear of remission always impinges upon you. There is an intangible weight to cancer that is unmistakably present.

Kane is the only known person to have returned from an Area X mission. Lena volunteers for the next expedition in the hopes of finding a cure for whatever is afflicting Kane. This expedition is being led by Dr. Ventress herself. Ventress has watched expedition after expedition fail; all the crews she psychologically profiled presumably dead. She has a cold and surface-level abrasiveness that is the facade for something deeper. Something personal. A vulnerability she refuses to divulge to Lena.

The expedition depicted in Annihilation is tasked with finding the source of The Shimmer. Lena joins the task force, which in addition to Dr. Ventress, includes a paramedic named Anya Thorensen (Gina Rodriguez), a surveyor and geologist named Cass Sheppard (Tuva Novotny), and a physicist named Josie Radek (Tessa Thompson). All of the participants volunteered. They each have a propensity toward self-destruction in their own way. Sheppard lost her daughter to Leukemia. Radek struggles with mental illness. Thorensen is a recovering alcoholic.

For Lena, it goes deeper than Kane’s unknown malady. It’s revealed in fragmented flashbacks that Lena committed an affair, and Kane found out, perhaps the motivation for him volunteering to explore Area X. It only takes one cancerous cell. One error. And annihilation follows. Self-destruction is inextricably programmed into us on a cellular level.

Lena and the team pass through the border of Area X, and the effects are almost immediate. The group inexplicably has gaps in their memory, as if Area X itself has sequestered them from the rest of the world and distorted time. Getting diagnosed with cancer is in itself a time distortion field. Everything falls away. All of your worries prior that seemed dire now seem trivial. All of your plans that were once concrete becomes an amorphous liquid of uncertainty. It is a fragmentation of the mind, the likes of which I had not felt again until Annihilation.

Once past the initial phase of entering Area X, Lena and the expedition team learn that the laws of nature don’t apply. Mutations occur in different species that are impossible. Closest to the perimeter these mutations are subtle, but farther inside they’re more overt. The Shimmer, in essence, is taking finished sculptures and reverting them into mounds of clay to be shaped into new things and perhaps with each other. From an alligator with the teeth of a shark to a blind bear that’s been incorporated with human DNA to humans interpolated with plants. The prerogative of a cancer cell is to propagate. To perpetually survive. That is the same prerogative of the amalgamated creations of The Shimmer. They don’t want anything more than to survive. It’s capricious. Cold. Cutthroat.

A dichotomy is ingrained into the essence of Annihilation, from a “cellular” level up close to a macro level from afar. A tumor is either benign (good) or malignant (bad). Age and cancer are inextricably linked, as the risk for cancers increase with age. There are two running theories as to why we age: preprogrammed into us on a cellular level or damage incurred throughout life. There are two theories as to what happens to expeditions inside Area X: something kills the entire crew or something drives them insane, and they kill each other. Annihilation begins with the imagery of two cervical cancer cells and ends with a shot of Kane and Lena embracing one another with luminescence in their eyes, both irrevocably changed by The Shimmer.

Sheppard, Thorensen, and Radek all perish in Area X. Each represents a different aspect of cancer patients. Sheppard is the first to die, but the act happens off-screen. She’s ripped away from the group by a force that’s later revealed to be an amalgamated bear-human. The expedition can hear her cries for help but can do nothing to save her. Lena later finds Sheppard’s corpse. Her throat just flayed flesh and red. Thorensen has a similar fate, her throat brutally ripped apart by the bear-human, only we see the act in full. It’s grotesque and unflinching, but purposeful. Radek chooses to surrender to the effects of The Shimmer and becomes what is implied to be a topiary that bears a humanoid form; a mixture of human and plant DNA. It’s a beautiful if not morose display.

Terminally ill cancer patients live the remainder of their days as a shell. A human bereft of what we recognize as human. Cancer mutates. It evolves. It transforms our co-workers, loved ones, and friends into unrecognizable things. Palliative care such as pain medication keeps them relatively comfortable, but those final images are forever ingrained in those with them in their final moments. A dear relative of mine died in a short period from aggressive cancer in her bones. Juxtaposing the before and after is heart-breaking. She was the first person I saw ravaged by cancer but was not the last.


A cancer diagnosis has an irrevocable impact. Some obsess over their disease and want to understand it. Others want to fight the illness head-on and aren’t concerned with the minutiae. And others relinquish their will to fight and choose to die on their own terms. Dr. Ventress herself has cancer, making the study of The Shimmer more personal than we previously thought, as she’s profiled participants for numerous expeditions, but hasn’t helped the agency come any closer to understanding Area X. Like an inchoate oncologist who has spent their career helping cancer patients to no avail, only to be diagnosed with the same illness and resigned to a similar fate.

