ARTICLE: The Problem With "Fighting" Cancer
The Problem with "Fighting" Cancer
The usually successful component is what results in problems. When we take the metaphor further, we describe it as "conquering cancer" when cancer goes into remission, or describe someone as a "survivor" of cancer. This is then further complicated by how medical professionals and researchers use the term "survivor" as they will have a very specific definition in mind. Some research studies use a five-year survival window following diagnoses, (see the Coleman study referenced below), while theCDC says: "The term cancer survivor refers to a person who has been diagnosed with cancer, from the time of diagnosis throughout his or her life."
This makes all the difference. "Survivorship" for research is a very precise, very defined term. It may not be the same as what an individual defines as being a survivor, and some definitions (such as the one above) may not include anything about quality of life following diagnosis. But even when cancer goes into remission, there's still a worry that it might come back, and so the term "survivor" may be a misnomer.
On the surface, I get why we use this language. The language is meant to be positive -- it's meant to evoke support. It's a tough and trying time, and family/friends/colleagues want to provide help in an way they can. So we follow the template set for us by the media and charities to try and help, as words fail us. I should point out though that this language (i.e. "surviving" "battling" "conquering") isn't used exclusively for military metaphors; it can also be used in a religious sense, or used in conjunction with sport metaphors, and there are distinct gender differences in how cancer is reported between men and women in the language and imagery we use.
But what's the other side of that conversation? Someone who "loses" their "fight" against cancer? Someone who has "fallen"? And to take it to the extreme, would they have "made it" if they "fought harder"? Kristen Garrison writes:
How can a woman with metastatic bone lesions read Lance Armstrong's story of conquering the disease and feel anything but failure? His story may be true, but does not represent the average person, and such narratives, which get so much press attention and bookshelf space, undercut the comparably determined but unsuccessful efforts of people fighting cancer.
There's a negative side to that language that is coming out, as those diagnosed with cancer speak up. Blogs and social media give people a platform from which to voice their displeasure and connect with others who feel the same way. Heather Cleland (herself diagnosed with cancer) writes:
The language around cancer -- of "battles" fought, won, lost, and succumbed to -- fails to consider the sheer chance of it all. Sure there are cancers that we bring upon ourselves, but most are a result of the tiniest bits of bodies going rogue for reasons we've yet to understand. To speak of lost battles as though the warrior didn't want victory badly enough projects our proclivity to control outcomes onto something that cannot be controlled.
In the same vein, I recommend these two pieces written after Canadian politician Jack Layton passed away by Carly Weeks and Edward Keenan. Both discuss the outpouring of support for Jack Layton that described him as "losing his fight against cancer" and the issues around those word choices.
Similarly, other people have spoken up; some notable pieces include Beyond Breast Cancer, an open letter by Aria Jones and finally, an excellent piece by the late Julie Mason. There are a number of people who are against the current language choices we made, and I think they raise some very valid and very compelling points.
While some people may not like the metaphor, some might find strength and solace in it. For those, this language helps them, and if they want to consider themselves a warrior, all the power to them. That's their decision and their prerogative. The Canadian Cancer Society sums it up well:
You may feel like a "survivor" or have heard the term used in conversation. But what does it mean? It means different things to different people. You may not like the way the word is used, or you might feel that it doesn't apply to you. But the word "survivor" helps many people. It can be powerful, and for some, it's a positive way of looking at themselves. Using it helps them to cope with their life after cancer.
Comments
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I don't have a problem with "fighting" or "battling" metaphor. The probability of dying in fighting in World War II during the toughest fighting was close to the probability of dying in metastatic breast cancer. Vets from wars are similar to "vets" from "battling" cancer in many ways. Including PTSD, and their priorities completely change after their return from active-duty fighting and making life-death friendships on the battlefield.
The problem I have is with the "survivor" metaphor. It does NOT make sense except in the case where someone returns from active duty battle/treatment, and has very minimal chances of needing to return to battle/treatment. ie, NO stage 2 BC patients should call themselves survivors until they are at least 5 year out. Luminal B BC patients should not call themselves survivors until longer because Luminal B seems to have the same chance of returning over 10 years. When you see a young lady in her 30s and 40s being called a "survivor", I just feel it's totally misleading. When you see a young lady in her 40s having her cancer recurrence and being caught flat footed, I just feel that metaphor has come home to roost.
"Veteran" is a much better and more accurate term for describing someone who had gone through breast cancer treatment before and may or may not have to deal with it again and again in the future.
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Yes, it seems that the longer we live with current tx (conventional and otherwise), the more we are finding 'survivor' no longer means 'cured'.
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I use battle language when referring to my experience with breast cancer, simply because that's how it made me feel. Embattled. And shellshocked.
Personally, I prefer using "warrior" over "survivor" because I will never know at what point I will become a "survivor". Who does? I agree wholeheartedly that "survivorship" depends so much on things we can't control, so I'm a little leery (superstitious?) of using the term in conjunction with myself. After all, I won't know that I've survived cancer until I die of something else. And, then, I still won't know.
