“Annihilation” Is the Greatest Film About Cancer You’ll Never See

Patrick Koske-McBride
12 min readMar 12, 2019


AUTHOR’S WARNING: As with all film/book reviews I do, there won’t be any images in this one because I don’t want all the fun of getting permission or legal authorizations. Plus, it’s a horror movie, I can’t show you anything that’ll top your imagination. Also, as with everything I write, there will be lengthy, discursive asides. Consider yourself warned of spoilers.

As the Baby Boomers start dying off — cancer is the go-to big one at the moment, since it is an inevitability if you live long enough — there have been numerous films that handle death and cancer, such as the fantastic “A Monster Calls.” However, none of them really captures the experience from the patient’s point of view. None, that is, until “Annihilation” which is — appropriately — a survival-horror film (a recently-developed sub-genre of horror). Even though it’s a sub-genre of horror movie, I’d argue that it has few of the standard conventions; and doesn’t even go for the classic scary movie feeling of leaving you terrified; it is, instead, deeply upsetting, disturbing, and depressing. Just like AYA cancer. This will not be the last obvious parallel.

I originally saw this film during my initial 6-week chemoradiation treatment, when my mind was being literally ripped apart at a subatomic level and I was on chemo daily. I’ve discussed chemo brain and the problems/symptoms of such elsewhere, as well as how I dealt with it (lots of CBD and sleep), but, in addition to being distractible and forgetful, in me, chemo created a sort of extreme state-dependent recall, in which anything seen/read/experienced was largely lost until the next round of chemo. Because almost no memory is worth being exposed to a dangerous, toxic substance (again, that is the selling point of chemotherapy — it’s toxic for both you and your cancer), I’m only too happy to let most of those memories go. However, while visiting a friend in Big Sur, I got to re-watch Annihilation while mostly-sober. The weird, tessellated sense of deja-vu was, it turns out, the perfect lens through which to watch the film.

The opening premise is that a meteor hits a light house along the coast of an unnamed gulf state and produces “The Shimmer,” a bright, colorful energy field from which nothing is detectable nor from which anything escapes. The US government — because it’s run by white dudes in a horror movie — establishes an agency called “Southern Reach” to investigate and deal with the new phenomenon. Because all films require some semblance of reality to help suspension of disbelief, the fictitious agency handles this like a real agency would — sending in team after team, presumably with bales of cash strapped on their backs. The film kicks off when Natalie Portman (playing Natalie Portman in fatigues) finds her husband, Kane — who was on the last team sent into the Shimmer — standing in her house with no memory of who he is, or how he got there.

Kane soon goes into physiological shock, and they’re both whisked off by Southern Reach into quarantine. While there, Portman meets Dr. Ventress, the head of Southern Reach. One of the film’s underrated selling points is that all of the lead characters are women. Yeah; all the guys complaining about the gender of Captain America are going to lose their shit when they have to watch a film in which the male gender isn’t even acknowledged (AUTHOR’S NOTE: this is done so subtly and skillfully that I didn’t even realize it until doing some research and someone had pointed out that 99% of the film passes the Bechdel Test). Anyway, Ventress explains that, based on Kane’s return, they’re sending another team in (which seems an almost-unnecessary rationale, since it seems — to me — that sending people into the meat-grinder was pretty much the agency’s only strategy). Ventress also reveals that The Shimmer is growing — invading and metastasizing, if you will — and has already swallowed up Southern Reach’s original military base.

By the way, it might seem a bit of a stretch to discuss the film as a metaphor for cancer, but the film itself goes out of its way to establish this, including an opening shot of dividing cells, which Portman explains is a shot of cervical cancer cells dividing. Say what you will about the horror genre, but subtle, it ain’t.

Back in the film, Portman is introduced to her fellow team-mates (in the film, they establish that she’s a cellular biologist with a military back-ground, making her an excellent candidate to be sent off into an alien phenomenon; but that seems like gilding the lily — we all knew she was going into The Shimmer from the opening credits because she’s Natalie Fucking Portman; a film company’s not going to pay her a few million bucks to come to set and just work on her tan), and, in a nod to Tremors (there’s a lot of great references to other sci-fi horror films, especially Aliens and John Carpenter’s The Thing), they give you the multiple choice options for what happened to the previous teams (side-note, if you are ever involved in a venture that had previous teams, and the commonality is that no one ever heard from those people again; seek alternative employment); something in The Shimmer devoured them (or they got lost), they went mad and killed each other, or they went mad and killed themselves. If you listen very, very carefully, you can hear Lance Henriksen saying, “It must be something we haven’t seen, yet.”

The expedition enters The Shimmer and discovers… nothing. The landscape is lush, wild, overgrown, and completely devoid of human life. The sign “15–35-year-old chemo ward” doesn’t actually appear, nor do the obsequious, hideous well-wishers (who aren’t getting weekly infusions) saying; “Positive attitude; you got this.” Like so many other pre-cancer friends and contacts, they’re there, in spirit. Thoughts and prayers.

The Team quickly discovers that, although they only remember being in The Shimmer a few days, they’ve somehow gone through several weeks’-worth of food. I can only assume they’ve been taking their temodar and steroids.

