Cancer And Fighting Talk

Cancer is strewn with violent metaphors that some find empowering and others find abhorrent.

It’s very common to hear personal narratives and reported experiences of cancer described in militaristic, war and battlefield terminology as the ‘enemy’ where patients are ‘brave warriors fighting cancer’ and tumours are ‘blasted’ or ‘exploded’ through ‘aggressive’ treatment.

The discourse of cancer is that it is ‘invasive’ and ‘attacks’ the body and so, with doctors as ‘allies’, we declare war on cancer, keep our morale high and become an active party in conquering a foe. No surrender!

But being placed on the courage pedestal as part of a ‘war effort’ isn’t always welcome especially when the side-effects of treatment kick-in. Some people don’t see themselves as warriors or want the association because they don’t want to be at war with themselves (Wackers et al 2021).

The reality is, a large part of the cancer experience is one where you are as far removed from fighting as you could be.

As Nagornaya and Nwankwo (2023) note,

it does not reflect the true character of the cancer experience. Being a cancer patient requires a great deal of passivity and a frugal use of physical and psychic resources, rather than constant readiness to fight back.

The concept of “fighting” cancer can also create in the minds on some a win-lose scenario and can place the responsibility for both getting cancer and surviving it on the patient. For some, the war metaphor applies pressure to prioritise positivity in the face of diagnosis and treatment.

What really irks many is when others (mostly journalistic obituaries) talk about someone with a fantastic ‘fighting spirit’ and a ‘true fighter’ having tragically ‘lost their battle with cancer‘ which somehow implies that it is their ‘fault’ and they did not fight hard enough.

Or do they? I don’t think anyone seriously believes that. And no, declining treatment if you are a terminal patient does not depict someone as ‘cowardly’ or ‘giving up’.

‘War on cancer’ metaphors may do harm but these metaphors and others do serve as valuable linguistic and cognitive tools for making sense of and managing life events. They can give us the opportunity to make the reality of having cancer more accessible and readily understandable.

They do work for some patients and they are rejected by others. And that’s okay. There is no right answer because you choose your own relationship with cancer and frame it as you see fit.

Some cancer patients detach themselves from the war metaphor and adopt their own metaphors to express their personal narrative.

Some choose fairground ride metaphors e.g. and describe cancer as ‘a roller-coaster’. Others might focus on a sports analogy such as ‘a race for a cure’ or the tennis star who aimed to `reach match point in recovery’. Other will frame it as a monster such as ‘a beast’ to be tamed. The most frequently suggested alternative is to describe cancer as a ‘journey’. Bioeth (2016) argues that we should adopt more humane metaphors from the outset.

Those of us touched by cancer search to personalise our metaphors to our own experiences with cancer and for many, the war metaphors work perfectly well.

On a personal level, adversarial ‘fighting’ metaphors work best for me because they dovetail my actual treatment. I use the boxing and war metaphors not only in the biological aspect of cancer but also the social and psychological.

I’m having immunotherapy and this is a type of cancer treatment that helps my immune system literally ‘fight’ cancer. It uses substances made by the body or in a laboratory to boost the immune system and help the body recognise, attack and destroy cancer cells. That’s what they do, they ‘patrol’ the body to identify and destroy cancer cells – it is their job to kill so they kill!

That’s fighting talk and that’s what the body does – it fights. The immune system is the system in your body that fights off infection. The metaphor therefore is a match for me and my experience as it is for many others as it gives agency and control. As Semino, Demejen and Demmen (2018) note,

‘fighter’ is used by patients to present themselves and others as active, determined, and optimistic people who never give up, in spite of finding themselves in adverse circumstances.

I find the metaphorical use of the noun ‘fighter’ fits my personality and I used the same approach when I was on my knees having chemotherapy treatment. I am not a pacifist patient. I’m going to fight to stay alive no matter what I have to do – it’s my life! My plan of attack is to use violent metaphors!

Indeed Bodd et al (2022) say,

The war metaphor should remain an integral part of cancer care. Disregarding war metaphors robs patients of an important framework for meaning-making-one that may promote strength, continuity, and resilience in navigating cancer.

The language of healthcare really is tricky and healthcare professionals across the board need to ‘read the room’ and tailor their conversations accordingly and in line with a patient’s best interests. There is no perfect metaphor for talking about cancer and as Semino et al (2017) say, “different metaphors suit different people, or the same person at different times.”

Hulse (2023) says in her research that healthcare settings “need to consider patients’ language preferences to best facilitate coping and psychological adjustment to illness.”

What’s clear is that oncologists have an unbelievably tough job in selecting the ‘right’ language for different patients and many might choose to abstain from using metaphors completely.

The ‘Metaphor Menu for People Living with Cancer’ is now available to read, share and use so please take a look at see what you think.