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Why Do We Still Describe Cancer As A "Battle" Or "War"?

Medical professionals debate whether war metaphors are helpful or harmful to patients.

[Photo: Flickr user Indi Samarajiva]

At the Future of Genomics Conference in San Diego, physicians repeatedly referred to cancer as a "battlefield" or a "war." By implication, they were the soldiers fighting the disease on the front lines of care.

The frequent use of military metaphors to describe the disease generated a fascinating discussion among attendees at the conference and on Twitter. Are we ready to move on from this kind of jargon? And is it helpful or harmful to patients?

We have used military imagery for more than a century, which culminated in President Nixon's famous declaration of a "war on cancer." This language is pervasive today. A 2015 study found that patients with cancer use violence metaphors about 1.5 times per 1,000 words to describe their illness.

But in recent years, some patients have argued that these terms are misleading or even dangerous. War metaphors imply that a patient has more control over the disease than they actually do. When a friend or family member is in remission, we say they "fought hard and won." But the opposite is true for those who don't survive. As Lisa Bonchek Adams wrote in her influential blog in 2012: "When I die don’t say I "fought a battle." Or "lost a battle." Or "succumbed."

Some physicians tell me they are actively working to banish this language from their vocabulary.

Dr. Steven Tucker, a cancer specialist and practicing physician, is particularly thoughtful on this topic. He believes that this terminology is biased toward the traditional methods of treating cancer, where we blasted cancer cells (the enemy) with radiation. These days, scientists are working to develop new therapies to strengthen the body's own immune system.

"Cancer has arisen from within my own body, from my own cells. To fight it would be 'waging a war' on myself," writes Kate Gringer in a recent op-ed for the Guardian.

Moreover, Tucker says that these metaphors shift responsibility away from the patient. We don't talk about how people can play an active role in prevention by living a healthy lifestyle, he says. All the focus is on defeating this "third party" cancer, rather than on the "self."

But Drew Olanoff, a cancer survivor who works in the tech industry, finds this language to be quite helpful. "Emotion needs to be pushed when discussing this or any disease. You push emotion with visuals and words, and cancer sure felt like a fight to me," he says. "I got my ass kicked, but I kicked it harder."

Olanoff, however, does take exception to using the word cancer if it is used pejoratively to describe people or groups. One example is the Pentagon's metaphor that ISIS is a cancer that must be excised before it can metastasize.

Regardless of whether you view these metaphors as positive or negative, researchers have found that a blanket rejection might not be the right approach. Instead, they recommend a greater awareness of the function of the metaphor. That could lead to a more "effective communication" about the real experience of cancer.

What do you think about the use of war imagery to describe cancer? Let me know at cfarr@fastcompany.com

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