After establishing that none of their communications or navigation gear are working — one of the few standard horror tropes to make it into the film — the team sets about exploring The Shimmer. They find mutants. In vast quantities. They find weird-ass flowers “Which look like completely different species, but these flowers are growing from the same branch.” There isn’t a flashing subtitle saying, “Cancer is when a group of cells becomes mutated, goes berserk, and tries to kill you,” but I’m sure that’s just an editing mistake. The team also stumbles across a sunken/flooded hut, and we get the first jump-scare, from a mutant alligator that eats one of the team members. After shooting it 40 times, the team opens the beast’s jaws (that seems like a good idea) and note that it has concentric rings of teeth, like a shark. Instead of tracking down the beast’s orthodontist, they conclude that The Shimmer must be mutating things at an unbelievable rate (again, the subtitles, “Radiation causes cancer, put down your smart phones” don’t flash on-screen, and it’s ridiculous to suggest it). Like everyone else who’s half-way through chemo, the team decides the best way out is through, and to push on (again, DO NOT stop treatment half-way through; that’s almost even worse than not starting it). The standard horror-survival trope where characters are slowly killed off one by one is also a lot like your new cancer BFFs — they’ll finish treatment and return to their lives or die, leaving you to deal with your own medical problems by yourself (that might be a stretch, but it mirrored some of my experience).

Eventually, the team makes its way to the ruins of the military base that served as Southern Reach HQ before it got swallowed by The Shimmer. They quickly find evidence that the previous team was using it as a base of operations and had set up a perimeter. Then they find a video card in a bag addressed “For those who follow.”

The next two minutes redefine the concept of body horror and cement the film as a cancer survival allegory. The film shows Kane cutting open the abdomen of another soldier in an attempt to stop the man’s writhing intestines from strangling him from the inside. It perfectly captures the horor, fear, and sense of betrayal every cancer survivor feels when they realize their own body is trying to kill them. Ventress immediately and vehemently denies what they’ve just seen. At first, this seemed ludicrous to me; after all, they are in an alien radiation bubble and have just been attacked by a Crocoshark, it would seem a safe assumption that all bets are off— then I remembered my own initial reaction to my diagnosis, especially the terminal nature of it — shock and denial would be an understatement. When you find yourself starring in a real-life horror movie, the basic preservation of your psyche dictates denial. Even with a positive scan result in front of you, you can’t comprehend — let alone orient yourself — to this waking nightmare. Denial isn’t a rejection of reality here, it’s a desperate attempt to preserve your tattered scraps of remaining sanity.

The team then makes the same mistake every newly-diagnosed cancer patient makes — they freeze. They set up camp in the creepy, abandoned base where — depending on whose viewpoint you accept, either the previous team went mad and carved each other up, or a man’s innards came alive and tried to kill him. Those typically aren’t talking points a realtor brings up. Like all newly-diagnosed patients, this lack of action is immediately and harshly punished. A mutant bear sneaks into camp and devours a secondary character. After finding the headless corpse, the team encounters a bunch of human-shaped plants, and one of the characters states that, if you sequenced their genes, you’d find human DNA. This is the first and only instance of “genetic analysis via squinting.” I hope Craig Venter has that patented.

I’ve heard elsewhere that the cancer allegory of this film is just a cursory reading of it, except there are moments where the characters almost halt, wink at the camera, and say, “This one’s for you, Pat.” We immediately get another one of those moments when, after seeing the human-tree hybrids, Anya (another character; forgive me for not going through and introducing them one by one, but we all know they’re going to die in the end) notices her fingerprints moving/mutating. Which brings us to the next stage in cancer psychology; paranoia and madness.

After you get a life-limiting diagnosis, you go through the Kubhler-Ross stages of grief (maybe, there’s a good chance I’m still in denial), then, as you begin treatment, you go through different stages (I’m still trying to figure those out). If everything goes well — as it did for me — and you go months without metastasis or recurrence, you start getting a little paranoid and stir-crazy waiting for the other shoe to drop. Especially once you start making friends with other cancer patients and hear horror stories about platelet levels, or clots, or the other side-effects of treatment. If those don’t happen to you — or if you only get the less-severe side-effects, it rattles you. Almost more than if everything suddenly went wrong and you got an imminently terminal diagnosis. So, I can kind of understand it when one of the characters freaks out about the situation and ties her friends down for an interrogation/possible murder (okay, so that’s a bit of an overreaction, but I do kind of empathize), pointing out that only Portman saw Cassie being eaten, and only Portman saw her body. I’d say that, even though I got a little paranoid and stir-crazy at some points, tying up your friends and threatening them at gun-point is probably an over-reaction.

