There is one word in medicine that I can guarantee will
strike fear when heard or thought about late at night: cancer. I can also bet that there is a second word
that is inextricably linked to that scary word: fight.
Have you ever thought about the symbols we adorn cancer
with? He fought cancer, she battled cancer, he won the war on cancer, she's a
survivor, he was so brave and didn't give up, and he beat cancer.
No wonder the word cancer evokes fear, with phrases like
that it sounds like a malicious enemy stalking us. It also implies that our character has
something to do with treatment, because who wins wars? The courageous and
persistent warriors win.
I'm here to break it to you. Cancer is a disease, and just
like heart disease, kidney disease, lung disease and liver disease, it can
cause death. There are also treatments
for cancer, just like those other diseases, which can prolong life. However,
your willingness, bravery and strength of character have little to do with
those treatments. We don't tell patients
taking their hypertension meds, "You are doing great on your war against
hypertension!" Or that patient with COPD, "Every time you use your
inhaler you are battling lung disease!"
We don't use war analogies for other diseases because we
know we can't separate out the disease as bad, and ourselves as good. Yet, we do this for cancer, by naming it an
enemy. This immediately makes cancer
much more personal and raises the stakes of fighting it, to a moral obligation.
Here is the harm that making cancer a war analogy does: To
the patient with stage 4 cancer that cannot be cured, they are now a failure.
To the patient who chooses not to undergo chemotherapy that may diminish his
quality of life, they are now a coward. To the patient who has tried to
overcome cancer with various therapies but is now exhausted and wants to quit,
they now feel guilty for letting their family and doctors down.
When cancer becomes a battle, then anything outside of a
cure becomes a failure, and with failure comes guilt, shame, and anger. It's hard enough dying with cancer without
those added emotions.
I know many of your loved ones, or you yourself, have
survived cancer or are currently in treatment. Please know that your victory is
meaningful and by all means continue treatment if it is helpful. However, we should equally praise those who
daily battle diabetes and obesity. To
those who struggle with depression or overcome smoking addictions, we should
call you survivors too. In other words,
let’s celebrate life and mourn death equally, no matter the cause.
To those who cannot be cured or chose quality of life over
longevity, let's give them permission to do so. Let us be the first to remind
them that usually it takes more courage to face a disease realistically than it
does with a metaphor. And most
importantly, if hospice is involved, it doesn't mean that a battle was lost,
only that the focus changed from treating an “enemy” to treating oneself.
