August 30, 2004
Don't ask about my battle, ask about me
We seem to struggle with language when the topic is cancer.
We don't think twice when cancer is discussed in military terms. Thirty years ago, Richard Nixon declared "war" on cancer in his State of the Union address.
When I was diagnosed with breast cancer a few years ago, countless people told me to "fight this thing." Since I'm still alive, I'm often referred to as a survivor. If I were to die, my obituary might well read, "Bob lost his long and courageous battle with cancer."
The language of cancer seems to mirror the language of war. Battles are won and lost. There are survivors and there are victims. But is this the language we should be using?
Over the last few years, I've had several friends die from cancer. I don't think it's appropriate to say that they lost their battles. That seems to blame them for not fighting hard enough.
I prefer to say that cancer was the cause of their deaths.
In a similar fashion, I'm not quite comfortable being referred to as a survivor of cancer. Survivor is a much better term than victim, but survivor seems to connote victory. I'm not sure that I have beaten cancer.
And what if I were living with metastatic cancer -- that is, what if the cancer had spread to distant parts of my body? Would I still be considered victorious? A survivor? I'm honestly not sure, but I wouldn't want anyone to think that I had lost or was losing. I would want people to think that I was living with cancer to the best of my ability.
One of the more difficult questions I wrestle with is whether I should say that I had cancer or that I have cancer. Even though I'm an optimist by nature, I usually say that I have cancer, but with no current evidence of disease. That's partly because I have breast cancer, as opposed to many other cancers that tend to recur quickly or not at all. Breast cancer can return after 10 or 20 or even 30 years, so there's never a comfortable feeling that it's securely in the past.
Even the treatment for cancer is saddled with language difficulties. I suspect that most people have heard of chemotherapy being referred to as poison. Chemotherapy is medicine. Any medicine -- even aspirin --can be poisonous if taken incorrectly.
Why should chemotherapy be singled out for its potential dangers and not for its potential benefits?
And I cringe when someone has a recurrence of cancer in spite of being on chemotherapy and it's said that "he failed chemotherapy." Wouldn't it be more accurate to say, "chemotherapy failed him?"
Casual conversations about cancer also cause people to speak in seemingly bizarre code. I recently heard a person refer to cancer as the Big C. I wanted to ask her if she referred to diabetes as the Big D or eczema as the Big E.
Although cancer can still make us tongue-tied, we have progressed in that it is discussed.
Fifty years ago, people sometimes died of cancer without ever being told the diagnosis. (Of course, most people dying of cancer knew they were dying of cancer, whether they were told or not). And today, more and more people are living -- in every sense of the word -- after a cancer diagnosis.
But we still have a ways to go in being comfortable with the language of cancer. It is a disease that scares people more than any other. But talking about cancer by using warlike metaphors or quirky code creates barriers that prevent us from really talking about it.
I'll be happy to discuss my cancer with you. But don't ask about my battle. Ask about me.
Bob Riter is associate director of the Ithaca Breast Cancer Alliance Reprinted by permission