When I expressed my reluctance to use the term "survivor" to a good friend, she suggested using "surviving" instead. Yes, that felt better: "surviving" cancer suggests an on-going process, which I feel - quite strongly - will be for the rest of my life.
I feel that it's not just the military language used to describe breast cancer and breast cancer treatment, it's that whole, nasty "Pink Ribbon Tyranny". The Pink Ribbon movement - started with the best of intentions to raise awareness and provide support for those "battling" breast cancer - has degenerated into a dictatorship. Once the movement moved beyond disseminating information and providing support, and started defining what comprises a "good" breast cancer patient and all the positive things that can arise out of breast cancer (don't get me started!), it became (in my opinion) an political entity seeking to empower itself rather than an organization seeking to empower women.
And, of course, one of the truly misleading things to come out of the Pink Ribbon Movement is the belief that if women are positive enough, nurturing enough, fight hard, and find strength and spiritual enlightenment in the fight, then breast cancer can be cured. Maybe the Pink Ribbon people never actually used the word "cured", but the inference is there. So many people that I've spoken with seem to feel that breast cancer can be cured if "... you just stay positive..." Not to mention, the number of people who believe that - after five years - it will never come back. Which amounts to cured.
Great thread!
"... good girls never made history ..."
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I like "cancer thriver", ala Kris Carr. I use it a lot to describe myself. But I do feel like a warrior a lot too, and am going to cut my hair short again (similar to my grow out period post-chemo) because 1) I got compliments on my short hair and it's easy, and 2), warriors don't have long hair that enemies can grab
Seriously, at times I think I might be hedging my bets against recurrence. If I grow my hair out, will I have to have chemo again and have it all fall out again and go through the trauma again? If I keep it short, it will be less difficult if it happens. I know: it's not logical at all to think this way, but there it is.
Selena, I'm with you on the whole pink ribbon pink walks crap. Breast cancer is big business, and I wonder if those who claim to want to cure it are really committed to doing so: so much money would be lost since there wouldn't be a need for "pink" any more.
Claire
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"So many people that I've spoken with seem to feel that breast cancer can be cured if "... you just stay positive..." Not to mention, the number of people who believe that - after five years - it will never come back. Which amounts to cured."
One thing I have most definitely learned from this whole experience is that I am an extremely positive and resilient person, so these pep talks from people really get to me. It very much makes me want to say:
But that would no doubt be considered bad attitude, which is not allowed by cancer patients. Cancer patients must always be perky, positive, inspirational and exuding love of the universe.
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Claire... I'm like you. Everybody keeps asking me when I'm going to grow my hair out, but I keep getting it cut like my avatar pciture. Part of me is afraid that I will be tempting fate if I grow it again. Your comment: warriors don't have long hair that enemies can grab... explains it in a nutshell.
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Me too! I like my hair really short. I never would have cut it like this without the bc experience.
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I don't get too worked up, one way or another, over the wording because the hair can be split so many ways. Life...no one survives it, do they? So no one's a survivor. Then again, almost everyone "survives" through some kind of adversity during the course of their lives, so we're all survivors then, cancer or no cancer. Whatever.
Although I can't relate to the militaristic sound of "battling" cancer, I guess I have battled phone companies, insurance companies, landlords, crazy-ass school principals, and the like so, in that sense, I have had a lot less peacetime than previously thought.
What about "cancer journey?" It's used a lot, but it almost sounds cheery; but where the heck are we off to? Like, hey wanna see some pictures of my "I was robbed at gunpoint journey?" It can get absurd and funny.
Lately, I have liked using the terms, "my cancer drama" or "my cancer ordeal." Those are just my current faves at the moment, subject to change. I do call myself a "survivor" because even tho' it might be misapplied and kind of vague, people generally understand I have gone thru' some kind of threatment and it displays my optimism.
The bottom line, as I see it, it that we wll have to allow for the existence of multiple terms. Those to our liking and those not to our liking. I can't fault people who make a big deal about breast cancer terminology, because I've made a bigger deal about things even smaller; but seriously, if it doesn't stop the rotation of the Earth, how worked up can you get about it? Shakespeare always said, "Survival, by any other name, would be as sweet," or something like that, didn't he?
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Momine, LOL...that perky Jack...exuding his love of the universe.
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When I was about 21, I lived in LA. One day as I stepped out of my house, Jack drove by in a BMW with the top down. As he saw me he gave me that incredibly cheeky grin and a huge wave. Made my day.
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So, he would have been about 45 at the time...ahahaha...that sounds about right.
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I hadn't thought of that aspect, lol.
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pip57
I'm not sure what is driving the miliatary metaphors but in the press here, I get tired of reading about "all clear" "survived" "battled" and other meaningless phrases written by well meaning but frightened people to make themselves feel better. I think that language exists to reassure those not exposed to cancer that if it happens to them there is an arsenal of weapons they can utilise to fight it. I also have a slight problem with the pink ribbon brigade; i have facebook friends (and genuine friends) who did not lift a finger or a telephone when they found out about me, but parade around in their pink ribbons.. When I was inviited by my local charity to take part in a 10k walk I decided to volunteer instead and stood along with other patients at way markers.. well when the photographs went up on the website, they were ALL of celebrities and well meaning charity workers, not one patient on the 280 pictures!! I laughed out loud, still they did raise a few thousand pounds. Dont' want to sound grumpy, but cannot talk about this with anybody really
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Pip, what a thoughtful post.
