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Should Cancer Be Described As A Battle?

Research suggests that using war metaphors to describe cancer can be harmful to patients — so why do so many people keep using them? Something about cancer makes us think of patients being involved in a battle.

Other illnesses, even potentially deadly ones, don’t get quite the same treatment. Rarely do people fight AIDs, tussle with typhoid, or duke it out with coronary artery disease. Cancer patients, however, battle their disease.

It’s easy to see why newspapers — both tabloid and broadsheet — latch onto the metaphor of cancer patients at war with their illness. The story of a sick person actively engaged in a life-or-death struggle may seem more captivating to a reader than one involving them sitting passively while being slowly filled with poison or blasted with radiation, hoping their body responds.

Patients themselves are often prone to using war metaphors, too. Describing his diagnosis with metastatic testicular cancer that had spread to his abdomen, lungs and brain, cyclist Lance Armstrong said that he was faced with two options, medically and emotionally: ‘give up or fight like hell’.

Armstrong clearly took pride in perceiving himself as a fighter. And research suggests that war metaphors can be helpful to patients in certain circumstances.

For example, children with cancer can see improved outcomes when given video games in which a protagonist fights cancer, according to one randomised trial conducted at 34 medical centres in the United States, Canada, and Australia. Characterising the flu as a threatening may make the public more inclined to get vaccinated, one study said.

Yet metaphors — particularly ones involving battles or fighting — can also be harmful. Some research — as well as the accounts of many patients — suggests that war metaphors in which people either ‘win’ or ‘lose’ to their disease may ultimately end up doing damage to patient well-being.

In 2019, two psychologists writing in ‘Health Communication‘ outlined some of the potential harms associated with using war metaphors to describe cancer.

Professor Norbert Schwarz, a psychologist at the University of Southern California, and Professor David Hauser, a psychologist at Queen’s University in Ontario, Canada, said that according to their research, 1,000 healthy participants in four different experiments perceived cancer treatment as more difficult after reading passages that portrayed cancer treatment as a battle.

This led the pair to another possible danger: patients may feel unnecessarily fearful of treatment if they see themselves as having to participate in a fight. It makes sense. For many people, a battle of any kind is an extremely daunting prospect; it’s a lot easier to just sit in a hospital and rest.

War metaphors are also more likely to make people ignore symptoms and feel fatalistic about cancer when ultimately diagnosed, Schwarz and Hauser said. Patients are additionally more likely to feel a sense of guilt if their treatment doesn’t go according to plan. Could they have ‘fought’ harder?

Would they have better prospects if they were just a bit stronger? Have they let their loved ones down by not recovering?

In a recent article for the ‘Irish Independent’, cancer patient Ann Marie O’Sullivan said she hates being described as a ‘survivor’ because it suggests a strength of character without which she would have perished. The term implies that other, weaker people perished due to a lack of character.

O’Sullivan explained, “the idea that cancer is a battlefield and only the strong survive is not something I believe in. It is a damaging rhetoric. If a friend told me that they were going to battle their heart condition, I would ask them if they needed a lie-down.”

Many patients report similar feelings. In 2014, Kate Granger wrote in the ‘Guardian’ that she would like to be remembered for the positive impact she had on the world and for her relationships with others — not as loser, saying, “when I do die, I will have defied the prognosis for my type of cancer and achieved a great deal with my life.”

In her essay ‘Illness as Metaphor’, Susan Sontag claimed that metaphors associated with TB, and in the modern era, cancer, are responses to diseases thought to be intractable and capricious. When illness is frightening, mysterious, and arrives without warning, it’s understandable for us to think metaphorically — in a bid to understand what is happening.

Patients deserve to choose whatever language they feel is appropriate to describe their experience of being ill; no one would begrudge someone with cancer who regards themselves as a fighter, or later a survivor.

But we in the media and elsewhere can be more mindful of how we discuss cancer. Not doing so may inadvertently contribute to an environment that negatively impacts patient outcomes. Not every patient feels compelled to ‘fight’.

Source: Irish Medical Times


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