The Cancer Conundrum: Searching for a Healthy Metaphor

“Fighting cancer”.

We see or hear these words every day.

Former England cricket captain Tony Greig used them to describe his diagnosis: “Vivian (his wife) and I are going to put the boxing gloves on and fight this like we’ve never fought anything before.” http://www.heraldsun.com.au/news/national/tony-greig-reveals-his-battle-with-lung-cancer/story-fndo317g-1226499858729

Fellow commentator Ian Healy said, “It’s terrible, but one thing he is though, is tough”, in a News Ltd. article describing Greig’s “battle”.

But are military metaphors the healthiest way to describe a diagnosis?

In 1971, US President Richard Nixon declared a “war on cancer” by boosting government funding for research; more than forty years later President Barack Obama committed to “waging a war against cancer as aggressive as the war cancer wages against us”.

While few would argue against a financial fight, scientists question the language labelling the illness.

They say it sets up a false expectation within the patient – and society.

“A war is by its nature a time-limited event, in which there’s a defined end point. If we’re still fighting for 40 years, then that implies failure,” medical oncologist and cancer epidemiologist Dr. Alfred Neugut told marketplace.org http://www.marketplace.org/topics/life/health-care/war-cancer-healthy-metaphor

As Sally Gritten wrote in her moving article, Living with Cancer, Fighting the Cliches, “People have told me how ‘brave’ I am. Does that mean the ones who died should have ‘put up a better fight’? Could they have ‘faced down the enemy’? If they died, did that mean the disease ‘won’ and they ‘lost’?”

http://www.saga.co.uk/saga-magazine/2012/september/living-with-cancer.aspx

When Mum was diagnosed with pancreatic cancer 13 years ago she said, “I will beat this bloody thing”.

She visualised the healthy cells smashing the cancerous ones.

In her mind, the battle-lines were drawn; she would emerge victorious.

But the cancer was terminal. The doctors gave her seven months. She died on deadline.

In the end, Mum couldn’t believe she had “lost” her “battle”.

She was a strong woman, winning workplace “wars” with aplomb.

How could she come out second best in the “fight of her life”?

After working in Oncology for nine months, nurse “Jess” says hearing the words “fighting cancer” is “worse than nails on a chalkboard (or) squeaky glass”.

http://allnurses.com/oncology-nursing/fighting-cancer-546603.html

“Cancer is not a game, a contest, a marathon, or even a physical opponent. You cannot ball up your fist and knock it out.”

She feels compassion for those find succour in such semantics.

Everyone is different. Whatever gets you through. But it shouldn’t be one-size-fits-all.

The military metaphor is inaccurate.

The enemy is you: the cancerous cells in your body.

In a battle you train to fight. Nothing can prepare you for this.

It doesn’t matter how well resourced your army is. Cancer doesn’t discriminate between rich and poor.

One oncologist, speaking as part of a panel discussion entitled Cancer as Metaphor, regrets talking about “winning” or “beating”.

“I do think, when it doesn’t go well, that you add to a sense of failure,” he told The Oncologist website. http://theoncologist.alphamedpress.org/content/9/6/708.full

He remembers one patient who was about to move to a hospice after eight years of treatment.

“I turned to her and said, ‘Listen, are we still going to keep fighting this thing, or are we just going to change the nature of the fight and the nature of this battle?’ The minute the words came out, I realised that was not the way I wanted to say (it).”

He believes we need to balance the instinct to fight, with words of healing and acceptance.

Some say we should remove metaphors altogether.

In her seminal work, Illness as Metaphor, Susan Sontag writes, “The most truthful way of regarding illness… is one most purified of, most resistant to, metaphoric thinking”.

I disagree. Words matter.

People grappling with a diagnosis need images, analogies, and symbols to better understand their illness.

But it doesn’t always have to be a battle.

In the words of Sally Gritten, “I am not sharing this as a blueprint or a signpost. I am simply offering an alternative to the metaphors of war for people who are experiencing serious illness, replacing the stark dualities of ‘win/lose’, ‘right/wrong’ and ‘good/bad’ with language that is open and allows for more nuance. It may not work for everyone; we all find our own ways. These are mine”.