I think there are tremendous subconscious forces at work. Of course other people want to think a positive attitude helps, or if a person fights hard enough they can win. If it hasn't happened to them, or to a close loved one, then it makes all the sense in the world. It brings the uncontrollable a little into control. When the lion is at your door and you realize it doesn't care if you smile or whack it in the snoot, you really know how much is out of our hands.
Edited to correct at typo
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Ha! How very timely:
STUDY: PESSIMISTS LIVE LONGER, HEALTHIER LIVES
Older people who look on the darker side of life tend to live longer than optimists, who in turn face an increased risk of illness and mortality, a new study by a German research institute found on Thursday.
Read more at http://www.wnd.com/2013/03/study-pessimists-live-longer-healthier-lives/#g0wK8Ye5Rk7RI5zA.99 -
Momine ---- LOVE your Jack post!!!! Made my day!! Regarding pessimists --- my father was one and lived to 89 after colon cancer and multiple strokes. Granted last 5 years miserable in a nursing home with excellent care........
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What is it about Jack? He certainly isn't a 'handsome' man...but he does have that 'something'.
I will have to read the pessimist article over afternoon coffee. I think I am more of a 'that's life' kind of person. I don't always get to decide how things are going to go, but I decide how to ride the wave when it comes.
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feel that it's not just the military language used to describe breast cancer and breast cancer treatment, it's that whole, nasty "Pink Ribbon Tyranny". The Pink Ribbon movement - started with the best of intentions to raise awareness and provide support for those "battling" breast cancer - has degenerated into a dictatorship
I so agree about the pretty pink ribbon. I have LE which seems to be the ugly stepsister of BC- nobody gives a hoot about LE awareness !
I like surviving. I wouldnt count my chickens before they were hatched :>)I'm sorry but personally, I hate cancer JOURNEY. This is about as far from what I have ever considered a journey to be.
Cancer nightmare might be ok, but then I might be considered the pessimist ( who lives longer and healthier
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Jack exudes enthusiasm generally and for women in particular.
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OMG! It was my damn optimism that caused my cancer. Imagine that.
Naw! I'm not that optimistic. Seems that there are conflicting studies out there about the impact of optimism vs. pessimism and all I can say is that I have tried both. Optimism is more fun.
purp, "Cancer nightmare" is a pretty accurate description.
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Eli, I prefer being optimistic too, but in light of our discussion, the headline made me chuckle.
Purple, yes, cancer nightmare would be more fitting than the flipping "journey." I am not hot on the "journey" either.
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This is great! Thank you so much. To me, the issue with the "battle" is that is implies the patient has the ability to shape the outcome, and we all know our real power over this disease is pretty small. In fact, the patient's participation in treatment is simply of compliance in many ways. There are actually very few options for cancer patients in general, very little has changed in terms of basic treatment, and all of this even moreso for metastatic patients. Frankly, the "battle" for Stage 1 is not the same as for Stage IV. The language around the disease in the media obfuscates the harsh reality that late stage patients will lose their battle much sooner in all likelihood. I think it is intended to do so, it overshadows the fact there is no "cure", and that 25% or more still succomb to the disease.
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the issue with the "battle" is that is implies the patient has the ability to shape the outcome,
I agree completely L to the K. It also places the ' blame' on those who ' lose their courageous battle with cancer.... "
Sometimes, it is not courageous it all- it is some sucky thing that is happening to us ...like it or not! -
Yes, purple et al., I agree about the "courageous battle." I am not courageous. I just want to live, so I show up for whatever misery the docs tell me might help me achieve that goal. The alternative is retreating to some cave and wait to die. It is kind of a no-brainer and does not take more courage than putting one foot in front of the other (OK, maybe a little more, but still, what else are you going to freakin do?).
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Purple - you were speaking for me too then...........and for me you are only brave if you have a choice such as do I run in to a burning building to rescue my dog or not? Not do I want to live or roll over and let cancer do its worst......
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That's so true Lily55... I don't see being brave as being a choice, and most of the time I don't feel brave, sometimes I even feel guilty - did I drink too much wine in my 20's etc.. blah blah too much sex? the list goes on, too much cheese?
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Lily, that's my definition of courage or bravery also. Being scared as snot of something but doing it anyway.
I don't feel like any part of my cancer nightmare (oh yes, Purple, that is definitely the most apt of the word choices) was an act of courage. I don't think it counts as being courageous to do something that scares the snot out of you if the alternative is even scarier. Of course I was scared of chemo and radiation. Knowing as much as I did about them, who wouldn't be? But an increased risk of dying young of my cancer was a lot scarier. I don't feel like I bravely battled anything: I ran from my disease into the ferocious arms of mainstream medicine and took all it could give me.
I don't think it's just Jack's enthusiasm. There appears to be something barely held back that's very hungry.
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Roaring enthusiasm? I know what you mean.
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