On fighting cancer (and other chronic diseases).
When I was diagnosed with cancer, I had the good fortune of being surrounded by people who were always supportive and kind. In the first days after my diagnosis, I was flooded with beautiful messages, words of incentive, and health wishes. The fact that people cared about me made me feel loved and supported, and it still moves me to this day. At the same time, I started noticing there was a language around cancer (and other chronic diseases), that was recurrent and quite fascinating. Having worked in oncology and palliative-care, I had heard and used this language before, so I cannot say I was surprised with it. However, I was surprised with the way it made me feel.
Frequently, people refer to cancer (and other chronic and life-threatening conditions) with war language. People with cancer are often labeled as “fighters” or “warriors”, and we try to convince them they “will beat the disease” and “come out victorious”. When someone dies of cancer, we say that person “lost their fight against cancer” after months or years “battling their disease”. We think about illnesses as an enemy, and we aim for their destruction through the use of “therapeutic weapons”. However, many people with cancer feel triggered by this language, which can be more discouraging than helpful at times. As one person living with cancer put it: “how can I fight cancer, when my body is the battlefield?”
The current language used around cancer can be traced back in history to when president Nixon declared “the war on cancer” in 1971. However, it is interesting to note that this perception is indissociable from modern society’s views on many other issues. We all heard about it in the context of other public health concerns (e.g. “war on drugs”). More broadly, violent language is a reflection of a model of society in which people believe that anything can be achieved through effort and will power. This world view implies that everything in life will bow to our will, if we just become determined enough in the pursue of our goals. Additionally, it is commonly believed that the more aggressive we are, the more likely we are to be successful. For example, many people believe that aggression is a required trait in a leader, when in reality, empathy and kindness achieve better results (Brown, 2018).
The question is that, when we realise we have way less control over life than we are made to believe, this fight-for-it attitude may be quite triggering. A person with cancer is way more likely to understand how vulnerable they are as human being. They are also likely to have a different relationship with the idea of death. There are, however, different perspectives on this subject. Some people, particularly some of those with potentially curable cancers, may feel strong and empowered with war language (Reisfield & Wilson, 2004; Semino et al., 2015). If that is the case, why not use it? If this is the strategy that makes them tolerate surgeries and chemotherapy sessions, or engage with life every day, it needs to be acknowledged and cherished. But what if this language is harmful for some people? What can we do then?
There are potential problems with the use of aggressive language around cancer. In many cases, telling someone to fight cancer makes them feel they are not doing enough (Granger, 2014; Semino et al., 2018). While people may like to think of themselves as warriors when they feel healthy and energised, it is hard to be a fighter after the 6th round of chemotherapy, or when you do not have enough strength to get out of bed. In addition, people with advanced cancers will probably not “beat their cancers”, but they can live with them for many years. Hearing someone else say they believe their can still beat their cancer may be distressing and alienating (Granger, 2014; Semino et al., 2018). The war language also creates a winner/loser mentality, in which people may feel like losers when their cancers are incurable, as if they have a choice.
Personally, I also felt this type of language was unhelpful. These are there reasons why:
The war metaphors used by some people around me did not match my internal experience with cancer. I never wanted to fight cancer, and just the idea made me feel exhausted. I just wanted to rest and create the conditions for my body to heal. My days were not a constant struggle. It was just me resting, and doing things I liked. Of course I had many hard days, but those usually required me to do less, instead of fighting more. Fighting implies we are actively doing something aggressive to literally remove a tumor out of our bodies. Of course many of us are proposed to receive aggressive cancer treatments such as surgery or chemotherapy. We may decide to accept these treatments or not, and there lies some power. But once the choice is made, we will need to surrender to the process. My cancer journey was easier for me when I softened and trusted, compared to when I tried to behave like Joan of Arc.
While most people around me seemed to hate my cancer, I was acutely aware it had come from my body. Cancer is not a foreign object. In the beginning, it was healthy body tissue. For some reason (or for many reasons), some of my healthy cells changed their genetic make-up, lost their ability to self-regulate, and to respond to their environment. They later developed into a large tumor with the potential to invade other body tissues. So cancer is no more than a state of cellular confusion and disharmony. But the same way we do not eradicate violence with violence, I never believed having an aggressive attitude towards my cancer would help me eliminate it. Instead of that, I focused on bringing harmony to my life and my body, so I could feel loved and supported in my path of healing.
Perhaps the thing that upsets me the most is hearing someone say that a person “lost their battle against cancer”, or that “the cancer took over”. Because the truth is, how can a group of confused cells take over a full individual with their story, their beauty, their hopes, and their dreams? When did our lives became a game of winners and losers? In the end, we are all going to die. Towards the end of our lives, we may become frailer, thinner, and lack control over our speech, or our bowels. But we will not be losers. We will not be losers because we are human beings, not human doings. Our power does not reside in what we do, but in what we are. As a result, we may do many things in life, but the important ones are those which are aligned with who we are. The story of a human being is reflected in every person who ever crossed their path. The size of that legacy is never truly known. It lies in every look exchanged, every act of kindness, every smile. So in the end, nothing is lost. Illness can never destroy people, but it is an opportunity to celebrate them.
So after all of this, what language should we use to empower people with life-threatening illnesses? The truth is, I do not think there is only one answer to this question. It depends on the person, their circumstances, and their illness. If you are a person living with a chronic or life-threatening illness, I invite you to reflect on the language you use and why you use it. How does it make you feel? Are some metaphors more empowering that others? Do you feel the need to reframe your language?
If you are someone who knows a person living with cancer, and you are not sure what to say, ask. From my experience, there are a few reasons why we use metaphors to talk about other people’s illnesses. Firstly, we believe we are helping them. Secondly, talking about life-threatening illnesses is uncomfortable, and we sometimes do not know what to say. If you feel uncomfortable talking about cancer, it is ok. I have talked about it so many times before, I have experienced cancer first-hand, and I am still unsure of what to say when I see someone affected by it. So, I invite you to be vulnerable. If you do not know what to say, say that. Vulnerability facilitates connection, and a sense of connection is one of the most important things to heal our lives. If the person has a clear preference, help them by using the language that feels true to them. In the end, words matter and you have the power to make a difference in someone’s life.
References:
Brown, B. (2018). Dare to Lead. New York, NY. Random House.
Granger K. 2014. ‘Having cancer is not a fight or a battle,’The Guardian, 25 April, available at http://www.theguardian.com/society/2014/apr/25/having-cancer-not-fight-or-battle.
Reisfield G., Wilson G.. 2004. ‘Use of metaphor in the discourse on cancer,’ Journal of Clinical Oncology 22/19: 4024–7
Semino E., Demjén Z., Demmen J., Koller V., Payne S., Hardie H., Rayson P. (2015). ‘The online use of violence and journey metaphors by patients with cancer, as compared with health professionals: A mixed methods study,’ BMJ Supportive and Palliative Care.
Semino, E., Demjén, Z., & Demmen, J. (2018). An integrated approach to metaphor and framing in cognition, discourse, and practice, with an application to metaphors for cancer. Applied linguistics, 39(5), 625-645.