It’s at this point the characters hear Cassie screaming, and the film subtly shifts into high gear. The mutant bear is back, and, in a move that scared the hell out of me when I first saw it, it’s imitating their dead friend’s final moments, vocally. The mutant bear kills Anya and is then shot to death by Josie. At this point, for those of you keeping track, there are only three characters left — Ventress, Portman, and Josie — again, this idea that everyone dies, goes mad, or just disappears is a disturbingly accurate recreation of my own experiences with cancer. I — and other survivors have written about this, but it bears repeating — there’s a really weird sensation of abandonment when your old friends, community, and support groups start distancing themselves after your diagnosis. As far as I can tell, this is largely a fear of saying the wrong thing, as if there’s something worse you can hear after, “I’m so sorry, it’s Stage IV.” And I’ve written it elsewhere, but I’ll repeat it; your healthy-person, get-out-of-embarrassment-free card for reaching out to sick people — and this will work for anything from glioblastoma (my disease) to measles (we have an outbreak in Oregon) -is, “I am so, so sorry this is happening to you. What do you need me to do?” It’s really that simple, and not saying anything is far more damning and shameful to you than saying the wrong thing.

In the aftermath of the mutant bear attack, Ventress goes on alone in search of the lighthouse, and Josie and Portman have a chat. Josie mentions that she just couldn’t bear (heh) the thought of dying like that, of your final moments being filled with pain and fear. Again, any time I thought this film wasn’t about cancer, the film almost stops and flashes the subtitles, “No, it’s about cancer.” I’ll admit I almost cried at that line when I saw it in theaters. Even if you put your nose to the grindstone and dedicate yourself to staying healthy and active, you never lose sight of the horrifying fact that you know exactly what your end is going to look like. I can not express how unbelievably disturbing it is to live in that reality; even if you’re at least a decade or so out from the hospice. And, eventually, it’s not the death itself that bothers you — I mean, I’m still horrified at that thought, but it’s no longer in the “Top Ten” of problems I go through when I wake up; it’s knowing that it’ll end in seizures, unending pain, and nausea (and, since I do have brain cancer, probably madness and crushing exhaustion).

At this point, Josie finishes mutating into a tree, and the responses of these three women typify survivor responses I’ve seen — give up in the hope of a cleaner, less painless death (Josie), forge ahead with treatment in the hope that you can dig your way out (Ventress), or keep going while trying to keep all options open (Portman)(that was my approach to treatment, too — just keep as healthy as possible for as long as possible in the hope that, if things turned south, I might be a viable candidate for other treatments or clinical trials).

We follow Portman to the light house — the source of The Shimmer. And here, the film again kicks into a higher gear of horror. Portman finds a video of Kane committing suicide via phosphorous grenade next to the hole in the ground caused by the meteor, and, afterward, into the frame steps… Kane. Except it’s not him, it’s clearly some sort of doppleganger (probably borrowed from The Thing). Portman, abandoning any last shreds of sanity or common sense, climbs into the hole in time to see Ventress consumed by The Shimmer. Portman is then attacked by the humanoid embodiment of The Shimmer, as it slowly and disturbingly morphs into her (or her doppleganger). After setting it ablaze, Portman flees the lighthouse, as The Shimmer evaporates. At a debriefing, when asked what it wants, Portman says, “I don’t think it wanted anything.”

Again, this was a sucker-punch to the gut when I first saw it. All cancer survivors — especially AYA survivors — want to know why this happens to us. I spent almost a decade in higher education looking for answers, and, unfortunately, the most-accurate one is, “Cancer is a horrible, but inevitable by-product of the way our genetic system is designed, and you’re a one-in-a-milion (actually, I did the math; I’m more like one in several hundred million) victim of horrific random chance” is also the least-satisfying (another contender is “God hates you, personally,” which isn’t scientifically accurate, but more psychologically satisfying, because at least there’s that personal aspect). In her book about teen lymphoma survivors, “Side Effects,” Amy Goldman Koss writes about the realization that cancer isn’t some sort of malevolent, evil force; it’s merely a disease trying to survive, but, unfortunately, that survival comes at the cost of the patient’s life. That’s definitely echoed in Portman’s line.

Then comes another doozy, after asking Kane (or his doppleganger) if he’s really Kane, he answers, “I don’t think so,” and his (and Portman’s) eyes shimmer. I’ve had three brain tumors (and three neurosurgeries), and, each time, the person who wakes up is not the same person who was rolled into the OR. I’ve struggled with trying to explain it, except that the nature of fiddling with a person’s brains (I once calculated that more people have sawed through my skull than walked on the moon)(although I’d have to go back and redo that calculation with more up-to-date info on the size of each surgical team and how long a residency is these days) fundamentally alters you. Same goes for anyone in active treatment; the process is so harsh and traumatic that the person who leaves the hospital is only similar-looking to the one that went in. And this film captures that unfortunate reality perfectly.

So, there you have it; the AYA cancer experience perfectly distilled and refracted into a horrifying film version. With mutant bears. It’s available with an Amazon Prime subscription, but, based on box office receipts, only 48 people saw it in theaters, and I can’t imagine my hearty endorsement of the film is going to make it immediately profitable (fun fact; a leaked memo from the studio reveals execs were worried the film was too cerebral for Americans, which might explain the disappointing box office).



Patrick Koske-McBride

Science journalist, cancer survivor, biomedical consultant, the “Wednesday Addams of travel writers.”