Although there are many discussions of politics and of cancer in Cancer Ward, the novel’s themes and meanings are conveyed primarily through the characters themselves. They are all measured by the degree to which they have a consciousness of society. Rusanov, for example, is found wanting because of his lack of imagination. This is most evident when his son Yuri tries to show him that the state cannot govern its people as surely as Rusanov supposes. In his government job, Yuri notices that certain stamps are missing from government documents. He comes to suspect that one of two women in the office has been using the stamps to add to her income. He dates both women, thinking that he will find in one of their homes fine furniture or other evidence of earnings in excess of a government salary. He finds instead that neither woman lives in luxury. In fact, he learns that both of them have been stealing the stamps just to have enough money to live. Rusanov is disappointed when Yuri tells him that he has not turned in the two women to the authorities. He does not understand that his son has tried to tell him that life is much more complicated than his simple Party maxims about loyalty to the state.

The pervasive theme of Cancer Ward is the human inability to confront the truth—whether that truth be the onset of a fatal disease, the corruption of the state, or a character’s blindness to his or his own limitations. Indeed, the novel ends with Kostoglotov, the bravest character in Cancer Ward, realizing that he too is afraid of real freedom, the freedom that finds people alone with the truth about themselves. Disease in this novel is the physical equivalent of the evil in human character. Just as there is something arbitrary about the cancer that can strike healthy human beings in their prime, so is there something arbitrary in the human character itself. Cancer Ward ends with Kostoglotov’s visit to a zoo. He sees a sign that explains that “the little monkey that used to live here was blinded because of the senseless cruelty of one of the visitors. An evil man threw tobacco into the Macaque Rhesus’ eyes.” It is the senselessness of the destructive act that profoundly disturbs Kostoglotov; there is no rational explanation for it. In itself, the sign is remarkable because it does not contain the usual jargon of Soviet public language that attributes foul deeds to antihumanists and agents of American imperialism. The simplicity of the word “evil” arrests Kostoglotov’s attention, for it is precisely the concept of evil that Soviet society no longer recognizes.