Another patient, Brian Hanamura, spoke about hope. He told of being diagnosed with stage-IV lung cancer when he broke his shoulder bone by massaging a sore spot he thought he had picked up while surfing. Now, says Hanamura, "Every morning I wake up and say, 'Thank God I'm alive.' " He has resumed surfing.

The essence of cancer is its potential for unlimited and destructive growth based on invasion of the body and systemic metastasis. The best defense is a cruel offense comprised of excision, radiology or chemical attack. Those who seek the biological romance of symbiotic relationships should look elsewhere.

The Kaiser Permanente tumor board, an adjunct to the Oncology Clinic, meets on Tuesday afternoons to review prognoses and possible next steps for those diagnosed with cancer. Some patients will go to radiology, some to surgery and some will be assigned to chemotherapy. The chemotherapy unit of the Oncology Clinic dispenses hundreds of drugs in various quantities and combinations. It also administers interferon alpha, a genetic copy of a protein normally produced by the body during viral infections and used in chemotherapy to stimulate immunity.

These treatments, as the Harvard Medical School Web site notes, can often be a two-edged sword: "The problem with (chemotherapy)," intones Harvard dryly, "is its toxicity profile."

The Charlie in this case is Dr. Charles F. Miller, the director of the Oncology Clinic at Kaiser, who this year is president of the Hawaii Society of Clinical Oncology. Dr. Miller is quick to acknowledge that "sometimes the treatment for cancer can seem worse than the disease."

Charlie's Angels are a handful of dedicated souls who specialize in the tough and heart-wrenching task of day-to-day combat with cancer. They are on the front lines.

The chemotherapy unit, on the third floor at Moanalua but about to move to the lobby level, is modernizing and expanding from four to eight of the reclining chairs used by patients. The chairs provide the look of a beauty salon — and oddly enough, there is beauty on display here, since what Charlie's Angels bring to chemotherapy is a reminder of how lovely the human spirit can be.

As John Daniel, a cancer survivor who recently lost his daughter to the same disease says, "Our commitment is to fight a good fight. We can help each other, so hold on."

What the angels at Kaiser emphasize is the idea that compassion and caring, and not tough facades and feigned aloofness, are important. One patient brought her 10-year-old daughter with her to watch a treatment so the daughter could see "how good they are to mom."

Nurse Barbara Tagert, who got her start in oncology at Sloan-Kettering Hospital in New York City and who served at military hospitals during the Persian Gulf War, fights back tears when she says she is emotionally involved with all her patients. Tagert studied at Catholic nursing schools on the Mainland and believes, "For nurses, God finds a niche." Her niche, she says, is fighting cancer.

Debbie Casuga, a graduate in nursing from the University of Hawai'i, has been in oncology since 1981. Pointing to the special relationships she has with her patients, Casuga emphasizes, "The patients bring us a lot. They're special. They lift us up, showing courage as we all fight the battle to sustain strength and provide for quality of life."

Then there's Diane Nakagaki, a registered nurse in oncology since 1978. She went into oncology for the research and new developments, but soon discovered her special empathy with patients in need of compassion. Nakagaki says the nurses have turned the chemotherapy department into an "oasis of hope."

One's daily or periodic treatment might begin with prochlorperazine or one of the other new anti-nausea drugs that have proven so effective. In preparation for what the nurses refer to as "sticks," the increasingly difficult daily attempts to successfully enter a viable vein so that fluids can be administered intravenously, the patient might be administered freezing spray or xylocaine to dull the sensation.

One of the characteristics of veins is that over time, like amoebae happy in their milieu, they adjust to intrusion by wiggling about. Nurses refer to these veins as rollers. Because of their increasing propensity to flee a sharp stick, they make a successful probe more difficult as each day passes. Nurses like Annette Viernes have learned to limit themselves to two failed sticks per patient per day before someone else is called in to take a fresh look.

With the stick completed and an IV up and running, the patient will be hooked up to a volumetric infusion pump, a mechanical device that resembles a metallic scarecrow. It comes complete with bulging plastic bags filled to the brims with chemical feasts.

Over time, armed with hematological counts and tests for platelets, electrolytes and the like, the nurses continually evaluate the patient to ensure that more good than harm is being done. Doses must be changed, proportions altered, respites provided. This is as much art as science, and the nurses factor their emotional empathy for the patients into the equations.

The stick-infusion-monitor routine, with variations, might continue for days, weeks or months. What doesn't change is the high dosage of compassion and caring and the celebration of patients as survivors.

At this year's Cancer Survivor Celebration Day, a survivor entertained the group with his 'ukulele version of "Home on the Range." There was a palatable sense of pride — and recognition — when he came to the plaintive lyric, "Where seldom is heard a discouraging word, and the skies are not cloudy all day."