Lena and Dr. Ventress are the two remaining members of the expedition in the climax of Annihilation. Lena reaches the lighthouse, the suspected epicenter of the anomalies. Inside is a charred corpse with a bag of phosphorous grenades next to it and a video camera in front of it on a tripod. Lena plays back the footage from the camera, and the corpse is revealed to be Kane. He sets off a phosphorous grenade and dies by self-immolation… All while being watched by his doppelgänger. The Kane outside of Area X in a coma most assuredly is not the Kane that first entered. Lena trudges through a tunnel that leads to a structure within the lighthouse. It’s a chamber that appears to be a mixture of obsidian rock and striking light with the pliability of human or animal tissue. The walls rhythmically pulsate, perhaps meant to be a beating heart or breathing lungs. Whatever it is, it’s alive.

Inside this chamber is Dr. Ventress, but she appears unwell. Otherworldly. She says cryptically that whatever caused The Shimmer is now inside of her. A luminescent liquid is “squeezed” out of Ventress by an unseen force. Like the cross-dimensional folding of a paper doll. Lena flees and comes face-to-face with an extraterrestrial being I call the “Obsidian Figure.” It mimics her in a haunting sequence that one might describe as a hypnotic dance. It’s dream-like. Tense. Like we are watching Lena’s body go through a series of motions without autonomy. My cancer made me feel as if I had become detached from myself. It was like I was in the dream of someone else. The figure morphs, and we catch a glimpse of a doppelgänger of Lena.

Using the Obsidian Figure’s mimicry against it, Lena pulls the pin from a phosphorous grenade from the bag left by Kane and unleashes an explosion. The Obsidian Figure takes the flames and abets the fire’s consumption of the lighthouse. Area X turns to ashes. The annihilation of everything. Lena escapes the lighthouse… but which Lena is it that watches it burn in that haunting, lingering shot? The events of the expedition are being retold by a Lena in quarantine. They’re subjective. Perhaps revised with details omitted.

Treatment for cancer is to eradicate the cancer cells either through treatment that destroys healthy tissue along with or the removal of the cancerous cells along with healthy tissue. It’s a harsh and capricious and uncaring treatment for a harsh and capricious and uncaring disease. Area X refracts everything inside of its perimeter, and in doing this, Annihilation illustrates the harsh realities of cancer. Except for the extraterrestrial being, everything inside The Shimmer is a manipulation of what already is present on Earth. Cancer is a mutation of cells, but it is our cells and our cells alone. It’s not a foreign entity, and its greatest contributor is time. The eradication of other illnesses and our prolonged lifespans have allowed cancer to become prominent.

At the beginning of Annihilation, an incandescent meteorite plummets from the stars and crashes into the lighthouse. The name “cancer” originated from Hippocrates’ description for tumors: carcinos and carcinoma. The consensus seems to be that the tendrils that sprouted from cancer reminded Hippocrates of the shape of a crab. The terms were translated into “cancer,” which is the Latin word for crab. Cancer is one of the constellations of the zodiac, and it is indeed the shape of a crab. It’s fitting that the source of The Shimmer in Annihilation is an extraterrestrial being from the stars. I’d like to think whatever it is came from the Cancer constellation because of the poetry of it.

The melanoma was removed from my left flank. It took two surgeries. No chemotherapy, immunotherapy, or radiation. A scar runs across my left side as a reminder. I’m lucky, although, in truth, the melanoma was likely the result of a DNA error. Melanomas can form anywhere in the body, including the eyes. The weight will never be lifted entirely, but I’m still here. Not everyone afflicted with cancer is still alive to talk about it.

With my profession, I’ve helped in the care of cancer patients. Those who survive are never the same. The ending of Annihilation is ambiguous. We know the Lena and Kane that embrace isn’t the same Lena and Kane before being exposed to Area X. Is this truly the end of the anomalies? What impact will they have if they leave their quarantine? There is much we don’t know and perhaps will never know. The universe is capricious, impartial, and chaotic. We are tempered by the adversities we face either of our own or through others. We rage against our mortality until we can no longer do so. All ultimately futile. Annihilation is inevitable. No matter the permutation, we have each other.

Mike X. Nichols: Adores storytelling and raccoons. Fought the void but the void won.